A partir del marco teórico de la fenomenología husserliana —afín al reciente enfoque dimensional de clasificación psicopatológica—, este escrito propone un análisis comparativo de la depresión y la esquizofrenia. Tras desarrollar algunas ideas básicas de Husserl sobre la descripción fenomenológica de la consciencia temporal, se profundiza en cómo estas bases teóricas pueden fundar una concepción de las mencionadas enfermedades mentales. En este sentido, se apela principalmente a Fuchs y Ratcliffe, quienes consideran que una anomalía en la experiencia de posibilidad daría (...) la clave para precisar tanto la experiencia depresiva como la esquizofrénica. El resultado de este análisis comparativo señala que la diferencia entre las psicopatologías en cuestión recae sobre el carácter de la anomalía de la experiencia de posibilidad: mientras la depresión apunta a una reducción de experiencias de posibilidad práctica, la esquizofrenia refiere a una fragmentación de la consciencia temporal debido a una disfunción protensional. (shrink)

Contemporary psychiatry finds itself in the midst of a crisis of classification. The developments begun in the 1980s—with the third edition of the Diagnostic and Statistical Manual of Mental Disorders —successfully increased inter-rater reliability. However, these developments have done little to increase the predictive validity of our categories of disorder. A diagnosis based on DSM categories and criteria often fails to accurately anticipate course of illness or treatment response. In addition, there is little evidence that the DSM categories link up (...) with genetic findings, and even less evidence that they... (shrink)

In this paper I offer an alternative phenomenological account of depression as consisting of a degradation of the degree to which one is situated in and attuned to the world. This account contrasts with recent accounts of depression offered by Matthew Ratcliffe and others. Ratcliffe develops an account in which depression is understood in terms of deep moods, or existential feelings, such as guilt or hopelessness. Such moods are capable of limiting the kinds of significance and meaning that one can (...) come across in the world. I argue that Ratcliffe’s account is unnecessarily constrained, making sense of the experience of depression by appealing only to changes in the mode of human existence. Drawing on Merleau-Ponty’s critique of traditional transcendental phenomenology, I show that many cases of severe psychiatric disorders are best understood as changes in the very structure of human existence, rather than changes in the mode of human existence. Working in this vein, I argue that we can make better sense of many first-person reports of the experience of depression by appealing to a loss or degradation of the degree to which one is situated in and attuned to the world, rather than attempting to make sense of depression as a particular mode of being situated and attuned. Finally, I argue that drawing distinctions between disorders of structure and mode will allow us to improve upon the currently heterogeneous categories of disorder offered in the DSM-5. (shrink)

The phenomenology of trauma is a historical, epistemological, and methodic inquiry that wishes to test the validity of an already settled dynamic model of surprise as shock-rupture based on its correlated inner structures of attention and emotion. Thanks to an integrative approach, crossing phenomenological subjective experiences and empirical data, we hope to renew the understanding of the blank lived experience of trauma and the passive preconscious dynamics of traumatism, as well as to generate possible therapeutic effects.

The origin of moral agency is a much-debated issue. While rationalists or Kantians have argued that moral agency is rooted in reason, sentimentalists or Humeans have ascribed its origin to empathic feelings. This debate between rationalists and sentimentalists still stands with respect to persons with mental disorders, such as individuals diagnosed with mild forms of Autism Spectrum Disorder, without intellectual impairment. Individuals with ASD are typically regarded as moral agents, however their ability for empathy remains debated. The goal of this (...) paper is to investigate the mechanisms of moral actions in people with ASD, by finding arguments for the origin of their moral actions, supporting either the sentimentalist or the rationalist view of the dispute. We propose to revisit the debate using Interpretative Phenomenological Analysis to study the autobiographies of individuals with High-Functioning Autism and Asperger Syndrome. While conducting the systematic analysis of 10 autobiographies, we re-examined both the rationalist and the sentimentalist positions, considering the links between empathic feelings and moral agency. The investigation of the temporal dimensions of emotional experiences, an aspect overlooked by previous research, indicated that individuals with ASD empathize with others, but in different ways as compared to neurotypicals. A relationship between emotional experience and the type of moral agency exhibited by individuals with forms of ASD was established. As a consequence, our analyses support the sentimentalist stance on moral action. (shrink)

