Phenomenology of illness has grown increasingly popular in recent times. However, the most prominent phenomenologists of illness defend a psychologizing notion of phenomenology, which argues that illness is primarily constituted by embodied experiences, feelings, and emotions of suffering, alienation etc. The article argues that this gives rise to three issues that need to be addressed. (1) How is the theory of embodiment compatible with the strong distinction between disease and illness? (2) What is the difference between problematic embodiment and illness? (...) (3) How is existential edification, that illness can give rise to according to the phenomenologists, to be understood? The article then engages in an analysis of Heidegger’s and Waldenfels’ phenomenology with the ambition of developing a notion of existence, which can transgress the psychologization of illness. Rather than arguing that illness is constituted by experiences of suffering and alienation, it emphasizes that broaches upon conatively guided activities constitute illness. (shrink)

Disturbances in social cognition are a core feature of schizophrenia. While most research in the field has focused on emotion perception, social knowledge, theory of mind, and attribution styles, the domain of social perception has received little specific attention. In this paper, we suggest that this issue can be explained by the lack of a precise and unitary definition of the concept, this leads to the existence of different competing uses of the concept and their conflation with other domains of (...) social cognition. Relying on resources coming from the ecological approach to psychology and the phenomenological tradition in psychiatry, we propose that the concept of Social Perception should be used to refer to low-level pre-reflective processes underlying the awareness of interpersonal interactions with and between others. Clinical data suggests that people with schizophrenia have problems perceiving social situations as opportunities for social engagement, so, in order to fulfil this explanatory need, we propose that the term should be used to capture this important—yet neglected—domain of social cognition. We conclude with the discussion of some future directions for research derived from our proposal. (shrink)

ZusammenfassungAuf dem Wiesbadener Internistenkongress von 1949 forderten Alexander Mitscherlich und Viktor von Weizsäcker eine Erweiterung des naturwissenschaftlichen Kausalitätsbegriffs um die Suche nach dem Sinn von Krankheit in der Lebensgeschichte. Hiermit wurde ein traditionelles psychiatrisches Paradigma infrage gestellt: die vermutete somatische Ursache psychischer Erkrankungen. Damit standen auch psychiatrische Evidenzpraktiken auf dem Prüfstand. Im ersten Teil dieses Beitrags werden im Sinne eines Querschnitts drei psychiatrische Positionen rekonstruiert, die auf dem Kongress zur Darstellung kamen. Im zweiten Teil wird die Entwicklung eines der beteiligten (...) Psychiater, Jürg Zutt, im Längsschnitt untersucht, wobei der Fokus auf der Frage nach möglichen Auswirkungen der Wiesbadener Debatte auf seine wissenschaftliche Neuausrichtung sowie den Konsequenzen für seine Auffassung von psychiatrischer Evidenz liegt. (shrink)

In this paper I aim to re-think the question of the world of persons with schizophrenia from the perspective of the German phenomenologist Max Scheler and that of the Japanese psychiatrist Bin Kimura. So far, no comparison between these two authors has been made, even though there are several convergences and evidence of Scheler’s indirect influence on Bin Kimura through Viktor von Weizsäcker. In recent years, Dan Zahavi, Louis Sass, and Josef Parnas have interpreted the modus vivendi of schizophrenic patients (...) in relation to a disturbance on the level of the “minimal self”. Subsequently, the discussion has highlighted the importance of disorders on the level of intercorporeality and intersubjectivity (Thomas Fuchs) and on the level of “existential feelings” (Matthew Ratcliffe). This paper argues that Max Scheler and Bin Kimura allow us to focus on an aspect which has been neglected so far: that of a “relational self” that relates to the very foundation of intersubjectivity and intercorporeality and that can thus be reborn in the encounter with the other and may position itself differently in the world. In Scheler’s perspective, the world of persons with schizophrenia is the result of an axiological disorder (valueception) that impairs contact with the primordial life impulse (Lebensdrang). As a consequence, they are incapable of attuning emotionally and socially with others: this prevents the singularity from being reborn in the encounter with the other and forces them to position themselves in their own solipsistic universe. Moving in a similar direction, Bin Kimura interprets the world of persons with schizophrenia as the result of a disorder of aida (one of the central concepts of Japanese culture that indicates the space of being in between). The disorder of aida compromises the basic relationship (Grundverhältnis in the sense of Viktor von Weizsäcker) and hinders what Bin Kimura calls festum, i.e. the birth of subjectivity, so that it is experienced by persons with schizophrenia only as ante festum. Starting from these two perspectives, I argue the existence of an axiological and anthropogenetic dimension of psychopathology. I begin with a discussion of Zahavi’s concept of minimal self and the thesis that reveals the disorders on this level of subjectivity as the origin of the world of persons with schizophrenia. I, then, analyze Max Scheler’s position and its historic importance for the emergence of phenomenological psychopathology. Thereafter, I introduce the concepts of “disorder of aida” (Bin Kimura) and “disorder of ordo amoris” (Max Scheler). Finally, I develop the concept of a “psychopathology of ordo amoris” by also comparing it with Ratcliffe’s thesis of “existential feelings”. (shrink)

