STANGHELLINI / PSYCHOPATHOLOGY OF COMMON SENSE ■ 201
Psychopathology of
Common Sense
ABSTRACT: It is well established by psychopathological
research that disorders of self-experience are among
the main features of schizophrenic prodromes in a
pathogenetic sense. Disorders of the phenomenal self,
as “lack of ipseity” (the vanishing of the feeling of
being embedded in oneself and of distinctiveness be-
tween the self and the outer world) and “hyper-reflex-
ivity” (the monitoring of one’s own life entailing the
tendency to objectify parts of one’s own self in an
outer space) are considered key phenomena of schizo-
phrenic vulnerability. In this paper, I argue that the
analyses of the disorders of phenomenal self catch
only some dimensions of schizophrenic vulnerability,
since they mainly focus on the pathological changes in
subjective experience of an isolated self and disregard
the fact that the self is not purely personal. Because
our existence is fundamentally tied to a social exist-
ence, the feeling of one’s own self and the sense of
“reality” of an experience are products of intersubjec-
tivity and not only a private process based on intro-
spection or reflexivity in which one is engaged in an
idiosyncratic way. Building on, and extending, contri-
butions of the phenomenological tradition, I attempt
to demonstrate that intuitive attunement is the basic
prerequisite for establishing one’s sense of “reality”
(feeling familiarly related to one’s environment) and
for establishing one’s sense of “ipseity” (the sense of
existing as a subject of awareness). In the last part of
the paper, I show the importance of the concepts
“lack of attunement” and “antagonomia” (the rejec-
tion of conventional knowledge and intuitive attune-
ment, experienced as dangerous sources of loss of
individuality) to establish a comprehensive theory of
schizophrenic vulnerability. I finally discuss the impli-
cations of this view for empirical research and clinical
management of schizophrenic vulnerability.
© 2002 by The Johns Hopkins University Press
Giovanni Stanghellini
KEYWORDS: antagonomia, attitude, attunement, com-
mon sense, intuition, schizophrenia, self, social knowl-
edge, vulnerability
Tandis que les autres sens nous mettent en rapport
avec des choses, le bon sens préside à nos rélations
avec des personnes.
—Henry Bergson
Introduction
A
N ESTABLISHED THEORY in the phenomeno-
logical tradition is that the key vulnera-
bility factor predisposing to schizophrenic
breakdown is what is generally called a “crisis of
common sense,” that is, a loss of the meaning
and significance that we usually attach without
conscious reflection to everyday objects and situ-
ations and to relationships with other persons. It
is usually assumed that the primary characteris-
tic of common sense is in subject-object attune-
ment. In this paper, I argue that the crisis of
common sense is in fact a consequence of a more
fundamental disturbance of intersubjectivity, i.e.,
that the primary disturbance is not in the attune-
ment between subject and object, but in the at-
tunement between subject and subject (or self-
other attunement).
I have elsewhere (Stanghellini 2000a) devel-
oped a model of vulnerability to schizophrenic
202 ■ PPP / VOL. 8, NO. 2–3 / JUNE–SEPTEMBER 2001
breakdown based on three key elements: sensory,
typification, and attitudinal disorders. Of these,
it is mainly the attitudinal element (see also Stang-
hellini 2000b), which is essential to the subject-
subject attunement, and it is on this that I con-
centrate in this paper. The attitudinal level of
schizophrenic vulnerability is analyzed as a skep-
tical attitude towards common sense and a height-
ened tolerance of ambiguity. The characteristics of
these phenomena are described in two detailed
clinical reports and exemplified in a number of
case vignettes. The implications of this argument
for theoretical and empirical research in psycho-
pathology and for management are discussed.
It is a matter of debate whether abnormalities
in interpersonal and social competence in pre-
schizophrenic people are simply correlates or con-
sequences of mild psychotic symptoms or, rather,
risk factors in a pathogenetical sense. DSM-IV
quite vaguely states that schizophrenia “involves”
dysfunctions in interpersonal relations (APA
1994, Criterion B). To involve means to include
as a part of a whole, with no pathogenetical
implication, and to imply or entail in a causal
sense. In the former sense, social dysfunctions
are seen as just co-occurring with other schizo-
phrenic symptoms such as psychotic symptoms;
in the latter, social dysfunctions are interpreted
as consequences of the schizophrenic syndrome,
although not as direct results of any other single
feature.
Several studies have suggested that lack of
social competence may be an early sign of schizo-
phrenic vulnerability (Parnas et al. 1982; Parnas
and Jorgensen 1989; Resch 1992; Dworkin et al.
1993; Dworkin et al. 1994; Hodges et al. 1999),
even in the absence of other symptoms. Some
authors (Broks 1997; Malmberg et al. 1998)
hypothesize that schizophrenia can be construed
essentially as a disorder of social cognition (Penn
et al. 1997), i.e., a disorder of the accurate per-
ception of the dispositions and intentions of oth-
er individuals (Brothers 1992), and that the rela-
tionship between interpersonal difficulties and
schizophrenia may be causal, since interpersonal
difficulties may be the only predictors of future
psychotic breakdowns (Malmberg et al. 1998).
Accordingly, it can be argued that the direction
of causality seems to go from interpersonal diffi-
culties to the schizophrenic syndrome as a whole.
Others (Bleuler 1922; Kretschmer 1922;
Minkowski 1927; Blankenburg 1971; Kraus
1977; Parnas and Bovet 1991; Cutting 1997)
consider impairments in the area of interperson-
al competence not just as an outcome of psychot-
ic syndromes, but also as a fundamental phe-
nomenon of psychotic (schizophrenic and
manic-depressive) vulnerability. Critics of DSM-
IV’s pseudo-atheoretical and syndromatological
approach to the diagnosis of schizophrenia main-
tain that, although we lack established criteria to
define the core features of schizophrenia, none-
theless, we feel, or intuit, the existence of a basic
relational deficit characterizing schizophrenic
patients (Maj 1998). However, we are at odds
when we try to define this “deficit” reliably. Despite
the clinical and theoretical importance attribut-
ed to the interpersonal deficit in schizophrenia,
we still know very little about its components
and about what contributes to establishing it.
Here we are confronted with a puzzling di-
lemma: Should we fully depend on our pre-con-
ceptual apprehension or should we attempt to
pin down our impressions and make abstract but
verifiable criteria from them? If we do not want
to renounce using non-operationalized but far-
reaching concepts focusing on the psychotic’s
attitude towards his social environment—such
as the schizoid/syntonic distinction (Bleuler 1922;
Minkowski 1927) or the schizoid/cycloid con-
ceptual couple (Kretschmer 1922)—through
which classic psychopathology catches the core
of schizophrenic and manic-depressive vulnera-
bilities, we should aim at making them compati-
ble with conceptual and empirical testing.
Disorders of the Phenomenal
Self in Early Schizophrenia
The recognition of the subjective experiences
provides the basis for psychopathological research
on psychoses (Lieberman 1983). Phenomenal dis-
orders of the self are, since Jaspers (1997), the
primary concern of phenomenological psycho-
pathology, which is primarily a study of abnor-
mal conscious phenomena.
