Psychopathology

Metaphysical realism about mental disorder is the thesis that mental disorder exists mind-independently. There are two ways to challenge metaphysical realism about mental disorder. The first is by denying that mental disorder exists. The second is by denying that mental disorder exists mind-independently. Or, differently put, by arguing that mental disorder is mind-dependent. The aim of this paper is three-fold: (a) to examine three ways in which mental disorder can be said to be mind-dependent (namely, by being causally dependent on (...) the human mind, by being weakly dependent on human attitudes, and by being strongly dependent on human attitudes), (b) to clarify their differences, and (c) to discuss their implications regarding metaphysical realism about mental disorder. I argue that mental disorder being mind-dependent in the first two senses is compatible with metaphysical realism about mental disorder, whereas mental disorder being mind-dependent in the third sense is not. (shrink)

The main message of Neuroethics is that neuroscience forces us to reconceptualize human agency as marvelously diverse and flexible. Free will can arise from unconscious brain processes. Individuals with mental disorders, including addiction and psychopathy, exhibit more agency than is often recognized. Brain interventions should be embraced with cautious optimism. Our moral intuitions, which arise from entangled reason and emotion, can generally be trusted. Nevertheless, we can and should safely enhance our brain chemistry, partly because motivated reasoning crops up in (...) everyday life and in the practice of neuroscience itself. Despite serious limitations, brain science can be useful in the courtroom and marketplace. Recognizing all this nuance leaves little room for anxious alarmism or overhype and urges an emphasis on neurodiversity. The result is a highly opinionated tour of neuroethics as an exciting field full of implications for philosophy, science, medicine, law, and public policy. (shrink)

Many methodologies for systematic study of lived experience have been proposed in recent decades. These methods are typically calibrated in terms of the depth and complexity of data collection, and whether they consider reports on pre-reflective experience admissible. Even though it has been shown that lived experience occurs at different timescales (elementary, integrative, narrative), contemporary methods tend to focus on momentary experience. We trace the focus on momentary experience to the current cultural milieu and attitudes in the history of psychology. (...) We point out the need for studying temporally extended experiences in the field of psychopathology. We propose that lived experiences at different timescales are nested within each other and that this principle can be used to organize data collected with qualitative methods for the study of experience. We suggest that temporally extended experiences occur at the narrative level of description (i.e. they consist of experiential reports and sense-making). (shrink)

Thomas Szasz famously argued that mental illness is a myth. Less famously, Szasz argued that since mental illness is a myth, so too is psychotherapy. Szasz’ claim that mental illness is a myth has been much discussed, but much less attention has been paid to his claim that psychotherapy is a myth. In the first part of this essay, I critically examine Szasz’ discussion of psychotherapy in order to uncover the strongest version of his case for thinking that it is (...) a myth. As we’ll see, this involves an understanding of psychotherapeutic interventions as treatments of psychopathological problems. In the rest of this essay, I turn to this directly and argue that psychotherapy has an important non-pathocentric dimension. I argue that we fail to appreciate the nature and variety of psychotherapy if we concentrate only on its pathocentric dimensions. Though I use Szasz as a stalking horse, the substantive topic is the nature of psychotherapy. This enquiry falls into the philosophy of psychotherapy as distinct from the philosophy of psychiatry and the philosophy of psychoanalysis. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy's Role in Psychopathology Back to Jaspers and an Appeal to Grow PracticalThe author reports no conflicts of interest.In "Philosophy's role in theorizing psychopathology," Gibson presents a defense of the continued relevance of philosophy to psychopathology, and a non-exhaustive framework for the role of philosophy in this domain (Gibson, 2024). I find it hard to disagree that psychopathology is soaked in philosophy from its origins, and that to try (...) and dry it out would be both unwise and impossible.In this commentary, I go back to Karl Jaspers' account of the role of philosophy in his General Psychopathology. In doing so, I do not find that Gibson adds anything new, but instead gives us a well-illustrated reminder that philosophy "is operative within every living science" (Jaspers, 1997, p. 770).Situated Psychopathological TheorizingGibson addresses a broad 'we' who might be engaged with psychopathological theorizing. This seems to encompass three main settings, from which examples are drawn.1. Everyday and regulative social practices (ordinary and legal setting).2. Empirically driven disciplines which work with psychopathological constructs (academic setting).3. Psychiatry and psychotherapy (clinical setting).In my view, it is a mistake not to map the terrain where psychopathological theorizing is situated. In each setting psychopathological theorizing has its own set of aims and constraints. In the ordinary setting, the aim might be to know whether to blame a loved one for their action. In the legal setting it might be to decide whether treatment or punishment is appropriate. In the clinical setting, the aim is usually a therapeutic assessment, and moral stance taking is often best kept at bay. In the academic setting, we might want to ensure our concepts are reliable and valid, opening them up to investigation using objective scientific methods. [End Page 13]Beyond what can be said in the most general terms, the role of philosophy will look different in these different situations.Understanding Is Not (Just) a Philosophical ToolUnderstanding is a mode of knowing that is concerned with the particular, rather than the general, and accessed inter-relationally, relying on tacit knowledge and empathetic imagination. Gibson introduces the concept as an elementary form of social intuition, used in ordinary life to make sense of social relations and other people's behaviors and reactions. I agree with Gibson, drawing on Strawson, that Understanding is a mode of knowledge that involves the subject of enquiry as a participant (Strawson, 1982). There is a moral imperative to take this stance, which drives us to value the expansion of what we are able to understand of other people's mental states. This at least partly motivates the agenda when we theorize about psychopathology.At times throughout his argument, Gibson seems to be arguing for the role of Understanding in psychopathological theorizing, in place of his explicit aim of arguing for the role of philosophy. However it is not at all clear that this replacement can be made. Accepting the picture drawn, Understanding is not any more the expertise or domain of the philosopher than the author, police officer, or sociologist. We are surely not meant to take Understanding as a uniquely philosophical tool, but rather a mode of knowing available to all social agents, integral to social reasoning in ordinary life and in the human studies.What philosophy can distinctively do is point to and defend the existence of forms of intersubjective and tacit knowledge within human studies such as psychopathology. For Jaspers, Understanding can be a scientific tool, albeit one that reminds us that knowledge in psychopathology is not all of one kind. One role for philosophy therefore is to help us to "distinguish the different modes of knowing," so that we might "order knowledge into a comprehensive whole" (Jaspers, 1997, p. 769). This is akin to the 'synthetic' role that Gibson proposes.Philosophy and ScienceJaspers defines scientific knowledge broadly as knowledge with "general validity, convincing insights (which can be proved), clarity of method, and the possibility for a meaningful discussion" (Jaspers, 1997, p. 768).We do not get such a definition from Gibson, but in the sections of... (shrink)

