News about PSYCHIATRY

Author: Torsten Oettinger
2023-01-12, 8th Edition

Table of Contents

Keywords

Psychiatry Metapsychiatry Schizophrenia Philosophy Linguistics Religion

Abstract

First, I follow here my conception of Metapsychology and Psychology. There, I use language patterns to represent metapsychological and psychological patterns. In addition, I use language meanings to derive metapsychological and psychological meanings.
Secondly, this part is based on the explanations of the `New Metapsychiatry´ part. There, the focus is on the hypothesis that the main causes of disorders of psychologically relevant facts in general and of mental illnesses in particular are inversions of fundamental meanings of our existence.
Note: The `Summary table ´ offers a very compressed textual and tabular overview.

Causes of mental disorders

For like the plant unable to root in its own ground,
the soul of a mortal will quickly die out.“ F. Hölderlin ¹.

Preliminary remarks:
      • In general to causes, see on `Causes and Results´ in Metapsychology.
      • Illness should not solely be interpreted as the consequence of misbehavior!
      • Illness should not be viewed as the absolute evil that has to be destroyed.
      • Every person can become ill (mentally and physically).
The causes of illness are similar to the causes of misfortunes: Every misfortune can hit any person, although with different probabilities. The person concerned can become sick without or by his/her own fault. ²

Underlying Hypotheses

I repeat briefly the most important:
      1. Illness and health are of relative importance.
      2. Illness is not absolutely negative and health is not absolutely positive. As Relatives, illness and health have both, positive and negative sides.
      3. The most frequent primary (!) causes of illness are ´Inversions´. ³ Inversion means that by reversal of Absolute, Relative and Nothing, basic reversals of meaning take place. Such reversals of meaning arise, above all, by attitudes that make a claim to absoluteness that excludes other attitudes. `Isms´ or ideologies are typical examples of this.
Of course, mental disorders may also be caused secondarily by physical disorders (“second-rate causes”).
      4. Causes of mental disorders are rarely to be found only within the affected person him-/herself but in all of the spheres that affect him. A similar statement can be found in various references about the discussion of the genesis of many mental disorders: “The genesis is assumed to be multifactorial, with genetic, neurobiological and psychosocial factors constituting the relevant pathogenic causes.”
The share of the single factors is different in every case. I tend to focus on the spiritual spheres because I am also convinced that there are the most options of efficient therapies. That is usually not the case if one only tries to influence the biological-material sphere (brain, genes) usually by using psychotropic drugs. ⁴.

MENTAL DISORDERS FROM THE BIOGRAPHIC PERSPECTIVE

Beginning

“And children grow up with deep eyes;
They know nothing; they grow up and die.” Hugo von Hofmannsthal

The story of mental disorders usually begins in childhood, or as I believe, even before being born. It is determined by the different attitudes that the parents or the environment transmit to the child or that are later on chosen by the child. All of those attitudes are ultimately based on different Absolutes. Whatever the parents and the environment of the child find absolutely important, they will convey to the child. This usually happens unconsciously and often in seemingly inconspicuous everyday situations. This Absolute may be an actual Absolute it or it is a strange Absolute. Only the first one will actually match the child, whereas the second one may be the cause of later mental disorders. Then the child may not be able to develop its personality freely. To be more exact: the Self will not be strong and independent. We defined the ‘Self’ as an unique, individual core of the personality.
I remind the main characteristics of the positive Self: It is the actual and the existential core of the person. It is unique and irreplaceable. It is the most important. It is independent at its core. It has something absolute, something holy to it. It is lovable in an unconditional way loved by God). It is made to exist forever. It is indestructible. It is a present (it is already given to a person and does not have to be earned). It lives on its own. Every person has the right to live with such Self. I will define any other basis of life as strange Self (sS), ‘It’ or complex.

The more the parents take a Relative as absolute, the more the basis of life will be relativized and weakened. Then, parents, as well as the children, feel like it is about all or nothing, about being or not being. In this situation, what was in itself only relatively right and good must be fulfilled (if absolutized) at any cost (coping), whereas the relatively wrong and evil (if absolutized) has to be fended and avoided. (→ Defense-mechanisms).
Many times, the cause for it lays in misunderstood love, whenever parents transfer such fixations onto their child(ren). They want to give their child orientation, but they interfere with the kid´s emotional and spiritual development if they absolutize Relatives because the Self is meant to be based on the actual Absolute. [This refers to the + A and its synonyms.] It needs a substantial ground – like a seed is put on solid ground so that it can grow freely. The Self does not only want to be strong, independent and precious, it also wants to be irreplaceable, wants to be itself, whatever it really is. That means that every person deeply longs for a true Absolute – he/she wants to be loved for him-/herself and wants to develop freely based on such love. When I speak about ‘free development´, I do not mean lack of orientation. The child should develop in a certain direction. Such as a plant grows towards the light, the sun. Without any kind of tightness or coercion. Such as the sun does not always stay in the spot but is shining on us with an enormous range. The parents/environment are not necessarily the light because every person/environment also spreads negative influences: In all families, there are (usually unconscious) fixed mindsets, taboos, strict principles, unspoken oaths and so on. Who does not know sentences such as: “Boys do not cry!”, “A good child listens to its parents!”, “Don’t you dare to contradict me!”, “A family has to stick together!” and many more. One may say that it is not the love speaking at that point but an imperative.
(To facilitate matters, the parents are named here as the most important reference persons. In reality, the child faces many different influences, such as traumas and environmental influences that have nothing to do with the parents.)

The initial situation is often in such a way that parents or the environment of the mentally ill people are also caught in inversions. Therefore, they lack freedom/independence themselves and are overwhelmed with unsolved problems. Their worldview is usually narrowed, frightening and fixated. Some seem to be strong on the outside and some might actually be strong, but they overexert themselves. What they are usually missing is a free, genuine, absolute Self, which is capable of tolerating and protecting a weak, frightened, faulty I. Instead one has to be strong, brave and good – and the weak I will be hidden due to fear and shame. To the parents, another world than the own, a bigger and more independent world is full of danger because they are not able to control it. And, to be honest, which parents are not concerned?
The psychical problems within a family can be compared to debts: Families that struggle with psychical disorders usually have psychical “debts”. Many times, one or more member(s) of the family will pay those debts by sacrificing their health, whereas others remain healthy. Later on, we will see why it is that way. One thing is for certain: It is mainly a matter of fortune or misfortune if a person becomes ill or not.
As already said: The child needs a stable basis, an invulnerable core, a real, good Absolute and not something Relative but an Absolute that is not based on fulfilling requirements but one that is unconditional and that loves, protects and guides the child to allow normal psychical development. Such Absolute would be the unconditional love of both parents. If they cannot give love enough – usually because they have not experienced such love themselves – the development of the child is endangered. Has the child bad luck, its Self is threatened to go down. Certain living conditions, personal misfortunes, traumatizations also play a big part since they may cause specific sA to occur. Usually, the child is too young to understand what is happening to it and is not able to fight against it. There is an unconscious mechanism that takes place in this dangerous situation. A mechanism that is of high cost. The child identifies itself with the Self of its parent(s). It adapts excessively.
That leads us to the second act:

Overadaptation or Enmity

To save his Self, the child identifies with the parents. Above all, the child takes over what is of absolute importance for the parents.
Collective Absolutes emerge. ⁵

The graphic shows how the child is shaped by misabsolutized positives or negatives (here by their parents).
The created imprinting is just like a barcode with black (negative), white (positive) or black-white (ambivalent) sS (or defects that are not illustrated here). There is an analogy with genetic embossing.The child mainly adapts to what the parents determine as good* and bad* ⁶ – whatever has to be fulfilled and achieved (the good*, the ideal*) and whatever has to be avoided (the bad*, the taboo*).

Since the parents have absolutized Relatives, the parents and the child have the feeling it is not just about something Relative but about all, about the Absolute, about being or not being. In normal development, the child also adapts to the parents and identifies itself with their worldview. However, it has the freedom to let go of whatever does not match its own identity, wishes or perception without being punished. Yes, children and teenagers have to question their parents absolutely and in a radical way to find themselves. Then they can choose whatever matches their own identity and perception or not. ⁷ They retain existential freedom of choice.
However, wherever the Self of the parents does not match the own Self, wherever the child experiences it as strange-I or strange Self, there will be a central, existential and uncontrollable conflict within the child. The strength of this conflict becomes apparent if we consider the fact that it is about something that is experienced as absolute by the concerned. However, the false Absolute is strange to the Self. Those strange parts are unsolved complexes (like cuckoo eggs) within the Self and suppress the own parts. At those parts, the I is not master in its own house. It has to share its innermost, its own, with something strange, perhaps even hostile. That is the price the child has to pay unknowingly to save itself.
On the other hand, the child also has some advantages from taking over the parent´s Absolutes/ Selves: The child does not want to conflict with the parents/ its environment. It can rely on these internalized parts and values and finds some strength and identity, even if they are relative and strange. The child is caught in a golden cage. It basically (unknowingly) agrees with the parents to stay within that cage to be protected. With that, some sort of emergency-solution is being created for the child: Rather having a strange Self than to have no self-perception. Here is already programmed what we also find later in mental illnesses: The division and depression of the Self by strange self-parts. ⁸
Thus kids will be denied of their first-rate Absolute resp. Self. They may be misused as an expedient, as the parent’s or environment’s object.

T. Moser explained:

“Many mothers need obedient children, to allow their own inner chaos to be organized. Or they need the children to have an echo in their empty lives. Or they need them to heal their own self-contempt by planning the child’s future.
The emotional life of the kid tips over (dies) like an overfertilized lake, that cannot regenerate itself anymore. The person that has to be the pride of their parents never knows if he/she is really loved: there are always requirements or even blackmailing. What emerges was called `false Self´ by Winnicott. That false Self makes the unconscious expectations of the parents to its own matter. The more important the child is as a crutch for the parents, the greater the fear becomes, when later, in a relationship or in a therapy, it finds confronted with the longed-for and at the same time terrifying possibility that one asks: Who are you really? Whoever happened to be the parent´s pride, due to expected success or presentable dressage, has to constantly achieve more and trying to adapt in order to avoid panic and depression if the outer appreciation fails.” ⁹

Karen Horney described it similarly.

“A child suffers from primal fear … when it has parents whose own neurotic conflicts prevent it from offering the child the basic acceptance necessary for the development of its autonomous Self. Throughout the early years of childhood, in which the child views its parents as almighty, the parental disapproval or rejection may only lead the child to conclude that something is horribly wrong with it. To get rid of the basic fear and to receive the essential acceptance and the love from its parents, the child realizes that it has to become different; it channelizes its energies away from the realization of its own Self, away from its personal potential and develops a construct of an idealized self-image – a possibility of how it has to become to survive and to avoid the primal fear.” ¹⁰

Kids usually do not have a chance to fight against the negative effects of the strange Absolutes/Its. On the contrary, they unconsciously confirm these attitudes, especially since these are often not false but “only” exaggerated and one-sided. In this respect, the child often believes that the parent’s behavior is correct and its own behavior is wrong so that it suppresses its own negative feelings towards the parents and believes that it has to be punished. With that, the child is drawn into some sort of vicious circle, in which the occurrence of symptoms is a typical “solution”. The situation becomes even worse if the child feels responsible for its parent’s problems. That is almost always the case. Even if the child is not able to understand and name the parent’s problems, it still has an idea of what it is about and tries to help them by sacrificing its Self. The child starts to act like a parent of its own parents and is absolutely overtaxed with that role, even if it is only unconsciously (`parentification´). In worst-case scenarios, the affected children are mentally (maybe also physically) like senile childlike-beings. They are blocked in their free development, and they are additionally confronted with problems that cannot be solved even by the grown parents. ¹¹
The worst thing that could happen is that the child experiences that it has to give up its own Self to receive appreciation and love. The child will despise or even hate itself and love the parents too much, although it unconsciously hates the parents too. However, it realizes that the parents are also caught in the game and it will try to love them still much more. It´s an endless circle, and nobody is there who knows how to end it.