The subjective experience of time in depression has been described to be altered in complex ways, with sensations of particular slowness, delay or stillness being the most often named articulations. However, the attempts to provide empirical evidence to the phenomenon of “time slowing down in depression” have resulted in inconsistent findings. In consequence, the overall claim that depressive time somehow differs from ordinary time has often been discarded as unfounded. The article argues against such conclusion, contending that the described ambiguity (...) might be caused by the methods employed to assess the phenomenon under observation. In the first part of the article, a reconceptualization of the experience of time in depression is proposed on the grounds of classic and contemporary phenomenological psychiatry. This leads to identify the essential features of depressive time as described both in clinical and philosophical contexts. In the second part, a critique of the existing methods of time perception assessment is conducted, with a specific focus on duration estimation and time passage perception tasks. The above-mentioned core features serve as guidelines in discussing to what degree such methods fit the phenomenon at stake. Finally, an alternative and innovative method is put forward, that might not only help to explore the scope of existing methods but might itself present an alternative to such: the micro-phenomenological interview. (shrink)

Neste trabalho procuramos compreender de que modo a queixa é articulada como sintoma na clínica, salientando a preponderância de tal “fase” para a validação epistémica e normativa dos procedimentos terapêuticos. Partindo da perspetiva da filosofia da psiquiatria, consideramos os pressupostos pré-clínicos da queixa e o contexto da sua inscrição na gramática médica, assim como os diferentes modelos compreensivos que lhe estão subjacentes. Nestes modelos, em conformidade com o auto-encerramento comunicativo dos discursos e práticas médicas, encontramos diferentes níveis de abertura às (...) dimensões subjetiva da queixa, isto é, à biografia e vivência do paciente, mas também à experiência clínica do terapeuta. Longe de apresentar um exame exaustivo dos tipos de queixa e sua relação com a particularidade do caso e da doença mental, ensaiamos um mapeamento ou cartografia conceptual que permitirá avançar para a exploração de problemas específicos. (shrink)

Against the backdrop of emerging medical technologies that promise transgression of temporal limits, this paper aims to show the importance that an individual lifetime’s finitude and fugacity have for the question of the good life. The paper’s first section examines how the passing of an individual’s finite lifetime can be experienced negatively, and thus cause “suffering from the passing of time.” The second section is based on a sociological analysis within the conceptual framework of individualization and capitalism, which characterizes many (...) modern individualized and consumerist societies and explains how the described problem of time’s passage is particularly relevant today. The paper then proceeds to show and discuss how individuals employ various, primarily medical, enhancement-technologies like social egg freezing, anti-aging-medicine and physical- and neuro-enhancement in an attempt to overcome time’s passing. Finally, the paper seeks to explain why such attempts fail and, moreover, why it is exactly the awareness of time’s passing that can constitute a prerequisite for a good life. (shrink)

This essay explores the unique temporal experience in anxiety. Drawing on first-person accounts as well as examples from literature, I attempt to show how anxiety not only disrupts our physiological and cognitive timing but also disturbs the embodied rhythms of everyday social life. The primary goal, however, is to articulate the extent to which human existence itself is a temporally structured event and to identity the ways that anxiety disrupts this structure. Using Martin Heidegger’s account of human existence as a (...) point of departure, I show how the mood of anxiety has the power to alter our self-interpretations by closing down or constricting our experience of the future. I argue that a constricted future impedes our ability ‘to be’ because it closes off the range of projective meanings that we would ordinarily draw on to create or fashion our identities. (shrink)

