The concepts: Disturbed state of consciousness and psychosis.

The paper offers a theoretical analysis of the concepts 'disturbed state of consciousness' (DSC) and 'psychosis,' aiming to define them in ways consistent with Continental clinical psychiatric practice. For DSC, two points are emphasized: that classifying a state as pathological involves evaluating the client's ability to change it voluntarily, and that stating a DSC was present during a time interval implies all experiences during that interval were abnormal, in the broad sense including William James' 'fringe' and 'embeddedness.' For psychosis, reality testing remains central, provided a clear distinction is made between theoretical full-blown syndromes and concrete syndromes with fewer symptoms.

Study at a glance

Abstract

A theoretical analysis is made of the two concepts: "disturbed state of consciousness" (DSC) and "psychosis", and these concepts are defined in ways which are consistent with actual clinical psychiatric work on the Continent. Concerning DSC's two points are emphasized: Whether we, as psychiatrists, are conscious of it or not--one of our premisses for classifying a state as a pathological DSC is an evaluation of the client's ability to change the state voluntarily. Furthermore, stating that a DSC was present in the time interval tl0tn implies stating that all experiences were abnormal in some way during the interval--when the word "experience" is taken in the broad sense, including William James' "fringe" and "embeddedness" in the stream of consciousness. Reality testing may remain the cardinal point in the definition of "psychosis"--if we make the distinction between theoretical, "fullblown", syndromes and concrete syndromes with fewer symptoms clear to ourselves.