There is a long tradition of employing a phenomenological approach to gain greater insight into the unique experience of psychiatric illness. Researchers in this field have shed light upon a distur...

The dominant conception of delusion in psychiatry (in textbooks, research papers, diagnostic manuals, etc.) is predominantly epistemic. Delusions are almost always characterized in terms of their epistemic defects, i.e., defects with respect to evidence, reasoning, judgment, etc. However, there is an individualistic bias in the epistemic conception; the alleged epistemic defects and abnormalities in delusions relate to individualistic epistemic processes rather than social epistemic processes. We endorse the social epistemological turn in recent philosophical epistemology, and claim that a corresponding turn (...) is needed in the study of delusions. It is a turn from the (purely) individualistic conception, which characterizes delusions only by individualistic epistemic defects and abnormalities, to the (partially) social epistemic conception, which characterizes delusions by individualistic as well as social epistemic defects and abnormalities. This paper is intended as an initial step toward such a social epistemological turn. In particular, we will develop a new model of the development of delusions according to which testimonial abnormalities, including testimonial isolation and testimonial discount, are a causal factor in the development of delusions. (shrink)

Delusions are often portrayed as paradigmatic instances of incomprehensibility and meaninglessness. Here we investigate the relationship between delusions and meaning from a philosophical perspective, integrating arguments and evidence from cognitive psychology and phenomenological psychopathology. We review some of the empirical and philosophical literature relevant to two claims about delusions and meaning: delusions are meaningful, despite being described as irrational and implausible beliefs; some delusions can also enhance the sense that one’s life is meaningful, supporting agency and creativity in some circumstances. (...) Delusions are not incomprehensible representations of reality. Rather, they can help make sense of one’s unusual experiences and in some circumstances even support one’s endeavours, albeit temporarily and imperfectly. Acknowledging that delusions have meaning and can also give meaning to people’s lives has implications for our understanding of psychotic symptoms and for addressing the stigma associated with psychiatric conditions. (shrink)

The idea that mental illnesses are impairments in rationality is very old, and very common (Kasanin 1944; Harvey et al. 2004; Graham 2010). But is it true? In this article two severe mental disorders, schizophrenia and delusional disorder, are investigated in order to find some defects in rationality. Through the analysis of patients’ performances on different tests, and the investigation of their typical reasoning styles, I will show that mental disorders can be deficits in social cognition, or common sense, but (...) not in rationality (Sass 1992; Johnson-Laird et al. 2006; Bergamin 2018). Moreover, my claim is that psychopathological patients can also be, in some circumstances, more logical than normal controls (Kemp et al. 1997; Owen et al. 2007). From a philosophical point of view these data seem to be very relevant, because they help us to reconsider our idea of rationality, and to challenge the common way to look at sanity and mental illness. (shrink)

Much of the characteristic symptomatology of schizophrenia can be understood as resulting from a pervasive sense of disembodiment. The body is experienced as an external machine that needs to be controlled with explicit intentional commands, which in turn leads to severe difficulties in interacting with the world in a fluid and intuitive manner. In consequence, there is a characteristic dissociality: Others become problems to be solved by intellectual effort and no longer present opportunities for spontaneous interpersonal alignment. This dissociality goes (...) hand in hand with a progressive loss of the socially extended mind, which normally affords opportunities for co-regulation of cognitive and affective processes. However, at times people with schizophrenia report that they are confronted by the opposite of this dissociality, namely an unusual fluidity of the self-other boundary as expressed in experiences of ambiguous body boundaries, intrusions, and even merging with others. Here the person has not lost access to the socially extended mind but has instead become lost in it, possibly due to a weakened sense of self. We argue that this neglected aspect of schizophrenic social dysfunction can be usefully approached via the concept of genuine intersubjectivity: We normally participate in a shared experience with another person by implicitly co-regulating how our interaction unfolds. This co-regulation integrates our respective experience’s dynamical bases into one interpersonal process and gives the interaction an ambiguous second-person character. The upshot is that reports of abnormal self-other fluidity are not indicative of hallucinations without any basis in reality, but of a heightened sensitivity and vulnerability to processes of interpersonal alignment and mutual incorporation that form the normal basis of social life. We conclude by discussing implications of this view for both the science of consciousness as well as approaches to intervention and therapy. (shrink)