In recent decades, the focus in autism research progressively expanded. It presently offers extensive material on sensorimotor disturbances as well as on perceptive-cognitive preferences of people with autism. The present article proposes not only a critical interpretation of the common theoretical framework in autism research but also focuses on certain experiences common to some people with autism and which can be appropriately understood by phenomenology. What I will call “hypnotic experiences” in autism are moments in which some individuals withdraw into (...) intense sensorial and perceptive experiences. Following their examples, I use the term “hypnosis” primarily to describe a trance state in which the individuals become highly alert to and awake for an experience of a totally new kind. Through a close analysis of autobiographical writings from people with autism I defend the idea that the particularity of hypnotic experiences in autism consists in a certain qualitative shift within experience itself: what changes, in the hypnotic moments, is the way a person with autism relates to his/her own bodily experiences. If this qualitative shift is indeed difficult to account for within a reifying and intellectualist research perspective, phenomenology offers a large conceptual framework for understanding it. Phenomenology, and precisely, phenomenological psychopathology, will thus emerge as a major device in accounting for such “hypnotic experiences”. The argument mainly draws on the twofold structure of experience which is traditionally used in phenomenological research: it claims that in hypnotic experience people with autism are inclined to focus on non-reified “sensings”, “perceivings” and “movings”, and thus leave aside the object itself and any intentional reification of it. Finally, I will claim that this restriction to mere non-reified sensings might lead to a completely new conception of self and world. In the hypnotic experiences of autism, neither the subject nor the object come to a full-blown and independent existence. A thorough phenomenological analysis of hypnotic experience in autism therefore also has to face the question of a corresponding ontology of these experiences. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

This paper presents the main contents of Geiger’s 1910 lecture on empathy and focuses on its possible influence on Jaspers’ General Psychopathology. In particular, some key methodological distinctions traced by Jaspers are compared to Geiger’s similar concepts. Geiger’s role in shaping Jaspers’ concept of understanding is still neglected and it is time to recognize it. In particular, Geiger’s distinction between the direct empathy for the other’s expressions at one side, and the ‘reliving after the event’ of the ‘inner correlation of (...) the psyche’ on the other side had a major role in shaping Jaspers’ similar distinction between static and genetic understanding. (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)

This collection brings together a selection of my recently published or forthcoming articles. What unites them is their common concern with one of the central ambitions of philosophy, namely to get clearer about our first-personal perspective onto the world and our minds. Three aspects of that perspective are of particular importance: consciousness, intentionality, and rationality. The collected essays address metaphysical and epistemological questions both concerning the nature of each of these aspects and concerning the various connections among them. More generally, (...) given that intentionality and ratio- nality are both normative phenomena, the main theme of the articles is the relationship between consciousness and normativity and the centrality of this relationship to our first-personal perspective. -/- This focus culminates in the defense of two specific views, experiential rationalism and experiential intentionalism. The first is, very roughly, the view that how our mental episodes are given in consciousness reflects their rational role in our mental lives: it is part of what our mental episodes subjectively are like that we phenomenally experience them as providing and/or responding to certain kinds of reasons. The central claim of the second view, on the other hand, is that the intentionality of our mental episodes is essentially linked to consciousness and involves a token-reflexive element: they intentionally present not only the world, but also themselves as being a certain way. -/- Some of the essays also deal with the contrast between our first- and our third-personal perspectives and the — to some extent related — division of labour between philosophy and the empirical sciences. Both perspectives have their limitations and sometimes conflict with each other, raising the question of what the consequences are for accounts of our first-personal knowledge and its internal or external objects. (shrink)

