T192. BINSWANGER’S THREE FORMS OF FAILED EXISTENCE AND ITS RELEVANCE FOR CONTEMPORARY PSYCHIATRY

Abstract Background Social impairment is a hallmark feature of schizophrenia spectrum disorders and the subject of much research attention. In contemporary psychiatry the principal way of understanding and examining these difficulties is closely linked to the concept of social cognition, but while this approach has yielded valuable results it has still left the bulk of the variance of social functioning unaccounted for. By zooming out from subpersonal constructs and engaging with first hand experiences of lived through sociality, the phenomenological tradition offers a complementary viewpoint. One prominent proponent hereof is Ludwig Binswanger, but unfortunately much of his pivotal work is only accessible in the original German. It is the purpose of this presentation to introduce some of his central but largely overlooked insights to a wider audience and to highlight their relevance for current research and clinical practice. Methods A reading of Binswanger’s magnum opus Drei Formen missglückten Daseins of which only a fraction has previously been presented to an Anglophone readership. Results To Binswanger, schizophrenic existence is, at its very core, marked by a breakdown of natural experience understood as the unreflective and unobtrusive processes which usually afford us a sense of harmony with ourselves, others, and the material world. In its place schizophrenic autism may transpire and be traced in three forms of existential failure: extravagance (“Verstiegenheit”), perverseness (“Verschrobenheit”), and manneristic behavior (“Maniertheit”). These are not mere defects or plain symptoms, but represent modified modes of being in the world, which all testify to a breakdown of the intersubjective dimension. In extravagance a certain disproportion between basic features of human existence eschews the existential “order of preference”, which usually affords us a basic trust in being, a tacit feeling of ontological security, and the possibility of true community with others. Perverseness, then, denotes a replacement of pragmatic prudence and seamless adjustment to the world and others with withdrawal, resistance, and certain private concepts, principles or rules. Finally, manneristic behavior, deeply rooted in a loss of basic trust, represents an inauthentic mode of being in which the self may be defeated in an effort to appropriate some foreign model of existence. Discussion From Binswanger’s descriptions of these modified modes of existence three key ins