From pleasure to anhedonia - Forbidden desires and the construction of schizophrenia

Author(s): Heinze, M.

Journal/Book: Theor Psychol. 1999; 9: 2455 Teller Rd, Thousand Oaks, CA 91320, USA. Sage Publications Inc. 47-65.

Abstract: Anhedonia is a negative symptom that has not always been given attention in schizophrenic patients. While phenomenologically oriented psychiatrists noticed a certain lack of emotional vivacity in schizophrenic patients, schizophrenia theory in the tradition of Bleuler emphasized a different facet of schizophrenic psychopathology. It held that the retreat into wishful fantasies, autism, is a fundamental symptom of schizophrenia. Bleuler's concept of schizophrenic psychopathology was based on J.H. Jackson's evolutionary account of mental disorders. In this view, mental diseases represent a dissolution of evolutionary progress and lead to the manifestation of primitive traits in 'modern' patients. This article argues that the resulting analogies perceived between schizophrenics and 'primitive' people lead to an overemphasis on wishful, irrational thinking and to the neglect of anhedonia, the inability to experience pleasure. Moreover, socially unacceptable desires were rediscovered in these supposedly 'primitive' individuals. This situation changed fundamentally only after social and historical transformations occurred that shifted the center of psychiatric research from Germany to the United States and from an emphasis on the rational control of desires to the use of social reward in ensuring social conformity. As a consequence, Rado and Meehl placed anhedonia at the heart of their schizophrenia theories. Current developments in social interaction seem to stimulate another shift in schizophrenia theory, de-emphasizing social reward and providing room for a differentiated assessment of anhedonia in schizophrenia.

Note: Article Heinz A, Ruhr Univ Bochum, Dept Neurol, St Josef Hosp, Gudrunstr 56, D-44791 Bochum, GERMANY

Keyword(s): anhedonia; desire; 'primitive' thought; schizophrenia; social conformity

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