Schizophrenia Research Trends

30Reiko Koide and Akira Tamaokadistance by regarding the whole situation in which he lives as if it were a fiction, acted on astage, and regarding himself as an audience. He described his own symptoms as “referentialdelusion” as if others observe him and felt himself “like a criminal who appears ontelevision”. His over-concern about age and many attempts to guess age without enoughevidence would be derived phenomenon from this withdrawal from the real world, in whichtime passes, into a fictional narcissistic world, in which there is no lapse of time. He isworried about “becoming old-fashioned.” This concern toward age seems consistent with theage-disorientation of schizophrenia (Crow & Johnstone, 1980; Crow & Stevens, 1978). It wasreported that 25% of the schizophrenic patients mistake their own ages by more than 5 years.In Case D, the mass-of-flesh percepts appeared in the perception, “A crab, with a torsowith a carapace and nippers” (Card III). A mass of flesh was seen in the elimination of thelegs with armor. This is consistent with her clinical picture, in which her violent acting-out isa prominent problem. As the risk of violence has come to be one of the current issues ofschizophrenia (Taylor, 1995; Fottrell,1980; Humphreys et al., 1992) the present findingseems to relate to some illness-specific risk factor to evoke violence in schizophrenicpatients. In this case, it is assumed that an “armored mass-of-flesh body image” would be acompromised product of an aggressive premorbid personality and schizophrenic illness.The body image as becoming a mass of flesh is considered to have four connotations.First, it suggests an image of the body, which is still alive, though exposed to the outer world.Second, it suggests an image of the body that is helplessly threatened and unprotected. Third,it suggests an image of the body that is unmovable. Fourth, it suggests an image of the bodythat is weakened and helpless. These would constitute an image of potential catastropheconcerning the patients’ own body.The image of becoming a mass of flesh was recognized in two stages. Stage 1 ispresented directly with reference to “a mass of muscles” or “mass of flesh,” as seen as atypical response one. Stage 2 as presented indirectly as an animal or a human being withoutlegs or arms, or without clarifying them, in which the mass of flesh is vaguely imaginedthrough the diminution of head or legs. In observation of these four cases above, stage 1presumably works with delusion, especially being closely linked with bizarre delusions andenhancing psychological factors for it. Stage 2 would exist as a rather general, thoughunderlying, disposition in schizophrenic patients. In the case of stage 2, it was further shownthat image of becoming a mass of flesh leads to some readiness for age-disorientation as oneof the major thought disorders, as well as violent acting-out behaviours, so that one of thefuture topics to be discussed should be the effect of the image of becoming a mass of flesh onthe formation of a variety of schizophrenic symptoms.ConclusionRorschach responses that imply the body images of becoming a mass of flesh wereshown in four chronic schizophrenic cases. The body images of becoming a mass of fleshwere experienced in two forms: one is experienced by the percept of a mass of muscles. Theother is by percepts of an animal or a human being with diminished legs, head, or arms. Instudying four cases carefully, these responses were found regardless of the illness type,duration of illness, life history, and neuroleptic doses, but they related not only to delusionaland hallucinatory symptoms but also to some other thought disorders such as age-