This essay, the last in a series, focuses on the relationship between Nietzsche’s mental illness and his philosophical art. It is predicated upon my original diagnosis of his mental condition as bipolar affective disorder, which began in early adulthood and continued throughout his creative life. The kaleidoscopic mood shifts allowed him to see things from different perspectives and may have imbued his writings with passion rarely encountered in philosophical texts. At times hovering on the verge of psychosis, Nietzsche was able (...) to gain access to unconscious images and the music of language, usually inhibited by the conscious mind. He reached many of his linguistic, psychological and philosophical insights by willing suspension of the rational. None of these, however, could have been communicated had he not tamed the subterranean psychic forces with his impressive discipline and hard work. (shrink)

Schizophrenia is usually described as a fragmentation of subjective experience and the impossibility to engage in meaningful cultural and intersubjective practices. Although the term schizophrenia is less than 100 years old, madness is generally believed to have accompanied mankind through its historical and cultural ontogeny. What does it mean to be “mad”? The failure to adopt social practices or to internalize cultural values of common sense? Despite the vast amount of literature and research, it seems that the study of schizophrenia (...) and of the psychoses is suffering from a generic disintegration. In this introduction, we offer an historical overview of the variety of theories and approaches to schizophrenia. We also provide an overview of how the authors in this volume attempt an integrative account where training, practice, theory and research are considered as parts of a larger whole. This is a varied and pluralistic volume, and it is up to the readers to make use of different chapters according to their own needs. (shrink)

A family of recent externalist approaches in philosophy of mind argues that our psychological capacities are synchronically and diachronically “scaffolded” by external resources. I consider how these “scaffolded” approaches might inform debates in phenomenological psychopathology. I first introduce the idea of “affective scaffolding” and make some taxonomic distinctions. Next, I use schizophrenia as a case study to argue—along with others in phenomenological psychopathology—that schizophrenia is fundamentally a self-disturbance. However, I offer a subtle reconfiguration of these approaches. I argue that schizophrenia (...) is not simply a disruption of ipseity or minimal self-consciousness but rather a disruption of the scaffolded self, established and regulated via its ongoing engagement with the world and others. I conclude by considering how this scaffolded framework indicates the need to consider new forms of intervention and treatment. (shrink)

This current study is a pilot project designed to clarify changes in the lived world among people with diagnoses within the schizophrenia spectrum. The Examination of Anomalous World Experience was used to interview ten participants with schizophrenia spectrum disorders and a comparison group of three participants with major depressive disorder. Interviews were analyzed using the descriptive phenomenological method. This analysis revealed two complementary forms of experience unique toszparticipants: Destabilization, the experience that reality and the intersubjective world are less comprehensible, less (...) stable, and generally less real; and Subjectivization, the dominance of one’s internal, subjective experiences in the perception or interpretation of the lived world. Persons with depressive disorders, by contrast, did not experience disruptions of the reality or independence of the world or any significant disruptions of appearance or meaning. These results are consistent with contemporary and classic phenomenological views on anomalous world experience in schizophrenia. (shrink)

I discuss Watsuji’s characterization of aidagara or “betweenness”. First, I develop a phenomenological reading of aidagara. I argue that the notion can help illuminate aspects of our embodied subjectivity and its interrelation with the world and others. Along the way, I also indicate how the notion can be fruitfully supplemented by different sources of empirical research. Second, I put aidagara to work in the context of psychopathology. I show how disruptions of aidagara in schizophrenia not only affirm the foundational role (...) it plays in organizing our experience of self and world in everyday life. Additionally, I suggest the notion can, in this context of application, potentially enhance our understanding of and empathy for those living with schizophrenic disorders. (shrink)