There is no unique and definitive definition of phenomenology. It is rather a method and an experience always open and always renewing itself. Phenomenology involves a change in the "sense of the world": everything acquires its sense and value only when it becomes the content of the lived experience of the subject correlated to his intentional acts. This is the main thesis of the phenomenological method aiming at overcoming the traditional opposition between rationalism and empiricism. Starting from Husserl, the father (...) of this approach, the history of phenomenology undertook different and unexpected developments which in some cases were rather far away from Husserl's original thought. In the U.K. attention has been given to an analytical-epistemological phenomenology focused on the relationship between intentionality and logical semantics. In France it is mainly an anthropological-existential phenomenology. In Germany an hermeneutic phenomenology was developed, mainly by Heidegger and Gadamer. Regardless of these raw distinctions, a big question is so far unresolved: how to reconcile the phenomenological/ existential stance claiming for the irreducibility of each lived experience and the scientific paradigm? Is it possible to imagine brain mechanisms and physiological systems explaining the endless mysteries and manifold paradoxes of the human being? Phenomenology claims that a human being can never be considered as an object, as if he was a natural thing; rather the task is to understand him as the focus of a relationship linking subjective attitudes to the objects showed by the experience. In this sense, an important contribution was Merleau-Ponty's view that man is not something psychic joined to an organism, but a sort of fluctuation of the existence that sometimes is a bodily one, sometimes refers to personal acts. Consequently, he proposes to reinstate in the existence both its "physiological" and "psychic" sides both being intentionally oriented towards a world. (shrink)

In my 1984 book on The Foundations of Psychoanalysis, I addressed two main questions: Are the analyst’s observations in the clinical setting reliable as ‘data,’ and if so, can they actually support the major hypotheses of the theory of repression or psychic conflict, which is the cornerstone of the psychoanalytic edifice, as we know? In the book, I argued for giving a negative answer to both of these questions. Clearly, if the evidence from the couch is unreliable from the outset, (...) then this defect alone suffices to jeopardize the very foundations of the clinical theory. But, as I strongly emphasized, even if clinical data were not contaminated by the analyst’s influence, the inability of the psychoanalytic method of clinical investigation by free association to warrant the required sort of causal inferences leaves the major pillars of the theory of psychic conflict ill-supported. Thus, I see a two-fold threat to the psychoanalytic case-study method as a means of scientific inquiry.It is an immediate corollary of my challenge that it applies not only to Freud’s own original hypotheses, but also to any and all post-Freudian versions of psychoanalysis that rely on his clinical methods of validating causal inferences, though the specific content of their theories of psychic conflict is different. After all, the alteration in the content of the hypotheses hardly makes their validation more secure. Therefore, as Morris Eagle documented in a recent publication, those analysts who have objected to my critique as anachronistic have simply not come to grips with it. For example, such inadequate engagement is present, in my view, in the recent Freud Anniversary Lecture ‘Psychoanalysis as a Science: A Response to the New Challenges,’ given by Robert Wallerstein, the current president of the International Psychoanalytical Association. As he tells us, ‘The Freud Anniversary Lecture was intended primarily as a response to Grünbaum.’ Yet he does not come to grips at all with the gravamen of my challenge: Even if clinical data could be taken at face value as being uncontaminated epistemically, the inability of the psychoanalytic method of clinical investigation by free association to warrant causal inferences leaves the major pillars of the clinical theory of repression ill-supported. (shrink)

My primary aim in this article is to provide a philosophical account of the unity of hallucinations, which can capture both perceptual hallucinations (which are subjectively indistinguishable from perceptions) and non-perceptual hallucinations (all others). Besides, I also mean to clarify further the division of labour and the nature of the collaboration between philosophy and the cognitive sciences. Assuming that the epistemic conception of hallucinations put forward by M. G. F. Martin and others is largely on the right track, I will (...) focus on two main tasks: (a) to provide a satisfactory phenomenology of the subjective character of perceptions and perceptual hallucinations and (b) to redress the philosophers’ neglect of non-perceptual hallucinations. More specifically, I intend to apply one of the central tenets of the epistemic conception—that hallucinations can and should be positively characterised in terms of their phenomenological connections to perceptions—to non-perceptual hallucinations as well. That is, I will try to show that we can positively specify the class of non-perceptual hallucinations by reference to the distinctive ways in which we first-personally experience them and perceptions in consciousness. The task of saying more about their underlying third-personal nature may then be left to the cognitive sciences. (shrink)