 STANGHELLINI / PSYCHOPATHOLOGY OF COMMON SENSE
In everyday experience, we use the word “self”
to define the singularity we each feel ourselves to
be, the site from which we perceive the world
and from which we act (Harré 1998). We all
have a sense of our own self. We often view our
self as an enduring structure in which our basic
characteristics (ideas, affects, mental processes,
etc.) are stored or at least as a rather stable
representation of our own personal identity
(Strawson 1999). The phenomenal self is the self
immediately given in subjective experience. My
phenomenal self is my present experience of my
own body and of the mental events occurring in
this moment (i.e., thoughts, emotions, feelings),
including perceptions of the outer world, memo-
ries of the past, and my projections into the future.
It was well established by qualitative (Jan-
zarik 1959; Conrad 1966) and quantitative
(Chapman 1966; Huber 1966) research that dis-
orders of self-experience are among the main
features of schizophrenic prodromes in a patho-
genetical sense. Researchers have emphasized the
relevance of auto-, somato-, and allo-psychic de-
personalization phenomena—i.e., strange changes
in self-awareness in which the person feels as if
he and/or the external environment is unreal—
for the pathogenesis of full-blown psychotic symp-
toms (Klosterkoetter 1988). Recently, Parnas et
al. (1998) have reconceptualized pre-schizophren-
ic self-disorders within a phenomenological
framework and classified them in the following
two main categories:
Transformations of Ipseity. Ipseity (Henry
2000) is the pre-reflective modality of self-aware-
ness. It is the feeling of swimming like a fish and
being present in water, of which I become aware
only when it is lacking. This sense is pre-reflec-
tive—it is there as an implicit mental phenome-
non. It guarantees that I sense myself as the
center of my own experiences and that I feel my
self as distinct from the object I am perceiving
and assures that my representation of that object
is experienced as distinct from the object itself.
When ipseity is lacking, complaints of deperson-
alization and derealization arise whose cardinal
component is a very characteristic, self-perceived
“lack of presence.” For instance, it is no longer
me the one who is perceiving that object—I am it.
■ 203
Hyper-Reflexivity. Reflexivity is the process
through which I take a part of myself, especially
of my mental life, as an object of awareness.
Schizophrenics, as Sass (1992) has demonstrat-
ed, tend to become hyper-reflexive, that is, to be
increasingly engaged in monitoring their own life
(especially mental life). This accompanies a lack
of fluidity in actions such as so-called loss of
automatic actions. Mental phenomena that would
usually be sensed as part of the self are objecti-
fied, spatialized, that is, felt as existing in an
“outer” space. They become objects of focal
awareness. For instance, thoughts are felt in some
special part of the brain.
In short, in schizophrenic prodromes, lack of
ipseity entails the lack of the feeling of distinc-
tiveness between the self and the outer world—a
sensation of fuzziness and feebleness of my being
present. Hyper-reflexivity entails spatialization
of one’s own bodily and mental phenomena—
parts of my own self become like things in an
outer space.
Disorders of the Social Self
The analyses of the disorders of phenomenal
self catch only some (although fundamental) di-
mensions of schizophrenic vulnerability. Disor-
ders of self-awareness mainly consider the per-
son as an isolated self and may disregard the fact
that the self is not purely personal. Our existence
is fundamentally tied to a social existence—the
phenomenon of intersubjectivity. My sense of
presence derives from the way I constitute myself
and the world in social situations. The sense of
“reality” of an experience and the definition of
one’s own self are products of intersubjectivity
(Berger and Luckmann 1966).
The breakdown of one’s own self in schizo-
phrenic prodromes is not only a matter of self-
perception but also of self-typification. I appre-
hend myself by means of typificatory schemes.
Self-typification is the process through which I
constitute my own sense of my self. This is not
only a process based on introspection or reflexiv-
ity, a private process in which I engage in an
idiosyncratic way. In constituting my own self
(and my own world) I also adopt stereotyped
204 ■ PPP / VOL. 8, NO. 2–3 / JUNE–SEPTEMBER 2001
roles (Mead 1934), which are relatively consen-
sual and normative identities. The person’s con-
nectedness to commonsensical meanings and ste-
reotyped roles is an essential component of the
constitution of one’s own self- and worldview.
Social psychologists have underscored that
people have two basic needs: the need to be
similar to others and the need to be unique.
Similarity assures the validation of one’s own
identity, whereas uniqueness enhances individu-
ation. People usually meet these demands for
consensus and individuality by developing a self
that is based on socially shared categories and
based on personal constructs (optimal distinc-
tiveness theory: Brewer 1991; Brewer and Pick-
ett 1999). Indeed, the vulnerabilities to major
psychoses can also be characterized as impair-
ments of the dialectical movement between in-
clusion-assimilation, on the one hand, and differ-
entiation-distinctiveness, on the other.
When this balance between inclusiveness and
separateness breaks down, and the polarization
into one of these components takes place, we
enter the field of psychopathology (Kretschmer
1922; Minkowski 1927; Stevens and Price 1996;
Blankenburg 1969; Cutting 1997). The forerun-
ner of this social-psychopathological approach is
Blankenburg’s analysis of the core disorder in
hebephrenic schizophrenia. Blankenburg (1969,
1971)—looking for the core of subjective phe-
nomena taking place in the intersubjective space—
pointed out that the fundamental character of
relational deficit phenomena occurring in schizo-
phrenics is the loss of natural evidence of com-
monsensical everyday reality. Schizophrenics, and
especially hebephrenics, can no longer typify their
experiences along commonsense categories. For
them, the rootedness and at-homeness that ac-
companies us in our everyday life are absent.
Persons vulnerable to schizophrenia seem to be
affected by an accentuated inclination to bracket
common sense. They seem to lack and to ignore,
or sometimes to refuse, commonsense categories
with which to typify their everyday experiences,
so that they sometimes are puzzled by ordinary
situations and are unable to think or act accord-
ing to what is commonly expected. Manic-de-
pressives, on the other hand, seem unable to
disentangle themselves from hyper-identification
with commonsensical social roles and norms; es-
pecially outside of clinical episodes, melancholic
patients look hyper-normal and over-adapted (Tel-
lenbach 1983; Kraus 1977, 1982), and manics,
too, seem to embody a caricature of autonomy
deeply rooted in their dependence on common
sense. In short, schizophrenics are hypo-connect-
ed to common sense, whereas manic-depressives
are hyper-connected to it (Stanghellini 1997).
My thesis is that the common-sense issue is
crucial for understanding psychotic (schizophrenic
and manic-depressive) worlds, since the break-
down of the social self, that is, the crisis of the
optimal relatedness to common sense, is one of
the main roots of the schizophrenics’ vulnerable
condition and, consequently, the origin of the
development of full-blown psychotic symptoma-
tology; over-identification with common sense is
the core of manic-depressive alienation. I pro-
pose that the concept of crisis of common sense
is a very sensible index of schizophrenic vulnera-
bility and an effective hermeneutic tool to ac-
count for the psychotic’s prodromal changes in
self- and worldviews and pre-morbid changes in
attitude towards self and world (e.g., nonconfor-
mity or normopathy). Persisting signs of with-
drawal (e.g., negative symptoms, reduced social
competence, and adjustment) and productive
symptomatology (delusions and hallucinations)
can be interpreted as consequences of disordered
emotional and cognitive attunement to the world.