The graphic illustrates how the parental ideals*, taboos* and their emptinesses overload and dominate the child´s actual Self. However, they also stabilize the child, since the child’s Self does not have enough stability on its own.

As I said, there are also over-adaptations in the so-called normal development, which are not necessarily required by the parents. Likewise, in normal development, there are always rebellions and resistance to the parents, which are very important for the self-discovery of the child, and are best taken serenely by their parents. ¹²

There will be no disruption if the child experiences a basic love from its parents and thus is able to relativize the sA-requirements. The child will not only be able to buffer the sA through this love but will be able to deal with them from a secure position. The child will learn at an early age, not to absolutize pleasure and displeasure and to be so much better prepared for later life. But “A child`s independence is too big a risk for the shaky balance of some parents.” [J. Greenberg, p 27]. The more the parents depend on something, the greater the risk for them. Then there will be a strong polarization of the differences and a fight against each other, an either that or that, a pro or contra, a black or white way of thinking, a win or lose behavior. The child then bites itself into the parents and these into the child. In addition, as I said, parents often transfer their own unsolved problems to the child. One parent may form coalitions with the child against the other parent, other family members may be involved, and so on.
Processes take place which become even more difficult and inscrutable because they are hardly or not conscious of the person concerned. ¹³
However it may have been, the child´s Self usually remains suppressed and enmity with the parents does not lead to real independence. The dependence of the child continues. That means that it leads to the same situation if the child makes whatever the parents want it to do, or if the child makes the complete opposite of what the parents want. The parents remain determining in both cases. However, the phase of rebellion represents a very important step in the right direction that sometimes takes place after many years (or never). Commonly, over-adaptation and defiance alternate with each other – a basic pattern that can be found again in future relationships of the affected people, unless they came to a deeper solution. Often, there will be also over-matched and opposite (pro and contra) parts of the strange Self at the same time. ¹⁴ It is usually a matter of time until the strength of the child is not strong enough anymore to pay the constant tribute, although that may take multiple years. Whenever that point is reached, there will be a crisis that is explained in the next chapter.

Crisis and Falling Ill

„Each torpid turn of the world has such disinherited children,
to whom no longer what´s been, and not yet what´s coming belongs.”
R.M. Rilke (Duino Elegies, VII,63-4)

The cause of the crisis is the conflict between the actual Self of the affected person and the requirements of the strange Selves, the conflict between the legit desires of self-determination and the opposite powers. Those opposite powers exist in the shape of real existent persons (usually parents) but also in the shape of internalized parts. That is, the person increasingly puts the strange requirements on him/herself because he/she considers them to be his/her own. The requirements consist of fulfilling the +sA and avoiding/ fending the ‒sA. The person is like a swimmer who has constantly to kick to prevent drowning. The main characteristics of the requirements are the many “musts” with the main requirements: You have to be good and you can’t be bad.[222] In these cases, it does not matter if what is considered good is actually good and bad is actually bad. Because even the really good can have become bad or ambivalent when forced. Likewise, the real bad can be well experienced.

Danger of losing the unstable mental balance due to additional mental burden or weakening of the person.
The width of the basis maintaining the balance equals the compensation force of the Self!

A crisis usually happens if the affected person is exposed to additional requirements. That may be bigger events (starting work life, unfortunate love, death or other traumas, etc.). Often, however, there are small triggers that cause the whole system to lose balance, and the crisis occurs out unexpected and cannot be explained.

E.g.,: Experience of a schizophrenic patient:
The “gods [+*] were laughing, golden personages … like guardian spirits. But something changed, and Yr was transformed from a source of beauty and guardianship to one of fear and pain [‒*]. Slowly Deborah was forced to assuage and placate, to spin from the queen-ship of a bright and comforting Yr to prison in its darker places.” ¹⁵
See also: `Reversal into the opposite´

This graphic illustrates the different phases of dynamics between the person (P) and dominating It/sA.
Phase 1 on the far left shows how the person is “positively” interacting with the It/sA even though the person is already dominated by them: P fulfills the requirements of It/sA and receives an extremely strong positive feedback (such as recognition).
Phase 2 (illustrated in the middle) shows: It is getting worse whenever the demands of It/sA become too high and/or the person becomes too weak to fulfill the requirements – such as an imbalance of emotional distress and resilience. The affected person is now being punished by the It/sA.
Phase 3, on the right, is intended to indicate the dual role of the disease. It protects P against excessive demands. On the other hand, the affected person remains ill and allows the continuing existence of the It/sA.

The system decompensates whenever the requirements of It/sA are higher than the compensation forces of the I. More exact: whenever the requirements cannot be fulfilled anymore, or whenever threats cannot be fended off anymore – i.e. in the moment when the power of defense and coping are not strong enough anymore. But also, if the person does not want to fulfill the requirements anymore – and therefore causes a positive crisis! In this situation, the affected person is back in the old position of his/her childhood: He/she feels existentially threatened, it is about being or not being, Self or No-self. The old emergency-solution does not work any longer – especially if the parents (or environments) are themselves in a crisis because they are confronted with similar conflicts that seem to be indissoluble.
This dilemma can also be described as follows: On the one side we are in desperate need of love; But love also became very dangerous, almost deadly for us because parental love was connected to prerequisites or even exploitation. Therefore, many people seek love while they also fear and avoid it. With that, the person is stuck within a dilemma because he/she received a fearful, destroying love. It can be compared to a barefooted person that flees from the ice by running over hot coals and back to the ice again instead of trying to put on his/her own shoes.
All this leads to reenactments (inward and/ or in new relationships) resp. to a compulsion to repeat until the affected person finds a solution. It is as if the person has to find out if he/she is loved for him/herself or not, no matter what. The situation appears hopeless – but the person is adult now. Maybe he/she can find a deeper solution now. What solutions are there?
We will find out in the chapters of therapy.

PSYCHOSES

Psychoses in General

Psychoses can be differentiated into three different groups: organic psychoses, psychoses of the schizophrenic forms and affective psychoses. This publication is mostly about affective and schizophrenic psychoses.
Affective psychoses are separated into psychotic depressions and manias (manic-depressive illnesses).
Schizophrenic psychoses (schizophrenia) will be discussed in more detail later on.
Schizo-affective psychoses show symptoms of both groups.
These classifications are arbitrary from a certain point on – on the other hand, they reflect certain basic patterns that play a role in the therapy. But: “At the end of the day, every psychosis is different and has to be seen in its individual peculiarity, the social connection and with all its different subjective meanings. Every schematic view leads to standardized treatment. That kind of treatment is not reasonable for psychoses. People that have experience with psychoses are very sensitive and will react in an offended way if they are not seen as an individual person and not treated with the necessary respect.” ¹⁶
A psychosis is always an expression of a severe existential crisis, which may happen to every person. Usually, a large number of different and various factors have to come together to cause a psychosis.

(To causes in general see on `Causes and Results´ and further on `Causes of mental disorders´).

I believe that solving the “mystery of the causes of psychoses” is no more difficult than solving existential crises in general. I am convinced that every (psychogenic) psychosis is curable.
I summarize my hypotheses: Psychoses are usually the expression of an inner conflict of the person between opposing absolutenesses with a loss of actual Absolute. Such as it is with all the other psychogenic illnesses, there are two main conditions first: The absolutization of the Relative and the loss of the actual Absolute with the result of emerging of strange Selves and self-sacrifice to maintain these strange Selves. The person pays with his own health and the loss of actual Self to solve the conflict between the Self and the strange Selves.
To make it easier to understand the emergence of psychoses I want to remind you of the following:
The forces of the absolutized Relative and the oppression of the actual Absolute change the I especially in the following ways:
1. Mainly dividing and causing faults.
2. Mainly oppressing and causing deficits.
The mainly splitting forces cause schizophrenic, and the losses due to oppressive forces cause depressive symptoms.
The arbitrary differentiation does not exist in real life but is a way of making it more understandable. It represents the main-symptomatology of those illnesses. There is neither a solely schizophrenic pathology nor a solely depressive one. Therefore, the term of schizo-affective psychoses for mixed forms is plausible.

Basic constellation of psychoses, based on strange Self (sS), that causes splitting (→) and oppression (┴). The person is divided into strange Self, and actual Self at the core and the strange Self is furthermore divided into pro-sS, contra-sS and s0. Each sS is potentially acting dividing and depressing. As mentioned, also Karl Jaspers already believed that the classification of psychoses in two main classes: manic-depressive and schizophrenic, contains an essential core of truth since this classification has asserted itself in principle, in contrast to previous terms of illnesses. ¹⁷

I believe that this `essential core of truth´ can be explained by the above-described basic constellation and also by two fundamental forms of the negative (false and nothing). The two major psychosis groups, depression and schizophrenia, can also be understood as the main consequences of inversions of the Absolute and Relative: nothing (⟶ depression) and false
(⟶ schizophrenia).
This basic pattern could also be called “Unitary psychosis”. Joseph Guislain and Albert Zeller suspected this about 200 years ago.
One could formulate, as in mathematics: A task can be solved falsely or not, i.e. the result can be wrong or it is missing. ¹⁸
In the case of the schizophrenic reactions, in particular, the divergent forces gain the upper hand, which causes in the center of the person splittings, contradictories, double bonds, pinch-mills, paradoxes, or the like. Especially the person is split, fragmented and torn apart in pro- and contra-parts. In the case of depression the s0-part mainly causes a central loss of the first-rate personal – or in case of mania too much of the “good” (*).
S. Freud explained that mental illness is a result of overpowering the Ego by the Id, which causes a separation of the outside world. Mania would be a fusion of Ego and Super-Ego and melancholy would be an oppression of the Ego due to a tormenting Super-ego. ¹⁹
This view largely correlates with the concept presented in this publication.
The manifestation of a psychosis takes place if the negative forces of the strange Selves are stronger than the positive forces of the actual Self and other strange Selves. (Mind: the sS as a Relative has positive sides along with the negative ones.) It is easy to imagine and comparable to the loss of the physical balance, that the mental balance is endangered at a certain point. If you compare the strange Self with a crutch that is helping and obstructive at the same time, the ill person can also be viewed as someone who is trying to get rid of the obstructive crutch although he is not yet strong enough to stand without it. The concerned loses balance and falls down → becomes psychotic. Distinguishing between a progressive and a regressive psychosis, this is an example of a progressive occurrence because the patient is trying to do the right thing. It would be regressive if he does not want to use the crutch because of the overestimation of his own capabilities. The comparison of a strange-Self and a crutch also seems suitable when it comes to good therapeutic handling: It is not reasonable to take away such a crutch at any price, nor is it reasonable to take them for much longer than necessary. Contemporary, the second option seems to be the more problematic one because a large number of psychiatrists are too focused on the goal of symptom relief which causes them to forget that to much help (such as giving too much medication) can cause weakness of the person’s Self.
The kind of sA resp. sS has also a main impact on what kind of symptomatic will be caused (schizophrenic, depressive or manic). Misabsolutizations that create a wrong, strange Self are more likely to be schizophrenic and such that cause the person to be in a deficiency or oppression are more likely to be depressiogenic.
As mentioned, the strange Selves become independent. They have their own structures and are like somewhat personal. Therefore, they are different than other volatile phenomena, such as single thoughts. Because of that, it seems obvious to view and treat them as dysfunctional metabolism or something similar to that. That thought is not really wrong but it is too superficial. To me, it is just as half-right as the thought that impotence is a circulatory disorder or a hormone disorder. We will also find such biological parameters while talking about psychoses. And I also believe that people will continuously find better drugs for psychoses such as there are for impotence. Why not? Without a doubt, a pill would be often a better option than the pain and sorrow without it. However: It is and will remain an emergency-solution. Impotence or psychosis would be gone, the main problems and reasons for it not. And they will always emerge somehow and somewhere. They only will be shifted to another place. And someone has to pay for it.
Overall, I view psychosis as a lifestyle in which the Relative dominates the actual Absolute. The not actual dominates the actual, the splitting dominates the wholeness, the object dominates the subject, the non-personal dominates the personal, the strange dominates the own, the second-rate dominates the first-rate, the functional dominates the lively, the strange Self dominates the Self and the strange-I (Ego) dominates the actual I.