Abstract. We point out that physical behavior is directed by the action principle (or Hamilton principle), while biological behavior is governed by the Bauer-principle which is directed against the action principle. Therefore, the ontological structure of reality have to be at least two-levelled. Consequently, we may escape from the paradoxes of endo-physics, since they arise from putting the observer into a physical context and compressing the ontological structure of reality into a one-levelled surface. We indicate that the concept of the (...) Universe as-a-whole leads to the concept of a timelessness Universe. The internal time of the timelessness Universe is related to the three archi, the first principles of physical matter, living matter and conscious matter. We explore the existence of an ultimate time in which the timelessness evolve, what is related to the timelessness of logic and point out how the dynamics of finiteness and infinity is related to the ultimate realities of our lives. An interesting connection is found to the von Neumann's critical number of the elements for self-reproducible systems, the number of neurons in the human brain and self-consciousness. The need for an integral cosmology is emphasized which should include the Bauer-principle. The origin of the first principles of physics, biology and consciousness may be found in the logical principles. In that case material reality governed by the first principles may originate from the primordial logical reality. This result discover the existence of a Pythagorean Gap between the ontological principles and the realm of logic and may confirm the idea of Pythagoras that material reality originates from numbers. (shrink)

The present paper reflects on hallucination and delusion in schizophrenia from a phenomenological perspective. The paper’s aim is to understand the relationship between these two symptoms within the theoretical paradigm of schizophrenia as a self-disorder. The paper draws on fundamental insights from contemporary phenomenological research by Louis A. Sass, Josef Parnas and Thomas Fuchs. The argument begins with current definitions of hallucination and schizophrenia in the DSM-5. I will critically illuminate these definitions by key thinkers of phenomenological psychopathology (or close (...) to it), such as Karl Jaspers, Eugène Minkowski, Henri Ey and Merleau-Ponty. The paper’s main challenge is to understand hallucination and delusion beyond their respective alignment with perception (as though hallucination would simply be a perception without an object to perceptive) or false belief (as if delusion would simply be an absurd conviction). (shrink)

A critical commentary on the article “The Epistemic Harms of Empathy in Phenomenological Psychopathology” by Lucienne Spencer and Matthew Broome (2023) is presented. The authors committed the “fallacy of ambiguous or vague definition” by incorrectly interpreting Karl Jaspers’ conceptualizations, resulting in difficulties following logical arguments and arriving at reasonable conclusions. To overcome this fallacy, the commentary provides conceptual clarifications regarding Jaspers’ empathic understanding (einfühlendes Verstehen), conceived as the foundational concept of his project to develop a phenomenologically oriented psychopathology. Jaspers initially (...) introduced this concept in the article “Die phänomenologische Forschungsrichtung in der Psychopathologie” [The Phenomenological Research Direction in Psychopathology], published in 1912, and extended in his magnum opus “Allgemeine Psychopathologie” [General Psychopathology], published in 1913. (shrink)

National University of «Kyiv-Mohyla academy» MEETING THE OTHER AS A CHALLENGE 15th International Conference “Philosophy: the New Generation” Summaries of Reports Kyiv, NaUKMA, April 21–22, 2023 .

Traumatic experiences do not merely impact on the individual’s body and psyche, they alter the way we experience others, our interpersonal relationships, and how we make sense of the world. In my dissertation, I integrate work in phenomenology, psychopathology, philosophy of mind, philosophy of psychiatry, and trauma studies, and draw on trauma testimonies ob- tained in an online questionnaire. I engage analytically with the question of what constitutes a trauma, whether psychological trauma is necessarily pathological, and what the causal and (...) im- plicatory relations between traumatising and post-traumatic experiences are. Informed by these preliminary elaborations, I focus on the intersubjective dimension of trauma, drawing on a qualitative study I conducted in 2020. I show that empathic abilities may be altered but are not necessarily diminished through traumatising experiences; I suggest a framework for under- standing feelings of alienation in the aftermath of trauma; and I demonstrate how feelings of belonging may be re-established. My dissertation is exemplary of how phenomenological frameworks can contribute to a better understanding of psychological trauma and that engaging with trauma can, in turn, inform and enrich philosophical thinking. (shrink)

A lo largo de la tradición psicopatológica, incluso de la pre-fenomenológica, se encuentra la categorización del delirio como creencia. Jaspers asumió ese uso y lo fundó fenomenológico-existencialmente, definiendo su carácter de convicción. El concepto de creencia ha tenido un largo recorrido dentro de la historia del pensamiento, aunque recientemente se ha intensificado el debate acerca de la visión doxástica del delirio. En virtud de lo ya mencionado, en el presente artículo presentamos un análisis conceptual de la creencia, con el objetivo (...) de identificar de manera precisa los aspectos esenciales que permiten al delirio definirse según ella. De esta manera, se discutirán algunas de las principales incursiones realizadas en el concepto desde la antigüedad periplatónica hasta José Ortega y Gasset, remarcando en cada pensador las directrices esenciales de su aproximación a la creencia. A su vez, introducir al filósofo español al debate psicopatológico permitirá incluir en la discusión dos aspectos importantes que creemos pueden ser fructíferos para la discusión filosófica sobre el delirio: la diferencia entre ideas y creencias, y la vitalidad de estas últimas. Finalmente, hacemos referencia al actual debate pro- y antidoxástico, haciendo hincapié en la necesidad de considerar la amplitud del concepto de creencia en su genealogía histórica. Con base en ello estaríamos en condición de acercarnos a la visión doxástica moderada que han defendido autoras como Lisa Bortolotti. (shrink)