What is Common Sense? Philosophical
and Psychological Cues to a
Definition of “Common Sense”
“Common sense” is not an easy concept to
define. The eighteenth-century Italian philoso-
pher G. B. Vico (1744) gave the following, sweep-
ing definition of common sense: “It is a judg-
ment without any reflection, commonly felt by a
whole order, a whole people, a whole nation or
the whole human kind.” Scottish philosopher
and Vico’s contemporary T. Reid (1764) postu-
lated that the human mind could harmonize with
common sense because of an innate “instinct”;
for Reid, common sense is a set of shared beliefs
representing the rock of knowledge and truth.
 STANGHELLINI / PSYCHOPATHOLOGY OF COMMON SENSE
The construct of common sense is a coin with
two faces. On the one face, common sense is
conceptualized as a stock of knowledge-at-hand
useful at the level of everyday life. It is represent-
ed as a set of “commonplaces,” a network of
beliefs—a background of knowledge shared by
the members of a given culture or society, a body
of rules that discipline behaviors in ordinary life
situations. On the other face of the coin, com-
mon sense is represented as a “sense” useful for
attuning with what is “common”; a “sense,” i.e.,
a psychic function aimed at understanding cur-
rent social situations. If we were to devise a
common sense test, should we try to measure the
integrity of a network of socially shared beliefs?
or the compliance to adopt the statements (the
knots of the network) as true? or should we
rather attempt to assess the individual capacity
to pre-conceptually attune with a given social
situation?
I will present and discuss separately the two
constructs: common sense as social knowledge
and common sense as attunement.
Common Sense as Social Knowledge
If we look at the first face of the coin, we
conceptualize common sense as social knowl-
edge, a sort of database of constructs to typify
reality, which is less explicit and less defined than
scientific knowledge. In this view, common sense
is also seen as a set of rules of inference shared by
a social group, through which its members con-
ceptualize objects, situations, and other persons’
behaviors. It is the foundation of people’s expec-
tations and of meaning attributions (Moscovici
and Hewstone 1983). As far as social situations
are concerned, their conceptualization is a pro-
cess of attribution of motivational explanations
to the others’ behaviors. This process works al-
most automatically, since motivations are attrib-
uted pre-reflectively, i.e., without much active
thinking and before a conscious and deliberate
search for explanation.
In this perspective, common sense is a kind of
knowledge whose purpose is not theoretical
(knowing about something), but practical (doing
something) (Aristotle, Metaphysics VI, 1). Com-
mon sense is the medium for organizing the ev-
■ 205
eryday experiences of individuals and social
groups (Flick 1998), which has its roots in evolu-
tion, and its purpose is an adaptive one, since it
provides an image of reality built up for the
pragmatic aim of survival and adaptation (Hor-
ton 1982). This adaptationist interpretation of
common sense was originally held by Locke
(1688), who emphasized that common sense con-
sists of a set of empirical cause-effect relation-
ships useful for practical orientation in everyday
actions. Following Locke, many modern psy-
chologists argue that the fundamental feature of
human thinking is its need to understand the
causes of behavior and everyday events (so-called
“attribution theory”: Heider 1958). Evolution-
ary psychologists highlight that “our literal sur-
vival depends upon a finely tuned knowledge of
the causal texture of the world” (Plotkin 1997).
Not only the adjustment to, and survival of,
each individual in his natural environment, but
also the identity and integrity of a whole society
or culture, depend on the possession of this “pri-
mary theory” of the world called common sense.
Common sense is all that the members of a given
society are disposed to take as obvious. How
does this consistency in their primary theory about
the world originate among different members of
a given group? Our knowledge of the world we
live in derives only in part from our personal,
first-hand experience; to a much greater extent it
is socially derived. The bulk of constructs used to
typify others’ behaviors, courses of actions, and
one’s own attitudes is taken for granted as a set
of institutionalized rules. We do not build our
common sense out of an individual inquiry into
the world—we inherit it, learning it as children
faithfully accepting the teachings of adults. We
get acquainted with this “inherited background”
at a stage of our psychological growth that is
antecedent to doubts and uncertainties. In short,
we are imprinted with it.
The commonsense world enjoys relative sta-
bility and consistency among individuals belong-
ing to the same group, since in it, abnormalities
undergo assimilation. The remarkable stability
of common sense is due to the tendency to assim-
ilate the unusual to the usual. Abnormal (i.e.,
non-standard, non-typical, un-expected) instances
206 ■ PPP / VOL. 8, NO. 2–3 / JUNE–SEPTEMBER 2001
are as a rule assimilated to “circles of similar” or
“normal kinds.” As a rule, experiences that fit
commonsense categorizations are felt as more
real than those that are idiosyncratic. If an expe-
rience does not fit commonsense schemata, it is
not the schemata that are put in jeopardy, but,
vice-versa, it is the new character of the experi-
ence that is ruled out and normalized. Wittgen-
stein (1969) argues that one’s sense of evidence
and certainty about individual experiences does
not derive from individual judgment, but from a
tacit acceptance of the picture of the world inher-
ited from the community to which one belongs.
Two main categories of events are dealt with
by common sense—the physical and the psycho-
logical. Common sense represents a guideline for
orientation in the realms of physical objects and
events and of psychological states and situations.
Hume (1955) held that the human mind’s main
purpose is detecting cause-effects relationships,
and modern psychologists more or less confirmed
his theory about the mind’s urge to establish
causal relations (Sperber et al. 1995). Every man
is a natural physicist and a natural psychologist
(Plotkin 1997). Guided by common sense, we
spontaneously look for cause-effect relationships.
Whereas physical causation deals with the rela-
tionships between material objects (e.g., “If I
touch fire, then my hand will burn or be dam-
aged”), the detection of psychological motiva-
tion is concerned with the understanding of the
others’ mental states (thoughts, feelings, inten-
tions, etc.) through the perception of the others’
behaviors (actions, facial expressions, etc.), e.g.,
“If she smiles, she is happy.” Following a cogni-
tive approach, Baron-Cohen (1995) called “mind-
reading” this property of inferring mental states
behind somebody’s behaviors, “mind- blindness”
being its pathological counterpart, evident in au-
tistic conditions.
Common Sense as Attunement
If we now look at the other side of the coin,
common sense is represented as a kind of intui-
tive knowledge. Phenomenological definitions of
common sense, both in philosophical (Merleau-
Ponty 1945; Husserl 1970) and in psychopatho-
logical literature (Minkowski 1926, 1927; Blan-
kenburg 1969, 1971; Parnas and Bovet 1991;
Bovet and Parnas 1993) emphasize that common
sense is a kind of pre-conceptual attunement
between the subject and the outer world which is
rooted in corporeality and affective/emotional
life. Lack of common sense manifests itself in a
lack of the sense for the “rules of the game” of
human behavior (Parnas and Bovet 1991) and in
the crisis of the “sense of reality” of everyday
experience (Blankenburg 1971).
