Phenomenology of Intuitive Judgment: Praecox-Feeling in the Diagnosis of Schizophrenia

This paper argues that intuition plays a role in the diagnosis of schizophrenia and presents its phenomenological rationale. A discussion of self-assessment questionnaires and empirical studies in the clinical setting provides evidence that despite the prevalence of operational diagnosis, the intuitive judgment of schizophrenia continues to take place. Two related notions of intuitive diagnosis are presented: Minkowski’s diagnostic by penetration and Rümke’s praecox feeling. Further on, the paper explores and clarifies the phenomenology behind the praecox feeling. First, it is argued, intuitive diagnosis is neither a feeling nor an experience, but a typification operating at an implicit level. Second, it is not simply subjective as spatially it takes place in the in-between of the clinical interaction. Finally, it is not just momentary, but temporally extended, and, hence, partly reflective. The paper suggests that intuitive diagnosis requires critical testing on the side of the psychiatrist to either confirm or falsify it through reflective operations. In conclusion, the merits and shortcomings of intuitive vs. operational diagnosis are presented.