In 2020, M. Summa developed a promising approach to understanding the concept of illness. This approach combines a theory of organisms with Responsive Phenomenology to gain a concept of illness. Following on from this, the present article shows that the normative presuppositions can be further explicated and justified by drawing on the theoretical resources of Aristotelian naturalism as propounded by Michael Thompson. Aristotelian naturalism does provide a theoretical option to grasp the normative foundations of human life. However, this article argues (...) that Aristotelian naturalism requires another criterion besides human nature to make the concept of illness intelligible. Following John McDowell’s critique of Aristotelian naturalism, it will be shown that this criterion consists in the capacity for autonomy. From this a concept of illness is developed which describes an impairment of the self-regulated and autonomous realisation of the human form of life. (shrink)

Contemporary perspectives on delusions offer valuable neuropsychiatric, psychoanalytic, and philosophical explanations of the formation and persistence of delusional phenomena. However, two problems arise. Firstly, these different perspectives offer us an explanation “from the outside”. They pay little attention to the actual personal experiences, and implicitly assume their incomprehensibility. This implicates a questionable validity. Secondly, these perspectives fail to account for two complex phenomena that are inherent to certain delusions, namely double book-keeping and the primary delusional experience. The purpose of this (...) article is to address both problems, by offering an understanding “from the inside”. Our phenomenological approach is a form of “radical empathy”, and crosses the Jaspersian limits of understanding. It compares delusional experiences with variations of reality experience in everyday life, and makes use of the structure of imagination. Six factors influencing the experience of reality are discussed and illustrated by clinical and non-clinical examples. These factors are: continuity, materiality and resistance, multiplicity of sensations and perceptions, intensity, the sense of authorship, and the complex role of intersubjectivity. I suggest that experiences of hypo- and hyperreality are not restricted to pathology, but have their place in everyday life as well. Delusional phenomena can be better understood by investigating the interplay of these six factors. With this framework, the two complex phenomena consequently prove to be better understandable to us. Our approach remains within the phenomenal experience and might thereby contribute to the validity of psychopathology. (shrink)

The aim of this paper is to analyze those passages of the Black Notebooks where Heidegger mentions Søren Kierkegaard and to see how Heidegger interprets Kierkegaard’s impact on his own philosophical thought. The paper intends to clarify whether, and to what extent, Heidegger’s rejection of an existentialist reading of his early thought is plausible and justified. The conclusions reached will be twofold. First, Heidegger tries to reinterpret his existential analytic by using the approach he has developed in his work after (...) Being and Time. In so doing, Heidegger tries to understate or diminish the Kierkegaardian background of his analytic of existence. Second, Heidegger’s retrospective self-interpretation argues for a continuity between the approach he develops in Being and Time and that which he calls the question of ‘the truth of beyng’. In so doing, he does not recognize the inconsistencies and mismatches that characterize his thought during the transition from the existential analytic to the philosophy of the event. The passages dealing with Kierkegaard in the Black Notebooks are important sources that allow us to note how problematic Heidegger’s self-interpretation is. (shrink)

This essay is a response to proposals to integrate patient-subjective or idiographic data into future versions of nosologies such as theDSMand theICD. It argues that a nosology is not a suitable vehicle for disseminating psychopathological-phenomenological research results throughout the field. Drawing on the work of Ludwig Binswanger, it examines, on the basis of four postulates, how he applies the Husserlian concept of intentionality in psychiatry and thus arrives at a psychopathological phenomenology. For each individual postulate, we then look in depth (...) at the implications for the current debate aroundDSM. The conclusion we come to is that, both because of the objective of phenomenological research and because of the complexity of the kind of information involved in findings based on that research, it is impossible to integrate these findings into a nosology without deviating from either them or the nosology itself. (shrink)

