ABSTRACT
Passivity phenomena range among the prominent core symptoms of schizophrenia and include thought insertion and blockade (APA 1994 2013; WHO 2011). In the German psychopathological tradition, Kurt Schneider (1942) called those phenomena “ego disorders” and emphasized their status as criteria for the diagnosis of schizophrenia. He insisted that such symptoms, which are reported by the patients themselves, are much more reliable signs of a schizophrenic psychosis compared to symptoms based on clinical impression, such as thought incoherence or flat affect. Indeed, prejudices and personal experiences of any examiner can substantially interfere with his or her judgment of “coherent” speech or the “depth” of any affective experience of a patient, while symptoms articulated by the patients themselves are supposed to reflect their own experiences, at least to the degree to which psychotic, unusual experiences can be translated into any common language. Schneider (1942) had named such symptoms “first-rank symptoms” of schizophrenia, and he assumed that they should guide clinical diagnosis. In a time when the diagnosis of schizophrenia meant that the patient would be sterilized against his or her will or even secretly murdered, Schneider thus suggested limiting the diagnosis of schizophrenia to patients who actively report core symptoms; while quite far from active resistance against Nazi atrocities, his call for “modesty” in diagnosing schizophrenia still resonates with a public that criticizes excessive diagnoses and pathologization of everyday human experiences.
