Concept of Representation and Mental Symptoms

Abstract

Background: Most current theories explaining theory of mind (ToM) rely on the concept of ‘representation’, as it is usually employed in cognitive science, and is thus affected by its epistemic shortcoming, namely its incapacity to use ‘sub-signifier’ level information. This shortcoming is responsible for the lack of specificity of ToM deficits, which are now found in very different syndromes, from schizophrenia to bipolar disorder or borderline personality disorder, in spite of its original formulation being restricted to childhood autism. Method: Representation, its shortcomings and the way they may affect clinical/research programs undergo a conceptual analysis, which shows how representational-founded semiology leave out information that is essential for symptom specificity and correct symptom assessment. Schizophrenic autism, delusional perception and axial syndromes are studied as examples of both the difficulties that have arisen and possible ways of dealing with them. Results: Transfers of properties between different meanings of ‘representation’ together with a systematic ambiguity in the use of ‘representation’ are proposed as the main ways for representational approaches to assure stability to their proposals in spite of the violence exerted on clinical phenomena. Conclusions: It is exposed how systematic ambiguity and epistemic shortcomings both affect Leslie’s formulation of ToM and, further, the importance of these characteristics of the concept of ‘representation’ for general issues in psychiatric semiology.

Historical epistemology of the body-mind interaction in psychiatry

“…Now both these philosophical positions have been important to the development of the epistemology of the hard sciences, 44 neurosciences, 45 psychology, 46 and psychiatry. 47 …”

Somatic-type Delusional Disorder: A Case Report and Comments

“…MK-K also suggested a possible connection between the onset of symptoms and menopause. Patients with delusional disorder absorb only selectively available information and make conclusions based on less information than healthy subjects and without considering alternative explanations (5). Difficulties in interpreting others' intentions and motivations seem also to be very common (6).…”

“…Moreover, in many societies psychiatric disorders are regarded as being embarrassing and highly stigmatizing. For this reason, patients prefer to consult a dermatologist, rather than a psychiatrist, if their condition involves the skin, and, if disappointed, are eager to change doctor (1,5). Our patient was treated by numerous specialists, but none of them have managed to instigate psychiatric treatment because ofthe patient's refusal to comply.…”

Emotional-instabile Persönlichkeitsstörung vom Borderline-Typ

“…Neben der Induktion von Vertrauen in sozialen Interaktionen scheint Oxytocin bei "Theory of Mind"(TOM)-Prozessen beteiligt zu sein (40). Auch bei der Borderline-Störung wird hinsichtlich TOM-Prozessen eine Dysfunktionalität vermutet (41). So fanden Dyck et al Defizite bei Borderline-Patienten in der raschen Diskrimination von negativen und neutralen Gesichtsausdrücken (42).…”