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Grand, S. (1982). The Body and its Boundaries: A Psychoanalytic View of Cognitive Process Disturbances in Schizophrenia. Int. R. Psycho-Anal., 9:327-342.

(1982). International Review of Psycho-Analysis, 9:327-342

The Body and its Boundaries: A Psychoanalytic View of Cognitive Process Disturbances in Schizophrenia

Stanley Grand

SUMMARY

The present paper considers the role of early body experience in the development of the peculiar mental symptoms of the schizophrenic disorder. Drawing on a wide range of theoretical, clinical and empirical literature, the conclusion is reached that at the core of the cognitive impairment in schizophrenia there appears to be a profound disturbance in the articulation of the body ego. This apparently is the result of early failure adequately to integrate the multiple sensory inputs for coenaesthetic and gravitational experiences which form the basis for orientation and focus in the experience of reality. Lacking in an articulated sense of body cohesiveness or boundedness, clear distinctions between inner and outer experience, as well as self and object representations cannot emerge. Thus, the core of self-experience and personal identity never become fully differentiated from the dual unity of the mother-infant bond. Functions of the executive apparatus implicated in the development of instrumentality in thought and action are unable to develop and the schizophrenic patient is, therefore, unable to benefit fully from self-correcting experiences provided by feedback from action in the external world. Such benefit can only accrue when one experiences himself as the initiator of his own actions. Compensatory mechanisms which bolster and support impaired body ego integration can apparently develop in the areas of somatosensory, proprioceptive and thermal experience, and may be useful for sustaining the integrity of the mental apparatus and preventing its complete dissolution during regressive episodes in this disorder.

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