Affect-Logic, Embodiment, Synergetics, and the Free Energy Principle: New Approaches to the Understanding and Treatment of Schizophrenia.

This theoretical paper explores the affect-logic approach to schizophrenia in light of the general complexity theories of cognition: embodied cognition, Haken's synergetics, and Friston's free energy principle. According to affect-logic, the mental apparatus is an embodied system open to its environment, driven by bioenergetic inputs of emotions. Emotions are rooted in goal-directed embodied states selected by evolutionary pressure for coping with specific situations such as fight, flight, attachment, and others. According to synergetics, nonlinear bifurcations and the emergence of new global patterns occur in open systems when control parameters reach a critical level. Applied to the emergence of psychotic states, synergetics and the proposed energetic understanding of emotions lead to the hypothesis that critical levels of emotional tension may be responsible for the transition from normal to psychotic modes of functioning in vulnerable individuals. In addition, the free energy principle through learning suggests that psychotic symptoms correspond to alternative modes of minimizing free energy, which then entails distorted perceptions of the body, self, and reality. This synthetic formulation has implications for novel therapeutic and preventive strategies in the treatment of psychoses, among these are milieu-therapeutic approaches of the Soteria type that focus on a sustained reduction of emotional tension and phenomenologically oriented methods for improving the perception of body, self, and reality.

The key role of emotions in the schizophrenia puzzle.

The aim of this paper is to show that the dynamic effects of emotions in schizophrenia are underestimated and partly misunderstood. This may be related to an insufficient consideration for certain key properties of emotions, especially their energizing effects. After introductory remarks on current notions on emotions in schizophrenia, I present an alternative view based on my concept of affect-logic and discuss some of its therapeutic implications.

[Toward a more gentle psychiatry--to patients and understanding illness of affect logic]. / Für eine sanftere Psychiatrie--zum Menschen- und Krankheitsverständnis der Affektlogik.

Based on the disease- and human understanding of "affect logic" developed by the author, new ways to a "more gentle psychiatry" than usual up to now are shown. Over 18 years continuous experience with the pilot project "Soteria Bern"--predominantly milieu- and psychotherapeutic treatment of acute schizophrenia--are used as examples. In refurbishing normal psychiatric hospital wards meant for all types of patients, a much less violent therapeutic atmosphere was created through the introduction of "Soteria-Elements" as well. In toto it can be shown that a more gentle psychiatry can be realized without greater costs, if the interaction between feeling, thinking and behavior are more fully understood and observed. For this, the concept of "affect logic" delivers a theoretic basis that has been proven in practice.

Soteria Berne: an innovative milieu therapeutic approach to acute schizophrenia based on the concept of affect-logic.

The name "Soteria" stands for an alternative low-drug milieu-therapeutic approach to acute schizophrenia that was first implemented by Mosher and Menn in San Francisco, and since 1984 further developed by Ciompi and co-workers in Berne, on the basis of their concept of affect-logic, that emphasizes the often neglected influence of emotional factors in schizophrenia. In both settings, equal and even partly better therapeutic results, compared with traditional methods, were obtained with much lower doses of antipsychotics and comparable daily costs. Basic concepts, practical proceedings and empirical findings of Soteria Berne are reported, and their theoretical and practical implications for mainstream psychiatry are discussed. They support the hypothesis of a crucial pathogenetic and therapeutic-preventive role played by emotional factors not only in the so-called affective psychoses, but also in schizophrenia.

Sentimientos, afectos y lógica afectiva. Su lugar en nuestra comprensión del otro y del mundo / Feelings, emotions and affective logic. Its place in the understanding of others and the world

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