Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-22T08:46:01.279Z Has data issue: false hasContentIssue false
  • English
  • Français

“To see oursels as others see us”

Aubrey Lewis's insight

Published online by Cambridge University Press:  03 January 2018

Anthony S. David
Anthony S. David*
Affiliation:
GKT School of Medicine and the Institute of Psychiatry, London SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

This paper takes as its starting point the paper by Aubrey Lewis entitled “The psychopathology of insight” published in 1934, unreferenced.

Aims

To attempt to explore the historical antecedents and consequences of this work.

Method

Speculative review.

Results

Lewis's approach to phenomenology, contemporaneous movements in psychology and Lewis's own life and times – notably the eugenics legislation in Nazi Germany – probably shaped his conclusions. Modern concepts of insight, which emphasise neuropsychology as well as social psychology, were anticipated in Lewis's writings.

Conclusions

The concept of insight has stimulated research into difficult theoretical and practical areas such as self-awareness and treatment compliance, respectively. Concern over a patients capacity for insight has the potential to humanise psychiatry.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 175 , Issue 3 , September 1999 , pp. 210 - 216
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Almeida, O., Howard, R., Levy, R., et al (1996) Insight and paranoid disorders of late life (late paraphrenia). International Journal of Geriatric Psychiatry, 11, 653–658.3.0.CO;2-9>CrossRefGoogle Scholar
Amador, X. F., Strauss, D. H., Yale, S. A., et al (1991) Awareness of illness in schizophrenia. Schizophrenia Bulletin, 17, 113.Google Scholar
Amador, X. F., Flaum, M., Andreasen, N. C., et al (1994) Awareness of illness in schizophrenia and schizoaffective and mood disorders. Archives of General Psychiatry, 51, 826.CrossRefGoogle ScholarPubMed
Amador, X. F. & Seckinger, B. A. (1997) The assessment of insight: a methodological review. Psychiatric Annals, 27, 798–805.CrossRefGoogle Scholar
Amador, X. F. & David, A. S. (eds) (1998) Insight and Psychosis. New York: Oxford University Press.CrossRefGoogle Scholar
Anonymous (1940) The mind of Hitler, Lancet, i, 36.Google Scholar
Anonymous (1990) Real insight (editorial), Lancet, 336, 408.CrossRefGoogle Scholar
Beck-Sander, A. (1998) Is insight into psychosis meaningful? Journal of Mental Health 7, 25–34.CrossRefGoogle Scholar
Berrios, G. E. & Markova, I. S. (1998) Insight in the psychoses: a conceptual history. In Insight and Psychosis (eds Amador, X. F. & David, A. S.), pp. 33–46. New York: Oxford University Press.CrossRefGoogle Scholar
Bleuler, E. (1913) Autistic thinking. American Journal of Insanity. 69, 873–886.Google Scholar
Chung, K. F., Chen, E. Y. H., Lam, L. C. W., et al (1997) How are psychotic symptoms perceived? A comparison between patients, relatives and the general public. Australia and New Zealand Journal of Psychiatry, 31, 756–761.Google Scholar
Collins, A. A., Remington, G. J., Coulter, K., et al (1997) Insight, neurocognitive function and symptom clusters in chronic schizophrenia. Schizophrenia Research, 27, 37–44.Google Scholar
Cuesta, M. J. & Peralta, V. (1994) Lack of insight in schizophrenia. Schizophrenia Bulletin, 20, 359–366.Google Scholar
Cuesta, M. J., Peralta, V., Caro, F., et al (1995) Is poor sight in psychotic disorders associated with poor performance on the Wisconsin Card Sorting Test? Correction. American Journal of Psychiatry, 152, 1380–1382.Google Scholar
Cuffel, B. J., Afford, J., Fischer, E. P., et al (1996) Awareness of illness in schizophrenia and outpatient treatment adherence. The Journal of Nervous and Mental Disease, 184, 653–659.CrossRefGoogle ScholarPubMed
Cutting, J. (1990) The Right Cerebral Hemisphere and Psychiatric Disorder. Oxford: Oxford University Press.Google Scholar
Damasio, A. R. (1994) Descartes' Error. New York: G. P. Putnam & Sons.Google ScholarPubMed
David, A. S. (1989) Reading about … The split brain syndrome. British Journal of Psychiatry, 154, 422–425.CrossRefGoogle Scholar
David, A. S. (1990) Insight and psychosis, British Journal of Psychiatry, 156, 798–808.Google Scholar
David, A. S. (1992) Frontal lobology – psychiatry's new pseudoscience, British Journal of Psychiatry, 161, 244–248.Google Scholar
