What do psychiatrists encounter when they encounter psychopathological experience in their patients? How should we interpret such experiences? In this chapter we contrast a standard checklist approach to diagnosing and treating psychopathology, based on psychological operationalizing, and a non-standard phenomenological approach that emphasizes the importance of a specific kind of interpretive interview.

We propose that typical schizophrenic delusions develop on the background of preexisting anomalies of self-experience. We argue that disorders of the Self represent the experiential core clinical phenomena of schizophrenia, as was already suggested by the founders of the concept of schizophrenia and elaborated in the phenomenological psychiatric tradition. The article provides detailed descriptions of the pre-psychotic or schizotypal anomalies of self-experience, often illustrated through clinical vignettes. We argue that delusional transformation in the evolution of schizophrenic psychosis reflects a global reorganization of consciousness and existential reorientation, both of which radiate from a fundamental alteration of the Self. We critically address the contemporary cognitive approaches to delusion formation, often finding them inconsistent with the clinical features of schizophrenia or implausible from a phenomenological point of view.

Key words: self-awareness, subjective experience, preschizophrenic prodrome, phenomenology, psychosis, cognitivism.