Schizophrenia

What is Schizophrenia?

One assumes that about 45 million people suffering from schizophrenia. ²⁰
The World Health Organization (WHO) rates schizophrenia as one of the most expensive illnesses worldwide.
It is hard to explain what schizophrenia is because the one schizophrenia does not exist.
What is meant with the group of schizophrenia is also an agreement. There are international committees of psychiatrists that listed certain symptoms as signs of schizophrenia. However, it is against human dignity to refer to people as hebephrenic or psychopath or similar. Those terms make it seem like the negative symptoms define the whole personality of the affected person. As Karl Kraus said: “One of the most widespread diseases is the diagnosis.”
But what is meant by the term ‘schizophrenia’? How do the affected people suffer? What are the symptoms?
There is a great variety of descriptions of schizophrenic people’s experiences. I think the following examples are more impressive than some psychiatric textbook: Joanne Greenberg’s “I never promised you a rose garden”, and Marguerite Sechhaye’s “Autobiography of a schizophrenic girl”, Jan Foudraine: “Wer ist aus Holz?” et al. Those accounts describe the feelings, experiences and thought of schizophrenic people in a way I could never describe. They talk about how the affected people lost their footing, stability and confidence, how they desperately strive not to go down or not to break or to implode, not to fuse with someone or something, not to be overwhelmed by foreign, uncanny powers, to feel that not only the inside but also the reality is odd changed, and thoughts and reality cannot be separated.
Delusion and hallucination will be discussed later on. A list of all possible schizophrenic symptoms can also be found in the Summary table columns T, U and V.

A New Psychodynamic Theory of Schizophrenia

Inversions as Main Cause

    But we cannot give an adequate account of the existential splittings unless we can begin from the concept
    of a unitary whole, and no such concept exists, nor can any such concept be expressed within the current
    language system of psychiatry or psychoanalysis.” R.D. Laing²¹
    „All evil is isolating … it is the principle of the separation.“ Novalis

Hypotheses:

• The most frequent primary (!) causes of schizophrenia are inversions. But not every schizophrenic symptom necessarily results from an inversion.
• Any Inversion can cause schizophrenic symptoms. Especially all strange Absolutes (sA) are potentially schizophrenogenic. [We know it: All kinds of things can drive us “crazy”.]
• Any second-rate system, such as P², has latent, or even obvious schizophrenic characteristics (e.g., it is more or less divided.)
• Causes of schizophrenic symptoms are often outside of the affected person.
• It is quite easy to integrate the existing theories about the causes of schizophrenic psychoses into the present paper.
Regarding the main hypothesis: ‘Any inversion can cause schizophrenic symptoms’, I have to ask the readers to look at the `Summary table´, which can be found either on the network or as an attachment or as a PDF file.

(In general to causes see on `Causes and Results´ and further on `Causes of mental disorders´ and on `Psychoses in General´. To guarantee a better understanding of the emergence of such a disorder, it is recommended also to read the chapter `Spreading and compression´ in `Metapsychiatry´.)

If a Relative irrupts into the absolute sphere of a person it becomes a strange Absolute (sA). At the same time, there is a loss of first-rate personal. Metaphorically speaking, the Relative overthrows the Absolute from the throne. By the loss of the Absolute, the integrating meta-level disappears, which cannot replace by something Relative, so that alienations, displacements, ruptures, madness, etc. can arise.
The resulting sA resp. It has not only in the sphere effects which has been absolutized but it also affects all other aspects in its sphere of influence.
There are also corresponding parallels to other disorders: If almost anything (albeit with varying probability) can make a person anxious or depressed or even addictive, why should not the causes for schizophrenic symptoms just as manifold?
However, I see the following specifics regarding schizophrenic symptoms:
• The affected person experiences the causes and results as determining.
• ‘Schizophrenia’ (as main term) includes especially the spiritual-mental dimension of man over more or less all aspects.
• Especially those It/sA will be acting schizophrenogenic which have a completely different or even opposite meaning to the originally Relative, which was absolutized (for example, when something relative positive is negatively absolutized and reversed). They can be found in the Summary table column `I´ usually in the middle line of the cells). It/sA with all-or-nothing character (= hyper or 0) have especially manic-depressive effects.
• A meta-position is lacking for those affected, which relativizes these contradictions. For this reason, there is no possibility of overcoming and solution of these contradictions.
• The It/sA-effects are stronger than first-rate (or second-rate) compensatory forces.
• Usually, the surroundings are caught in the same or similar contradictions, which then may transfer.
Affected children experience their surroundings, especially their parents, with second-rate characteristics, such as they are listed in the Summary table column I and K.
• The schizophrenic It/sA must act over a longer period, so that the initial absolutized mental position has been materialized and has become independent.
(See also `Persistence of the strange Absolutes´).
These characteristics explain why schizophrenic symptoms and no other symptoms usually occur, although inversions are ubiquitous. ²²

Do the affected, which are involved in such contradictions and paradoxes, see so wrong about the world? Does somebody see it more correctly who tells us that the world is fair, unambiguous, logical, clear and not contradictory? Our affected families or patients certainly see the world more realistic when they see them full of opposites. Their “mistake” is only that they take that not relatively but absolutely.

For the causes of the schizophrenic symptoms I also refer to the beginning of the chapter. (→). There is not the one cause for schizophrenia. The causes for these symptoms are as varied as the individuals which were affected by them. ²³

Manfred Bleuler sums up:

„Decades of research has not succeeded in proving just one specific cause of schizophrenic disturbances. Today we are ready for the thought that there is possible, not such. Rather it has become clear, how manifold disharmonies that disrupt personality development form the predisposition to schizophrenic illness.” ²⁴

As described in the part ‘Metapsychiatry’, one can see the mentioned ‘ideologies’ as a starting point for inversions. This leads to reversals of fundamental meanings, which are solidified by a multitude of “Its”. These Its are generating centers of second-rank realities in the world, in the person and in the I (WPI).
Each It changes more or less all aspects (‘spreading’) with one ‘main impact direction’ each. Although the main impact direction of the particular It essentially determines which kind of symptom group develops, on the other hand, manifold symptoms can be produced by each one of the Its. Viewing from the symptom, this means that every symptom can have a variety of causes. In terms of schizophrenia, this means that there is not the specific cause for schizophrenia but that multiple factors must come together for this or that symptom group to arise. This also corresponds to the clinical experience and many theories of schizophrenia development (see later). As I said, in my opinion, a common denominator of these different causes is that they all invertingly act.
I listed all sorts of schizophrenic forms and schizophrenic functional and quality disorders in the Summary table (see the last 3 columns). They correspond in many respects to the symptoms stated in the literature but are listed here systematically according to my classification.
I have tried to make plausible the common of the schizophrenia causes in these statements. Probably everything can make us crazy or split if it is not taken any more relatively but absolutely, and I have tried to illustrate with the concept of the strange Self (resp. It) most different of such absolutized forms with her main results. As said, it seems that in this model most of the numerous theories of the origin of schizophrenic reactions have a place. But one should see them not alternative but in addition. ²⁵
I believe that only disturbances of the absolute sphere of the human being (the self) can cause psychoses, because as long as the causes and the disturbances are only of relative importance, a mental disorder, or even psychosis, will hardly be able to manifest itself.
On the other hand, if we look at the enormous integrative power of the actual Self (resp. +A), which makes people identical, valuable and free in every situation, this basis is probably the strongest force against any kind of psychosis, and we should beware of ideology-based models and therapies, because they basically do what the patient does with himself – they create new preconditions for his existence.

Table Example: To the genesis of fusions and splittings

This chart outlines parts of the Summary table. The first column represents a selection of well-known ideologies, the second column refers to possible, individual attitudes that correlate to these ideologies. All attitudes have inverting effects – one main effect in the main aspect and many side effects (`spreading’) in all other aspects. In the example above, I consider an inversion in the aspect a4 that mainly affects this particular aspect but can also cause disturbances in other aspects. In this example, it means that social or individual ‘monistic’ or ‘dualistic’ attitudes, (such as everything-or-nothing, friend-or-enemy attitudes) can not only cause disorders of unity and variety but can also lead to disorders of identity, reality, security, freedom and so on.
But the inversions of other aspects can also lead to these schizophrenic symptoms (“compression” from the 4th column to the right).
In our example, they lead to disorders within aspect a4. This means, that not only the inversion in aspect 4 itself can lead to disorders of unity and variety but also inversions in other aspects can cause disorders of unity and variety, more precisely: disorders of personal unity and variety (column T), functional disorders such as fusion and separation (column U), or quality disorders (column V) such as autism, ambivalence, splitting and contradictions.

Schizophrenic Symptoms and their Meanings

Once, a snake came into my heart, it had two heads, a black one and a white one.
And each head was telling the opposite of the other.
Both were speaking the truth, but the center of their word was a lie.

General Information about Splitting (Partly Repetition)

Here are some notes:
A ‘real’, actual wholeness/unity cannot be divided. (See motto by R.D. Laing above). I.e., if the subject (resp. person) is connected with the +A, which can integrate all objects, also the negative ones, then no permanent subject-object- or other splittings can occur.
Schizophrenia is a mental breakdown = “Zusammenbruch”. The German term reflects two typical features: `zusammen´ (`fusioned´) and `Bruch´ (`split´). Inversion causes our souls to become divisible and fusible.
Splitting affects the whole absolute-sphere of the person as a result of an experience of absolute opposites.
Within the relative-sphere, I only will speak of differences, divergences or polarities.
In the following chapter, I will discuss mainly the phenomena of splitting and fusion.
They shall stand exemplary and representative for other schizophrenic symptoms.

Spheres of splittings

Inversions may cause splittings within all aspects. One may differentiate between:
    A: splittings in the dimensions-spheres
    B: splittings in the differentiations-spheres (for example subject-object-splittings , matter-spirit-splittings or soul-body-splittings , or splittings of different realities and people).

    To A
1. The absolute splitting between +A and ‒A.
2. splittings between A and It resp. between Self and strange-Self. ²⁶
3. splittings within an It into its parts: pro-sA, contra-sA and s0.
4. splittings within an It-part into one of its three sides (+/‒/0).
5. splittings between the different sA/sS.

    To 1. In my opinion, the split between +A and ‒A is the only absolute split. But you must believe in the existence of +A and ‒A.
    To 2. In relation to the person, the splittings concern the Self and the strange-Self(s). The affected person experiences a contradiction, splittings of the actual Self and the strange-Selves. That contradiction is not absolute because Self and strange-Selves coincide in some parts. Yet, that contradiction will be experienced as absolute. Due to the strange-Selves, the person will be ‘de-individualized’ and the individual (literally: the indivisible) will become divisible!
    To 3. The third area of splittings exists within the opposites inside of the It resp. the strange-Self itself in the splitting in pro-sS, contra-sS and 0S (or: +sA,‒sA and s0; Example: ideal*, taboo* and 0*).

The graphic illustrates the splittings between the Self and the It resp. strange-Self
and in addition, how the It/ sS continues to divide into three parts.