It is a mistake to think that any philosophical contribution to the study of psychopathology is otiose. I identify three non-exhaustive roles that philosophy can and does occupy in the study of mental disorder, which I call the agenda-setting role, the synthetic role, and the regulative role. The three roles are illustrated via consideration of the importance of Jaspers' notion of understanding and its application to specific examples of mental disorder, including delusions of reference, Capgras delusion and other monothematic delusions, (...) and clinical depression. Together the three roles assign to philosophy of psychopathology the task of determining how to situate the varieties of mental disorder within the system of interpretive and evaluative concepts that partially make up the dynamic but indispensable manifest image. (shrink)

The article aims at expanding the horizon of phenomenological psychopathology of depression from a social theoretical perspective. Based on Merleau-Ponty’s phenomenological ontology, in the first section, depression is reinterpreted as a disruption of chiasm: it is not merely the illness of the body, the disorder of the mind, or a specific form of social suffering, but the interrelated distortion of time consciousness, agency, and interaffectivity. The phenomenological clarification of these components provides opportunity for connecting sociological and psychopathological insight. In the (...) second part, contemporary critical theories of acceleration, globalization, biopolitics, and system colonization are reinterpreted to highlight the structural and cultural context of late modern time consciousness, agency, and interaffectivity. In the third section, it is analyzed, how these social constituents shape the space of contemporary socialization processes, including the emergence of those intersubjective distortions, which potentially affect the entirety of chiasm in a depressive way. In the final section, the conclusions for therapy are explored, including the potentials for expanding the epistemological, substantive, and emancipatory horizon of phenomenological psychopathology. (shrink)

According to a common philosophical intuition, the deep nature of things is hidden from us, and the world as we know it through perception and science is, just like a dream, shadows, or a computer simulation, somehow shallow and lacking in reality. This “intuition of unreality” clashes with a strong, but perhaps more naive, intuition to the effect that the world as we know it seems perfectly real. Shadows, dreams, or informational structures appear too unreal to be identical to the (...) world as we know it! This clash between the two intuitions forms the basis of the “problem of reality.” In the late nineteenth century psychiatrists encountered patients they referred to as “metaphysician doubters” who constantly questioned the reality of the world. This essay draws on studies of these patients in order to reject, and indeed diagnose, the intuition of unreality and recent metaphysical doctrines drawing on it, such as structuralism, digitalism, and virtual realism. (shrink)

Traditional evolutionary theory invoked natural and sexual selection to explain species- and sex-typical traits. However, some heritable inter-individual variability in behaviour and psychology – personality – is probably adaptive. Here we extend this insight to common psychopathological traits. Reviewing key findings from three background areas of importance – theoretical models, non-human personality and evolved human social dynamics – we propose that a combination of social niche specialisation, negative frequency-dependency, balancing selection and adaptive developmental plasticity should explain adaptation for individual differences (...) in psychology – ‘specialised minds’ – explaining some variance in personality and psychopathology trait dimensions, which share various characteristics. We suggest that anthropological research of behavioural differences should be extended past broad demographic factors (age and sex) to include individual specialisations. As a first step towards grounding psychopathology in ancestral social structure, we propose a minimum plausible prevalence, given likely ancestral group sizes, for negatively frequency-dependent phenotypes to be maintained as specialised tails of adaptive distributions – below the calculated prevalence, specialisation is highly unlikely. For instance, chronic highly debilitating forms of autism or schizophrenia are too rare for such explanations, whereas attention-deficit-hyperactivity disorder and broad autism phenotypes are common enough to have existed in most hunter-gatherer bands, making adaptive explanations more plausible. (shrink)

According to a common philosophical intuition, the deep nature of things is hidden from us, and the world as we know it through perception and science is somehow shallow and lacking in reality. For all we knwo, the intuition goes, we could be living in a cave facing shadows, in a dream or even in a computer simulation, This “intuition of unreality” clashes with a strong, but perhaps more naive, intuition to the effect that the world as we know it (...) seems perfectly real. Shadows, dreams, or informational structures appear too unreal to be identical to the world as we know it! This clash between the two intuitions forms the basis of the "problem of reality." At the turn of the nineteenth century psychiatrists encountered patients they referred to as “metaphysician doubters” who constantly questioned the reality of the world. This essay draws on the study of these patients to reject, and indeed diagnose, the intuition of unreality and recent metaphysical doctrines drawing on it, such as structuralism, digitalism, and virtual realism. (shrink)