There are several points of overlap between
the phenomenological conception of common
sense and the cognitive approach described in
the previous sub-section. Both highlight the in-
tersubjective character of common sense (Bell
1990; Smith 1995), its implications for mutual
understanding (Schutz 1962; Searle 1995) and
social adaptation, and its social origin (Schutz
1962, 1970). However, many phenomenologists
would not agree that the main goal of common
sense is detecting physical causation and psycho-
logical motivation. The cognitivist tradition thinks
that meanings are inferred from and projected
onto brute facts of the world, but this is disputed
by phenomenology. This is a very important point,
since to understand the difference between the
cognitive approach and the phenomenological,
one has to realize that for phenomenology, the
constitution of the meaning of an object is not a
derived thought (i.e., the product of an I’s think-
ing act). A good definition of phenomenology is
that this is the discipline analyzing how self and
world constitute each other as complementary
polarities. Understanding one’s social partners,
according to phenomenologists, does not depend
on a cognitive ability to detect expressions and
on a capacity to infer intentions and motivations
behind behavioral signs. The understanding of
the others is not an inference of mental states,
but a pre-cognitive, intuitive experience (Husserl
1977), a direct perception of the others’ emo-
tional life (Scheler 1973).
Another important point of disagreement be-
tween the cognitive and the phenomenological
approaches is the hypostatization of common sense
brought about by cognitive sciences. In a phe-
nomenological approach, the “attunement hy-
pothesis” of common sense is preferred to the
 STANGHELLINI / PSYCHOPATHOLOGY OF COMMON SENSE
“social knowledge hypothesis,” because common
sense is not like an encyclopedia of socially shared
behavioral rules existing somewhere in the world,
but mainly a process placed in face-to-face en-
counters.
However, the concept of “attunement” is rather
vague and deserves further explications. What
sort of process is referred to by “attunement,”
and what is (or is not) a person attuned with?
The following definition can improve our un-
derstanding of “common sense”: Common sense
is what one thinks that the others think. This is a
good phenomenological definition of “common
sense,” but it needs explanations. I propose this
definition for three main reasons. It is primarily
centered on the noetic process of attunement,
more than on its noematic content: how one gets
to realize the way to behave in a certain situation
and how one’s sense of reality is established,
more than what these rules of the game are and
what this sense of reality consists in. It focuses
on the interaction between one individual and
his social partners: a face-to-face interaction in
which a transfer between two individuals hap-
pens. It provides one possible description of the
frame in which one’s knowledge about the rules
of the game of human behavior and one’s sense
of reality are established: They do not derive
from individual judgment, but from a kind of
tacit understanding of (and agreement with) one’s
partners.
The common-sense-as-attunement paradigm
assumes that the affective-conative capacity to
get involved in and directly perceive the other’s
mental life is the basic prerequisite for the famil-
iarity feeling with the environment, at home, and
in everyday social situations. The sense of reality
of an experience is a product of intersubjectivity.
The “reality” of everyday life is shared with
others: Something presents itself to me as “real”
when I know that my experience corresponds to
(although is not identical with) the experience of
others. The definition of my own self is also a
product of intersubjectivity. The reflection about
myself that produces my own sense of my self is
occasioned in the face-to-face situation by the
attitude toward me that the other exhibits. It is
typically a “mirror response” (Berger and Luck-
■ 207
mann 1966). The way I apprehend the other
contributes to the way I apprehend myself. In
this circular process, two components are in-
volved. On the one hand, I apprehend myself
and the other through typificatory schemes, but
on the other hand, since the face-to-face situa-
tion is extremely flexible and in it the other is
available “through a maximum of symptoms”
(Berger and Luckmann 1966), it is very difficult
to impose rigid patterns of typification onto the
other and onto myself. In the face-to-face situa-
tion, the apprehension of the other and of myself
may become less and less “typical” and anony-
mous and increasingly personal and original.
Thus I feel attuned with the phenomenal world
when I experience it as a communal (“real”)
world; and the phenomenal world appears as
such when I feel attuned with the others, that is,
when I experience the others, like myself, as
living organisms related to the world and to the
others as I am related to them.
It is beyond the scope of this paper to deal
with the nature of the self-other relation. One
interpretation of it is the one that acknowledges
the crucial role of the lived body in the founda-
tion of intersubjectivity (Merleau-Ponty 1964;
Dillon 1997). Intersubjectivity is based on my
identification with my partner’s body that I per-
ceive over there. I perceive his body as like my
own. I recognize the other as an “alter ego”
through an immediate perceptual linkage with
his body. This is a primordial phenomenon called
“syncretic sociability,” antecedent to the self-
other distinction. Intersubjectivity is based on
this transfer of corporeal schema (Merleau-Ponty
1964). A better word to account for the phenom-
enon of intersubjectivity would then be “inter-
corporeality,” since “at the most basic level, human
communion is a communion of flesh and not a
relation between isolated subjects” (Dillon 1997).
Levels of Vulnerability
My views, in summary, concerning schizo-
phrenic vulnerability are that it involves disor-
ders of common sense, and I distinguish three
levels of vulnerability to schizophrenia (Stang-
hellini 2000a): 1) sensory, 2) typification, and 3)
attitudinal phenomena:
208 ■ PPP / VOL. 8, NO. 2–3 / JUNE–SEPTEMBER 2001
1. Sensory level (perception of self, body and world)
2. Typification level (attribution of meaning and in-
tention):
2.1. damaged social knowledge network
2.1.1. atrophy of social knowledge network
2.1.2. hypertrophy of social knowledge network
2.2. disorders of attunement
3. Attitudinal level (structure of value and belief)—
distrust towards conventional knowledge and at-
tunement:
3.1. skepticism
3.2. hyper-tolerance of ambiguity
In this section, I will present a synthesis of this
proposal, and in the next, focus on the attitude
of schizophrenic persons toward commonsense
knowledge and attunement.
Sensory-level disorders (level 1) are not com-
monsense disorders in a strict sense, but they
should be mentioned, because they are intercon-
nected with commonsense disorders. Sensory-
level disorders are aberrations in self-, body-,
and world perception. It is well established in
current literature that these disorders of subjec-
tive experience include sensations of loss of con-
trol, loss of automatism, over-stimulation; com-
plaints of impaired world perception, of impaired
expressive and receptive language, of impaired
thought, memory, and motricity; and anhedonia
and anxiety (Suellwold and Huber 1986). These
disorders of basic cognition are involved in the
pathogenesis of schizophrenic psychoses and are
related to disorders of social cognition, since
they interfere with the perception of external and
especially social reality. In the bottom-up patho-
genetical hypothesis, sensory-level disorders are
considered primary or basic phenomena—the
primum movens or trouble générateur and also
the conditio sine qua non of schizophrenia.
Typification disorders (level 2) are related to
disturbances of the social knowledge network or
to a lack of attunement. Social knowledge net-
work disorders (level 2.1) are assessed either as
atrophies of the social knowledge database (Cut-
ting and Murphy 1988, 1990) or as a kind of
hypertrophy due to a hyper-extended network of
semantic associations between the concepts stored
in the database itself (Spitzer 1992; Spitzer et al.
