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Schizophrenia: a disease of brain, consciousness, or spirit? (Dialogue between a psychiatrist and a philosopher)

The paper is a dialogue between the psychiatrist and the philosopher on schizophrenia and the problems of consciousness, personality, “norms” and “deviations” in human psychic life. Considering some classical and contemporary approaches to schizophrenia, the paper offers a new gaze at this phenomenon of human cultural history. Parallels are drawn between schizophrenia and mythology as well as poetic and artistic creativity. In order to illustrate their statements, the authors give many examples from different mythologies such as Papua New Guinea and Altai also known for its old shamanistic rituals. V.P. Samokhvalov considers delirium as typologically close to myth; A.Y. Nedel points out that despite certain similarities, the shaman and the schizophrenic radically differ one from another: the latter is unable to control his or her conscious acts, unlike the shaman who holds sway over his “intentional madness” at every level. The paper also puts forward a new hypothesis about the etiology of schizophrenia and its psycho-cultural role: schizophrenia, characterized by dopamine abnormalities, is a kind of censorship imposed on the subject who always strives to maximize pleasure, including the sexual one; schizophrenia is an “anti-orgasm”. Therefore it can be compared with taboo existing in any human society. The hypothesis may be useful in future studies on schizophrenia and its etiology. Also, the article discusses political issues as the politization of psychiatry in Nazi Germany, the US and former Soviet Union where schizophrenic diagnoses were often used to confront “socially unfit members of society”.