إن للعب دور أساس في تنمية مختلف جوانب شخصيات الأطفال، الحسية الحركية والعقلية والوجدانية واللغوية والاجتماعية ... فهو يؤهلهم لاكتساب القدرة على احترام النظام وقوانين الجماعة، كما يدفعهم إلى تبني قيم التعاون والتضامن وضبط النفس والصبر واحترام الآخر...ولقد تعددت التفسيرات التي أعطيت للعب الأطفال بتعدد النظريات والمدارس السيكولوجية التي اهتمت بهذه الممارسة. لذا سنحاول تقديم مقاربة مركزة لهذا الموضوع عبر الإجابة على الأسئلة التالية: ما الذي نقصده باللعب؟ وكيف يسهم اللعب في تنمية جوانب الشخصية عند الطفل؟ وما هي أهم النظريات (...) السيكولوجية التي اهتمت بتفسير اللعب؟ وما علاقة اللعب بالتعلم؟ اللعب هو نشاط جسمي وعقلي ونفسي تلقائي لا يصدر تحت أي إكراه أو ضغط خارجي¹، وهو يعتبر وسيلة أساسية لتنشئة الأطفال وإدماجهم في محيطهم الاجتماعي. فعبر اللعب يستضمر الطفل القوانين والمعايير المتحكمة في إقامة علاقات اجتماعية متوازنة وسليمة مع الآخرين. إن هذه الممارسة تعتبر «وسيلة للتنشئة و إدماج الطفل في بيئته، فاللعب يجعل الطفل فردا مشاركا في الجماعة، ويطور فهمه للغة وللنظام الاجتماعي، كما يمكنه من إدماج مفهوم المعيار بإدراكه أن العلاقة مع الآخرين تحكمها معايير و يجعله مساهما فعالا في سيرورة تعلمه»². إن مدرسة علم النفس التقليدية لم تعر أي اهتمام باللعب ولم تعطه أي قيمة، فبالنسبة لها يعتبر تسلية فقط وتزجية للوقت. حيث يرى أصحاب هذه المدرسة، كما يؤكد ذلك بياجيه³، أن اللعب خال من المعنى التربوي. كما أن البحث في موضوع اللعب من طرف المربين التقلديين لم ينل ما يستحقه من العناية والاهتمام. (shrink)

This book is a call to expand and diversify our approach to the study of the human mind in relation to the Theory of Mind. It proposes that it is necessary to combine cross-disciplinary methods to arrive at a more complete understanding of how our minds work. Seeking to expand the discussion surrounding the Theory of Mind beyond the field of psychology, and its focus on our capacity to ascribe mental states to other people, this volume collects evidence and research (...) to point to a more holistic understanding of our own minds, the minds of others, behavior, language, and reasoning. This book therefore illuminates the conceptual intricacy underlying the Theory of Mind. It posits that a wide scope is necessary to make a breakthrough in scientific research towards a full understanding of the nature, function, and development of our capacity to converge on biological processes of the brain towards consciousness, emotion, awareness, and cognition. The volume presents methods, results, critiques, and models intended to provoke debates in various academic disciplines. It is of interest to scholars working in psychology, neuroscience, philosophy of mind, and artificial intelligence. (shrink)

Recent research has drawn attention to the prevalence of self-reported autism within online communities of involuntary celibates (incels). These studies suggest that some individuals with autism may be particularly vulnerable to the impact of incel forums and the hopelessness they generate. However, a more precise description of the experiential connection between inceldom, self-reported autism, and hopelessness has remained unarticulated. Therefore, this article combines empirical studies on the incel community with phenomenological and embodiment approaches to autism, hopelessness, and online affectivity. We (...) analyze three interrelated aspects of online interactions in incel communities – worldview, bodily self-relation, and mutual dismissals – and examine how these elements contribute to the consolidation of the loss of significant life possibilities. By investigating the potential negative influence of specific online environments on affective dispositions, our approach contributes to the debate on current challenges to “situate” phenomenological psychopathology. (shrink)