This essay explores the unique temporal experience in anxiety. Drawing on first-person accounts as well as examples from literature, I attempt to show how anxiety not only disrupts our physiological and cognitive timing but also disturbs the embodied rhythms of everyday social life. The primary goal, however, is to articulate the extent to which human existence itself is a temporally structured event and to identity the ways that anxiety disrupts this structure. Using Martin Heidegger’s account of human existence as a (...) point of departure, I show how the mood of anxiety has the power to alter our self-interpretations by closing down or constricting our experience of the future. I argue that a constricted future impedes our ability ‘to be’ because it closes off the range of projective meanings that we would ordinarily draw on to create or fashion our identities. (shrink)

Time is an essential feature in bipolar disorder (BP). Manic and depressed BP patients perceive the speed of time as either too fast or too slow. The present article combines theoretical and empirical approaches to integrate phenomenological, psychological, and neuroscientific accounts of abnormal time perception in BP. Phenomenology distinguishes between perception of inner time, ie, self-time, and outer time, ie, world-time, that desynchronize or dissociate from each other in BP: inner time speed is abnormally slow (as in depression) or fast (...) (as in mania) and, by taking on the role as default-mode function, impacts and modulates the perception of outer time speed in an opposite way, ie, as too fast in depression and too slow in mania. Complementing, psychological investigation show opposite results in time perception, ie, time estimation and reproduction, in manic and depressed BP. Neuronally, time speed can be indexed by neuronal variability, ie, SD. Our own empirical data show opposite changes in manic and depressed BP (and major depressive disorder [MDD]) with abnormal SD balance, ie, SD ratio, between somatomotor and sensory networks that can be associated with inner and outer time. Taken together, our combined theoretical-empirical approach demonstrates that desynchronization or dissociation between inner and outer time in BP can be traced to opposite neuronal variability patterns in somatomotor and sensory networks. This opens the door for individualized therapeutic “normalization” of neuronal variability pattern in somatomotor and sensory networks by stimulation with TMS and/or tDCS. (shrink)

In this chapter we first elucidate the subjective flow of time particularly as developed by Husserl. We next discuss time and timescales in predictive processing. We then consider how the phenomenological analysis of time can be naturalized within a predictive processing framework. In the final section, we develop an analysis of the temporal disturbances characteristic of depression using the resources of both phenomenology and predictive processing.

In this chapter, I introduce phenomenology and phenomenological psychopathology by clarifying the kind of implicit experiences that phenomenologists are concerned with. In section one, I introduce the phenomenological concept of pre-reflective experience, focusing especially on its relation to the concept of implicit experience. In section two, I introduce the structure of pre-reflective self-consciousness, which has been studied extensively by both classical phenomenologists and contemporary phenomenological psychopathologists. In section three, I show how phenomenological psychopathologists rely on an account of pre-reflective self-consciousness (...) to better understand the experience of schizophrenia and I outline some of the methodological challenges that arise in this field of research. This introduction should facilitate critical engagement and collaboration between phenomenologists and researchers working across a variety of disciplines, including psychology, psychiatry, the cognitive sciences, and analytic philosophy of mind. (shrink)

Time plays a significant role in science and everyday life. Despite being experienced as a continuous flow, computational models of consciousness are typically restricted to a sequential temporal structure. This difference poses a serious challenge for computational phenomenology—a novel field combining phenomenology and computational modelling. By analysing the temporal structure of the active inference framework, we show that an integrated continuity of time can be achieved by merging Husserlian temporality with a sequential order of time. We also show that a (...) Markov blanket of the present moment integrates past and future moments of both subjective temporality and objective time in an asynchronous manner. By applying the integrated continuity, it is clear that active inference makes use of both subjective temporality and objective time in an integrated fashion. We conclude that active inference, on a temporal note, qualifies as a computational model for phenomenological investigations. (shrink)