For easier understanding, I recommend taking a look at the chapter ‘The emergence of the It‘ again. There, I describe the structure of It. The It is made of two/three contrary, yet fixed connected parts, which are the starting point of splitting- and fusion phenomena of different illnesses.
To 4. The 4th splitting possibility arises when one of the three sides of an sS is opposed to another. (This would be the case, for example, if the advantages and disadvantages of an absolutized object were the same.)
To 5. The fifth sphere of splitting develops if two or more strange-Selves are contrary to each other.

Everything, that enters the core of a person and is not the Self, will decay, break apart and therefore causes a splitting or fusion of the person. We all live in a world that is more or less divided (or fusioned) and whoever internalizes these splittings/ fusions of the world without being able to process or integrate it, will be divided/ fusioned as well. (O Splitting and/or fusion phenomena otherwise.)

Opposites in Schizophrenia and their Dynamics

Here, using examples of splitting- and fusion-phenomena, representative of all other opposing phenomena. As generally described in the dynamics of second-rate realities, opposites are interdependent and have a particular dynamic: one part generates or fights its opposite, both associated with the loss of first-rate reality.

See also `It-parts and opposites in general‘ and `Possibilities of interactions‘ in `Metapsychiatry´.

We can find the same in schizophrenia. More precisely: Similar to the second-rate realities, schizophrenic people lose due to the It/sA their original unities and connections: the connection between A and R, between mind and matter, between person and thing, subject and object, but also between different persons.
But opposing phenomena can also arise: mergers, one-sidedness, false connections, etc.
In this case, the diversity of various units is lost, such as those of different persons, different things, mind and body, subject and object, etc., or they are reversed. Thus, people often become more like things, things become more like persons, subjects become object-like and objects become subjective.
Schizophrenic psychoses often develop in families that either have strong tendencies of fusion (symbiosis) or they are very divided or both opposing tendencies can be found side by side. The index patient either takes the pro-side, the contra-side or will be torn apart between those two sides. This person usually has no clear position of his own (no actual Self) and still needs an old position to guarantee psychic stability. But the more this position is overtaxing the affected, the more he will be forced towards the contra-position, or he will alternate between the two positions or becomes divided. In the meantime, the 0-position can be chosen as a balance between the opposite positions, but of high costs, too.

R. D. Laing:

“Therefore, the polarity is between complete isolation or complete merging of identity … The individual oscillates perpetually, between the two extremes, each equally unfeasible. He comes to live rather like those mechanical toys which have a positive tropism that impels them towards a stimulus until they reach a specific point, whereupon a built-in negative tropism directs them away until the positive tropism takes over again, this oscillation being repeated ad infinitum.”
And Manfred Bleuler pointed out that autism and split are two sides of one psychological process. ²⁷

All of these reactions are associated with deficits in the first-rate reality and personality.
I believe that the extreme introversion in autism or schizophrenia is an act of protection to guard the personal core from splitting or decay. Since the affected person has a weaker Self, every additional pressure threatens to destroy the remaining Self too. The person is caught in a vicious cycle of splitting- and fusion tendencies and cannot escape. (`Psychical Bermuda Triangle´). He may find some sort of balance between the two sides but that balance is of the very high cost. It will be very hard for the person to forgo that balance (although which would mean to can lose his symptoms) because as soon as he wants to get away from one side, the other side will threaten him. The threat will be experienced as existential. The affected person believes that he will die if he tries to give up the balance between the dividing and merging positions. Why? Because the person identified himself with the underlying sA, even though that sA is the reason for the splitting and the autistic reactions. To lose the sA and the symptoms, the person basically has to let the sA “die”. However, since the person identifies himself with the sA, he will experience the `death´ of the sA like his own death. The person will not take that risk, especially not as long as he can not find a stronger Absolute.
Not only division and fusion can create an expensive balance, but the pro-and-contra positions (↔) of all personal aspects, especially those that lie on the same aspect level.

Here are some examples:

    strange-I ↔ loss of I
    splitting, isolation, `explosion´ ↔ fusion, compression, `implosion´
    chaos ↔ inner constraints, automatism
    peculiarity, specifics ↔ no individuality
    ecstasy ↔ lack of emotions
    hallucinations ↔ inner emptiness, isolation
    symbolized, encrypted topics ↔ concrete simplified topics
    closing, isolating ↔ opening, exposing
    insensitivity, petrification ↔ sensitivity, pain
    reification ↔ liquidation
    bizarre topics ↔ amorphous topics
    emptiness, inner poverty ↔ heaviness
    weakness, powerlessness ↔ false potency, feeling of almightiness
    sense of inferiority ↔ megalomania
    fixation ↔ instability, dissolution, shifting.

It is not only schizophrenia itself but also single symptoms that can be interpreted as positive sometimes. They may occur as part of a progression as well as a part of regression. ²⁸

Splitting and fusion phenomena otherwise

– Social, family, divorces/ symbiotic relationships (see above).
– Other diseases (e.g. dissociative identity disorders, multiple personality disorders, anorexia/bulimia, dyslexia, stuttering, from a certain point on for most mental illnesses).

Parallels to Physics?

We already established, that there are similarities between the rules/laws of second-rate realities (such as in P²), and the laws of physics. That also applies to the impacts of pressure on an object or splitting of an object. In both cases, there are both fracture points and compression points (~ fusions). In some cases, the fractures predominate, in others the compressed. One may even see the third result between the divided parts: the nothingness.
Perhaps there are parallels of second-rate dynamics to physical processes such as nuclear fusion or nuclear fission. The chaos theory describes chaotic conditions which also represent an analogy for psychotic conditions. Autopoietic system theories also describe bifurcations resembling splittings in P².

Shifting and Fixation

Everything that I mentioned regarding the opposite-pair ‘splittings and fusion ‘ also applies to ‘shifting and fixation’ because splitting always goes along with shifting and fusion with fixation. The affected person is therefore not only divided and/or fused but also shifted and/or fixated. We are all not only somewhat split or ‘compressed’ but also shifted (crazy).The graphic in chapter “Fear” should illustrate how the fA / Es displace (make crazy) the person.
The clinically shifted/ crazy person, may have adapted himself to our craziness and was not able to deal with them.²⁹
As mentioned above, one may find certain opposite-pairs and their symptoms throughout all aspects.

Paradoxes and Schizophrenia

Like schizophrenia, paradoxes arise from contradictions within a system that has no meta-level – ultimately caused by ‘inversions’.
E.g. Pictures of schizophrenic artists are usually without horizon ~ missing transcendence, meta-level.³⁰
One may also say: Whatever causes paradoxes, may also cause schizophrenia.
In their characteristics, paradoxes (as well as schizophrenia) show contradictions/ ambivalence on the one hand and the indissolubility of those contradictions on the other hand. In addition: A characteristic of schizophrenia is its inherent paradoxes, which the person concerned cannot resolve.
The solution for both consists in the introduction of a meta-level that can relativize or resolve the contradictions.
By the way: our world is more or less ambivalent, ambiguous or even contradictory and paradoxical. The paradox is also, that interpretation and counter-interpretation often appear equally true.

See also chapter `About the emergence of paradoxes‘

Further Thoughts on Schizophrenia

After inversion, P² will live on many different foundations. The affected individual will experience those foundations as contradicting, ambivalent, incompatible, not capable of being integrated and therefore unsolvable.
The really relative limits become absolute and will be experienced as insuperable („fehlender Überstieg“ – “missing cross over“ Conrad). In itself, the Self (as well as God¹) compensates for all contradictions and opposites, but the sA does not. While the person (P), who is based on the actual Self, has no problems cooperating with all the different areas of life and always remaining himself, now, strange foundations make P opposite and crazy. The strange Selves of these people are sometimes like wolves. They are distrustful and lonely but in a pinch, they will stick together. They are not friends but fellows at most or conspired communities. They quickly have common enemies, but also quickly get into hostility with each other. Or they are like helpless lambs. They can never rest because they are constantly being haunted. They have to escape and overcome different obstacles. Or they have defective or contradicting views and behavior according to that sS on which they depend on. Therefore they act in ways that cannot be understood by others. Or they are forced into further roles by other strange-Selves.
And is the I once it is itself, an I-self, then it is still uncertain in view of other positions, “is it really me or not”?
The schizophrenic patient is lacking the self-evidentness. The individual does not experience himself nor the world as self-evident.
(See W. Blankenburg elsewhere.) The person concerned lacks a secure Self that gives identity and integrates everything negative. Since P is identified with a number of different objects or other persons, he is very dependent on them. He can see the same thing completely reverse or distorted and crazy, depending on which strange Self dominates him. He is no longer able to deal objectively with these issues/objects. He will take it personally.
The centers, the strange Selves, of these persons, are weak and heteronomous. Their limits are perforated. The graphic in the chapter ‘Vulnerability-stress-theory‘ shows how the self area, which is in itself unassailable, becomes vulnerable to the strange Selves. The person does not give priority to his own Self but the strange parts. Those strange introjects receive the status of a subject, become quasi-personal, and the Ego becomes a passive and assailable object. No wonder that the person concerned delusionally reacts or hallucinates in this situation. Since the strange has established itself in a dominant position, the person also feels how these foreign powers dominate him, how they do something to him, as an object, pursue him, observe him, or even talk to him. As inexplicable as these phenomena may seem, at first sight, they become understandable when we consider the role of the strange-Self (sS) because the strange-Self was personalized while the I-self was depersonalized. If, for example, parents or what they represent are absolutely taken, the child will develop structures that conform to the absolutized parental parts, which now (quasi-personal) take on some sort of subject-role. They act as subjects and will also be experienced as such. Therefore, there are many affected people that are able to assign voices to specific people. The sS becomes a quasi-personal foreign body that is also able to ‘speak’. One can also say: a strange Ego speaks of an sS basis.
There are many more phenomena caused by the mentioned sS resp. It and are noted in the Summary table column T-V. Therefore, I will not list them again at this point. Of course, the actual occurrences are barely as simple but I think in principle plausible explicable, and it’s amazing why schizophrenia is still considered as a total mystery.
    Regarding the causes of schizophrenic reactions, I recommend looking at the chapter
‘About the causes of mental disorders‘ and `Mental disorders from the biographic perspective´.
If we read these sections from the point of view of splitting phenomena, we find that the most frequent and typical genesis of schizophrenic reactions is the following “story”: The most important reference persons (mostly the parents) of the later ill individual are sS-determined if they are apparently ill themselves or not. These strange-Selves of the most important persons add up in their effects. The child is confronted with different absolutized positives (+*) and negatives (-*), with things they have to obey and things they have to avoid. The core of this child will depend on if it obeys or avoids the specific subjects. The actual Self of the child, that mainly wants to be free and independent, has to subordinate itself and will be forced aside. This is the main splitting. Surely, we all have such splittings within us. They will have a more negatively effect, the more the actual Self will be forced aside, the less the child is itself but has to be strange-self. The parents barely ever deal with such a process consciously, which does not mean that the parents do not make conscious mistakes. As already said, they are very often strange-determined themselves but either they have enough own Self still not become ill or they can compensate the sS-parts somehow or live with another emergency solution (that will be discussed later on).
As long as the child takes over (mainly unconsciously) the strange-Selves of its parents, existing splittings or other symptoms will not be as noticeable as at the point where the individual tries to live more out of its own actual Self-basis. That point can also be later on in life when the child is all grown up. Then, the affected will stand in distinct opposition to his outer and inner strange-ideals* and strange-taboos*. The contradictions will be experienced now as full of tension or even highly existentially threatening. That is a very important point: Even if the situation seems to be easily manageable, the personal experience is very otherwise because the affected person (P) perceives it as absolute. P will feel as if it were a matter of life and death. While some people, who are a little more fortunate find a solution, others do not. The tensions and splittings threaten P to tear apart. As mention in the paragraph ‘solutions’, there are different possibilities now. In our case, the individual will become ill (which we refer to as emergency solution B.) That means, that the person takes a compromise (alternative) as a solution, which relieves him to a certain point but is also of high cost: the price is his health.
People with psychotic reactions, or mental illnesses in general, often want to live deeper, want to live their own lives. Therefore, it seems important to me not to regard mental illnesses only as something negative, because even if the individual tries to do the right thing – for example, to part with his parents, he can become ill.
    Even though we all have latent schizophrenic phenomena within us (according to my theory), not every person will become clinically schizophrenic. Why not?
For one, extent and nature of the sS play a big role. Then, whether they tend to weaken or intensify each other’s effects.
I believe, schizophrenic phenomenons will be experienced, above all, if the person dares to venture into the tension between the actual Self and the strange-Selves. The sick person experiences the sS resp. It as ‘gilded cages’ and wants to escape somehow. (Mostly unconsciously.) He tries to change his basic life foundations, his strange Selves because the old ones increasingly constrict him. He tries to cross the border of the strange-Selves but the danger is: He falls in between the chairs or will be torn apart. He could make it simple and just sit on the old sS-chairs. Then P wouldn´t become schizophrenic but would pay the price of a second-rate, over-adapted life. It seems like many people decide on that. But some affected people prefer a divided life that is at least halfway real and maladjusted compared with a life that is all the way adapted and inauthentic but then they risk a crisis.
I believe that many clinically healthy people have more inner splittings or similar phenomena than those who are diagnosed as schizophrenic because they solve it in an easy and comfortable way with being adjusted. Even though they prevent their own manifest disease, they will become some sort of transmitter of the causes of illness. I do not want to condemn this, but I want to show people with psychotic reactions, that they might be more courageous (even if unhappier) than some so-called healthy people. They are often more honest in a frightening, but also a self-destructive way. Frightening for us so-called normal people, who barely dare to face the lies of our lives and the heteronomy. The clinically healthy people are therefore not automatically less crazy, they only suffer less.
R.D. Laing said: “Thus I would wish to emphasize that our ‘normal’, ‘adjusted’ state is too often the abdication of ecstasy, the betrayal of our true potentialities, that many of us are only too successful in acquiring a false self to adapt to false realities.” [R.D. Laing in `The divided Self´].
On the other hand, psychotic reactions can, of course, also occur in a regressive way.
While the above-mentioned people tried to jump into life but crashed halfway, others are running away from a life that seems unbearable. A psychosis can, therefore, arise both, when moving forwards (`progressive) or backward (´regressive´) since the future is unknown and insecure or past and presence seem unbearable. Often the stalemate situation appears to be the safest. But it is too much to die and too little to live.
    Schizophrenia can be described as life in conflict between the actual Absolute and the Relative that seems to be absolute, as live between the Self and strange-Selves or between different strange-Selves themselves.
It is a suffering from contradictions that is experienced as unbearable for the person concerned. This fact can only be explained by the assumption of disturbances in the absolute realm in the person because there are no relative fragmentations. Those affected trie to live on two or many bases, two or many Absolutes. They are chronically desperate and undecided. They live in an existential dilemma.