Imagine a person with a compulsive illness that leads her to frequently wash her hands. She will scrub her hands under all sorts of bizarre conditions, such as seeing a garbage truck drive down the road or hearing the word ‘trash’ on television. Sometimes her hands do need to be cleaned but this is usually a fortunate coincidence. This person does not have control over her behavior because she cannot help herself from washing her hands (unless dire consequences were to (...) follow, such as the threat of imminent death, poisonous gassing of her children, and so on). Because she lacks control over her behavior, most people are inclined to think that she is not responsible for her compulsive washing or any harm that comes of it. We might even think that it is inappropriate to blame her if she cannot stop washing when she ought to. Importantly, the impact of her illness extends beyond the issues of responsibility and blame since it impacts the degree to which she is autonomous. After all, if she experiences extreme discomfort or alienation from her washing then it seems reasonable to suppose that her compulsive behavior does not truly represent her (or her deeper self). -/- This is the story that many philosophers of agency who have written about obsessive-compulsive disorder (OCD) tell. These theorists tend to depict those with OCD as lacking control over their behavior to such a degree that their moral responsibility and capacity for self-governance are impaired or obviated. So understood, people with OCD are of interest to philosophers of agency only insofar as they provide a colorful counterexample to one theory or another. But this story is false. In fact, it is really a caricature of the disorder that not only obscures its nature but, and more importantly, obscures the serious implications that OCD (properly understood) has for our understanding of core agential concepts, such as moral responsibility or identification with an attitude. In my dissertation I both correct this long-standing and entrenched misunderstanding of OCD in philosophical literature and work out the implications it carries for our understanding of human agency. -/- On my approach, an accurate understanding of OCD requires examining leading psychiatric literature on the disorder as well as consulting the words and experiences of people living with OCD. Although the disorder is formally defined in terms of experiencing thoughts, images, or impulses (obsessions) alongside rituals the person feels pressure to complete (compulsions), the thematic presentation of these symptoms can vary widely. For example, in Story of a Soul, St. Therese of Liseaux describes “a terrible disease of the scruples” that filled her with seemingly sinful thoughts, driving her to repeatedly pray and visit confession with little relief. In contrast, J. J. Keeler describes painful obsessions about unknowingly causing a fatal traffic collision, leading to hours spent retracing her route, scouring the news for reports of a hit-and-run, and so on. Yet despite this diversity, nearly all manifestations of OCD involve dysfunctional beliefs. These beliefs typically over-represent the chance of harm associated with an action and the person’s responsibility for preventing or causing harm. Consequently, they make those with OCD more likely to experience exaggeration of certain features of their environment or stimuli, skewing and disrupting their thinking and deliberation, leading them to engage in, as I argue, voluntary and intentional compulsive rituals aimed at averting harm and relieving anxiety. St. Therese’s sinful thoughts involve her dysfunctional beliefs about perfection, about what harms or helps her relationship with God, and about her responsibility for having those thoughts. She is driven to voluntarily pray as an attempt to relieve her anxiety and to make good with God. By comparison, Keeler obsesses that she may have caused or will cause a death and so checks her behavior on the road constantly and reduces ‘dangerous activities’ (such as driving on highways). In these memoirs we see that the pattern of beliefs at work in OCD can lead agents like Therese and Keeler to interpret certain acts as courting disaster when they are not especially risky, or certain thoughts and ideas as blasphemous when they are not representative of who that person is. -/- As noted, when philosophers discuss OCD in the context of moral responsibility, their depictions tend to stress a lack of control over one’s behavior. In reason-responsive theories, the person with OCD is thought to be unable to properly react to sufficient reasons for action even if she is able to recognize that they exist and have bearing. This is termed a failure of reason-reactivity. This is how one theorist, Michael Mckenna, frames his example of Handy the compulsive handwasher. Handy is a purported counterexample to Fischer & Ravizza’s reason-responsive theory (semicompatibilism) because Handy can recognize and react to at least one sufficient reason to refrain from washing his hands (despite ostensibly being a compelled agent). McKenna caricatures OCD by under-describing Handy’s mental states and over-emphasizing his limited ability to abstain from washing his hands in the presence of powerful countervailing considerations (e.g., to save the life of his child). McKenna’s example of Handy chiefly ignores the robust cognitive features of the disorder described above, specifically the agent’s beliefs about her own obsessions and compulsions and how they relate to the world around her. In contrast to this depiction of OCD, I argue that people with OCD are overly receptive to apparent reasons for action, seeing reasons where there are none or distorting the weight certain reasons have in deliberation. Furthermore, an accurate picture of OCD reveals that most people with the disorder do possess guidance control and are thus morally responsible. If we wish to argue that these agents are blameless, we must refine our understanding of what it means to ‘resist’ a compulsion. Instead, we must understand the difficulty associated with resisting the dysfunctional beliefs at the heart of OCD. -/- The fact that people with OCD are overly receptive to apparent reasons for action has implications not just for responsibility and freedom but also for other core concepts in agency like identification and autonomy. Identification generally refers to attitudes that ‘stand for’ an agent and so have the authority to represent her. Some philosophers argue that internal attitudes (those the agent identifies with) must be explicitly endorsed by the agent in some kind of reflective process, while others argue that more fundamental attitudes (such as our cares) are internal. Stretching back to Frankfurt’s first description of identification, obsessions have long been considered external to the agent, usually because obsessive thoughts are experienced as unwanted or upsetting. For example, Keeler’s thought that she has caused a fatal hit-and-run is distressing because the thought of having harmed someone so much is unbearable. Similarly, the rituals Keeler engages in, like checking the news for accident reports or searching the exterior of her car for blood, are upsetting to her even though they are aimed at relieving her distress. However, the same features of the disorder that lead people with OCD to become overwhelmed by reasons also appear to lead some to develop caring-like behaviors. For example, when Keeler experiences obsessions about the risk of hitting someone with her car, she becomes particularly attuned to situations in which she perceives her behavior as a threat to others on the road. In response Keeler takes serious steps to change her driving habits, including driving on surface roads rather than highways or traveling well under the speed limit. This behavior closely tracks the way agents behave when they care about something (whether it is a person, a value, an outcome). This means that, contrary to the way philosophers have hitherto understood clinical obsessions, obsessions can be internal to the agent and speak for her in a meaningful way. As I argue this is a feature and not a bug. In fact, it is a very significant, and from a therapeutic point of view, very worrying feature. This is because those cases of OCD that most resemble caring are also those in which the person lacks significant insight into her own disorder. The disorder is hidden from her own insight precisely because it is expressed in what she most cares about. Such individuals are often the most ill in terms of symptom severity and recovery trajectory. Reframing this behavior as dysfunctional caring explains why these obsessions take on ever greater significance to the agent and take up increasing space in her deliberative horizon. This finding, in turn, may indicate that therapies aimed at externalizing obsessions and removing them from one’s deliberative agenda could wear away at otherwise recalcitrant obsessions and compulsive rituals. -/- Mischaracterizations of OCD in philosophy of agency have driven a number of problematic depictions of the disorder, and the arguments built around such mischaracterizations are necessarily deficient. Depicting OCD as largely about control has yoked our discussions of the disorder’s symptoms to older, inaccurate conceptions of psychological compulsion as a kind of force. This has been to our theoretical detriment since it has concealed the degree to which compulsion in OCD is both voluntary and purposeful as well as driven significantly by dysfunctional beliefs. Recognizing these features of OCD and their impact on agency has significant implications for the way we theorize about concepts like responsibility and identification. For example, if people with OCD do possess guidance control then we must reassess our intuition that they are excused from blame, or else modify our understanding of what the relevant excusing conditions are. Similarly, understanding that seriously ill people with OCD may display caring-like behavior may inform our understanding of internality’s role in agency as well as potential treatment methods. (shrink)