1993; Schwartz et al. 1997). Both disorders lead
to deficits in interpersonal competence. For Cut-
ting and Murphy, deficient real-world knowl-
edge is something different from thinking distur-
bances, perceptual disorders, conversational dis-
course, and formal thought disorders. They argue
that incompetent social judgment is an intrinsic
feature of schizophrenia (and especially of the
subgroup, hebephrenic schizophrenia) and not a
consequence of environmental factors or actual
illness. The phenomenon described by Schwartz
et al. shows that dis-entanglement from common
sense can occur not only through a defective
state (atrophy of social knowledge network) but
vice-versa via a plus condition. When all possible
meanings linked to a given situation emerge,
context-relevant meanings (Schutz 1970) are no
more selected from the set of all possible mean-
ings. Because of a failure of the processes of
unburdening (Gehlen 1978) from the flooding of
perceptive stimuli, it is no longer possible to
select those meanings that are relevant to attune
to that given situation.
Empirical studies assessing disorders of attun-
ement (level 2.2) in the phenomenological sense
are currently not available. The capacity to un-
derstand what is going on in another’s mind or in
a given social situation is currently assessed in
the form of the ability to infer the utterer’s inten-
tions behind indirect speech, or to detect a char-
acter’s beliefs in short stories, or to attribute
mental states in non-verbal scenarios (Cocoran
et al. 1995; Frith and Cocoran 1996; Sarfati et
al. 1997a,b). This approach is reliant on a cogni-
tive approach to interpersonal disorders—i.e.,
the theory-of-mind deficit (Frith and Frith 1988;
Frith 1992). It is argued that schizophrenic sub-
jects who have difficulties in extracting inten-
tions may rely on two competing strategies of
decoding: They may choose the prevailing mean-
ing of an ambiguous stimulus (e.g., a word) inde-
pendently of the context, thus relying on their
background knowledge (Chapman et al. 1964;
Swiney 1984), or show facilitation for word rec-
ognition by semantic categorization (Koh and
Peterson 1978; Traupman 1980). In general, what
they seem to lack is a strategy to notice and
extrapolate context-relevant elements and make
use of other systems to establish relevant connec-
tions, inferences, and interpretations.
 STANGHELLINI / PSYCHOPATHOLOGY OF COMMON SENSE
Attitudinal disorders (level 3) are character-
ized by distrust towards common sense, i.e., con-
ventional knowledge and attunement. They in-
clude a skeptical attitude towards common sense,
a hyper-tolerance of ambiguity, and bracketing
of the unburdening process, reflecting the refusal
to conceptualize the world through the simplify-
ing views given by commonsense typificatory
schemes and the refusal to restrict one’s appre-
hension of the world to its empirical, pragmatic,
and at-hand meanings.
Fighting against Heteronomia:
The schizophrenics’ Attitude
toward Commonsense Knowledge
and Attunement
Another oft-neglected aspect of the schizo-
phrenic condition is the world of values of the
schizophrenic person—the personal reasons for
his or her behaviors. Psychopathologists mainly
emphasize sensory and typification disorders and
overlook the schizophrenic’s reasons for actively
and voluntarily bracketing commonsense world-
views. The concept of “attitude” refers to the
individual’s philosophy of life, i.e., the structure
of values and beliefs that orients her attitudes
and actions. Persons vulnerable to schizophrenia
may show an attitude of distrust towards con-
ventional knowledge and attunement.
Ariel and the Sailors
V.V. is a twenty-three-year-old university stu-
dent of the classics. She is cultured, sensitive, shy,
restless, and devoid of an ubi consistam. Ever
since her childhood, she has felt a difference
between what was “natural” for herself and what
was natural for others. “I was interested to know
what mechanisms are involved in everyday be-
havior. How we operate in those things which
we take for granted. For example: How is it that
in the mornings we get up to have breakfast? In
order to breathe, do we need to think or not?”
She sets for herself the problem of naturalness
and what is correlated with it: the ethical prob-
lem of spontaneity and authenticity. “Only spon-
taneity is authentic. If I know what is right, then
my action must follow spontaneously. If it does
not follow spontaneously, then (if it is performed)
it is inauthentic.”
■ 209
On being asked whether she had started set-
ting herself these questions because there was
some hindrance that made the so-called natural
actions of everyday life difficult for her (that is, if
she was trying to explain life because she was not
able to live it) or independently from this, she
replies: “I do not know which came first, wheth-
er my questions about life or my hindrance in
living. However, those questions were a hin-
drance.” To which she adds: “I have created this
rigid container since my childhood, perhaps be-
cause I had no exterior authoritative model. Fi-
nally something took shape that had a rigid con-
trol function.”
During adolescence the established ideal of
autonomy came to be added to her doubts as to
what was natural and doubts as to her myth of
spontaneity: “I considered everything that had to
do with being with others heteronomia. What I
then thought to be autonomy was really autism.
How was I to justify my autistic way of living
from a theoretical point of view? By saying that
each relationship damaged me.”
Her existential project is getting rid of what
she calls “heteronomia,” i.e., the dependence on
the rules established by the others. She gets too
emotionally involved when she gets in touch with
other people and rejects her tendency to identify
with the point of view of the others.
She now explains her choices on this subject
through a personal interpretation of the myth of
Anphiaraus. In Greek mythology, the poet An-
phiaraus is dragged reluctantly into a war of
which he already knows the miserable outcome.
While he is fleeing with the Argive army, and just
as Periclymenus is about to stab him in the back
with his spear, Anphiaraus is swallowed into the
ground, which was split open by a thunderbolt
from Zeus. “Before man can oppress him with
his violence and kill him, he is swept away by
Jupiter and made immortal. Before contact with
reality can make him perform inauthentic ac-
tions, the gods gather him into their chthonic
embrace. That is how, according to the myth, his
identity is preserved.”
Her identity and her autonomy are endan-
gered by contact with others: “I am unable to
conceive the contact and confrontation with oth-
er people in any different way from heterono-
210 ■ PPP / VOL. 8, NO. 2–3 / JUNE–SEPTEMBER 2001
mia. At the moment in which someone thinks
something about me, this thought becomes a risk
for my existence, because I see others as en-
dowed with the possibility of manipulating the
way I am. What for other people would be no
more than an innocent remark, for me becomes
something that can mold me,” and she adds, “It
is very unpleasant not to be able to say ‘no.’
When I am walking with somebody else, I do not
know if I want to turn right or left, because I
only attempt to understand what the other per-
son would like to do and adapt to that. A dog
tries to understand to oblige its master, as op-
posed to a cat that tries to understand so as to do
as it likes.” The presence of another person sus-
pends her ability to make autonomous choices:
“To understand and to comply are not two sepa-
rate things for me.” She explains that the prob-
lem arises from the lability of her boundaries:
“To have an experience means to gamble with
my boundaries. For me contacts with everything
are particularly strong and involving. I am un-
able to mediate. And if I speak with living beings
it is even worse.”