Hints
1. “The desperate is like a wave, which is driven by the wind back and forth. He is a man with two souls. ” (James 1: 6,8). 2. I have, as I said, placed the symptom of `splittings’ in the center of this article because it gave its name to schizophrenia – it is, as the Summary table shows, by no means the only and most typical symptom of schizophrenia.

I think also we tend to overemphasize the differences between the different mental illnesses, whereas not seeing the common in depth, like the strange-Selves.
I also do not have a problem to see direct parallels of schizophrenic psychodynamics and corresponding external situations such as divorce – only with the difference, that in case of schizophrenia, the `divorce´ takes place inside and the schizophrenic person is not able to fully separation from himself, even if he tries. By the way: I would give a human in divorce and a human with schizophrenic reactions medication only if they could be overwhelmed by the respective suffering, but not from the outset as self-evident “relapse prevention”. I also want to point out, that I do not think that the elimination of schizophrenic symptoms is the first and most important step of therapy. Above all, the therapist should accept the patient with all his splittings and unsolved problems. Symptoms are not the absolute bad, just as health is not the absolute good. By not giving absolute significance to schizophrenic symptoms, the therapist does not cause any additional disturbances that would otherwise occur. But also the relativization of symptoms is not of absolute importance and does not guarantee their cure but the chances are much higher.
Finally, the positive sides of the schizophrenic symptoms should be pointed out once again.
Here, they shall be named only as keywords and hypotheses:
With psychoses, the patients defend their remaining parts of dignity, freedom, individuality and self-determination, albeit at the cost of giving up part of themselves. The disease is both protection and self-abandonment. “You know, the thing that is so wrong about being mentally ill is the terrible price you have to pay for survival.”- so it says in ‘I never promised you a rose garden’. Or as a patient of Luc Kaufmann said: “If I woke up I would die!”. On one side, it will be good if doctors and patients respect this psychotic defense but on the other hand, the question remains whether the patient cannot do without this expensive protection. Therefore, I present the psychotic reactions, like mental illness in general, to the patient as an `allowed emergency solution’. With that, the patient has the opportunity to allow that option without feeling guilty but one should also always questioning the necessity of that very expensive protection. The same applies to medication protection. Psychosis is not only emergency protection but also offers an emergency solution in all other personal aspects: it can give substitute individuality, substitute dignity, freedom, variety, order, reality, past, present, and future. It can give substitute communication, substitute well-being and all other positives of the second-rate reality. Better an expensive alternative than a total loss of Self. Thus the disease can become an emergency rescue of the Self.

Accordance with Other Schizophrenia Theories

Do not all common concepts of schizophrenia have a certain rightness? At least in the sense by describing many different possibilities of causes of schizophrenia. I can integrate most of the theories into my concept without any problem i.e., with the concept of inversions with their It/sA, I am trying to find a common denominator.

The known schizophrenia theories emphasize the following factors as the cause of schizophrenia:

• High-expressed emotions (HEE) (G.W. Brown and others).
• Double-bind-theory (Gregory Bateson).
• Entanglement (S. Minuchin).
• ‘Delegation’ and ‘impossible mission’ (H. Stierlin).
• ‘Paradoxes’ (M. Selvini Palazzoli).
• Narcissism and contradictions based on internalized object-relationship (Kernberg).
• Ego-weakness, often emphasized by psychoanalysts.
• Disturbed family / interpersonal relationships (H. S. Sullivan, Th. Lidz et al.).
• Schizophrenogenic mothers (Frieda Fromm-Reichmann).
   Similar Margaret Mahler, D. Winnicott.
• Social isolation, especially emigrants (Scheflen).
• Vulnerability-stress-model. (See below).
• Psychosis is the result of a collapse of openness in the face of the event. (H. Maldiney).
• Schizophrenia as the result of the ‘loss of the natural self-evidence’ of the person.
  (W. Brandenburg).
• Genetic, neurobiological factors, immune disorders, birth defects and Infections are in my opinion overestimated as the polluter. It also remains open whether some are not the result of primary psychogenic disorders.  (→ Neuroscience).
• Drugs and alcohol can induce psychosis.

Each of these theories could easily be assigned to one of the aspects in column A of the Summary table or in Summary of the classification, as I do with the following examples.

In the following paragraph, I will compare these most common theories with the hypotheses of this work: the vulnerability-stress-theory, Kernberg’s Object-Relations Theory, the Double-bind theory and the Expressed-Emotion Concept.

Vulnerability-Stress-Theory

“Authors such as Zubin and Spring, Ciompi and Nuechterlein all used the vulnerability-stress-model to explain the multifactorial psycho-social-biological development of schizophrenia. People at risk of schizophrenia … show a particular vulnerability and sensitivity which – combined with stress and social or physical strain – can lead to an outbreak of psychosis.”³¹

Typical for any schizophrenia is “a break-in of something exterior and foreign into one’s own experience which means a deep disorder of one´s personal identity with the blurring of one’s ego boundaries and the abolition of the clear difference between inner and outer reality”.³²
With the following two illustrations I try to translate these views into the terminology of my theory:

Fig. The stress-vulnerability concept applied to my concepts.
Note: The vulnerable areas are also areas for manipulation and areas in which over-stimulation can take place because the external stimuli can freely penetrate into the self-area. In the Summary table, this topic is shown above all in the row of Asp. 23.

All psychiatrists agree that many factors must come together, that are also rather unspecific by themselves.
It is probably a mistake to find the one cause, especially since there are not one but many forms of schizophrenia, which also differ individually.
Note: The so-called ‘demands and capacities model‘ (explanation for stuttering) is very similar to the vulnerability-stress-model.

Manfred Bleuler, who is very close to me in his psychodynamic understanding of the development of schizophrenia, expressed himself in a similar way.

“In my own experience, however, we are closer to a first solution of the riddle than is often acknowledged … The conditions of the development of schizophrenic mental disorders are, in my opinion, best understood in terms of an unfavorable interaction between contradictory developmental tendencies and contradictory living conditions. The schizophrenic falls ill in a struggle which everyone has to fight, but which the healthy person passes: The struggle to reconcile his often conflicting needs to some extent and to adapt them to the environment; he falls ill in the struggle for a unified ego, for a unified personality despite inner tendencies that are difficult to reconcile and adverse environmental conditions. In this struggle the schizo-
phrenic has crossed a critical threshold. Beyond this threshold, he abandons the struggle to adapt to reality and creates for himself a fantastic world adapted to his conflicting needs.” ³³

Kernberg’s Object-Relations Theory

Kernberg’s theory of the confusion of self- and object-representations and the related lack of distinction between inner and outer worlds can be explained by the above right figure. It is illustrated how absolutized objects of the world penetrate the self-sphere of the person, become strange-Selves thus disturb the differentiation between one’s own Self and the strange objects, or the inner and the outer world. Ciompi also describes the blurred borders between self-representatives and object-representatives and the connected problem of schizophrenic people to differentiate between the inner and outer world.

Melanie Klein emphasized the child’s relationship to good and bad objects in their development and the difficulties or disruptions in their integration. In the Summary table ,
this topic is represented particularly in row IV (subject-object relations).

Double-Bind Theory

The double-bind theory is G. Bateson’s theory of schizophrenic disorders, presented as early as 1956. In the following paragraph, I describe the double-bind theory using information taken from Wikipedia.³⁴
It will be shortened and written in italics, and I compare my corresponding hypotheses in this regard in square brackets [ ].

    “The classical double-bind theory describes the following requirements for a double bind to take place: A primarily negative commandment or prohibition that is essential for survival and incompatible with a second essential commandment, and a third commandment that prohibits the victim from attempting metacommunication and makes it seem impossible for him to leave the conflict. These conditions are usually internalized and a self-runner.”
[This theory is largely compatible with my concept: it emphasizes the absolute character of that which binds twice, the incompatibility of commandments with one another, the impossibility of the person concerned to resolve these contradictions, even if they could objectively be solved and that it is impossible for the individual to solve them due to subjective reasons because they have acquired an absolute meaning and a relativizing meta-level is missing.]
    “The main difference between a [relative] contradictory and a paradoxical rule of action is that in the case of the former, one can consciously perceive and choose the alternatives. Although one loses with the choice of an option the other option, but one consciously accepts its loss. “(Which is not the case with the paradoxical rule.)
[Here, the loss of the option to choose in a paradoxical situation is rightly mentioned because the individual has no superordinate Absolute which would allow the choice of option. Instead, the differences are absolute.]
    “The double-bind theory considers two levels (at first): A dominant parent and the dependent child. A third, superordinate level, such as social norms, ideals, or goals, to which the dominant sender of the double bind message feels committed, is not considered at first. However, such a third superordinate level can be found in the Stanford-Prison-experiment and in the Milgram-experiment.”
[The necessity of considering a third, superordinate meta-level is mentioned here. That also means considering an absolute sphere in which the “offenders” are also captured.]
    “There is … a wide field of potential contradictions that are not really contradicting itself on the level of logic. The real determinant is … the subjective excessive demand in the awareness of the child. A certain problem may overtax the child but as long as the child must not solve the problem, the child can look at the problem with a relaxed interest, and will learn from the situation.”
[With those statements, the classic double-bind theory is expanded to all the problems or contradictions of the individual that seem to be unsolvable, which coincides with my hypotheses.]
Regarding the pressure to adaptation and the self-image:
    “… in double-bind relationship patterns, the kind of influence also includes the kind of self-perception the victim has for itself.”
[Important reference to the disturbance of the victim´s identity whereby not just the identity but all psychical aspects are disturbed. And the causes are not only double binds (or splittings) but all inversions.]