This text aims to show how vulnerability is an essential feature of subjectivity. The fragility of existence is thematically addressed by accounting for phenomenology and psychopathology. In the first part, I will show how the Husserlian subject is anything but a pure and merely transcendental ego. Instead, I argue that a subject, immersed in and conditioned by factuality, emerges through discussions on the concept of “liminality” in his posthumous writings. In the second part, I will compare Husserl’s and Jaspers’ views—perspectives (...) that compensate and enrich each other. According to Jaspers, “limit-situations” are characterized by inevitable antinomies that prevent a person from going on as usual. They are super-individual challenges intrinsic to existence, thus unavoidable. Furthermore, in his view, limit situations enlighten the paradoxical structure of existence and call for what has been named an existential turn up, i.e., to reach a higher level of self-awareness and depth of feeling in case the limit situation is mastered. The final aim is to show that ‘limit phenomena’ are intrinsic to human existence, which is nothing more than a continuous struggle (Streben). Such a vision of the subject can be useful in rethinking the notion of ‘well-being’, which today is anchored to an ideal of perfection devoid of all weakness. Accordingly, taking care of vulnerability becomes a moral and ontological imperative to be followed if we want to survive the “sea of suffering” that envelops us. (shrink)

This work begins with a brief review – from the _physical education_ movement that began in ancient Greece and is deeply rooted in 19th century Europe, to the _somatics_ movement alive today. The review captures primary historical and conceptual references, relevant to the therapeutic-embodied exploratory work. Then, G. Stanghellini’s mental health care model [ 2 ] is reviewed. This model is considered within reflexive self-awareness and spoken dialogue: the main vehicles in relation with alterity and its consequences in the realm (...) of psychotherapeutic encounter and intervention. This will highlight the individual’s bodily movement and inter-corporeal ‘proto-dialogue’ as a prior realm of therapeutic intervention. Next, a brief consideration of E. Strauss work [ 31 ] is presented. This paper’s hypothesis is that bodily qualitative dynamics highlighted by phenomenology are essential for an effective mental health therapeutic intervention. A ‘seed’ of a framework is proposed in this paper; this seed assesses some phenomenological assets of a positive conception of mental health, for which self-awareness education is key to develop skills such as _kinaesthetic intelligence_ and _attunement_ and to educate healthy persons who can promote edifying social relations and environments. (shrink)

In this chapter, we explain how Karl Jaspers’ concept of empathy can be expanded by drawing upon the tradition of philosophical phenomenology. In the first section, we offer an account of Jaspers' concepts of empathy and incomprehensibility as he develops them in General Psychopathology and “The Phenomenological Approach in Psychopathology.” In the second section, we survey the recent literature on overcoming Jaspers' notion of incomprehensibility and expanding his concept of empathy. In the third section, we outline the levels of investigation (...) at which phenomenological inquiries into psychopathology may proceed. These levels of human existence are, in descending order of depth, (1) phenomenal experiences, (2) interpretive frameworks, (3) modes of existence, and (4) existentials. In the fourth and final section, we argue that to fully empathically comprehend patients with schizophrenia and other mental disorders, the possibility of alterations at all four levels of existence must be acknowledged. (shrink)

A mechanistic explanation is a desired outcome in many studies of perception. Such explanations require discovering the processes that contribute to the realization of a perceptual phenomenon at different levels of information processing. The present analysis aims at investigating the obstacles to develop such mechanistic explanations and their potential solutions in the context of psychopathology. Geometric-Optical Illusions (GOIs) are among perceptual phenomena that have been studied to understand psychopathology in various clinical populations. In the present analysis, the GOIs will be (...) discussed as a methodological tool in the investigation of the mechanistic approach to understanding perception in such populations. I will argue that the fact that most such studies are mainly focused on the investigation of susceptibility to GOIs can only lead to classifying such phenomena or to reporting some correlations between different aspects of such phenomena with certain brain activities, without formulating a mechanistic explanation. The investigation of the variables that mediate perceptual phenomena at earlier stages of information processing is required for the formulation of such explanations. Thus, the objective of the present analysis is twofold: 1) showing how ignoring such variables have prevented the formulation of mechanistic explanations of responses to GOIs in clinical populations, such as schizophrenia and autism, 2) analyzing the methodological aspects of an effective approach in which a top-down guidance based on phenomenological insights (the first-person data) along with the insights provided by the existing theories help overcome obstacles in developing mechanistic explanations of GOIs. (shrink)

Jaspers identifies empathic understanding as an essential tool for grasping not the mere psychic content of the condition at hand, but the lived experience of the patient. This method then serves as the basis for the phenomenological investigation into the psychiatric condition known as ‘Phenomenological Psychopathology’. In recent years, scholars in the field of phenomenological psychopathology have attempted to refine the concept of empathic understanding for its use in contemporary clinical encounters. Most notably, we have Stanghellini’s contribution of ‘second-order’ empathy (...) and Ratcliffe’s ‘radical empathy’. Through this paper, we reject the pursuit of a renewed version of ‘empathic understanding’, on the grounds that the concept is fundamentally epistemically flawed. We argue that ‘empathic understanding’ risks (1) error, leading to misdiagnosis, mistreatment and an overall misunderstanding of the experience at hand, (2) a unique form of epistemic harm that we call ‘epistemic co-opting’ and (3) epistemic objectification. To conclude, we propose that empathic understanding ought to be replaced with a phenomenological account of Fricker’s virtuous listening. (shrink)

Intersubjectivity impairment has been considered the main pathogenic nucleus of schizophrenia. Enriching this concept with references to Scheler’s phenomenology, our hypothesis is that schizophrenic subjects are affected by a deeper impairment: the inability to resonate with unipathic affectivity. Fragmentation of the Leibschema, valueception impairment, and the lack of vital impulse are, in our hypothesis, the original alterations of the schizophrenic bodily experience from which all relational impairments originate. Our proposal is, therefore, to enhance a psychotherapy that does not only focus (...) on the verbal level, but endeavors to touch the patient’s Leib, focusing on emotional sharing and on the development of a sense of cohesion of one’s body as the starting point for accessing intersubjectivity. (shrink)

The Demands of the Historical Unconscious : the Psychopathology of History.