As the years go by, her identity splits into two
opposite halves: ethereal Ariel, the eternal child
who plays and lives within the all-powerful mag-
ic of thought divided from reality, and Sailors, a
sort of Greek tragedy chorus, critical and mock-
ing, that stigmatizes Ariel’s hybris. Ariel was
born in secondary school days, at first just as
“the child” who strove to live the present mo-
ment. Ariel is the yearning for autonomy as an
absolute value, reached through play and pure
thought. Everyday reality is painful because it is
too close (“The contact with everything is partic-
ularly strong”), but it is problematic also be-
cause it is at an unreachable distance: “Everyday
reality is not to be despised. The problem is that
it is distant. And the solution is to get even
further away.” Gradually, but relentlessly, Ariel
proceeds to the “euthanasia of the ego.” First, it
restricts it in space, in the name of its own all-
powerful ambition of autonomy; finally, it con-
tributes to its end. The ego’s incipient death and
Ariel’s overbearing power find an immediate con-
sequence in the advent of the Sailors. At first
Ariel’s ambitions might have been compatible
with survival, but very soon the yearning for
autonomy becomes a flight from reality. The
Sailors stigmatize the hybris of this project in
which, at first, Ariel is active part, but of which it
later loses control. The Sailors try to make Ariel
ashamed of its (the ego’s) over-ambitious project,
on the one hand, and of its incapacity to live a
practical life, on the other. They underline the
ridiculous aspects of Ariel’s behavior, its dispro-
portionate ambition, its excesses, and they en-
deavor to put a limit to Ariel—to normalize her
behavior. Last, they accuse her behavior of “kill-
ing the ego.”
A merciless struggle takes place between Ariel
and the Sailors. The ego’s space becomes restrict-
ed under the pressure of Ariel’s overwhelming
yearning for autonomy and the sarcastic com-
ments of the Sailors that fan the flames of Ariel’s
hybris. Finally, the ego dies. From this moment
on, “the use of the personal pronoun ‘I’ becomes
a mere linguistic artifice, a simple concession to
communication.” Where before the ego used to
be, now, “somewhere in the middle there is just a
sort of puppet,” whose strings are pulled some-
times by Ariel and sometimes by the Sailors.
At first, the Sailors “are just a metaphor”: a
metaphor of common sense. “I can say that the
‘Sailors’ are everything that questions authentic-
ity and spontaneity, and whatever obliges me to
live everyday life.” Up until secondary school
times, the Sailors used to represent a counter-
point with which to argue, but matters have
changed since late adolescence and up until the
present day. With the ego’s death, which took
place in those years, the Sailors have come to be
Ariel’s only check and so come to be something
concrete—they become substance: “Until I was
at secondary school, they had no correspondence
with the exterior that could confirm what they
said. Now there are entities that I call Sailors.
Before, they were moments. We talked; they talked
to me. Now they do not talk to me; they speak.
First, they were part of me, now no longer.” The
Sailors become hallucinatory voices.
The Sailors “lead Ariel to take advantage of
supposed signs to discover what other people
think.” The Sailors’ aim is to bring Ariel back
inside a shareable horizon of meaning. They are
 STANGHELLINI / PSYCHOPATHOLOGY OF COMMON SENSE
also a guide to interpret other people’s behavior
and thoughts: “The interpretation of other peo-
ple’s thoughts always starts from what the Sail-
ors think.” The Sailors’ function is to lead Ariel
back to the realm of common sense; but in so
doing, they frustrate the yearning for autonomy.
For instance, during an oral test at university, the
Sailors lay down the rules of the game for a
standard university exam, preventing the student
from personalizing the situation, from express-
ing herself in an autonomous and original man-
ner. The Sailors impose their own lines, which
are lines that follow the rules, that say, “This is
the way to behave,” which is an anonymous and
impersonal behavior—that aurea mediocritas,
which is so disliked by Ariel. At the height of the
piercing hallucinatory din, they overthrow Ariel:
“The Sailors have exaggerated. In their efforts to
control Ariel, they have chased it away altogether.”
Case Reports
P.S. is a forty-two-year-old man who has been
affected by paranoid schizophrenia since the age
of twenty. At the onset of his psychosis, he was
trying in various ways to compensate for his
difficulties in getting in touch with other people.
He had no secure ground to interpret the others’
intentions. He lacked the structure of the rules of
social life and systematically set about searching
for a well-grounded and natural style of behav-
ior. For instance, he was busy with an ethological
study of the “biological” (i.e., not “cultural,”
not artificial) foundation of the others’ behaviors
through a double observation of animal and hu-
man habits. The former was done through TV
documentaries, the latter via the analyses of hu-
man interactions in public parks. An atrophy in
his knowledge of the “rules of the game” led him
to engage in intellectual investigations and to
establish his own “know-how” for social inter-
actions in a reflective way. Many years after the
onset of his psychosis, he would explain that his
withdrawal was also a consequence of his dis-
dain for the others’ opinions, but mainly the
effect of his fright to lose his own ideas in the
face-to-face interactions with the others. He iron-
ically says, “I feel weak, very weak . . . someone
would say sensible.”
■ 211
M.M. is a forty-two-year-old woman affected
by paranoid schizophrenia. During a therapy ses-
sion, she asked me and herself, “What is ‘reason-
ableness?’ It is the light that allows the interpre-
tation of reality. In me it is switched off. It is not
spontaneous. One must work on it. I feel switched
off here in my forehead. Interpreting reality is
also saying, ‘I don’t like him!’ It is a subjective
interpretation of reality. Everything becomes gray,
flat. Anything goes. Indeed, nothing goes: I can-
not move away from my bed. I do feel a ‘lunar’
energy that is tackling the sun and eclipses it. I
experience the others as if they were empty. The
sun is missing. The perception of oneness and
multiplicity is missing. When a subject gets to
know something, he becomes one with it. But
subjectivity is needed in order to get to know
something. In me, it is as if subjectivity were
subjugated, and I do not know by what. I dive a
lot of times into my psychologist’s head, because
I can manage to get out from it. I do not dive into
my mother’s head because I am scared. She was a
medium. I am afraid to get lost in her head, to get
caught in it.”
Case Vignettes
E.C., a young schizophrenic, speaks out his
disdainful refusal of conventional values and be-
liefs that he identifies with his parents’ teachings.
M.Mo., another young schizophrenic man,
when recovered from an acute schizo- obsessive
episode, says that what he hates most is “to be
persuaded by the others” and, therefore, he avoids
any discussion.
T.T.R, another schizotype, tells that his reason
for withdrawal is that he hates the inauthenticity
of the others and any standard and taken-for-
granted view about the world. He does not want
“to get caught in their way of thinking.”
G. B., a thirty-nine-year-old schizoid, who
withdrew into his house about ten years ago and
spends much of his time sitting on his bed in a
very unnatural position, is afraid of starting a
program of body awareness and rehabilitation,
because this is his “personal, unique posture,”
comfortable for him, although not spontaneous,
and above all, different from the posture of all
the others.
212 ■ PPP / VOL. 8, NO. 2–3 / JUNE–SEPTEMBER 2001
These persons’ experiences reflect disorders of
the phenomenal self and, in particular, a lack of
ipseity, e.g., patients V.V. and M.Ma. get too
emotionally involved when they get in touch
with other people.
