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Delusions in both psychiatry and psychoanalysis are usually thought of as being some sort of false belief about external reality. Psychoanalysts tend to think of them as due to regression to the wish-fulfilling fantasising of early infancy. So delusions are taken to be due to a break-down in reality testing. It is assumed that babies are out of touch with reality. The problem therefore becomes one of accounting for the gradual development of accurate reality testing, of how a child learns to differentiate truth from illusion and why this developmental process breaks down in schizophrenia.
Sass argues that this way of posing the problem is misguided and due to psychiatrists and psychoanalysts unconsciously assuming the beliefs of enlightenment rationalism. This form of rationalism rigidly divides form from content. It is assumed that the content of the delusion is unrealistic, it is a false belief; but that the form or ‘feel’ or way of belief is essentially normal, or rather like that of the ordinary adult.
Sass uses examples from Schreber's Memoirs and his own practice to show that schizophrenics usually do not experience their delusions as being literally true, but are aware that they are in some sense the products of their own consciousness. Delusions then are not mistaken beliefs about external reality. Rather they are imaginative pictures or representations, a mode of what Wittgenstein has termed ‘seeing-as’, which is neither a percept nor a concept but something added on to a percept. For example I may perceive a cloud but then see it as a donkey floating in the sky.
But whereas the ordinary person can switch in and out of seeing-as, the schizophrenic is locked into it. He has been overcome by the metaphysical vision of solipsism in which other people are experienced as but figments of the solipsist's own conscious activity. Wittgenstein spoke of solipsism as ‘a serious and deep-seated disease of language’ and explored it with great subtlety. Sass uses his work to