Die Schmerzasymbolie – um 1930 von Paul F. Schilder entdeckt und heute fast vergessen?

Paul Ferdinand Schilder was born in Vienna in 1886 and died in New York in 1940. Today he is remembered particularly as a psychoanalyst and a psychotherapist. His research in neuroscience, however, was also both comprehensive and innovative. For example, he is considered to be the first to describe Schilder’s disease, which was named after him. This article focuses on pain asymbolia, which was also first described by Schilder, and is currently little known and considered to be rarely encountered. Pain asymbolia is a central impairment of pain experience with no negative affective-emotional component. The basis of Schilder’s discovery and the differential diagnosis of pain asymbolia was the detailed examination of eleven medical cases between 1928 and 1930. His publications on the condition are characterized by meticulousness, progressive thinking and critical reflection. He nosologically assigned pain asymbolia to the group of agnosias and integrated it into the concept of body image, which was a central issue in his entire scientific work. This article additionally addresses the question of whether Schilder’s assumptions are still valid today and what consequences might arise from this.