However, these people’s reports especially re-
flect disorders of the social self, i.e., the loss of
common sense (e.g., V.V. and P.S.). Often, their
conduct shows the deliberate attempt to disen-
gage from all the sources of taken-for-granted-
ness, unwitting typification and inauthenticity
(e.g., V.V and E.C.).
Since many of them suffer from an over-recep-
tiveness of the thoughts of the others (e.g., P.S.,
V.V., M.Ma.), their existential project is getting
rid of what V.V. calls “heteronomia,” i.e., the
dependence on the rules established by the others.
These people’s experiences may spring from
their proneness to heteronomia but also from
their fear of an excess of attunement and adapta-
tion (e.g., V.V.). Their behaviors may reflect their
tragic fight for differentiation and uniqueness
(e.g., G.B.) and their need for distinctiveness and
individuation (e.g., P.S., M.Mo., T.T.R.). Since
for them fear of assimilation and an urge for
differentiation are more important than related-
ness, the price they all pay for individuation is
being disconnected from spontaneity, instinctive-
ness, automatic actions, and above all, intercor-
poreality and intersubjectivity.
The Schizophrenic’s Skeptical
Attitude towards Common Sense
Young schizophrenics often show a skeptical
attitude towards conventional typifications, a dis-
trust of pre-reflective attunement, and an em-
phasis on rationality and abstract thinking. When
this happens, the destruction of the building
blocks of everyday experience seems to come
from above and not from the bottom: It is by
means of a philosophical (or pseudo-philosophi-
cal) skepticism that common sense is dismissed.
The German philosopher Rosenzweig (1984)
ironically defined this paralysis of commonsense
“apoplexia philosophica,” an intellectualistic con-
dition derived from a distrust of commonsense
typification and related to hyper-reflexivity. Cut-
ting (1997) described this condition as related to
a shift to the left along the “intelligence-intu-
ition” axis. This issue is also addressed by
Minkowski’s (1927) “morbid rationalism” and
Sass’s (1992) “hyper-reflexivity.” While the lat-
ter especially addresses the topic of the schizo-
phrenic mind’s self-destruction, Minkowski usu-
ally holds that morbid rationalism is a coping
reaction that invades the psychic life of the indi-
vidual when she has lost the vital contact with
reality. Morbid rationalism is an attempt to rees-
tablish new rules for typification when life can-
not be lived anymore, but only thought
(Minkowski 1947). Loss of the vital contact with
reality and of common sense, on the one hand,
and fear of inclusion and need for differentia-
tion, on the other, are two faces of the same coin.
It can neither be established, once and for all,
which is the primary and which the secondary
set of phenomena in a pathogenetical sense, nor
which of the two is the sole fundamental condi-
tion of possibility of schizophrenic psychoses in
an anthropological sense.
Schizophrenic vulnerability is often consid-
ered as a condition characterized by defective
attunement to the social environment. Yet, the
schizophrenic’s skeptical behaviors may reflect
the attempt to disengage from heteronomia, i.e.,
over-receptiveness of the thoughts of others (rath-
er than the lack of socially shared roles and rules
for engaging in “real life” or a purely theoretical
refusal of conventionality). It is common to find
among persons vulnerable to schizophrenia and
young schizophrenics the rejection of attunement
and intuitiveness, because these are considered
sources of conformity, inauthenticity, narrow-
mindedness, loss of selfness, and of differentia-
tion. We might call this individualistic attitude
antagonomia, because it is based on the opposi-
tion to the others’ norms, which are experienced
as one dangerous source of loss of individuality.
The Schizophrenic’s Hyper-Tolerance
of Ambiguity
Another pathway to the loss of common sense
can originate from a hyper-tolerance of ambigu-
ity. Tolerance of ambiguity is the ease with which
a person can perceive dissonant characteristics in
the same object, person, or situation (Frenkel-
 STANGHELLINI / PSYCHOPATHOLOGY OF COMMON SENSE
Brunswik 1949). This phenomenon was first stud-
ied in the so-called “authoritarian personality”
(Adorno et al. 1950), the anthropological config-
uration that predisposes individuals to be preju-
diced. However, the tendency to rule out ambi-
guities and uncertainties from one’s own
life-world is very common. The process through
which the complexity of reality is simplified and
only one of the multiplicity of possible meanings
of a given situation becomes fixated was called
by Gehlen (1978) the “unburdening process”
(Entlastung). Gehlen thought that this symbolic
process was the structural law of human action,
since through it, only those stimuli and meanings
are selected that are relevant for a given action.
Among the main features of the vulnerability
to schizophrenia, over-inclusive thinking (Cam-
eron 1944) is one of the best established—mean-
ings that are remotely linked to each other be-
come incorporated within the same train of
thoughts. As in the case of skepticism, the schizo-
phrenics’ hyper-tolerance of ambiguity, rather
than a disorder of thinking, may also be a delib-
erate epistemological attitude, i.e., the concern
for the complexity of reality and the rejection of
taken-for-granted simplifications. Facts-in-the-world
cannot be caught by a single conceptualization,
reducing their multifaceted complexity to a uni-
dimensional surface designation. If one conceives
of the world as a “forest of symbols” and each
symbol as a bundle of facets, only a webwork of
concepts can catch its essence via a flow of ad-
umbrations showing its infinite, changing profiles.
The bracketing of the unburdening process
and the attitude of intolerance towards the re-
stricted horizon of common sense can be traced
back to the individual’s set of values and beliefs,
as it is reflected in the case of the E.B., a young
schizophrenic who does all he can to enhance his
memory and the understanding capacity of his
mind. He puts forward all his strength to volun-
tarily connect the perception of the meaning of
one object with a network of associated mean-
ings. In this case, an enlarged horizon of mean-
ings does not simply reflect a forceful train of
more or less relevant associations, but reveals a
deliberate attempt to enlarge one’s own mental
capacities to transcend the commonsense world.
■ 213
The philosophical paragon of this attitude,
which may predispose to schizophrenic experi-
ences, is the “art of memory” (Yates 1966; Rossi
1983), i.e., a mental exercise to improve memory
through the activation of fluid semantic associa-
tions. The art of memory, however, is not only a
means to enhance memory, but also an esoteric
hermeneutic instrument to break through the
innermost secrets of Nature.
Suspending commonsense worldview, brack-
eting the unburdening process, enlarging one’s
own capacity to be impressed by different mean-
ings, looking for a metaphysical dimension of
reality, and disengaging from intersubjectivity
are the many facets of the same phenomenon.
They form a Gestalt in which affective-conative
(i.e., lack of attunement), cognitive (i.e., over-
inclusive thinking), and attitudinal phenomena
(i.e., concern for the complexity of reality and
for the uniqueness of one’s own worldview) are
related coherently to each other.
Conclusions
In this paper, which builds on and extends
contributions of the phenomenological tradition,
I have attempted to sketch a theoretical frame-
work for exploring some fundamental features
of schizophrenic vulnerability. The basic hypoth-
esis is that the interpersonal disorder observed in
schizophrenic patients is not a consequence of
acute symptomatology, or a social or institution-
al artifact, but a fundamental aspect of the vul-
nerability to schizophrenic breakdown. Psycho-
pathological studies, and mainly phenomenological
analyses, have attempted to describe and define
this basic interpersonal disorder, one compre-
hensive definition being “lack of common sense.”