This dissertation combines two scientific disciplines and research fields, namely philosophy and psychopathology. Within such a wide field of investigation, two precise perspectives are to be adopted in this inquiry: stemming from the first field, the phenomenological perspective on subjectivity and intersubjectivity; stemming from the second, the psychopathological perspective on schizophrenia. The combination of philosophy and psychopathology has often proven fruitful. Moreover, the main motivation for such combined approach is justified by the strong belief that, when critically used, phenomenology offers (...) a viable method of studying the first-personal perspective of experience, including the experiences of people with mental disorders. Philosophical analysis can thereby be used as a means to evaluate the meaning and adequacy of psychopathological concepts and ideas. As a result, phenomenological psychopathology may help understand what is often claimed to be incomprehensible. Particularly for the understanding of schizophrenia, this is taken to be a valuable contribution. For more than twenty years now, the phenomenological approach to schizophrenia has developed a strong and influential hypothesis on the basic alterations of this disorder. Schizophrenia, it is claimed, is a disorder of subjectivity, and more specifically, a disorder of the minimal self. Simultaneously, and often in conjunction, philosophical research on the self has vastly proliferated. The vivid interaction between these two fields makes the phenomenology of schizophrenia a good example of effective interdisciplinary work. Within the philosophical debate on subjectivity, intersubjectivity, or the relation between self and other, is currently a key topic. However, this has not significantly influenced the psychopathology of schizophrenia yet. The initial and fundamental claim of this dissertation is indeed that a renewed evaluation and inclusion of intersubjectivity, next to subjectivity, is to increase the validity of the phenomenological approach to schizophrenia. This would allow the previous hypothesis on schizophrenia as minimal self disorder to be challenged, criticized, or complemented, which would accordingly increase the significance and its clinical value. What I will attempt to do in this dissertation is then to thoroughly evaluate the role of intersubjectivity in schizophrenia. It will hence become clear what this role and its significance are. Consequently, I will finally argue that the basic alterations of schizophrenia concern both subjectivity and intersubjectivity. My argument is developed in four chapters. In the first, I introduce the topic of the self, including the distinction between the minimal and the extended self. This chapter equally introduces schizophrenia as a psychiatric concept, and three different clinical approaches are discussed, among which the phenomenological approach in most detail. After the topics of the self and schizophrenia, I introduce intersubjectivity, notably from a developmental-psychological perspective. By way of status quaestionis, I recapitulate the current research on intersubjectivity and schizophrenia. It will become clear that this research is relatively scarce. I then conclude the chapter with a full formulation of the two research questions informing this dissertation, namely Is schizophrenia an intersubjectivity-disorder? and Which self-concept is suited to define schizophrenia as a self and intersubjectivity disorder? The second chapter examines the phenomenology of intersubjectivity. The exact delineation of what is meant here by intersubjectivity will allow the reader to acknowledge its extent and variety. This chapter is aimed to provide the necessary philosophical tools to analyse schizophrenia in the light of intersubjectivity. In the third chapter I turn to psychopathology. In the first section, I analyse the work of seven major psychopathologists on schizophrenia. The goal of this section is to look for elements of intersubjectivity in their accounts of schizophrenia. Many of these psychopathologists have been influential for the development of the current self-disorder hypothesis, and the investigation intends to show how some crucial intersubjective elements in their work have been neglected. In the second section of this chapter, I focus on the symptoms, signs, and phenomena of schizophrenia that relate to intersubjectivity. This chapter finally offers all the material needed to positively answer the first research question. In the fourth chapter, I bring together psychopathology and philosophy, and I attempt to answer the two research questions. Since Chapter 3 allows me to affirmatively answer the first question, I examine whether the current self-disorder hypothesis is adequate to integrate intersubjectivity disturbances. It will appear that it is not, and the first section of this chapter consequently deals with the question why intersubjectivity and its disturbances have been neglected until now. In the second section it will become clear that no different self-concept is required, but that schizophrenia primarily concerns a particular capacity or orientation of subjectivity. I introduce the concept of open subjectivity and thereby answer the second research question. By describing schizophrenia as a disturbance of open subjectivity, I am finally able to integrate both self-disturbances and intersubjectivity-disturbances into a coherent and unified theory. To conclude this dissertation, I summarize and recapitulate its major issues, questions, and results in Chapter 5. Both clinical implications and possible future research are also discussed here. (shrink)

