Life and education
Luc Ciompi studied medicine in Berne, Geneva and Paris from 1951 to 1956. He then specialized in psychiatry and psychotherapy (1957-1963), first training in psychoanalysis, then later also in systemic family therapy (1959-1970).
Between 1963 and 1973 he led the so-called Enquête de Lausanne at the Lausanne University Psychiatric Hospital, an extensive research program on the long-term course of various mental disorders into old age. In the 1970s, he established in Lausanne a network of so-called halfway institutions aimed at social reintegration of long-term psychiatric patients.
From 1977 to 1994, he directed the Social Psychiatric University Hospital in Berne, where he again set up a network of halfway institutions, and created the residential therapeutic community Soteria Berne (1984), an alternative institution for a mainly psychotherapeutic and sociotherapeutic treatment of acute schizophrenic psychoses.
After his retirement in 1994, he spent one and a half years as guest professor at the Konrad Lorenz Institute in Altenberg near Vienna, studying the evolutionary roots of emotion and cognition. Subsequently, he has mainly been active as a book author, lecturer, psychotherapist and supervisor.
Ciompi has been married since 1959 and has two sons and three grandchildren. He lives in Belmont-sur-Lausanne, Switzerland.
Work
His first major research program, the Enquête de Lausanne focussed on the long-term evolution of all kinds of mental diseases over several decades, until old age. He studied an initial sample of some 5000 former patients, combining his data with mortality studies in order to identify biases in his sample.
His main findings were that, contrary to common beliefs, in about a quarter of the cases, schizophrenic disorders disappear altogether in the long run, and improve considerably in another roughly a quarter to a third of cases. Several other mental illnesses also displayed a tendency to attenuation in old age. [1] [2] [3] [4]
Ciompi is also one of the proponents of the vulnerability-stress model of schizophrenia, which may explain the great variability of symptomatology and of long-term evolutions of the illness. [1] [4]
In his studies on rehabilitation, Ciompi and his collaborators found that social and professional reintegration of long-term mental patients depends more on the expectations of their environment (family, psychiatrists, nurses etc.) than on a number of general, psychopathologic and social variables.
Since the 1980s, Ciompi has also been developing the above mentioned concept of affect-logics, an interdisciplinary synthesis of neurobiological, psychological psychoanalytical, sociological and evolution-theoretical notions aimed at understanding the interactions between cognition and emotion.
Based on the affect-logics approach, he eventually proposed a partly new understanding of the psyche and of psychotic disorders, in which both linear and non-linear emotional dynamics and critically increasing emotional tensions play a key role.
Eight testable working hypotheses on affective-cognitive interactions were elaborated in a joint paper with the American neurobiologist Jaak Panksepp. These concepts have also been supported by a computer-simulation of basic affective-cognitve interactions. [5] [6] [7] [8] [4]
A practical application of these principles is the therapeutic community Soteria Berne, founded in 1984 and functioning for almost four decades, entirely focused on a sustained reduction of emotional tensions in and around the psychotic patient. [9] [10] [11]
In a recent theoretical publication, Ciompi and Tschacher also link the concept of affect-logics with the concepts of synergetics, of embodiment, as well as with Karl J. Friston’s principle of minimization of free energy. [12]
In later publications, Ciompi dealt also with more general problems such as the experience of time, the social effects of collective emotions, and the question of mind and consciousness, postulating that emotions play an important role in the evolutionary emergence of consciousness. [13] [14]
Emotions are mental states brought on by neurophysiological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or displeasure. There is no scientific consensus on a definition. Emotions are often intertwined with mood, temperament, personality, disposition, or creativity.
Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety, suspicion, or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself. Paranoia is distinct from phobias, which also involve irrational fear, but usually no blame.
Schizophrenia is a mental disorder characterized by reoccurring episodes of psychosis that are correlated with a general misperception of reality. Other common signs include hallucinations, delusions, disorganized thinking, social withdrawal, and flat affect. Symptoms develop gradually and typically begin during young adulthood and are never resolved. There is no objective diagnostic test; diagnosis is based on observed behavior, a psychiatric history that includes the person's reported experiences, and reports of others familiar with the person. For a diagnosis of schizophrenia, the described symptoms need to have been present for at least six months or one month. Many people with schizophrenia have other mental disorders, especially substance use disorders, depressive disorders, anxiety disorders, and obsessive–compulsive disorder.