Whether, and in what sense, research in phenomenology and phenomenological psychopathology has—in addition to its descriptive and hermeneutic value—explanatory power is somewhat controversial. This paper shows why it is legitimate to recognize such explanatory power. To this end, the paper analyzes two central concerns underlying the debate about explanation in phenomenology: (a) the warning against reductionism, which is implicit in a conception of causal explanation exclusively based on models of natural/physical causation; and (b) the warning against top-down generalizations, which neglect (...) the specificity of the individual. While acknowledging that these two caveats express serious concerns regarding the debate on explanatory models, I show that phenomenology has the resources to respond to them. These can be found in analyses of different types of causation relating to different regions of reality and in the structure of explanatory models based on exemplarity. On the basis of these analyses, I defend a pluralist account vis-à-vis explanatory models. (shrink)

Embodiment and mindfulness interventions provide a range of benefits for individuals living with trauma yet a lack of clarity surrounds their integration in group work practice. This article provides a framework for the integration of embodiment and mindfulness interventions in group settings for trauma. While such interventions can be utilised in primary trauma processing and open process group psychotherapy, this article provides particular guidance for the more general integration of these tools in structured format resourcing groups. Attention is given to (...) the value and features of a phasic, staged integration of these interventions for specialised trauma-oriented group work. This article details how mindfulness and embodiment interventions support participants to cultivate the capacity to counter experiential avoidance and reorient attention towards the present moment, consequently increasing bodily and affective self-awareness. This serves to reduce patterns of reactivity, thereby supporting symptom stabilisation, improved reflective and mentalising ability, and cultivation of the self- and co-regulatory capacities necessary for trauma-processing group work. These interventions also possess supportive implications for the facilitator’s wellbeing, the formation and cohesiveness of the group, and, crucially, the norming process, both implicit and explicit. Attention is given also to safety considerations, including contraindications of mindfulness practices with certain trauma presentations, and the necessary screening requirements and exclusion criteria in the formation of a trauma-oriented group. (shrink)

This paper clarifies Merleau-Ponty’s original account of “higher-order” cognition as fundamentally embodied and enacted. Merleau-Ponty’s philosophy inspired theories that deemphasize overlaps between conceptual knowledge and motor intentionality or, on the contrary, focus exclusively on abstract thought. In contrast, this paper explores the link between Merleau-Ponty’s account of motor intentionality and his interpretations of our capacity to understand and interact productively with cultural symbolic systems. I develop my interpretation based on Merleau-Ponty’s analysis of two neuropathological modifications of motor intentionality, the case (...) of the brain-injured war veteran Schneider, and a neurological disorder known as Gerstmann’s syndrome. Building on my analysis of Schneider’s sensorimotor compensatory performances in relation to his limitations in the domains of algebra, geometry, and language usage, I demonstrate a strong continuity between the sense of embodiment and enaction at all these levels. Based on Merleau-Ponty’s interpretations, I argue that “higher-order” cognition is impaired in Schneider insofar as his injury limits his sensorimotor capacity to dynamically produce comparatively more complex differentiations of any given phenomenal structure. I then show how Merleau-Ponty develops and specifies his interpretation of Schneider’s intellectual difficulties in relation to the ambiguous role of the body, and in particular the hand, in Gerstmann’s syndrome. I explain how Merleau-Ponty defends the idea that sensorimotor and quasi-representational cognition are mutually irreducible, while maintaining that symbol-based cognition is a fundamentally enactive and embodied process. (shrink)

In contemporary philosophy of mind and psychiatry, schizophrenic thought insertion is often used as a validating or invalidating counterexample in various theories about how we experience ourselves. Recent work has taken cases of thought insertion to provide an invalidating counterexample to the Humean denial of self-experience, arguing that deficiencies of agency in thought insertion suggest that we normally experience ourselves as the agent of our thoughts. In this paper, I argue that appealing to a breakdown in the sense of agency (...) to explain thought insertion is problematic, and that rather than following the prevailing binary approach which holds that certain features of consciousness go missing while others remain wholly intact, a better explanation involves construing thought insertion as a disturbing or disrupting of the subjectivity (for-me-ness) of experience. The result is that experiencing ourselves as the subject of our thoughts is where future research should be directed, given the robust persistence of this form of self-experience across psychopathological and non-psychopathological cases alike. (shrink)

Delusions have traditionally been considered the hallmark of mental illness, and their conception, diagnosis and treatment raise many of the fundamental conceptual and practical questions of psychopathology. One of these fundamental questions is whether delusions are understandable. In this paper, we propose to consider the question of understandability of delusions from a philosophy of language perspective. For this purpose, we frame the question of how delusions can be understood as a question about the meaning of delusional utterances. Accordingly, we ask: (...) “what meaning(s) can delusional utterances possibly have?”. We argue that in the current literature, there is a standard approach to the meaning of delusional utterances, namely the descriptive account which assumes that a delusional utterance “p” means that p is the case. Drawing on Speech Act Theory, we argue that solely relying on the descriptive account disregards essential ways of how linguistic meaning is constituted. Further, we show that Speech Act Theory can prove a helpful addition to the theoretical and clinical “toolbox” used for attempting to understand delusional utterances. This, we believe, may address some of the theoretical and clinical shortcomings of using only the currently predominant descriptive account. (shrink)

In this paper, I draw on phenomenological analyses of religious voice-hearing and related experiences to elucidate the role of phenomenology in discerning benign from pathological religious experience. First, I present phenomenological discontinuities between cases of benign and pathological voice-hearing by drawing on a study of first-person accounts of voice-hearers within the Pentecostal movement which evinces that voice-hearing is not inherently pathological. Second, I introduce the epidemiological continuity of psychotic-like phenomena by drawing on a study of the contextual and responsive differences (...) between clinical and non-clinical voice-hearers which point to the contexts wherein voice-hearing does not lead to pathology. Third, I present a successful case where the meaning of the anomalous experiences is validated and normalized by drawing on studies of mediumistic experience which illuminate its therapeutic benefits. Finally, I argue that failing to take the voice-hearer’s lived experience into account in the diagnostic moment can result in the pathologization of benign experiences. (shrink)

