Ambivalence According to Bleuler: New Trajectories for a Forgotten Symptom
Beretta, Véronique
Ambivalence According to Bleuler: New Trajectories for a Forgotten Symptom - 2015.
26
Defined in 1910 by Eugen Bleuler as the fundamental symptom of disorders in the spectrum of schizophrenia, ambivalence is the tendency of the schizophrenic mind to make—in a non-dialectic and unsurpassable manner for the subject—two affective attitudes or two opposite ideas coexist at the same time and with the same intensity. Bleuler’s originality was that he thought of ambivalence as the result of an associative loosening brought on by a splitting (Spaltung), or even the clear and radical disappearance (Zerspaltung) of strong associations coming from empirical thought. This symptom, which is always present, even in the mildest of cases, can manifest itself in an affective form (affective Ambivalenz), a volitional form (Ambitendenz), or an intellectual form (intellektuelle Ambivalenz). Nowadays, criterium for diagnosing schizophrenia no longer mention Bleuler’s notion of ambivalence, the major reproach being that it is a symptom that is too rare, too vague, and too psychoanalytic. It is probably this last point that is the most justified. Affective ambivalence, placed at the center of the theory of instincts, is defined according to the subject’s personality structure: it is integrated in a neurotic patient (Freud, 1938), split in a borderline patient (Kernberg, 2004), and paradoxical in a schizophrenic patient (Racamier, 1990). Examined from the viewpoint of psychopathology, we will describe these different forms of ambivalence and explain in what way they differ, to show that Bleulerian ambivalence remains a most interesting basic disorder to diagnose, before presenting equivalents that we were able to find from the angle of phenomenological psychiatry. We will then complete our exposé with contributions from the fields of experimental psychology and psychiatric neurosciences.
Ambivalence According to Bleuler: New Trajectories for a Forgotten Symptom - 2015.
26
Defined in 1910 by Eugen Bleuler as the fundamental symptom of disorders in the spectrum of schizophrenia, ambivalence is the tendency of the schizophrenic mind to make—in a non-dialectic and unsurpassable manner for the subject—two affective attitudes or two opposite ideas coexist at the same time and with the same intensity. Bleuler’s originality was that he thought of ambivalence as the result of an associative loosening brought on by a splitting (Spaltung), or even the clear and radical disappearance (Zerspaltung) of strong associations coming from empirical thought. This symptom, which is always present, even in the mildest of cases, can manifest itself in an affective form (affective Ambivalenz), a volitional form (Ambitendenz), or an intellectual form (intellektuelle Ambivalenz). Nowadays, criterium for diagnosing schizophrenia no longer mention Bleuler’s notion of ambivalence, the major reproach being that it is a symptom that is too rare, too vague, and too psychoanalytic. It is probably this last point that is the most justified. Affective ambivalence, placed at the center of the theory of instincts, is defined according to the subject’s personality structure: it is integrated in a neurotic patient (Freud, 1938), split in a borderline patient (Kernberg, 2004), and paradoxical in a schizophrenic patient (Racamier, 1990). Examined from the viewpoint of psychopathology, we will describe these different forms of ambivalence and explain in what way they differ, to show that Bleulerian ambivalence remains a most interesting basic disorder to diagnose, before presenting equivalents that we were able to find from the angle of phenomenological psychiatry. We will then complete our exposé with contributions from the fields of experimental psychology and psychiatric neurosciences.
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