A thought disorder (TD) is a disturbance in cognition which affects language, thought and communication. Psychiatric and psychological glossaries in 2015 and 2017 identified thought disorders as encompassing poverty of ideas, neologisms, paralogia, word salad, and delusions - all disturbances of thought content and form. Two specific terms have been suggested — content thought disorder (CTD) and formal thought disorder (FTD). CTD has been defined as a thought disturbance characterized by multiple fragmented delusions, and the term thought disorder is often used to refer to an FTD: a disruption of the form of thought. Also known as disorganized thinking, FTD results in disorganized speech and is recognized as a major feature of schizophrenia and other psychoses. Disorganized speech leads to an inference of disorganized thought. Thought disorders include derailment, pressured speech, poverty of speech, tangentiality, verbigeration, and thought blocking. One of the first known cases of thought disorders, or specifically OCD as it is known today, was in 1691. John Moore, who was a bishop, had a speech in front of Queen Mary II, about "religious melancholy."
In psychology, schizotypy is a theoretical concept that posits a continuum of personality characteristics and experiences, ranging from normal dissociative, imaginative states to extreme states of mind related to psychosis, especially schizophrenia. The continuum of personality proposed in schizotypy is in contrast to a categorical view of psychosis, wherein psychosis is considered a particular state of mind, which the person either has or does not have.
Expressed emotion (EE), is a measure of the family environment that is based on how the relatives of a psychiatric patient spontaneously talk about the patient. It specifically measures three to five aspects of the family environment: the most important are critical comments, hostility, emotional over-involvement, with positivity and warmth sometimes also included as indications of a low-EE environment. The psychiatric measure of expressed emotion is distinct from the general notion of communicating emotion in interpersonal relationships, and from another psychological metric known as family emotional expressiveness.
Reduced affect display, sometimes referred to as emotional blunting or emotional numbing, is a condition of reduced emotional reactivity in an individual. It manifests as a failure to express feelings either verbally or nonverbally, especially when talking about issues that would normally be expected to engage emotions. In this condition, expressive gestures are rare and there is little animation in facial expression or vocal inflection. Additionally, reduced affect can be symptomatic of autism, schizophrenia, depression, post-traumatic stress disorder, depersonalization disorder, schizoid personality disorder or brain damage. It may also be a side effect of certain medications.
The Soteria model is a milieu-therapeutic approach developed to treat acute schizophrenia, usually implemented in Soteria houses.
Theodore Lidz was an American psychiatrist best known for his articles and books on the causes of schizophrenia and on psychotherapy with patients with schizophrenia. An advocate of research into environmental causes of mental illness, Lidz was a notable critic of what he saw as a disproportionate focus on biological psychiatry. Lidz was a Sterling Professor of Psychiatry at Yale University. In his lifetime, he did a great amount of research on interpersonal causes of schizophrenia.
Oneiroid syndrome (OS) is a condition involving dream-like disturbances of one's consciousness by vivid scenic hallucinations, accompanied by catatonic symptoms (either catatonic stupor or excitement), delusions, or psychopathological experiences of a kaleidoscopic nature. The term is from Ancient Greek "ὄνειρος" (óneiros, meaning "dream") and "εἶδος" (eîdos, meaning "form, likeness"; literally dream-like / oneiric or oniric, sometimes called "nightmare-like"). It is a common complication of catatonic schizophrenia, although it can also be caused by other mental disorders. The dream-like experiences are vivid enough to seem real to the patient. OS is distinguished from delirium by the fact that the imaginative experiences of patients always have an internal projection. This syndrome is hardly mentioned in standard psychiatric textbooks, possibly because it is not listed in DSM.
Loren Richard Mosher was an American psychiatrist, clinical professor of psychiatry, expert on schizophrenia and the chief of the Center for Studies of Schizophrenia in the National Institute of Mental Health (1968–1980). Mosher spent his professional career advocating for humane and effective treatment for people diagnosed as having schizophrenia and was instrumental in developing an innovative, residential, home-like, non-hospital, non-drug treatment model for newly identified acutely psychotic persons.