Karl Jaspers was influential in the phenomenological psychopathology movement. Contemporary phenomenological scholarship provides fruitful propositions in psychopathology as well as renewed recognition of Jaspers’ pioneering works. This paper is an attempt to give a more general account on how Jaspers’ oeuvre stands in face of contemporary phenomenological scholarship, outlining the intersections between them. Both poles critic the reductionism of consciousness, affirm the necessary relationship with the sciences and philosophy as well as the training and effort that the field demands. Disagreements (...) are related to Jaspersian’ restricted use of phenomenology. We claim that Jaspers provides an interesting model of applying phenomenology in psychopathology that is scientifically robust without losing the due primacy of experience in both conceptual and clinical developments. We recognize Jaspers` limitations on the development of phenomenology, nevertheless we consider that one should go with Jaspers in his rigorous descriptions, scientific endeavors, philosophical groundings, and also beyond him, emphasizing the structures of consciousness in its embodied, temporal and intersubjective features. (shrink)

This special issue presents a Portuguese translation of the EAWE: Examination of Anomalous World Experience (Sass et al., this issue; original publication Sass et al., 2017). The EAWE is a semi-structured, phenomenologically-oriented interview designed to elicit descriptions of changes in the lived world, particularly those that may be more commonly found in schizophrenia spectrum disorders (though it may also be used to study disorders outside the schizophrenia spectrum). The EAWE represents an important trend in psychiatric research and practice: a growing (...) appreciation for the role of subjectivity in understanding, explaining (Sass, 2010), classifying and treating psychiatric disorders, especially complex and heterogeneous disorders such as schizophrenia. The EAWE’s translation into Portuguese reflects several equally important developments. The ability to collect detailed information about the experience of schizophrenia and other psychiatric conditions among Portuguese-speaking participants will make it possible to study the phenomenological characteristics of schizophrenia outside of Anglophone cultures, providing important data about the intersections of individual, interpersonal, and cultural experiences in the development of the disorder. In addition, it occurs at a time of renewed energy and collaboration in phenomenological psychopathology, particularly in Brazil. (shrink)

The aim of this work is to present the triontic theory of the normal and pathological human psychism, elaborated by the Romanian psychiatrist Eduard Pamfil, and to highlight its deep connection with the Holy Trinity model of God. The main idea of the work is that mental illness, considered from a wider anthropo-phenomenological perspective, appears as the result of a deficit within interpersonal communication and, in a deeper way, of the lack of communion between human persons. According to Pamfil, the (...) conscious human being is the result of the interaction of its three poles: I (ipseity), You (tui-ty) and He (ille-ity). Pamfil emphasises the inter-ontic nature of the person, its unity and uniqueness. I (ipseity), stands for the “archaic-primitive condition of the person”. You (tui-ty) stands for the “alter ego function”, the structural pole of personality. He (ille-ity) is the “systemic, axiological pole”. Thus, personality is a “mobile crossroad” between I, You and He, which are “moments of phenomenological subjectivity”. The psychopathological commentary of mental illness is made for three major clinical entities: neurosis, psychosis, psychopathy. The above presented theory is closely related to the Orthodox view of human person, who has its spiritual and moral model in the Holy Trinty of God. The modification of the triontic structure of the human person will lead to important changes in the existence of each person (I, You, He) within the trinitary relational system, among which mental illness is certainly the most significant. (shrink)

This paper intends to examine, both from a psychopathological and a phenomenological perspective, the state of “being-at-the-world”, which is common in drug addicted people. Past abuse, as well as present abuse, are crucial in the modification of the psychiatric impact in the history of drug abuse. The former drug lifestyle characterized by the use of heroin led to a form of psychosis which is known with the symptomatological expression as basic psychosis. On the other hand, the contemporary poly-abuse of NPS (...) leads to what is called a synthetic psychosis: a very rich paraphrenic state with continuous hallucinations caused by a mental automatism syndrome and secondary delusions. From a phenomenological point of view, all addictions lead to the final collapse of the Dasein structure. Subsequent to having travelled down many different psychopathological pathways, many addicts remain without the spatial-temporal “here and now” dimension. This makes it impossible for them to stay in a space-with-others and to project themselves in time. The result of this time/space cleavage is emptiness. It is very difficult to treat this existential situation, which is characterized by patients frequently dropping out of conventional treatment, the loss of the being-at-the-world structure, boredom, emptiness, dread, anger, lack of meaning, loneliness, and isolation. In this paper Dasein Group-Analysis is proposed and discussed. Unlike Dasein-Analysis, this approach applies phenomenology beyond the classic pair of analyst and patient, to a group of people made up of doctors and patients, in which everyone is simply a human being at the world. If the psychopathological and therapeutical approaches prove to be ineffective, the frequent consequences are: the patient’s admission into a psychiatric hospital; his/her arrest for crimes related to antisocial behaviour; a worsening of their psychopathology and addiction; a diffusion of infective diseases commonly found in addicts; more frequent overdoses; aggressive behaviour; legal problems; an increase in the costs of public health system and, finally, even the suicide of the patient. (shrink)

This book uses rare pathologies to inform questions on topics such as consciousness and rationality. Rather than trying to answer these by inventing far-fetched scenario or 'thought experiments', it is better to utilize a rich but under-used clinical resource.