This article examines Kant’s discussion of the division between reason and unreason in his Anthropology from a Pragmatic Point of View . On the one hand, Kant says that there is a normative, clear, and definite division between reason and unreason. On the other hand, Kant offers three arguments showing that we cannot draw such a division. First, we cannot explain the normative grounds for the division. Second, both reason and unreason are present in everyone to varying degrees in different (...) ways. Third, Kant invalidates the division as such by characterizing what should be more incomprehensible than an extreme case of unreason as also being a rational way of life. (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)

What is art? The arts establishment has a simple answer: anything is art if a reputed artist or expert says it is. Though many people are skeptical about the alleged new art forms that have proliferated since the early twentieth century, today's critics claim that all such work, however incomprehensible, is art. A groundbreaking alternative to this view is provided by philosopher-novelist Ayn Rand (1905-1982). Best known as the author of The Fountainhead and Atlas Shrugged, Rand also created an original (...) and illuminating theory of art, which confirms the widespread view that much of today's purported art is really not art at all. In What Art Is, Torres and Kamhi present a lucid introduction to Rand's esthetic theory, contrasting her ideas with those of other thinkers. They conclude that, in its basic principles, her account is compelling, and is corroborated by evidence from anthropology, neurology, cognitive science, and psychology. The authors apply Rand's theory to a debunking of the work of prominent modernists and postmodernists--from Mondrian, Jackson Pollock, and Samuel Beckett to John Cage, Merce Cunningham, and other highly regarded avant-garde figures. Finally, they explore the implications of Rand's ideas for the issues of government and corporate support of the arts, art law, and arts education. Table of Contents / Chapter Summaries / Introduction (excerpts) / Endorsements / Reviews & Responses: Choice (Association of College and Research Libraries, 2001); The Art Book (U.K. Association of Art Historians, 2001); and more. Jacques Barzun (1907-2012), Cultural Historian - Bio / Endorsements / Letters from / "In Depth" interview on Book TV [C-SPAN2]: Endorsement. (shrink)

On the basis of neuropsychological evidence, it is clear that attention should be given a role in any model of consciousness. What is known about the many instances of dissociation between explicit and implicit knowledge after brain damage suggests that conscious experience might not be linked to a restricted area of the brain. Even if it were true that there is a single brain area devoted to consciousness, the subicular area would seem to be an unlikely possibility.

The commentary argues that we cannot be sure that human consciousness has survival value and that in order to understand the origins and, perhaps, the function of consciousness, we should examine the behavioural and neural precursors to consciousness in nonhumans. An example is given of research on the role of context in decisions regarding fleeing from probable predators in the Mongolian gerbil.

According to the traditional Western concept of freedom, the ability to exercise free will depends on the availability of options and the possibility to consciously decide which one to choose. Since neuroscientific research increasingly shows the limits of what we in fact consciously control, it seems that our belief in free will and hence in personal autonomy is in trouble. -/- A closer look at the phenomenology of Obsessive-Compulsive Disorder (OCD) gives us reason to doubt the traditional concept of freedom (...) in terms of conscious control. Patients suffering from OCD experience themselves as unfree. The question is whether their lack of freedom is due to a lack of will power. Do they have too little conscious control over their thoughts and actions? Or could it be the opposite: are they exerting too much conscious control over their thoughts and actions? -/- In this chapter, we will argue that OCD patients testify to the general condition that exercising an increased conscious control over actions can in fact diminish the sense of agency rather than increase the experience of freedom. The experiences of these patients show that the traditional conception of freedom in terms of ‘free will’ has major shortcomings. There is an alternative, however, to be found in the work of Hannah Arendt. She advocates a conception of freedom as freedom in action. Combined with phenomenological insights on action, Arendt’s account of freedom helps us to get a more adequate understanding of the role of deliberation in the experience of freedom. We argue that the experience of freedom depends on the right balance between deliberate control and unreflective actions. (shrink)