David, A. S., Buchanan, A., Read, A., et al (1992) The assessment of insight in psychosis. British Journal of Psychiatry, 161, 599–602.CrossRefGoogle ScholarPubMed
David, A. S., Owen, A. M. & Forstl, H. (1993) An annotated summary and translation of “On self-awareness of focal brain diseases by the patient in cortical blindness and cortical deafness” by Gabriel Anton. Cognitive Neuropsychology, 10, 263–272.CrossRefGoogle Scholar
David, A. S., van Os, J., Jones, P., et al (1995) Insight and psychotic illness. Cross-sectional and longitudinal associations, British Journal of Psychiatry, 167, 621–628.Google Scholar
David, A. S. & Kemp, R. (1997) Five perspectives on the phenomenon of insight in psychosis. Psychiatric Annals, 27, 791–797.CrossRefGoogle Scholar
Davidoff, S. A., Forester, B. P., Ghaemi, S. N., et al (1998) Effect of video self-observation on development of insight in psychotic disorders. Journal of Nervous and Mental Disease. 186, 697–700.Google Scholar
Dickerson, F. B., Boronow, J. J., Ringel, N., et al (1997) Lack of insight among outpatients with schizophrenia. Psychiatric Services, 48, 195–199.Google ScholarPubMed
Fodor, J. A. (1983) The Modularity of Mind. Cambridge. MA: MIT Press.Google Scholar
Gallois, P., Ovelacq, E., Hautecoeur, P., et al (1988) Disconnexion et reconnaissance des visages. Revue Neurologique, 144, 133–119.Google Scholar
Healey, A., Knapp, M., Astin, J., et al (1998) Cost-effectiveness evaluation of compliance therapy for people with psychosis, British Journal of Psychiatry, 172, 420–424.CrossRefGoogle ScholarPubMed
Heinrichs, D. W., Cohen, B. P. & Carpenter, W. T. (1985) Early insight and the management of schizophrenia decompensation. Journal of Nervous & Mental Disease, 173, 133–138.CrossRefGoogle ScholarPubMed
Howarth, C. I. & Gillham, W. E. C. (1981) The Structure of Psychology. London: Allen & Unwin.Google Scholar
Jaspers, K. (1913) General Psychopathology. Manchester: Manchester University Press.Google Scholar
Johnson, S. & Orrell, M. (1995) Insight and psychosis: a social perspective. Psychological Medicine, 25, 515–520.Google Scholar
Kemp, R., Applewhaite, G., Hayward, P., et al (1996a) Compliance therapy in psychotic disorders: randomised controlled trial. British Medical Journal, 312, 345–349.Google Scholar
Kemp, R. & David, A. (1996b) Psychological predictors of insight and compliance in psychotic patients. British Journal of Psychiatry, 169, 444–450.Google Scholar
Kemp, R. & David, A. (1997) Insight and compliance. In Treatment Compliance and the Treatment Alliance in Serious Mental Illness (ed. Blackwell, B.), pp. 61–84. Amsterdam: Harwood Academic.Google Scholar
Kemp, R., Kirov, G., Everitt, B., et al (1998) Randomised controlled trial of compliance therapy. 18-month follow-up. British Journal of Psychiatry, 172, 413–419.Google Scholar
Kraepelin, E. (1919) Dementia Praecox and Paraphrenia (trans. Barclay, R. M.). Edinburgh: E. & S. Livingstone.Google Scholar
Lam, D. & Wong, G. (1997) Prodromes, coping strategies, insight and social functioning in bipolar affective disorders. Psychological Medicine, 27, 1091–1100.Google Scholar
Laws, K. R. (1999) A meta analytic review of Wisconsin Card Sorting studies in schiozphrenia: general intellectual deficit in disguise? Cognitive Neuropsychiatry, 4, 1–35.Google Scholar
Lewis, A. (1933) Eugenics in Germany. Lancet, ii, 297–298.Google Scholar
Lewis, A. (1934a) The psychopathology of insight. British Journal of Medical Psychology, 14, 332–348.CrossRefGoogle Scholar
Lewis, A. (1934b) German eugenic legislation: an examination of fact and theory. Eugenics Review, 26, 183–191.Google ScholarPubMed
Lewis, A. (1935) Research in psychiatry. Lancet, i, 1223–1224.Google Scholar
Lewis, A. (1951) Henry Maudsley: his work and influence. Journal of Mental Science, 97, 259–277.Google Scholar
Lewis, A. (1955) Philippe Pinel and the English. Proceedings of the Royal Society of Medicine, 48, 581–586.CrossRefGoogle Scholar
Lewis, A. (1978) Psychiatry and the Jewish tradition. Psychological Medicine, 8, 9–19.Google Scholar
Lewis, A. & Campbell, T. D. (1926) The aborigines of South Australia: anthropometric descriptive and other observations recorded at Ooldea. Transactions of the Royal Society of Southern Australia, 50, 183–191.Google Scholar
