Tarun, doctors and therapists will project onto patients/clients, carrying professional stereotypes /archetypes into even a brief relationship. I have done the same only to have my prejudgements squashed. A doctor for example will discuss a patient, read notes alluding to the patient, not necessarily checking to find what is true and what isn´t, and thereby build up a mainly anecdotal portrait of whoever they are dealing with. The space between people is thereby filled with imaginings. Tarun, you see this as the patient as if their disturbance (isn't that itself a provocative term)doing things or somehow impressing their inner turmoil/known illness-but is it? Maybe, the patient feels the same regarding you.

Feelings are all but unhuman and cannot describe a patient in a few minutes...

Thank you for the answers so far, but I think there is some misunderstanding about the intent of the question. The question does not aim to stigmatize the experiences/psychopathology of patients; it does not even indicate that patients are being judged due to some feelings of clinician; it also does not imply that experiencing these feelings has some diagnostic validity; it also does not mean that the feelings should mean the same as inferred by Rumke. The question only implies that whether any such phenomenological experiences are felt by the clinicians and what they make out of it. It can be some form of Transference also, or some feelings that are triggered in a certain interpersonal context. Please look at the question from an empirical and an experiential point of view. If there is such a feeling, then it must be explored.

Thank you...

Tarun, I take your point but I will still pursue mine. I had a friend who was Schizophrenic (fitting the symptom based diagnosis of the DSM), a lovely woman who held down a reasonable job in sales. Except with regard to certain issues she was very ordinary with no lack of cognitive skills. I also knew a woman labelled psychotic who had set up a charity. Neither had nor were capable of producing the effects or affects you itemise.

Again, I suggest the root of the feelings are not in the patient but in the observer. I know you want more, but I'm afraid you have separated out 'mentally ill', that is they are different. Not only different, but even alien.

I have a client, no longer young, who was diagnosed as psychotic at fifteen because he liked poetry and wanted to be a writer. Would you have felt strange around him? Or would you have felt strange around the idiot that diagnosed him?

Boredom is a feeling that is felt when communicating with a NPD client.

Dear Tarun

Clearly you appreciate that definition is at least a semi challenging matter. Subjectively then i may only be useful as another member of the dutch race when it comes to "Praecox Gefuhl" - a sense of the place

Tentatively and informally i can relate a period when i was seeking phenomenological outlooks with PG in mind. The occasions were non clinically based, being research sessions performed ad hoc across some 11 years in spurts of opportunism. A diversity of persons being diagnosed with schizophrenia, aspergers syndrome. Others such as the so called jesus complex, angel dilemma's and UFO style matters also.

I concur in several area's with Stanley Wilkin, specifically where i may have gained somewhat of an impression during this, that more than one diagnosis for schizophrenia among them could have been questionable. However in the overall sense of the awareness research sought,- i was interested in Jaspers way of thinking concerning the nature of delusions.

I'd add it was fortunate to encounter such participants from outside of psychiatry, and they gave open accommodating responses. The cross referencing ( as it were) which i was looking into regarded aspects far more within an entirely separate perceptual awareness setting. The rationale to study motives for artificial divergences during malformed habits which may lead to convoluted states of awareness or delusional aberrations - in other words versions that are not clinical.

This is somewhere on the circumference of BD's, though those were not the precise quarry. I was looking for self induced emulative effects able to bring a complementary delusion as a sense field which begins to gain some elements of the clinical - i.e neurotypical misjudgement becomes assisted misjudgement where reality almost bi-polarises into pathological lying or worse - the subject is aware is everything but the fantasy behaviour is extremely detrimental.

Hopefully that shall be seen as a polite turn of phrases to describe the oblique sense in comparison sought.

The consciousness debate is infested with bias and even so, may i say the research was hoping to glimpse some of form of reasonable topographical placement in the ostensibly healthy conscious mind. It was expected that the source could be stimming and risk taking forms of escapism in some cases. Hence in view of either their diagnosis, or of yet to be clarified 'delusions', emphasis tended to exemplify a sentinel value on gaining a sense of pivotal motivational signal.