Clinical fields of the “sciences of the mind” (psychotherapy, psychiatry, etc.) lack integrative conceptual frameworks that have explanatory power. Mainly descriptive-classificatory taxonomies like DSM dominate the field. New taxonomies such as Research Domain Criteria (RDoC) aim to collect scientific knowledge regarding “systems” for “processes” of the brain. These terms have a supradisciplinary” meaning if they are considered in context of Systems Science. This field emerges as a platform of theories like general systems theory, catastrophe theory, synergetics, chaos theory, etc. It (...) provides a lot of abstract concepts, constructs, methods and models. We assume that these tools also enable theoretical integration in the diversified field of clinical practice in the sciences of the mind. Additionally, systems thinking in clinical psychology improves conceptual links to currently network-oriented neurobiology. However, clear definitions of systemic terms are necessary to emerge from their mainly metaphorical use. Here we revise mainly terms like “structure”, “process” and “dynamics” as they are used already in psychology, psychoanalysis, psychopathology and psychiatry in an ill-defined way. For instance, affective-cognitive structures like “life space” or “object representations” can be seen as products of mental processing. These structures, in turn, modulate dynamics of mental processes. Additionally, we suggest a coupled network concept of emotions and motivations as the main subsystem that modulates mental dynamics that results in a qualitative systemic model of the mind. Finally, we assume that a revisited systemic approach could improve interdisciplinary understanding of the mental. ystem for mental dynamics. In this context, we assume that a revisited systemic approach could improve interdisciplinary understanding of the mental. (shrink)

2013 sees the centenary of Jaspers' foundation of psychopathology as a science in its own right. The general sense of the General Psychopathology and its specific contribution are discussed. In particular, the lecture focuses on three major contributions: the methodological import (Jaspers perspectivism), the importance to study subjective experiences scientifically (Jaspers' phenomenology), and the concept of understanding. Three psychiatrists with partly different theoretical background discuss with the members of the Roman Circle of Psychopathology questions like: the specific historical and theoretical (...) features of early Twentieth Century culture, science and psychiatry in Germany; Jaspers' relationship with other great thinkers of his time (Freud, Husserl, Heidegger, Kretschmer); the reception of the General Psychopathology in different countries; and the importance and limitations of Jaspers' approach for nowadays psychopathology. (shrink)

This paper focuses on one of the original moments of the development of the “phenomenological” current of psychiatry, namely, the psychopathological research of Ludwig Binswanger. By means of the clinical and conceptual problem of schizophrenia as it was conceived and developed at the beginning of the twentieth century, I will try to outline and analyze Binswanger’s perspective from a both historical and epistemological point of view. Binswanger’s own way means of approaching and conceiving schizophrenia within the scientific, medical, and psychiatric (...) context of that time will lead us to grasp the epistemological stakes at the origins of his project of reforming psychiatry by means of phenomenology. I will finally attempt to upgrade and update Binswanger’s project in light of the current reappraisal of phenomenology within the ongoing debate on psychopathology engaged by studies in the field of science and philosophy of mind. (shrink)

Eugen Bleuler, in 1911, renamed the group of mental disorders with poor prognosis which Emil Kraepel in had called ``dementia praecox'' ``group of schizophrenias'',because for him the splitting of personality was the main symptom.Biographical, scientific and methodological influences on Bleuler's concept of schizophrenia are shown with special reference to Kraepelin and Freud.Bleuler was a passionate and very experienced clinician. He lived with his patients, taking care of them and writing down his observations. Methodologically he was an empiricist and an eclecticist (...) with a wide reading knowledge.In an impaired association of ideas, in disordered affectivity, in marked ambivalence and autism Bleuler saw the main symptoms of schizophrenia. For him these so-called pathological phenomena actually seemed to be only exaggerations of normal psychic functions. So there were only a quantitative, not a qualitative difference between schizophrenia and normal psychic processes and studies on schizophrenic ``pathology'' –seen as a disturbance, not as a disease – might analogously illustrate normal psychic reactions and vice versa.In etiology as well as in therapy Bleuler took into account psychological and (neuro)physiological(somatic) mechanisms – thus combining organicism and dynamic psychiatry and coming very close to modern concepts, e.g. the one of stress and vulnerability. Bleuler's main merit is the stressing of an idiographic ``understanding'' of the patient and a plausible and subtle explanation of schizophrenia which helped to reduce the alienation of the affected persons. (shrink)

Biography is a story, and a story is something that is meant to be told. It is thus quite evident that biography is the tale of a life: a life-story (Lebensgeschichte in German). But then the question arises as to what exactly is a story and how apt is it for representing life within the limits of this representation as compared to other representations of life: the painted or written portrait, the private diary, the oral or tape-recorded interview, the curriculum (...) vitae, the anthropometric file or the epitaph, which at least has the merit of being concise. (shrink)