Lewis, G. (1993) Some studies of social causes of and cultural response to disease. In The Anthropology of Disease (ed. Mascie-Taylor, C. G. N.) pp. 91–123. Oxford: Oxford University Press.Google Scholar
Lysaker, P., Bell, M., Milstein, R., et al (1994) Insight and psychosocial treatment compliance in schizophrenia. Psychiatry, 57, 332–348.CrossRefGoogle ScholarPubMed
Macpherson, R., Jerrom, B. & Hughes, A. (1996) Relationship between insight, educational background and cognition in schizophrenia. British Journal of Psychiatry, 168, 718–722.Google Scholar
Maudsley, H. (1863) Delusions. Journal of Mental Science. 9, 1–24.CrossRefGoogle Scholar
McEvoy, J. P. (1998) The relationship between insight in psychosis and compliance with medications. In Insight and Psychosis (eds Amador, X. F. & David, A. S.). New York: Oxford University Press.Google Scholar
McEvoy, J. P., Apperson, L. J., Appelbaum, P. S., et al (1989) Insight into schizophrenia: its relationship to acute psychopathology. Journal of Nervous and Mental Disease, 177, 43–47.CrossRefGoogle ScholarPubMed
McEvoy, J. P., Schooler, N. J., Friedman, E., et al (1993) Use of psychopathology vignettes by patients with schizophrenia or schizoaffective disorder and by mental health professionals to judge patients' insight. American Journal of Psychiatry, 150, 1649–1653.Google Scholar
McEvoy, J. P., Harunan, M., Gottlieb, D., et al (1996) Commonsense, insight and neuropsychological test performance in schizophrenia patients. Schizophrenia Bulletin, 22, 635–641.Google Scholar
McGlynn, S. M. & Schacter, D. J. (1989) Unawareness of deficits in neuropsychology syndromes. Journal of Experimental and Clinical Neuropsychology, 11, 143–205.Google Scholar
McNally, S. E. & Goldberg, J O. (1997) Natural cognitive coping strategies in schizophrenia. British Journal of Medical Psychology, 70, 159–167.Google Scholar
Nayani, T. H. & David, A. S. (1996) The auditory hallucination – a phenomenological survey. Psychological Medicine, 26, 177–189.CrossRefGoogle ScholarPubMed
Parker, S. T., Mitchell, R. W. & Boccia, M. L. (eds) (1994) Self Awareness in Animals and Humans. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Perkins, R. & Moodley, P. (1993) The arrogance of insight? Psychiatric Bulletin, 17, 233–234.Google Scholar
Povinelli, D. J. (1993) Reconstructing the evolution of the mind. American Psychologist, 48, 493–509.Google Scholar
Rokeach, M. (1964) The Three Christs of Ypsilanti. New York: Knopf.Google Scholar
Sanz, M., Constable, G., Lopez-lbor, I., et al (1998) A comparative study of insight scales and their relationship to psychopathological and clinical variables. Psychological Mediane. 28, 437–446.CrossRefGoogle ScholarPubMed
Shepherd, M. (1986) A representative psychiatrist: the career, contributions and legacies of Sir Aubrey Lewis. Psychological Medicine. 16 (suppl. 10), 1–31.Google Scholar
Sperry, R. W., Zaidel, E. & Zaidel, D. (1979) Self-recognition and social awareness in the disconnected hemispheres. Neuropsychologia, 22, 661–673.Google Scholar
Startup, M. (1996) Insight and cognitive deficits in schizophrenia: evidence for a curvilinear relationship. Psychological Medicine, 26, 1277–1281.Google Scholar
Startup, M. (1997) Awareness of own and others' schizophrenic illness. Schizophrenia Research, 26, 203–211.Google Scholar
Swanson, S. L., Freudenreich, O., McEvoy, J. P., et al (1995) Insight in schizophrenia and mania. Journal of Nervous and Mental Disease, 183, 752–755.CrossRefGoogle ScholarPubMed
Tolor, A. & Reznikoff, M. (1960) A new approach to insight: a preliminary report. Journal of Nervous and Mental Disease, 130, 286–296.Google Scholar
Turner, T. (1988) Henry Maudsley – psychiatrist, philosopher and entrepreneur. Psychological Medicine, 18, 551–574.CrossRefGoogle ScholarPubMed
Weiden, P. J. & Olfson, M. (1995) The cost of relapse in schizophrenia. Schizophrenia Bulletin, 21, 419–429.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Young, D. A., Davila, R. & Scher, H. (1993) Unawareness of illness and neuropsychological performance in chronic schizophrenia. Schizophrenia Research, 10, 117–124.Google Scholar
Young, D. A., Zakzanis, K. K., Bailey, C., et al (1998) Further parameters of insight and neuropsychological deficit in schizophrenia and other chronic mental disease. Journal of Nervous and Mental Disease, 186, 44–50.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.