My concept confirms and extends the double-bind theories.
In detail:
• The counterparts of double-binds are double-splitting and lack of ties. They are the other It-effects (when the It is a triad); i.e., there can be two, or three possible effects of the same It/sA.
• Double bonds/splittings can occur if the solution of an inversion is forbidden or impossible, as it is of absolute importance to the persons concerned. Uncovering of fundamental errors in the system is banned because it would plunge the system into crisis, and system members therefore believe that their common Absolutes must remain in all circumstances.
• All inversions can have double-bind, multiple-bind, -splitting or deficit effects.
• Even one single It/sA may cause double-binds or double-splittings or deficits.
• All P² can be the cause, as well as the target of those double-effects because every P² is dominated by It/sA that can have contradicting effects. But keep in mind: the whole P does not only consist of P²-parts.
• If people live sA-determined (= P²), they send double-bind messages.
• Every (absolute) bond is also a discrepancy of outer or inner necessities and the inner need for freedom.
Note
With terms such as double-bind or double-message, also paradoxical binds, predicaments, dilemmas, traps and so on can be described. When S. Freud stated, that these are the results of “two opposite affective reactions or drive reactions where one of them is a partial drive” and “the other one tries to prevent it” and that this is absolutely typical of neurotic symptoms, then the similar is said – as is also the statement of H. F. Searles that one cause of the double-bind is, “that one is in the same relationship with the other on two (or even more) different levels at the same time, that do not have any kind of connection with each other. This has the tendency to force the other person to dissociate his participation from one or other of these levels (possibly both) because he finds it inappropriate to refer to a particular level if it has no relation whatsoever to what is going on at the other level …”. Searles describes how a very attractive and provocatively dressed woman made him nearly crazy by a sterile discussion with him about theology and philosophy. ³⁵
• Double-binds/splittings may also occur if they originate from two contradicting sides of one part of an It (e.g., a front side and a reverse side). But because they are based on the same part, it falsely seems like they cannot be contradictory. A second possibility: A part and the opposite part state the same thing because the reverse side of a part and the front side of the opposite have the same connotation.
• There are 1000 causes that may lead to bonds or separations or deficits of two (or many) people, as well as 1000 causes that may lead to bonds or separations or deficits within one person. In both cases, many different possible causes, that may lead to one very specific but individual various result.
Examples:
– Mother and father take an absolute position for the child. This creates a double bond: The child must follow both mother and father, although they are different. But this is also a splitting of the childish image of the parents and the truth, which states that that the parents are not of absolute importance.
– Analogous example: Mother is the good, father is the bad → bond, splitting and trap for the child.

Possibilities of double-binds and splittings in systemic and dimensional spheres².

In the `Summary table´ this topic will be displayed particularly in row a4.

If a first-rate +metaposition is engaged, the subjective or objective contradictions (including all dichotomies and their double-binds/splitting) will be solved or at least modified.

Expressed-Emotion Concept

“High expressed emotions (HEE) means, that the family members mention a lot of critiques towards the patient. They show animosity or are characterized by an emotional hyper-commitment. The unfavorable influence of HEE on the relapse rate of schizophrenia, depression, bipolar disorders and eating disorders is scientifically proven. However, there is no recognized theory on the mechanism of action.” ³⁶.
Even this concept accords with the ideas of my theory, which emphasizes the absolute importance of certain people and their attitudes toward the person affected. That absolute importance has certain consequences in the area of emotion and behavior (esp. aspect 7) and, regarding emotions that are illustrated in cells I7 and N7 of the Summary table (hyper-emotion, mis-emotion and insensibility). I believe that common literature over-interprets hyper-emotion, whereas neglecting mis-emotion and insensibility.

Criticism on Certain Schizophrenia-Theories

• Holistic concepts seem to be missing.
Questions: How can theories that have no concept of a whole explain sufficiently schizophrenic phenomena?
How can therapies solve splittings that split off anything that is not scientific and thus are split themselves, too? Don’t they lack a meta-theory that integrates everything that is psychical relevant? I.e., a band for the person/system that encompasses everything and ‘holds together’? The integrating instance has to lie on a meta-personal, or meta-individual level if the person is no longer able to solve the splitting by himself, or with the help of other people.
*As Antoine de Saint-Exupéry said: “For one day I will speak to you about the necessity or the Absolute, which is the divine knot that connects things.” ³⁷
The index-patient and his family can be considerably relieved if the main responsibility for solving the problems lies in an instance outside of the affected people. Here, we can also notice a disadvantage of one-sided psychiatry. I refer to the predominant personal image of psychiatry today, consisting of many self-representations, that are not being held together by a superordinate unity so that an unfavorable initial situation of therapy of schizophrenic psychoses exists.
• Many concepts solely focus on the elimination of disorders. In contrast, Eugen Bleuler said, that basic characteristic in psychoses is, that the healthy parts remain over in schizophrenia. They are not be gone but only hidden. ³⁸
• C. Kulenkampff stated: Griesinger’s statement from the second half of the 19th century, that states that mental illnesses are brain diseases was too dogmatic. His hypothesis – “schizophrenia is a somatic-based illness” – eventually became an “unreflected assertion”. “The elephant of worldwide biochemical, anatomical, genetic and natural scientific research has not yet given birth to a mouse when it comes to the area of etiology.”³⁹
I have the impression that nothing has changed in principle about this statement to this day, even if more detailed neuropathological research results are available today.
• Most of the theories of schizophrenia are based on a positivistic principle which means, they only accept hard facts. M. Musalek, on the other hand, is right to say: “The main problem of positivistic research approaches lays in the circumstance that nature obviously knows nothing about our principles of classification and order. We are the ones who create disease categories into which we then order the nature surrounding us. Nature does not know those forms and categories. Therefore, on positivism based schizophrenia-researches … remained without any success.” ⁴⁰ R.D. Laing even went so far as to regard schizophrenia as a projection of some schizophrenic theories. ⁴¹

Why can be seen, regarding the above-named theories, inversions with their effects (sA/It) as the common denominator for the schizophrenia genesis?
I have stated in the previous sections in what way the inversions-impacts explain the vulnerability-stress-model, the double bond theory, the “paradoxes” (M. Selvini Palazzoli), the pathological narcissism after Kernberg and the High expressed emotions theory.

Regarding other theories:
– S. Minuchin says, that the entanglements happen because the affected individuals are not able to find a solution at the certain (sA dominated) spheres, i.e. they are not able to engage a solving meta-level.
– “Delegation” and “impossible mission” (H. Stierlin) may be explained likewise: The affected individuals are not able to fulfill the sA-demands delegated by other people.
– The common I-weakness can be explained with an Ego that is overtaxed by the sA.
– The “broken-home-situation”, often described in older literature, may be found, as well as the opposite form of fusion/ hyper-proximity.
– The schizophrenogenic mothers (Frieda Fromm-Reichmann) can also be found in addition to all other schizophrenogenic factors.

See also chapter `‘Psychotherapy of Schizophrenia‘ in part `Psychotherapy’.

Delusion

Delusion can be explained by the fact that the person (P) does not judge himself and the world from a first-rate perspective, i.e. from the actual Self, but P interprets the world from foreign, distorted, partly contradictory points of view by the Its/sA. This disturbed way of thinking and interpreting cause disorders that are particularly found in aspect 18 of this work. I am assuming, that other absolutizations are also added which determine the content of the delusion.
The topics of delusion reflect certain absolutizations: e.g., absolutization of one´s own responsibilities and morals → everything is my fault → delusional guilt; Others, depending on the absolutized topic: paranoia, delusional impairment, persecutory delusion, delusional jealousy, megalomania, hypochondriac delusion, and so on.
The connection between ideology and delusion seems obvious: ideologies believe to possess absolute truths. In other words, ideologies are more or less delusional and encourage delusion. One may assign the different delusions to certain aspects of differentiation of this work.
Instead of a +A, the individuals experience strange Absolutes in their systems. “Such people live in their own solar systems …” said F. Nietzsche once. ⁴²
The causes are by no means only to be found in the person affected. People with delusions are often the victims of healthy people with non-clinical delusions whose price the sufferers pay. Therefore, misidentifications play an important role in delusion: I identify myself with somebody/something or I identify somebody/something with me. Exterior topics then represent the inside of P² and the other way around the exterior acquires other meanings to the person. Example of delusional jealousy: A patient who compensates his low self-esteem by representing his attractive wife like an object towards other men: “Look what a guy I am that I have such a sexy wife.” But at the same time, he develops the delusion that his wife might like other men better and he could then lose his love object* (sA), his wife. E. Bleuler: “The development of delusion seems to be less puzzling if one imagines it as a result of a comprehensible confrontation of an inner and outer conflict-situation: [e.g.,] an ambitious, young man wants to achieve great things but he does not accomplish great things. His self-esteem does not allow his own inability to be the reason for his misfortune: he protects himself from inferiority feelings by ascribing blame for his fate to the evil intrigues of other peoples. Or, a girl, who has no boyfriend because of her contact difficulties, dreams of men of much higher rank falling in love with her but she blames evil people who prevent coming together with those men.” ⁴³
Bleuler is only able to imagine the transition from normal to psychotic by picturing a certain ‘point of no return’. That would be the point, where the confrontation of the own situation with the reality becomes as painful and shattering, that one gives up the reality and is caught in a surreal world of imagination.” I would describe that ‘point of no return’ as the point where a Relative became a strange Absolute (resp.It), that is not to integrate.

Table: Example of the genesis of delusion (extract)

Along with the thoughts about splitting and other schizophrenic phenomena mentioned earlier, this table is meant to illustrate some possibilities of development of delusional thoughts and similar mental disorders due to inversions. Especially absolutizations and negations of different meanings and values will promote the development of delusions. Those are often about degradation or the idealization of people.
The table also emphasizes the fact that it is not only inversions of meanings and values (asp.18) that can cause delusions but potentially also all inversions of the other aspects. Dogmatism and anarchism, for example, do not solely cause disorders of order but may also lead to disorders of thought and judging and therefore promote delusional thinking. Or, if we are fixated on responsibility and functionality, then we will feel secure and self-confident towards other people as long as we fulfill the responsibilities and functions. If we do not fulfill them, we may become ill and even paranoid.
I want to give a personal example: When I had to undergo psychiatric treatment myself about 30 years ago, it was mainly based on one reason: I was filled with absolute musts. I believed that I had to be necessarily a good human being (also in the way of misunderstood Christian views). I had ever to be helpful and as a doctor, I felt like I always had to be available to my patients but also to gain a certain amount of appreciation. As long as I fulfilled those requirements I received a lot of appreciation and had a strong Ego. However, it all collapsed when I was not able to fulfill all of the requirements anymore – maybe I did not want to fulfill them either. My fellow men, especially my patients became more and more alien threatening. Everyone who entered my consulting room during this phase made me think: “That person is expecting much help, and I have to give it.” I was not aware, that my attitude made me vulnerable and that it caused me to view his wishes as unconditional demands towards me. The patient eventually became my opponent and I became my own opponent, too. “Why is everybody asking me for everything?”, “Why do some people weirdly look at me?”, “What can I do?”, “Nobody can help me.” Fear, strangeness, despair and helplessness became overwhelming. I was only moments away from experiencing a manifest delusion, only moments away from losing my mind. Fortunately, I decided to seek professional help. I experienced a turning point when I realized that I am absolutely loved by God¹, that I may be, whoever I am, who does not make his love and my self dependent on whether I fulfill these or those responsibilities and functions, no matter how good or meaningful they are, or not. (Although the psychotherapy did not intend this at that time, it fortunately lead me in this direction, for which I am grateful.)