It goes without saying that i was offering no opinions while probing carefully without overarching respectable limits during these voluntary visits.

It will not help now to explore particular results. The aim so far has been to create a lucid outline sufficient enough to describe the settings by which these humble exchanges came about.

Considering your inquiries thus its research purpose & without the outright intention to discuss outward impressions it did happen to be so that :

Of 6 formally diagnosed schizophrenics i may have been inclined to feel only 1 was correctly diagnosed. 3 of them may have illustrated traits closer to aspergers syndrome. The remaining 2 could well have had nothing more than anger management & alcohol problems having got in states with the police and matters which had gone out of control.

Again the meaning of the endeavour was not to conclude this & doing so was a facilitation step.

I encountered a great many aspergers syndrome subjects and the results of that was deeply interesting. I will mention the contrast between they and the schizophrenia group appeared to be distinctive though errors are easy to make.

The Jesus and angel complex people appeared to have reasonably clear synthetic self inferences into the conscious mind. If so, appeared to be placing themselves on the path of inauthentic delusions for a variety of reasons whilst my impression was they were perfectly able to recognise themselves free of their accounts with regard to being sent by a god as Jesus or an Angel.

I found the UFO people too chaotic but there seemed to be something going on with the need to implant many things - alien tech in they mostly.

It matters not what i compiled data wise in all when wishing to speak of Rumke's Praecox Gefuhl. Likewise right now we'd not specially require Jasper for your inquiry. Still - with the small offering to come the link below on he can suffice a moment of reflection :

https://academic.oup.com/schizophreniabulletin/article/36/4/667/1915032.

Here :

''He also offers a triad of external indicators—falsity, conviction, and incorrigibility—but does not appear to consider these indicators as providing a definition of what delusion actually is''.

Hence a poignant focus on the orientation of the alleged delusion species.

As we can see it seems Jasper decided this probe does not lead to insight regarding true clinical based delusions as such. This stage for the more 'artificial dilemma'. Presumably this can mean episodes when a schizophrenic is truly deluded, though they may be deliberately misleading at a certain times rendering the ability to discern the actual position more difficult.

You have heard how this area is the target area i was mostly exploring.

A dichotomy might exist in that to detect artificial in some individuals is equally to find true delusional conviction in others. From this double standpoint the approach also serves the case concerning the far more profoundly entangled mind. In other words - one can gain confidence the deluded person isn't actually deluded, or that the state is serious or that serious cases of schizophrenia are being deceptive. Personally i tend to avoid a deliberate incision of tools with a view to 0ne or the other impression. I'd rather adopt a modified stance for those believe to be schizophrenic. Nonetheless in establishing whether the - subject - reasonably has the conviction to be as disarranged as they are showing Jasper is useful as i am sure you are aware.

"Praecox Gefuhl"

Phenomenologically speaking the immediate caveat is obvious as it would be to dissociate the terms entirely from let us say pure intuition. If there is to be any then it is surely a technical one. Far be it from me, but perhaps insight upon the concepts beginning on the pathway to a experiential technical sense? - an Alpha point for impetus ?.

The individual i encountered who seemed like a true schizophrenic was almost certainly a pathological liar. Secondly the subject was one of the most futile persons i have ever met. When the subject did begin to stream his consciousness in a genuine way it was unstoppable - none of this means the next example shall. However - i was informed over hours upon hours, in total perhaps 200 hours split over various sessions. The subject described with a great sense of pride & achievement how a 20 year reign of torment and sociopathic anti social behaviour had been manifested. (TS - The Subject) had inflicted this on numerous neighbours and the police had been informed countless times. Criminal damage, psychological abuse, trespass, stalking and much more - the mayhem and interference this person described was beyond belief.

The research objective is being served somewhat less on being shown forms of delusion which were not artificial. TS was able to show that the compulsion to traumatise & affect people was on the lines near indubitably clinical. It now sounds ruthless of i, - i found myself seeking a way to obtain something useful after so many research hours with this TS.