The objective of this study is to present a theoretical paper about a clinical issue. Our aim is to propose some clinical and semiological considerations for a psychopathological conception of psychopathy. We will discuss several major theoretical works dedicated to this nosographic entity. We will also examine a significant issue raised by Cooke et al., namely whether psychopathic functioning is consistently related to antisocial behavior. This theoretical essay is informed by clinical situations. The method applied a phenomenological psychopathology analysis to (...) the clinical material. We first compare Binswanger’s conception of mania with psychopathic functioning. Patients’ behavior is similar but there is a difference related to the dialectic between the ego and the alter ego. A patient with mania has a fundamental crisis of the ego, which a psychopath does not have. A second finding of our investigations concerns emotions and the adaptive dimension of the psychopathic disorder. An epistemological discussion of the concept of emotions reveals that psychopaths are competent in the management of emotional stimuli, which confers a psychological advantage upon them. (shrink)

The aim of this paper is to study anomalies of self- and world-experience in schizophrenia from a phenomenological perspective, through the use of the EASE and the EAWE interviews. Four patients with diagnoses of schizophrenia were interviewed with both EASE and EAWE. A qualitative analysis of these interviews was carried out on all the data; quantitative scores were also assigned based on the frequency and intensity of items endorsed by the subjects. For the EASE, subjects endorsed an average frequency of (...) 45% of all items. For the EAWE, subjects endorsed an average frequency of 26% of all items. Furthermore, EAWE data indicated more heterogeneous profiles of experience than the EASE. This heterogeneity is not surprising, given that the EAWE was designed to be a more broad-based or less targeted exploration of various changes likely to be associated with schizophrenia spectrum. Our data suggest that, although disturbances of world experience may always be present in schizophrenia, they may take numerous and varied forms. Because the experience of the world occurs across many different modalities, disturbances of this experience would be fundamentally less unitary, whereas the experience of the self present a more coherent and unitary gestalt. These results show certain overlapping between the scales while also indicating the potential value of combined use of the two instruments. Finally, we discussed the relationship between experiential description and behavioral observation, and their potentially complementary value in exploring the first-person perspective, particular in the case of experiences that occur at a more pre-reflective level. (shrink)

In this paper, I examine recent phenomenological research on both depressive and manic episodes, with the intention of showing how phenomenologically oriented studies can help us overcome the apparently paradoxical nature of mixed states. First, I argue that some of the symptoms included in the diagnostic criteria for depressive and manic episodes in the DSM-5 are not actually essential features of these episodes. Second, I reconsider the category of major depressive disorder (MDD) from the perspective of phenomenological psychopathology, arguing that (...) severe depressive episodes should not be characterized by any particular moods (such as sadness, hopelessness, or guilt), and should instead be characterized by a diminished capacity for finding ourselves situated in and attuned to the world at all. In other words, the affective dimension of depression should be characterized as a change in the way we have moods, not as a change from one kind of mood to another. Third, I turn to mania, arguing that manic episodes, taken as the opposite of depressive episodes, should be characterized not by any particular moods (such as euphoria, grandiosity, or even irritability), but should instead be characterized by an enhanced or heightened capacity for finding ourselves situated in and attuned to the world. In other words, the affective dimension of mania, like the affective dimension of depression, should be understood as a change in the way we have moods, not as a change from one kind of mood to another. Fourth, I return to the phenomenon of mixed states and argue that the affective dimension of depression and mania, when conceived along the phenomenological lines I set forth in the previous sections, dissolves the paradox of mixed states by showing that the essential characteristics of depression and mania cannot and do not coincide. Many cases of mixed states are diagnosed because moods that we take to be essential features of either depression or mania arise within the context of what is considered to be the opposite kind of episode (e.g. dysphoria, typically associated with depression, often arises in what is otherwise considered a manic state). However, if we conceive of the affective dimension of depression as a decrease in the degree to which one is situated in and attune to the world through moods, and the affective dimension of mania as an increase in the degree to which one is situated in and attuned to the world through moods, then the particular mood one finds oneself in is simply irrelevant to the diagnosis of either depression or mania. As a result, the manifestation of any particular moods in what otherwise seems to be a pure manic or depressive episode does not constitute a mixed state. (shrink)