Questions:
– Can not every ideology create delusion?
– Doesn’t every person or every group of society have delusions and mania in the shape of absolutization of growth, progress, perfection, beauty and others?
– What is the difference between a delusion of a healthy person compared to the delusion of a mentally ill person? (The so-called healthy one does not suffer from it because he/she experiences the delusion/mania/obsession positive, whereas the ill person experiences it as painful).
– Doesn’t the delusions/ obsessions/ manias of the healthy people promote clinical delusions of the patients? See also about the therapy of delusion in `Values´.

Hallucinations

Delusions and hallucinations are closely related. Hallucinations are sensory illusions, without a demonstrable cause of stimuli.
Hypotheses:
While the main reason for delusions is most found in aspect 18 (thinking and judging), the main reason for hallucinations is found in aspect 16 (perception). The affected person has a contradicting perception of himself and the world. He sees, hears and feels everything in an alienated way.⁴⁴ Such as all the other symptoms, hallucinations may also be caused by Inversions.

Due to certain It/sA, the affected person views the world as though looking through a faulty pair of glasses:
black and white, too clear or unclear, distorted and so on.

Acoustic hallucinations are mainly developed through internalized absolutizations of people that act like a homunculus towards the affected person. It speaks to him, gives advice or orders etc. It is expressions of a special strange Self (sS), that become effective here as pseudo-personal, homunculus-like “central internalization”. It was pushed from a subject role and the affected into the object role. (“It commands me…”, “It comments my behavior”, “It threatens me” etc.) These kinds of personal voices are being created because the personal sA/It (as `humunculi´) are often stronger than some other personal forces. Acoustic hallucinations are mainly voices of introjections of absolutized people (of people as sS), that were/are loved or hated too much. Or they are a transference of pathogenic behavior patterns of people surrounding the ill person. These are usually healthy themselves but they transfer their pathogenic issues and attitudes onto others who cannot defend themselves.
I think, that phenomena such as delusions and hallucinations should not be viewed solely negative and absolutely pathological. Those disorders may also be an expression of going the right direction and may have progressive characteristics. Thus, they may also be an expression of the actual I-self. Consider, how many intuitions, illusions or predictions were thought to be abnormal and turned out to be absolutely true.
(See also about the therapy of hallucinations in `New and old´.)

Depressive and Manic Reactions

“It is the phantom of our own self whose deep affinity and profound influence
on our mind either damns us to hell or uplifts us into heaven.” E.T.A. Hoffmann, ‘The Sandman’.

Depressive and manic symptoms may be caused by every inversion that leads to certain strange-Selves.
The following graphs illustrate which sS mainly caused depressions and which cause manic symptoms: ⁴⁵

This graph is meant to illustrate kinds of the strange-Selves (resp. personal Its) and their effects.

Main positions of the depressive and the manic: The absolutized positive (+*) has to be fulfilled and the absolutized negative (-*) has to be avoided or fended off and the 0* (here not drawn) has to be filled. As soon as the person goes against those requirements, he will become depressive. If he meets the requirements, he may become manic.

I postulated: If a person absolutizes something Relative or negates an actual Absolute, depressive and manic reactions may be the consequence. Absolutized Relatives become a strange-Self, which intrude in the actual Self and it pushes aside. The actual I can no longer live freely with the actual Self (as I-self) but will be rejected and also pushed aside.
We were talking about the subject-object-splitting and understood it as a process of the strange-I (Ego) becoming the subject instead of the actual I. The actual I becomes the object being degraded and oppressed. That is the suppressing and depression-causing side. But the strange-Self will also give something ‘positive’:
It will give exaggerated ‘good’ feelings, ‘lust’ in the sense or compensatory satisfaction. I cannot repeat enough, that it is important to not only view the strange-Self as solely negative but as ambivalent, substitute, or second-rate. The motto for that could be: It is better to experience inebriation than to commit suicide.
We discussed those two sides of the strange Self: the pro-sS (ideal*) and the contra-sS (taboo*).⁴⁶ The ideal* gives, motivates, stimulates and makes the person happy and proud if it is being fulfilled. On the other side, it will constantly demand something and therefore it oppressively acts if it is not being fulfilled enough. And if the affected person decides to act against the ideal*, it becomes a tyrant and causes a sense of inferiority and guilt, a feeling of loss and depression. The person will keep trying with self-denial to fulfill the ideal. However, he/she becomes overtaxed and gets symptoms of depression.⁴⁷
Along with the punishment through the strange Self, there will be a loss of the positives of the actual Self, since it is no longer the only base of the person. That mainly means loss of identity, vitality, uniqueness, freedom, self-confidence, which are all signs of depression. Therefore, depression can be viewed as a loss of the actual Absolute and as oppression through a strange Absolute (resp. strange Self).
I view mania as an expression of conformity of the person with an absolutized positive* (ideal*).⁴⁸ A manic person has the feeling that he/she found the +Absolute or is identical with it. ⁴⁹ However, it is only a short-time fulfillment of the ideal that is giving that kind of feeling. Since the strange Self only gives substitutes, the positive feeling is not only limited but also less worth quality-wise. It remains a meager feeling of luck: A short rush, a thrill. Therefore, a manic person is not happy but more like being `high´.
Such as the term ‘bipolar disorder’ describes, mania and depression are two sides of the same thing – the ambivalence of the strange Self.
Mania is also protection against depression, such as depression is protection against mania. Mania is an inverse co-form of depression and vice-versa. Therefore, the depressive person has always latent manic parts and the manic person has always latent depressive parts. ⁵⁰
It is well-known that the illness proceeds in different phases. Since those phases run autonomously and do not correlate with the actual situation of the affected person, they do not appear to be explainable in a psycho-dynamic way which makes a lot of people think of them as some sort of metabolic disease. Unfortunately, we do not have enough time to discuss this problem. But if we look at the hypotheses made earlier, it becomes very clear why the named phases may appear. The main reason lays in the characteristics of the strange Self. In the first part of ‘meta-psychiatry’ I already mentioned how the flowing transitions of black and white, right and wrong, good and bad, positive and negate are being reduced to their opposites. The same thing happens to the mental state of a person. Regarding the reversal of mania in depression and vice versa see paragraph `Reversal into the opposite´.
Based on the strange-Selves, the person is either too far within the positive sphere or too far within the negative sphere, even if he/she is acting no more incorrectly than the healthy people around him.
Looking at it from the side of the strange-Selves, it appears thus: Such like dictators, they allow us to experience some sort of ecstasy whenever we were being good and sacrificed a large number for them. Somebody could say: Why not. I sacrifice myself for my own good, for my own ideals. Therefore I am the beneficiary. That is partly correct, and as mentioned before, the strange Self is not only the bad. The person is also doing something good for him-/herself, more exact, for what he/she thinks is his/her own Self even though it is not. But if a person sacrifices him/herself for the ideal*, he/she will receive only a substitute but not the actual reward and more often than receiving the substitute he/she will experience frustration, oppression or depression.⁵¹
Can somebody become depressive without having a strange Self? Yes, in the way you may also become depressive due to progressive causes. No, if talking about a so-called ‘neurotic’ or ‘endogenous’ depression.

Remarks about Other Disorders

In the following chapter, I will only briefly discuss some mental disorders.

Obsessive-Compulsive Disorder

“Today I know that I had ‘absolute’ claims as an obsessive-compulsive patient .” (Ulrike S.)

A short summary of the known facts:
“Psychoanalysts believe that obsessive-compulsive disorders (OCD) are being developed when children start to fear their own Id-impulses and use defense-mechanisms to reduce the resulting fear. … The Id-impulses usually appear as obsessive thoughts whereupon the defense-mechanisms appear as contra-thoughts or obsessive behavior. … It is probable that a combination of genetic tendency, disorder of the cerebral metabolism and psychical causes (such as stress) is the reason for an outbreak of obsessive-compulsive disorders. An isolated, singular cause is still unknown.” ⁵²
U.H. Peters states: “The symptoms illustrate compromises between drives, their restrictions, the demanded expiation of the super-ego and masked substitute-satisfaction, between which the ego cannot decide (ambivalence).” ⁵³
I believe that the causes are based on the unsolved conflicts between the actual Self and some specific strange Selves and the conflicts within those strange Selves. The basic idea would look as followed: The actual Self strives to be free, to be unconditionally loved and always maintain to be itself. (Being allowed to have certain sexual fantasies, allowed to be aggressive and bad and so on). However, strange Selves limit that freedom of being unconditioned and only give substitute-love and substitute-freedom under certain preconditions (fulfillment of +sA-requirements and avoidance of ‒sA-requirements). If those requirements are not being fulfilled, the strange Selves threaten with sanctions, which cause fear within the affected person. To reduce those fears, the affected person develops an obsession to fulfill those requirements though that usually leads to short liberation only. I.e. everything that has been absolutized can become a compulsion.
Psychoanalysts discovered the compromise-character of those mechanisms a long time ago. The affected person tries to develop a compromise between the Self and the strange Selves – a compromise between his/her actual needs and tempting promises or threats of the strange-Selves. However, he/she does not risk, or is not able to relativize the strange-Selves because he/she identified him/herself with it and views them as his/her own Self.
One may find a better understanding of these internal processes when compared to similar external circumstances, such as comparing the strange Self with a dictator who, like with carrot and stick lures us on the one hand with false promises but on the other hand it scares us and compels us to behave in a certain way (compulsion) if we do not obey and do not have the courage to free ourselves from him. This view does not exclude neurobiological or genetic factors, even if I would not focus on them as long as there are credible psycho-dynamic hypotheses that allow for causal therapy.

I want to give a specific example for the different views and approaches. The case example I would like to illustrate and discuss is out of the publication “Zwangsstörungen im Kindes-und Jugendalter” (obsessive-compulsive disorders in childhood and adolescence). ⁵⁴
That article is about an obsessive-compulsive disorder of a 10-year old girl, which appeared after her grandfather had passed away.
The authors describe the disease progression based on scientific criteria along the guidelines. They named possible causes and certain treatments that “showed a significant improvement but no complete remission of the symptoms”. Although a direct connection between the grandfather’s death and the onset of the obsessive-compulsive disorder of the child was evident, the significance of the grandfather’s death for the girl was surprisingly not discussed! My guess is that because of the guidelines, dealing with such “final” metaphysical issues did not fit into the concept. But what, if the girl was confronted with unsolved metaphysical questions due to the grandfather’s death, which were relevant for the development of her illness? Surely, it would be absurd to seek metaphysical problems for each kind of symptomatic. However, if there are signs of relevance such as there are in the described case, we should not ignore them. ⁵⁵
Note: When I sent a discussion commentary to the authors of the publishing magazine with my thoughts, I received the typical answer that only scientific discussions would be published.