During recovery from psychosis (diagnosed as schizophrenia) things must often be done slower than normally expected. The tempo of the socially shared reality is often experienced as being too fast for the recovering person. We will describe how this impairment stems from the pre-reflective mental structure underlying psychosis and how it can be transferred into an active skill supporting recovery, often including social retreat. In this paper, co-written by a psychiatrist and a person experienced in psychosis (= participatory health research), (...) we will draw on personal experiences, (participatory) qualitative research and first-hand accounts for our arguments. We will sketch out the process and three crucial building blocks of recovery: laid-back situations, switch-off skills, places to talk. We will then describe the acquired skill of slowing-down as an amalgam of the building blocks ‘switch-off skill’ and ‘laid-back situation’, since slowing-down answers the situation in a laid-back manner and enforces a slow behavioral pace on it. While this might be okay in private and in some situations shared with others (i.e. during serene situations), it may be tantalizing for others in many everyday situations resulting in stigma or exclusion (i.e. during work). Slowing-down therefore challenges the surrounding others and demonstrates the necessity to synchronize private and public tempos. This is most challenging while living in two realities at once, being the second and often a long-lasting stage of recovery (stage of double realities). (shrink)

Dysphoria is a complex phenomenon which must be defi ned in the framework of different forms of affections. It belongs to the broader field of emotions, which are characterized by some essential features: i.e. movement, passiveness, tran-sitoriness, and reference to the others. All these four essential features of emotion are specifi cally altered in depression, whose phenomenology is presented in a clinical case. In discussing dysphoria, a first distinction is made between par-ticular and global affections. The fi rst type encompasses (...) emotions and feelings, while the second one includes humor, mood and temper. Dysphoria belongs to one of these global affective states: the humor, which has to do with the spatial dimension of existence. In dysphoria the patient experiences the world as oppressive and invasive of his/her intimacy; the others are lived as persons demanding answers or actions he/she is not able to fulfill. Finally, the phenomenology of dysphoria is analyzed through the four essential features described above and examples are given. (shrink)

The purpose of this article is to demonstrate the epistemic position of psychiatry between the science of general laws in relation to frequently encountered generality and the science of specific events which is directed towards the particular. In this respect the development of the dichotomy of nomothetic and idiographic methodology from its generally forgotten neo-Kantian origins is delineated within the context of a historical-philosophical analysis and then its incorporation into psychology and psychopathology is reconstructed. In the course of this analysis (...) and also in the discussion of the currently accepted theories of analytical philosophy and critical rationalism it becomes clear that, in spite of widespread current opinions to the contrary, individualizing concept formation is an indispensable element in the methodological inventory of psychiatric science. (shrink)

In the Letter of Humanism, Heidegger reinterprets the Greek notion of ethos as designating the way in which human beings dwell in the world through a “unifying” language. Through various down strokes in the autobiographical and psychopathological literature on schizophrenia as well as in literary texts and literary criticism, this paper, experimental in its effort, argues that the language productions of schizophrenia and poetry, each in its own way, seem to fall outside this unification of a language in common. Furthermore, (...) it argues that this “falling outside” is related to radical experiences of “alienation” and “otherness,” which call for an alteration of conventional language. However, whereas poetry appears to open new linguistic possibilities, schizophrenia runs the risk of reducing language to the silence of incomprehensible “nonsense.” The paper ends with the suggestion that a poetic employment of language may hold a double potential with regard to the understanding and possible treatment of schizophrenia spectrum disorders. (shrink)

ABSTRACT This essay shows how certain limit-points of Lacan's psychoanalytic discourse in his 1955–56 seminar on The Psychoses tangentially brush up against Maurice Blanchot's writing on the neuter, as presented in The Space of Literature from 1955. The effort is to strike up a conversation between Lacan's “clinical discourse” and Blanchot's “critical writing” on the topics of language, writing, authority, and madness. In this regard, the essay approaches an infinite point of approximation between the procedure of psychosis and the procedure (...) of literary writing by questioning whether, at some point in these different ways of proceeding, they may share a certain experience of language. Namely, this is an experience of a language that, as stated by both Jacques Lacan and Maurice Blanchot, “speaks all by itself” and does so incessantly and with a certain furious neutrality. (shrink)