We are perceivers, we are thinkers, and we are also agents, bringing about physical events, such as bodily movements and their consequences. What we do tells us, and others, a lot about who we are. On the one hand, who we are determines what we do. On the other hand, acting is also a process of self-discovery and self-shaping. Pivotal to this mutual shaping of self and agency is the sense of agency, or agentive self-awareness, i.e., the sense that one (...) is the agent of an action. (shrink)

Engaging with the question of the extent to which the so-called human, economic or social sciences are actually sciences, this book moves away from the search for a criterion or definition that will allow us to sharply distinguish the scientific from the non-scientific. Instead, the book favours the pursuit of clarity with regard to the various enterprises undertaken by human beings, with a view to dissolving the felt need for such a demarcation. In other words, Read pursues a ‘therapeutic’ approach (...) to the issue of the status and nature of these subjects. Discussing the work of Kuhn, Winch and Wittgenstein in relation to fundamental question of methodology, Wittgenstein among the Sciences undertakes an examination of the nature of (natural) science itself, in the light of which a series of successive cases of putatively scientific disciplines are analysed. A novel and significant contribution to social science methodology and the philosophy of science and ‘the human sciences’, this book will be of interest to social scientists and philosophers, as well as to psychiatrists, economists and cognitive scientists. (shrink)

In this article the author seeks to highlight a specific disorder related to bodily experience in melancholia conceived as a severe form of clinical depression. The article is divided into three parts. In the first section, the author investigates the intersubjective dimension of bodily experience in light of the categories of Außen- and Innenleiblichkeit. In the second section, I explore a specific disturbance of the dimension of intercorporeality. The excessive feeling of the bodily (außenleibliche) visibility of his/her own sufferance is (...) a fundamental aspect of depression. At a pre-reflexive level, we constantly assume the noncoincidence between one's own bodily expression and the Other's experience/reading of these expressions. An alteration of this (pre-reflexive) awareness occurs in melancholia. The patient feels as if the melancholic condition would be transparent to the other. In the third section, the author intends to show the alteration of the embodied communication between the melancholic person and the other investigating two particular phenomena: the exchange of gaze in a face to face encounter, and the disturbance of the oral sense, revealing a specific form of irresponsiveness and the experience of void. (shrink)

The paper first introduces the concept of implicit and explicit temporality, referring to time as pre-reflectively lived vs. consciously experienced. Implicit time is based on the constitutive synthesis of inner time consciousness on the one hand, and on the conative–affective dynamics of life on the other hand. Explicit time results from an interruption or negation of implicit time and unfolds itself in the dimensions of present, past and future. It is further shown that temporality, embodiment and intersubjectivity are closely connected: (...) While implicit temporality is characterised by tacit bodily functioning and by synchronisation with others, explicit temporality arises with states of desynchronisation, that is, of a retardation or acceleration of inner time in relation to external or social processes. These states often bring the body to awareness as an obstacle as well. On this basis, schizophrenia and melancholic depression are investigated as paradigm cases for a psychopathology of temporality. Major symptoms of schizophrenia such as thought disorder, thought insertion, hallucinations or passivity experiences may be regarded as manifesting a disturbance of the constitutive synthesis of time consciousness, closely connected with a weakening of the underlying pre-reflective self-awareness or ipseity. This results in a fragmentation of the intentional arc, a loss of self-coherence and the appearance of major self-disturbances. Depression, on the other hand, is mostly triggered by a desynchronisation from the social environment and further develops into an inhibition of the conative–affective dynamics of life. As will be shown, both mental illnesses bear witness of the close connection of temporality, embodiment and intersubjectivity. (shrink)