Paradoxical laughter is an exaggerated expression of humour which is unwarranted by external events. It may be uncontrollable laughter which may be recognised as inappropriate by the person involved. It is associated with mental illness, such as mania, hypomania or schizophrenia, schizotypal disorder and can have other causes. Paradoxical laughter is indicative of an unstable mood, often caused by the pseudobulbar affect, which can quickly change to anger and back again, on minor external cues.
Jaak Panksepp was an Estonian-American neuroscientist and psychobiologist who coined the term "affective neuroscience", the name for the field that studies the neural mechanisms of emotion. He was the Baily Endowed Chair of Animal Well-Being Science for the Department of Veterinary and Comparative Anatomy, Pharmacology, and Physiology at Washington State University's College of Veterinary Medicine, and Emeritus Professor of the Department of Psychology at Bowling Green State University. He was known in the popular press for his research on laughter in non-human animals.
Affect-logics or Affect logic is a biopsychosocial notion, introduced in 1988 by Swiss psychiatrist Luc Ciompi, relating initially to schizophrenia and other mental conditions, and later elaborated into a general meta-theory on the interactions between emotion and cognition, expanding from the individual level to collective phenomena.
In psychiatry, catastrophic schizophrenia or schizocaria is an obsolete term for a rare and acute form of schizophrenia leading directly to a severe and unremitting chronic psychosis and deterioration of the personality. Catastrophic schizophrenia was thought to be the most severe subtype of schizophrenia, as it had "an acute onset and rapid decline into a chronic state without remission". Catastrophic schizophrenia was also referred to as schizocaria, which was defined by Gerhard Mauz as a psychosis that caused the absolute destruction of the core of one's being. The term "catastrophic schizophrenia" has fallen out of use due to a number of reasons, including advances in psychiatric treatment, which led to a significant decline in patients that fit the diagnosis as their symptoms did not reach the severity of catastrophic schizophrenia, along with modern refinement of the definition and subtypes of schizophrenia. This term has not been included in any version of the DSM. In modern terms, catastrophic schizophrenia would likely be defined as 'acute-onset chronic schizophrenia with poor prognosis'.
Pseudoneurotic schizophrenia is a postulated mental disorder categorized by the presence of two or more symptoms of mental illness such as anxiety, hysteria, and phobic or obsessive-compulsive neuroses. It is often acknowledged as a personality disorder. Patients generally display salient anxiety symptoms that disguise an underlying psychotic disorder.
The evolution of schizophrenia refers to the theory of natural selection working in favor of selecting traits that are characteristic of the disorder. Positive symptoms are features that are not present in healthy individuals but appear as a result of the disease process. These include visual and/or auditory hallucinations, delusions, paranoia, and major thought disorders. Negative symptoms refer to features that are normally present but are reduced or absent as a result of the disease process, including social withdrawal, apathy, anhedonia, alogia, and behavioral perseveration. Cognitive symptoms of schizophrenia involve disturbances in executive functions, working memory impairment, and inability to sustain attention.
The epigenetics of schizophrenia is the study of how inherited epigenetic changes are regulated and modified by the environment and external factors and how these changes influence the onset and development of, and vulnerability to, schizophrenia. Epigenetics concerns the heritability of those changes, too. Schizophrenia is a debilitating and often misunderstood disorder that affects up to 1% of the world's population. Although schizophrenia is a heavily studied disorder, it has remained largely impervious to scientific understanding; epigenetics offers a new avenue for research, understanding, and treatment.
Bouffée délirante (BD) is an acute and transient psychotic disorder. It is a uniquely French psychiatric diagnostic term with a long history in France and various French speaking nations: Caribbean, e.g., Haiti, Guadeloupe, Antilles and Francophone Africa. The term BD was originally coined and described by Valentin Magnan (1835–1916), fell into relative disuse and was later revived by Henri Ey (1900–1977).
Wolfgang Tschacher is a Swiss psychologist and university lecturer. He is professor at the University of Bern.., Switzerland. He has conducted theoretical and empirical research in the fields of psychotherapy and psychopathology, especially from a systems-theoretical perspective that includes self-organization and complexity theory. He is active in the development of time series methods for the modeling of psychotherapeutic processes and generally social systems.