Later it emerged that in confluence with the abnormal behaviour TS was double binding by acting as a community spirit. TS was also involved in residents association activity, neighbourhood watch, police panels - and since TS occupied social housing, the housing providers own tenants association !. Once this was revealed TS took matters to new levels in illustrations of psychotic self gratification describing how the satisfaction rests within the observation of the confusion. For consider TS was under regular investigation and said was always cleared of wrong doing.

All being as claimed ? - if it all happened would seem a complex psychological abuse at the core using anti social behaviour the facilitation accessories - interesting in a way insomuch TS commitment so much energy over so long at such risk just to obtain these outcomes.

On returning to the same facility a few years later i was informed that TS had committed suicide not long after being institutionalised again as TS had embarked upon an identical campaign at a new address and had been arrested within months committing similar activity. The thrill had gone ? - self humiliation had entered the cycle ?

I considered the surprising double element for quite sometime. I could only come to the conclusion that TS really did have a micro model going among the local establishment and the targets themselves up until the apparent collapse of the festivities. For a very long time before that TS had controlled and manipulated a large amount of resident & professional people in circumstances they could not win. The schizophrenic powered trickery, daring, lack of concern for own well being, the customary non empathy problem, lack of fear in face of investigation - manifold risk and so on. All of it was beyond the entire group understanding therefore was so far into bizarre bands that TS got away with it until he underestimated the way a separate community could respond differently from a fresh start up.

My digressions an equally huge span maybe, therefore exploration further into the assumed 'schizotype' is already too much.

If nothing else and for lack of formal definition - "Praecox Gefuhl" it could be true to say is obtaining a degree of precision concerning what a subjects delusions are ( or are not ) - nevertheless.

I feel one cultivates and evolves their methods and approaches with a quite intense focus . From there a second nature element might be possible - as he says :

''Jaspers contrasted what he called “delusions proper” or “true delusions,” which are primary and rather specific to schizophrenia, with “secondary delusion” or “delusion-like ideas,” which can be found both in schizophrenia and other disorders''.

Once that is reasonbly well understood then perhaps whatever "Praecox Gefuhl" is according to Rumke, it could then occur quite naturally ?.

Regards

This answer reflects my experiences in 15 years of actual nearly full-time clinical practice. I believe these are the sorts of answer you were pursuing?

1) There are times that walking into the hospital room of a patient who is severely depressed feels as if there is a palpable gust of "sad" that "comes off" the patient (this is not literal of course). I have described this experience over the years to students and trainees as similar to the actual gust of heat one feels when opening the door of an oven that has been at 400 F for a while.

2) I think we can all universally agree there are some persons with Autism you meet and it's completely clear immediately - by this I mean the sort of classic, profound Autism characterized by a person being non-verbal, lacking joint attention, and engaging in repetitive, self-stimulatory behaviors. When people say they "just know" someone has Autism without doing a complete diagnostic short of those sorts of presentations, frankly I get concerned.

3) As for ADHD, many times you will see behaviors from a child that could have you immediately conclude that the child must have it, until you take a history that includes significant trauma. So that immediate feeling is not trustworthy at all, and because it can be strong, has to be actively fought against.

I'm sure there are other similar phenomena if you were to ask people who do a lot of clinical work. I believe that all of this is what is intended to be captured under the concept of transference. But that does not mean it isn't possibly worthy of more careful description and understanding than lumping into one big pot.

The discussion became more interesting it seems in many ways. The use of constant categorising though as a means for the therapist or doctor to establish reality is disturbing. Each category appears to describe a different species, not another human being andseems to serve other purposes. Distancing patient/client from therapist, creating an aid to character? What if this was done in the reverse fashion where a client denotes instead?

Reading some of these I was reminded that psychiatrists in particular appear to believe they have no impact on the situation in which the rituals (because that is what they actually are) are performed and the subject/object paradigm is preserved. My impression was that psychiatrists feel they have no responsibility regarding the patient, as here they were simply determining a state. The normal operation of cause and effect is suspended.