Schizophrenic Delusions, Embodiment, and the Background Giovanni Stanghellini (bio) Keywords schizophrenia, delusion, embodiment, common sense, phenomenology In their article Delusions, Certainty, and the Background, Rhodes and Gipps (2008) argue for a Background theory of delusions. Their central argument may be summed up as follows: • The formation and maintenance of delusions becomes intelligible once they are seen to reflect a basic disturbance. When studying delusions, the focus should be on providing an adequate framework for understanding, rather than providing empirical hypotheses to be tested. • The basic disturbance in delusions, and insanity in general, is not a deficiency in reasoning or a defect in the content of experience, but rather something more fundamental. • Delusions––this is their central claim––are caused by a failure of the Bedrock of beliefs (Wittgenstein) or the Background (Searle) to adequately inform or constrain the process of belief formation. • Our Bedrock certainties are defined––following Wittgenstein––as ultimately constituted by our ability to act in the world and demonstrate our primary engagement with the world. They are born out of our everyday experience of the world, conveying our direct, pre-reflective, and practical grasp of the world, rather than expressing judgments we make about it. • Similarly, the Background is defined as those abilities and dispositions that are neither representations nor rules, that function before we can make sense of our experiences. • Wittgenstein’s Bedrock and Searle’s Background in great part overlap with Blankenburg’s pre-reflective natural self-evidence and Stanghellini’s common sense, namely, our own unreflecting know-how, a set of nonpropositional skills, capacities, and dispositions that attune us with the world. • Without a fully functioning Background, the distinctions between imaginary and real (mind and world), self and non-self, and cause and coincidence fail to be adequately drawn within experience. Also, grasping the meaning of others’ behaviors and a weakening of contextual influences are entailed by an erosion of Background sensibilities. I feel extremely sympathetic to this account and, as Rhodes and Gipps report, there are remarkable points of overlap between their and my own ideas about the formation of schizophrenic delusions. I would like to add some comments on the main theories on the basic disorders entailed in the pathogenesis of delusions and conclude with some suggestions to integrate the Background theory of delusions. [End Page 311] Syntagmatic Versus Paradigmatic Models of Delusions Let me raise first an epistemological point: paradigmatic models of delusions––defining what a delusion is in itself and what are its borders with similar phenomena––proved to be unsatisfactory in psychopathology. As Schneider and Huber (1975) put it more that 40 years ago, “[w]hat counts in delusions is not the delusion itself . . . but snagging the course of the lived experience, rather than its product” (p. 2042). What we do need, to understand what delusions really are, are syntagmatic models how––delusions (in this case, delusions in persons with schizophrenia) are connected to other phenomena within a structure or a process. What we should look for, then, are the phenomena that contribute as motivationally (or causally) necessary vulnerability, that is, the basic disturbance for the development of delusions. This logically implies that we need studying delusions in fieri, or the pathways that lead to delusions themselves. I subscribe to the principle that studying delusion by merely concentrating exclusively on its crystallized forms would be like studying stroke victims to know more about hypertension (Parnas and Sass 2001). This methodological move from crystallized delusions to delusions in-the-making is quintessential to define the subtle, basic, phenomenal invariant core that characterizes a given psychopathological phenomenon and that emerges across the manifold facets of the phenomenon itself and shapes them and keeps them meaningfully interconnected. A syntagmatic model should account for (at least) the following features of schizophrenic delusions: • abnormalities in symbolization (loss of commonsense meaning of a given thing or fact), • formal aspects (e.g., revelation character, experience of centrality), and • specificity of content (e.g., metaphysical tinge). It should also be compatible with those phenomena like self-disorders (loss of sense of ownership and of agency) that are entailed in most schizophrenic symptoms (e.g., verbal–acoustic hallucinations and experiences of alien control). Finally, it should keep meaningfully...