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Schizophrenia as a clinical phenomenon has had a fascination for both psychoanalytic thinkers and for those involved in more objective neuroscientific research. Something about the oddness we experience around these patients draws on our need to understand and explain. This article raises questions about the concepts of empathy and psychodynamic meaningfulness in our thinking about schizophrenia, suggesting that attempts to reconcile psychoanalytic and neuroscientific points of view on this subject may result in our defining some experiences as essentially meaningless, and opening the question of how empathy can exist between two people—particularly a patient and a therapist—who have vastly different experiences of the world.
Schizophrenia has always been considered to be associated with cognitive and perceptual difficulties as well as thought disorder; significant deficits in attention and information processing in schizophrenics were noted by Bleuler and Kraepelin. In 1949 Bergman and Escalona described a group of young children with “unusual sensitivities manifesting themselves in several, if not in all sensory modalities” (1949, p. 333); each of the cases they discussed became psychotic. As early as 1961 cognitive deficits associated with attention and perception were hypothesized as causally related to schizophrenic symptoms and behavior (McGhie and Chapman, 1961). Numerous clinical and experimental observations seem to demonstrate that schizophrenic subjects do not take in and process sensory information smoothly and appropriately, a dysfunction that may well extend to internally generated cues and that may involve slowed information processing, increased distractibility, and inefficient allocation of attention (Braff et al., 1992). In one line of experimental paradigms, galvanic skin resistance,