Le controversie nosologiche in psichiatria siano orientate da ragioni sia epistemiche che non epistemiche, da questioni di evidenza ma anche di etica e sociologia della scienza, data la presenza di vari programmi di ricerca, di metodologie e anche di agenti differenti che si focalizzano sul problema del disturbo mentale. I due casi qui brevemente considerati, quello della Disposofobia e quello del Disturbo di personalità narcisistica mostrano, assieme al ruolo dell’evidenza empirica, da un lato il peso delle ragioni etiche dei gruppi (...) di pazienti e di quelle culturali della società allargata, dall’altro le dinamiche del consenso tra esperti. Che i disturbi mentali siano o non siano generi naturali, la loro classificazione è un processo razionale complesso che comprende norme e deviazioni dalle norme di diverso tipo. (shrink)

This paper returns to a seminal case in the historical of phenomenological psychopathology, Ludwig Binswanger’s discussion of “Ellen West A woman with a long history of melancholia and disordered eating, Ellen West was treated at Binswanger’s Bellevue sanatorium in 1921, a two-and-a-half month-long stay that resulted in a diagnosis of schizophrenia and Ellen West’s suicide. Binswanger relied on West’s personal writings and clinical history to develop and apply an original approach to case analysis, Daseinsanalyse or “existential analysis.” This paper takes (...) up this case and Binswanger’s analysis to explore the origins of contemporary phenomenological psychopathology, the recent progress in this field, and areas for continued growth. The paper argues that new approaches to exploring the embedded or situated quality of psychopathology are needed for advancing clinical phenomenology, and that feminist and critical phenomenology are among the disciplines that can provide important methodological and theoretical foundations for this work. Without this, the field risks repeating Binswanger’s original mistakes and viewing psychiatric illness solely as the expression of a disturbed individual. (shrink)

Therapist’s and client’s experience in the session are emerging from the field forc-es in play; these forces are the intrinsic tensions of the emerging field. We propose an understanding of the therapeutic process as a field phenomenon: the process of change is made by the forces already active in the field and the therapist has just to let them move on without interfering, or sometimes to support them. Psy-chopathology is then the emerging absence, and therapy becomes the art of presence.

This paper is about Kant’s late unfinished manuscript, Opus postumum (1796–1803) and some of the resonances it has with Schelling’s early Naturphiloso­phie (1797–1800). Most of the secondary literature on Opus postumum investigates its relation to the rest of Kant’s corpus, often framing the drafts as an attempt to fill a so-called “gap” in the Critical philosophy whilst ignoring the relationship it has to the wider landscape of late eighteenth century German philosophy. Whether Opus postumum may provide grounds for reviewing the (...) relationship between Kant and Schelling’s Naturphilosophie, for example, is rarely discussed. Some scholars have remarked upon the striking parallels between Opus postumum and Naturphilosophie, but there has yet to appear a single monograph-length text on the relation. Whilst certainly “Schelling’s Post-Kantian confrontation with nature itself begins with the overthrow of the Copernican revolution” (Grant 2008, 6), what if Kant was himself overthrowing the Copernican revolution? In this paper, I will outline some of the points of contact to start from in support of posing this question. (shrink)

In his earlier work on the System of Transcendental Idealism, which combined Naturphilosophie and transcendental philosophy, Schelling argued that it is only by becoming-art that philosophy can complete itself as a discipline. He proposed this formulation in response to Kant’s critical inventory of reason offering to reclaim philosophy from its entanglement in pre-critical or dogmatic traditions. But Kant avoided to ground reason in the notion of externality, the in-itself, which, owing to its pre-critical derivation, must give way to the a (...) prioris and categories of the understanding. Meanwhile, by renewing the problem of the in-itself via the self-positing ego, Fichte was the first to challenge the Kantian legacy. But the emphasis on subjectivity through its power of self-positing gave way to what in principle negates nature as the true ground of the initself; in Schelling’s description, the equivalent of the annihilation of nature. Comparatively, Schelling proposed to demonstrate the reverse, which is the extinction of the subject that has continued to nourish the reflexive standpoint of reason. To accomplish this end, Schelling invoked in his Philosophy of Art, one of the places in which he extended his discussion of the so-called identity-system, the concept of the ideal type, or rather, the destroyer of known world established by critical reason. (shrink)

This article focuses on analysis of a handwritten fragment by F. W. J. Schelling “Psychological scheme”, which is a study of main principles of philosophical anthropology. The article reconstructs the circumstances of creating the mentioned text, which are connected with the trusting relationship between Schelling and Bavarian Crown Prince Maximilian; it also highlights the parallels between the text and the earlier Schelling's works exploring philosophical-anthropological problematic: “Philosophical Investigations into the Essence of Human Freedom” and “Stuttgart Seminars”. In the course of (...) terminological analysis of the fragment author displays that the the main source of influence was the work by I. Kant “Religion within the Limits of Reason Alone”. Major problem, considered by Schelling's anthropology, is defining the correlation between intelligible and empirical human character, the main resolving instrument being Schelling’s doctrine of potencies as ontological modalities developed in 1820-1830. (shrink)

The gives the detailed analysis of the ratio of freedom and imagination in an unpublished manuscript written by F.V.Y. Schelling, which contains the materials for the lecture course read at Erlangen University in 1820-1821. The author focuses on the question of imagination as a condition for the possibility to unfold the modal differences that provide the hierarchy of predicative definitions. The article shows that both the draft philosophy of mythology and the philosophy of revelation are a direct continuation of the (...) transcendentalist program given by Kant.Those projects bases on the thesis that the consciousness of freedom and consciousness of the law, justified in the “Critique of Practical Reason”, are related one another. Schelling following Kant’s theory, points to the law and to the unconditional imperative of freedom as the main principle which is not only theoretical or practical, but determines the separation of ontological and deontological modalities. At the same time, the formal structure of an imperative as a command has the specific character of “hiden opening”: what is themed in an imperative is not opened as a meaningful opportunity, it is only opened as theopportunity in its difference from necessity. I show in this article that interpreting the Schelling possibility relies on the teachings of I. Kant in his transcendental idealconception, connected with Kant's interpretation of the imagination’s productive ability. In the middle of Schelling’s theological interpretation of Kant's consciousness of lawdoctrine as the “fact of mind” lies the analogy between peacemaking and the ancestral sin of the first people. This concept is the main source of the theory of potency as ontological modalities, developed by Schelling in the 1830s - 1840s in lectures on the philosophy of mythology and the philosophy of revelation. (shrink)