This paper offers a critique of a central psychopathological concept, the notion of "poor reality-testing. "Using ideas from the philosopher Ludwig Wittgenstein, I consider the nature of delusions in schizophrenia, largely through examining Daniel Paul Schreber's famous Memoirs of My Nervous Illness. Many schizophrenic individuals do not in fact mistake their fantasies for reality, as is traditionally assumed. Rather, I argue, they engage in a solipsistic mode of experience, a felt subjectivization of the lived world that is associated with a (...) stance of passivity and hyperconsciousness. I discuss the existential conditions and consequences of this stance and show that certain anomalous or paradoxical features of schizophrenic delusion are explicable on this phenomenological account. (shrink)

This paper examines the philosophical substructure to the theoretical conflicts that permeate contemporary mental health care in the UK. Theoretical conflicts are treated here as those that arise among practitioners holding divergent theoretical orientations towards the phenomena being treated. Such conflicts, although steeped in history, have become revitalized by recent attempts at integrating mental health services that have forced diversely trained practitioners to work collaboratively together, often under one roof. Part I of this paper examines how the history of these (...) conflicts can be understood as a tension between, on the one hand, the medical model and its use by the dominant profession of psychiatry, and on the other, those alternative models and practitioners in some way differentiated from the medical model camp. Examples will be given from recent policy and research to highlight the prevalence of this tension in contemporary practice. Part II of this paper explores the deeper commonalities that lay beneath the theoretical conflict outlined in Part I. These commonalities will be shown to be apart of a captivating framework that has continued to grip the conflict since its inception. By exposing this underlying framework--and the motivations inherent therein--the topic of integration appears in wholly different light, allowing a renewed philosophical basis for integration to emerge. (shrink)

Louis Sass disputes that schizophrenia can be understood successfully according to the hitherto dominant models--for much of what schizophrenics say and do is neither regressive (as psychoanalysis claims) nor just faulty reasoning (as "cognitivists" claim). Sass argues instead that schizophrenics frequently exhibit hyper-rationality, much as philosophers do. He holds that schizophrenic language can after all be interpreted--if we hear it as Wittgenstein hears solipsistic language. I counter first that broadly Winchian considerations undermine both the hermeneutic conception of interpreting other humans (...) in general and Sass's hope of interpreting schizophrenics in particular. I then go on to argue that even if these Winchian considerations are not accepted, Sass in any case doesn't take sufficiently seriously Wittgenstein's use of nonsense as a term of criticism. Solipsism is not something we can understand so as to be able to understand analogically the schizophrenic's "world"--for there is no such thing as understanding it. Solipsism is nonsense, is nothing--there is no "world" there, in solipsists (as I show by reference to Cora Diamond's reading of Wittgenstein). Nor in any actually analogous cases of schizophrenia. Their "alienness" is the alienness of nothingness; roughly, of the fantasy of "logically alien thought". (shrink)

This monograph discusses the question of what it is to be a reason – mainly in practical ethics – and proposes an original contribution to metaethics.It critically examines theories of metaethical realism, constructivism and error theory and identifies several misunderstandings or unclarities in contemporary debates. Based on this examination, the book suggests a distinction between a conceptual question, that can be answered by pure first-personal thinking, and a material question, that targets responses to reasons as a natural phenomenon in space (...) and time and that can be answered by help of the sciences. While this book defends a sharp distinction between these approaches, it also argues that the insights gained by the distinct approaches can be fruitfully integrated into a comprehensive picture.The comprehensive picture promoted in this book, based on both philosophical analysis and resources from psychology and cognitive science, is a picture of reasons as items in a collective archive of mind – reconfiguring the “domain of reasons” as a collectively established and socially cultivated fund of considerations with normative weight. The developed Collective Archive View combines Reasons Fundamentalism as an answer to the conceptual question, with a social ontological proposal, similar to Haslanger’s critical realism, as an answer to the material question.Thereby, it introduces central ideas from the field of social metaphysics into metaethics. At the same time, it offers a way of settling some controversies within metaethics, going on between proponents of Reasons Fundamentalism and Constitutivism, realism and constructivism, as well as proponents of mind-dependence and mind-independence of normative facts. Finally, the proposal enables us to envision and conceptualize genuine normative change within a metaethical theory. (shrink)

In Gray's conjecture, mismatches in the subicular comparator and matches have equal prominence in consciousness. In rival cognitive views novelty and difficulty especially elicit more conscious modes of cognition and higher levels of self-regulation. The mismatch between Gray's conjecture and these views is discussed.