Traditional phenomenological analyses of
schizophrenic vulnerability and of the disorders
occurring in early schizophrenia emphasize the
importance of lack of ipseity and hyper- reflexiv-
ity. It is commonly argued that the lack of the
feeling of distinctiveness between one’s own self
and the outer world (lack of ipseity), and the
heightened engagement in monitoring oneself in-
volving the spatialization of one’s own bodily
and mental phenomena (hyper-reflexivity), can
214 ■ PPP / VOL. 8, NO. 2–3 / JUNE–SEPTEMBER 2001
entail interpersonal disorders. However, these
analyses of the phenomenal self in early schizo-
phrenia catch only one dimension of schizophren-
ic vulnerability (i.e., the dimension of the person-
al self), disregarding the fact that the self is not a
purely personal but, rather, a social phenome-
non. In this paper, I maintained that our exist-
ence is fundamentally tied to a social existence
and that one’s sense of presence derives from the
way one constitutes oneself and the world in
social situations. The sense of “reality” of an
experience and the definition of one’s own self
are products of intersubjectivity; hence, I argued
that disorders of intersubjectivity can entail dis-
orders of the personal self. Therefore, the need
emerges for integrating traditional phenomeno-
logical views on phenomenal self disorders in
early schizophrenia with the analyses of the so-
cial self of schizotypes and young schizophrenics
in the light of disorders of common sense.
To stipulate a satisfactory definition of “com-
mon sense,” I have gathered philosophical cues
and empirical psychopathological evidence. Com-
mon sense can be represented as a network of
beliefs (i.e., social knowledge) and as a basic
individual attunement with the social world of
an intuitive kind. Whereas the concept of “social
knowledge” defines the background of constructs
useful for organizing the everyday experiences,
the concept of “attunement” reflects the affec-
tive-conative capacity to get involved in the oth-
ers’ lives and to catch context-relevant cues to
make sense of the others and of situations. I have
tried to point out the main differences between
these two—cognitive and phenomenological—
theoretical approaches and the reasons why the
second should not be overlooked and is probably
to be preferred: The understanding of the others
is not an inference of mental states, but a pre-
cognitive, intuitive experience, a direct percep-
tion of the others’ emotional life. The fundamen-
tal sphere on which intersubjectivity is built can
be understood better as a process placed in face-
to-face encounters and based in intercorporeali-
ty—my identification with my partner’s body
that I perceive over there—rather than as an
encyclopedia of socially shared behavioral rules
existing somewhere in the world.
Although empirical studies on the interper-
sonal disturbances in schizophrenia, which are
mainly based on cognitive models, demonstrate
that these disturbances can be assessed as senso-
ry-level disorders (level 1) and as disorders of the
social knowledge network (level 2.1), I have also
argued that there are two other kinds of psycho-
pathological phenomena to be taken into ac-
count: disorders of attunement (level 2.2) and
the personal attitude toward commonsense
knowledge and attunement (level 3). To establish
a comprehensive understanding of the interper-
sonal disorders occurring in schizophrenia, one
should not overlook the concepts of “lack of
intuitive attunement” and of “antagonomia.”
The affective-conative capacity for attunement
is the basic prerequisite for getting involved in
and directly perceiving the other’s mental life
and for feeling familiarly related to the social
environment. When intuitive attunement is dis-
ordered, not only do the others appear enigmatic
and the social environment uncanny, but also,
one’s sense of the self and the boundaries be-
tween oneself and the others may become blurred.
Antagonomia is the core phenomenon of the
schizophrenic’s vulnerable system of values and
beliefs. It is characterized by the distrust towards
conventional knowledge and attunement, which
includes skepticism towards common sense and
hyper-tolerance of ambiguity, reflecting the re-
fusal to conceptualize the world through the sim-
plifying views given by common sense. Since
conventional knowledge is experienced as a dan-
gerous source of loss of individuality, their rejec-
tion manifests itself as the deliberate attempt to
disconnect oneself from the others in which con-
ventionality is embodied.
In the schizophrenic world, disorders of ipse-
ity (phenomenal self disorders), disorders of at-
tunement (affective-conative disorders), and an-
tagonomia (attitudinal disorders) are related
coherently to each other and form a Gestalt.
However, the causal relationships between these
different phenomena need further empirical in-
vestigations. In addition, the relationship between
the disorders of attunement and antagonomia
and the disturbances of “social knowledge” needs
to be empirically examined in more detail. It
 STANGHELLINI / PSYCHOPATHOLOGY OF COMMON SENSE
could be argued that lack of social knowledge
and lack of attunement are the two faces of the
same psychopathological condition, but it could
also be hypothesized that the deficit in social
knowledge is an epiphenomenon of the lack of
attunement, the latter responsible for a deficient
development in one’s life course of the knowl-
edge of everyday social issues. Furthermore, a
disorder of corporeality, e.g., of the perception
of one’s own bodily sensations, may be involved
in the pathogenesis of defective attunement (i.e.,
inter-corporeality) and of a deficit in social func-
tioning. Moreover, a disorder of social knowl-
edge could be an epiphenomenon of antagonomia.
These investigations can improve the clinical-
phenomenological assessment and characteriza-
tion of single cases and allow the definition of
subcategories within the schizophrenic spectrum,
according to specific areas of interpersonal disor-
ders. Many researchers have stigmatized the clin-
ical heterogeneity of the “group of schizophre-
nias”: The subcategorization of the schizophrenic
spectrum, in terms of different components of
the interpersonal disorder, could provide a more
reliable basis for epidemiological (high-risk stud-
ies) and neuro-biological (structural and func-
tional correlates) research.
In practical terms, the assessment of the indi-
vidual’s attitude is fundamental in promoting a
therapeutic alliance to empathize with her symp-
toms and also to understand her life-projects.
Persons affected by early manifestations of psy-
choses may not be aware of their vulnerability
and, therefore, drop out of preventive programs.
Alternative effective therapeutic projects can be
based on the understanding of the system of
values and beliefs of the person and on cooperat-
ing with him/her in evaluating the pros and cons
of his/her philosophy of life.
In terms of an anthropological-philosophical
viewpoint, schizophrenic vulnerability represents
miscarried attempts to drastically solve the Self-
Other existential dilemma. The vulnerabilities to
major psychoses can be characterized as impair-
ments of the dialectical movement between the
need for assimilation-consensus, on the one hand,
and distinctiveness- individuation, on the other.
Being disconnected from common sense—i.e.,
■ 215
from intersubjectivity, intercorporeality, and tak-
en-for-grantedness—is the price some pay for
our tragic fight for individuation. Schizophrenic
vulnerability, in this sense, is an anomalous phi-
losophy of life. “What I then thought to be au-
tonomy was really autism,” are the words of a
twenty-three-year-old patient who, since her ad-
olescence, had been embroiled in a self-destruc-
tive Odyssey to overcome heteronomia, and I
take her words as puzzling evidence of our so-
cial, that is, vulnerable descent.
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