Drawing upon core phenomenological contributions of the last decades, the present paper provides an integrated description of the development of auditory hallucinations in schizophrenia. Specifically, these contributions are the transitional sequences of development of psychotic symptoms of schizophrenia as envisioned by Klosterkötter and rooted in the basic symptoms approach, Conrad’s Gestalt-analysis of developing psychosis, and Sass and Parnas’ self-disturbance approach. Klosterkötter’s contribution provides a general descriptive psychopathological approach to the transitional sequence of the development of auditory hallucinations. The key concepts (...) in Conrad’s proposal are discussed, as their role is central as driving forces of the process from non-psychotic symptoms to overt hallucinations. Finally, Parnas and Sass link psychiatry to philosophy and psychology, and provide an in-depth and thorough description of these phenomena in their work on schizophrenia as a disorder of consciousness and self-experience with hyper-reflexivity and diminished self-affection as key aspects. (shrink)

On a widely held view, episodes of inner speech provide at least one way in which we become conscious of our thoughts. However, it can be argued, on the one hand, that consciousness of thoughts in virtue of inner speech presupposes interpretation of the simulated speech. On the other hand, the need for such self-interpretation seems to clash with distinctive first-personal characteristics that we would normally ascribe to consciousness of one’s own thoughts: a special reliability; a lack of conscious ambiguity (...) and incomprehensibility; and a sense of causal agency. I try to resolve this puzzle by proposing an account for the requisite self-interpretation of inner speech in terms of Bayesian probabilistic inference. Drawing on “perceptual loop” accounts of speech control, I argue that such interpretive probabilistic inferences are used for the control of inner speech, and that as a consequence of this function, they are biased toward the correct interpretations. I conclude by showing how this model can explain the first-personal characteristics of consciousness of one’s own thoughts. In the case of the sense of causal agency, the resulting explanation yields novel accounts for “audible thoughts” and thought insertion. (shrink)

[The Complex Self: Empirical and theoretical perspectives] I have throughout this paper emphasized the complexity of the self. This complexity necessitates interdisciplinary collaboration; collaboration across the divide between theoretical analysis and empirical investigation. To think that a single discipline, be it philosophy or neuroscience, should have a monopoly on the investigation of self is merely an expression of both arrogance and ignorance.

Patients suffering from mental disorders are often not treated on an equal basis with patients suffering from organic diseases. In Germany, for example, alcohol-dependent patients will be detoxified on a clinical ward to ensure that they survive acute alcohol withdrawal; however, medical insurances often do not cover treatment costs for a therapy for the addictive behavior that underlies the acute alcohol problem. While patients suffering from diabetes mellitus can also display personally harmful choices and, for example, consume sugar although they (...) know that this is detrimental for their health, medical insurances pay for the acute hyperglycemic shock treatment as well as for dietary and medical treatment of the .. (shrink)

Going beyond the scope of psychiatric diagnoses, this study introduces the concept of human vulnerability as a means of linking the phenomenological approach—focusing on the patient’s experience—with psychotherapeutic treatment. To this end, it applies Karl Jaspers’ concept of “limit situation” to the existential vulnerability in the manifestation of mental illness and the ontological vulnerability in schizophrenia. From a psychological or empathic standpoint, vulnerability, as experienced in different cases of mental illness, refers to the condition of being confronted with disturbing meaningful (...) social encounters with others. In these social encounters, existential meanings acquire disturbing qualities for a person’s integrity, giving rise to various psychopathological phenomena. This study incorporates the practice of psychotherapy and empirical research to suggest that the experience of vulnerability is crucial not only in understanding the manifestation of mental illness but also a key element of phenomenological psychotherapeutic treatment, and it uses schizophrenia as an example. (shrink)

Assistive systems based on Artificial Intelligence (AI) are bound to reshape decision-making in all areas of society. One of the most intricate challenges arising from their implementation in high-stakes environments such as medicine concerns their frequently unsatisfying levels of explainability, especially in the guise of the so-called black-box problem: highly successful models based on deep learning seem to be inherently opaque, resisting comprehensive explanations. This may explain why some scholars claim that research should focus on rendering AI systems understandable, rather (...) than explainable. Yet, there is a grave lack of agreement concerning these terms in much of the literature on AI. We argue that the seminal distinction made by the philosopher and physician Karl Jaspers between different types of explaining and understanding in psychopathology can be used to promote greater conceptual clarity in the context of Machine Learning (ML). Following Jaspers, we claim that explaining and understanding constitute multi-faceted epistemic approaches that should not be seen as mutually exclusive, but rather as complementary ones as in and of themselves they are necessarily limited. Drawing on the famous example of Watson for Oncology we highlight how Jaspers’ methodology translates to the case of medical AI. Classical considerations from the philosophy of psychiatry can therefore inform a debate at the centre of current AI ethics, which in turn may be crucial for a successful implementation of ethically and legally sound AI in medicine. (shrink)