I suppose that psychiatrists who do not feel responsible for such questions of belief, would allow the choice to patients to seek help from a pastor. However, that does not help, because:
• there are barely any people who seek help from pastors when it comes to mental illness and
• the person would be sent away from the pastor as soon as he reckons with ‘pathological problems’. ⁵⁶
The dilemma: In such situations, the mentally ill person(s) are left alone with their problems if pastors reject work with mental illnesses and psychiatrists solely work scientifically. What would be an option to solve this problem? We should probably show more courage to open closed theoretical and practical systems (scientific or theological) and risk more multidisciplinarity.

Fear

The main causes and the psycho-dynamics are very similar to the ones of obsessive-compulsive disorders. Therefore, I did not further describe those. Here are only a few remarks. Fear is not necessarily a bad sign such as living without fear is not always a good thing. Both are Relatives. That also means that no symptom has absolute importance, even if the appearance of fear is relatively negative at most times, whereas lack of fear is also relatively positive only.
The pathological fear has three sources, based on the dimensions:
    • fear of loss of a +sA
    • fear of the manifestation of a ‒sA
    • fear of nothingness
On the one hand threatens the ‒sA, on the other the emptiness (0 *) and on the third the loss of a +sA.

P is caught in a psychical ‘Bermuda Triangle’:
A +sA and its opponent drive the person in front of themselves, from one to another or into nothingness.
How here the inner sA/ It make fear, madness etc. this psycho-terror – in the form of `carrot and stick ‘(and emptiness) – is also used in totalitarian systems to suppress people.

Example: “I am absolutely ignorant of, as you say, `the pleasure of doing nothing´. As soon as I no longer hold a book, or am not dreaming of writing one, a lamentable boredom [0*] seizes upon me. Life, in short seems tolerable to me only by legerdemain. Or else one must give oneself up to disordered pleasure [+sA] . . . and even then!”⁵⁷

Burn-Out

P is usually too identified with the +*, which he/she sacrifices him/herself for. In other words, P burns for something +* and then burns out. P is full of experiencing a high at first and eventually exploiting his/her Self.
At the same time, P needs too much energy to fend off what he experiences as absolutely negative (‒*).

Example

Yes, I know from where I came!
Ever hungry like a flame,
I consume myself and glow.
Light grows all that I conceive,
Ashes everything I leave:
Flame I am assuredly.
F. Nietzsche, Ecce Homo.

Pain

Every It/sA may cause pain: a +sA if it is being lost, a ‒sA or ‒0 if it appears or may appear.
It mainly affects the sA that are effective in aspects 7 and 23. When it comes to sA in aspect 23 it is especially about traumata and injuries that affect the absolute-area of a person and/or absolutizations that avert the development of effective protection.
S. Freud already ascertained that nothing hurts as much as the loss of a love-object ( sA).
[+A however, can never be lost – only the belief in it.]
Situations of pain may also occur with positive processes (labor pain, pain when going through a reasonable separation). However, those are usually limited in time, do not become chronic and have positive results. (`Your pain today is your freedom of tomorrow ‘.)

Post-Traumatic Stress Disorders

Post-traumatic stress disorders (PTSD) occur:
• Objectively through confrontation with death, through serious injuries, through sexual abuse, rape, violent attacks, kidnapping, terror, war, torture, imprisonment, catastrophes, accidents, or diagnosis of a life-threatening disease. It can be experienced personally or through another person.
• Subjectively through intensive fear, helplessness or shock.⁵⁸

There are highly differentiated concepts of treatment that are mainly based on behavioral therapeutic fundamentals. I do believe that an extension of those concepts by including good spirituality, or religion would be reasonable for the following two reasons:
1) Statistics show that people who are religious or spiritual have better chances of recovery.⁵⁹
2) PTSD’s have especially to do with relationships between offenders and victims and the context of problems of death. I do believe, that those difficulties are of existential importance (absolute-area) for the affected people and are therefore best solved based on good beliefs. Why? Such as the PTSD-therapists suppose, the trauma is best rehabilitated when there is a secure and trustworthy relationship between victim and therapist.
The offenders are usually not available. The belief in a fair or maybe even avenging God¹, however, may relieve the victims more than the options a therapist has. Another difficulty lies in the resolving of the victim´s feelings of guilt, vengeance, and aggression that come along with traumatizations. In the best-case scenario that would mean giving it away to a higher power such as God¹. More exact: An important problem is that the victim often starts viewing him-/herself as a potential offender or may become too and is not able to unite both roles in a satisfactory way unless he/she gives the problem to a higher authority. This higher authority (God¹) is able to avenge the sacrifice if the offender does not repent of his behavior and may show mercy if the victim him/herself becomes a perpetrator and regrets his actions.
When it comes to the mentioned ‘confrontation with death’, it is a question of belief if death is the last or not. Why should a psychotherapist convey a negative or no faith at all if there are just as many (or more) reasons for an afterlife? Why should a psychotherapist not convey a belief/faith, that reflects a relieving and liberating possibility? ⁶⁰

Communication Disturbances

See Complex personal dynamics and relationship disorders elsewhere.

ADHD

Some brief therapeutic remarks to attention deficit hyperactivity disorder (ADHD):
Avoid the black-or-white-thinking regarding medication! Just like medication for other mental illnesses, they should be used as ‘mental crutches’. They do not heal but they might save the affected person from a breakdown. If the affected child of the family is overtaxed and the symptoms are no longer able to be compensated, taking medication is usually a reasonable option. However, the dose should be relatively low, so that the symptoms are not completely covered but remain in a certain extent. If you give too much of the drugs, you take away the children the opportunity to develop complex skills themselves.

See also G. Hüther, section “Problem antipsychotics“

There are very good behavioral therapies available, although they are often too focused on total elimination of symptoms. To me, it seems reasonable to practice symptoms consciously sometimes, to avoid a fixation on total symptom-elimination and thus to let the child know that it is unconditionally loved beyond any symptoms and performances.
A collateral family-therapy is also important, not to seek fault on the parents’ side but to relieve them, to strengthen them and to loosen unnecessary and overstraining attitudes. In the sense of ‘primary psychotherapy’, as described in this work later, attempts of change are ultimately secondary and subordinate to the unconditional acceptance of all involved parties.

Alzheimer´s

A hypothesis regarding Dementia

It is known that mental trauma can cause brain changes. In my experience, emotional traumas are a common cause of many dementias. Older people are increasingly confronted with existential problems (loss of meaning, serious illnesses, relatives’ deaths, etc.) which are usually not diagnosed as traumas, however, they are often experienced in the same way.
In addition to these traumas, any demands can be experienced as negative Absolutes if the person affected can no longer compensate what (s)he could still handle before his/her illness but is no longer able to do so, now.⁶¹
In terminology of this work, the older person is no longer able to reach his/her +sA, to fend off the ‒sA and to fill inner emptiness (0). If the person concerned also fights against forgetting, his chances deteriorate. He is then like the stutterer who fights stuttering and then stutters even more. The sA burn out because they can no longer be served by the person concerned. And with them, his/her spirit goes out. They burn out like dying stars and remain in the brains only as dead nerve cells.
Every person has experienced how their thinking and remembering was blocked in an every-day situation, due to certain unsolved problems. Why should that temporary mechanism not become chronic and somatized?
It also needs to be mentioned that such psychodynamic hypotheses are rarely pursued because they are not a source of income for the pharmaceutical companies, whereas billions of dollars are earned only with the pharmacotherapy of dementia.

Others

I suppose that many diseases that are not primarily organic, such as psychosomatic diseases in general but also many that have multi-factorial causes such as epilepsy, rheumatism, migraine, irritable bowel syndrome, Crohn’s disease, asthma, etc., are less genetic than caused by basic pre- or postnatal psychical reasons due to certain It/sA.

Repetition for Clarification

Mental illness may also occur due to the process of trying deep solutions, which is reflected by the term ‘progressive illness’.
The opinion that a healthy person acts more correct than an ill person or that a healthy person may even be a better human is wrong. In the Christian ambit there are often misunderstandings when it comes to the connection of ‘sin’ and illness, which is mostly based on certain parts of the old testament. Especially the assumption that an ill person has to be some sort of sinner is very common. Jesus disagrees with this error. We cannot automatically assume closeness to God¹or strong faith just because someone is healthy and well, just as pain, sorrow or illness does not indicate distance from God¹or a lack of faith. But on the other way, there are positive connections between good belief and health as I try to explain in this book.

About Anti-Psychiatry

The list of `anti-psychiatrists´ is long. I will name the most important ones: Silvano Arieti, Franco Basaglia, Fred Baughman, Ernest Becker, Clifford Beers, Lauretta Bender, Richard Bentall, Peter Breggin, Paula Caplan, Ted Chabasinski, Judi Chamberlin, David Cooper, Lyn Duff, Michel Foucault, Jan Foudraine, Leonard Roy Frank, Erving Goffman, James Gottstein, Otto Gross, Jacques Lacan, R. D. Laing, Peter Lehmann, Theodore Lidz, Kate Millett, J. Moncrieff, Loren Mosher, David Oaks, Elizabeth Packard, Sascha Scatter, David Smail, Thomas Szasz, Stephen Ticktin, Robert Whitaker and others.
Some of their publications are listed in the bibliography.
The anti-psychiatrists had/have different professions and criticized the established psychiatry in diverse ways. The criticism varied from radical denial to suggestions for improvement.
I believe that it was a failure of the established psychiatry not to involve reasonable anti-psychiatric perceptions. It is unfortunate that psychiatry and anti-psychiatry are contrary faced in literature. Therefore I would preferably call it ‘complementary psychiatry’ instead of ‘anti-psychiatry.’

Abbreviations of all Parts

+ = positive
− = negative
¹ = first-rate or primary
² = second-rate (or secondary) not to be confused with coordinate
→ = ‘see or `result is´.
* = Sign for absolutizing and / or dominance. (Often used to point to an absolutizing.)
| = a sign that the German original version has been shortened at this point.
A = the Absolute (+A = positive Absolute, −A = negative Absolute)
All (“) = here strange everything, which stands in opposition to the nothing(ness).
asp. = aspect
BLQC = being, life, qualities, connections
C = general abbreviation for complexes that dominate personal and other areas of reality.
D = Dynamism D¹ = first-rate D., D² = second-rate D.
DM = Dimensions
DM = Defense-mechanisms
e.g. = exempli gratia (for example)
etc. = et cetera
God¹ = I partly write God¹ to indicate my own conceptions of God, which do not necessarily agree with definitions of official theology. (See also: “Christian” One-Sidednesses and Misinterpretations).
I = I in general ( I¹ = first-rate I, I² = strange I = Ego)
i.e. = id est (that is)
It = dominating entity/instance, consisting of 2 or 3 cores:
    2 parts: all and nothing (“/ 0) = `dyad’ or
    3 parts: pro-sA or + sA, contra-sA or -sA and 0 = `triad’
It/sA resp. It/sS: if I want to emphasize the absolute role of an It-part.
KW = keyword = headword
ns = new-strange/ new-second-rate (new secondary)
No. = Number
P = Person; P¹ = first-rate personality; P² = second-rate personality (often only P labeled)
pr = psychically relevant
r = relative
R = the Relative (R represents everything that is not A or 0.)
R* = Relativistic
resp. = respectively
s = strange = second-rate (²)[1
sA = strange resp. second-rate Absolute
             pro-sA and contra-sA = opposing sA.
             asA = absolutistic strange Absolute
             rsA= relativistic strange Absolute
s0 (or 0) = strange, determining nothing(ness) = nihilistic
sS = strange Self
syn. = synonym
W = World, reality
WPI = world, person, I.

References

References of all parts of `New Psychiatry´ see German Edition
https://new-psychiatry.com/wp-content/uploads/New-Psychiatry-Web.html#mozTocId417834