This paper examines the madness of Gerard de Nerval, the nineteenth-century French writer. It looks at his account of mental disturbance, how he responded to the psychiatric profession and how he reacted to being diagnosed as insane. It considers his autobiographical novella of madness, Aurelia, which he began at the suggestion of his alienist, Dr Emile Blanche, and while he was still an asylum inmate. Nerval's story raises important questions about the nature of madness. Is it, as he contended, a (...) mystical experience revealing truths about spiritual worlds inaccessible to the ‘sane’? Does psychiatry fail to understand it and inappropriately reduce it to the categories of scientific reason? Or are such notions of the spiritual value of madness guilty of the charge that they romanticise insanity? Do they make extravagant claims for an experience that is often disturbing and debilitating? What is the relationship between madness and recovery? Should an individual try to forget their experience of mental disturbance once they recover, or should they examine what the event reveals about themselves? Can the language of madness be decoded to unveil profound truths as Carl Jung and R.D. Laing have suggested, or is it, as the psychiatrist German Berrios maintains, merely a series of ‘empty speech acts’, signifying nothing? And finally, how does one avoid writing about madness, and instead write madness? (shrink)

Various forms of anomalous self-experience can be seen as central to schizophrenia and other psychiatric disorders. We examined similarities and differences between anomalous self-experiences common in schizophrenia-spectrum disorders, as listed in the EASE , and those described in published accounts of severe depersonalization. Our aims were to consider anomalous self-experience in schizophrenia in a comparative context, to refine and enlarge upon existing descriptions of experiential disturbances in depersonalization, and to explore hypotheses concerning a possible core process in schizophrenia . Numerous (...) affinities between depersonalization and schizophrenia-spectrum experience were found: these demonstrate that rather pure forms of diminished self-affection can involve many experiences that resemble those of schizophrenia. Important discrepancies also emerged, suggesting that more automatic or deficiency-like factors—probably involving self/world or self/other confusion and erosion of first-person perspective—are more distinctive of schizophrenia-spectrum disorders. (shrink)

This paper proposes that the ‘problem of consciousness’, in its most popular formulation, is based upon a misinterpretation of the structure of experience. A contrast between my subjective perspective and the shared world in which I take up that perspective is part of my experience. However, descriptions of experience upon which the problem of consciousness is founded tend to emphasise only the former, remaining strangely oblivious to the fact that experience involves a sense of belonging to a world in which (...) one occupies a contingent subjective perspective. The next step in formulating the problem is to muse over how this abstraction can be integrated into the scientifically described world . I argue that the scientifically described world itself takes for granted the experientially constituted sense of a shared reality. Hence the problem of consciousness involves abstracting A from B, denying B and then trying to insert A into C, when C presupposes aspects of B. The problem in this form is symptomatic of serious phenomenological confusion. No wonder then that consciousness remains a mystery. (shrink)

The target article sketched and explored a mechanism (action-oriented predictive processing) most plausibly associated with core forms of cortical processing. In assessing the attractions and pitfalls of the proposal we should keep that element distinct from larger, though interlocking, issues concerning the nature of adaptive organization in general.

Abstract This paper proposes that adopting a ?phenomenological stance? enables a distinctive kind of empathy, which is required in order to understand forms of experience that occur in psychiatric illness and elsewhere. For the most part, we interpret other people's experiences against the backdrop of a shared world. Hence our attempts to appreciate interpersonal differences do not call into question a deeper level of commonality. A phenomenological stance involves suspending our habitual acceptance of that world. It thus allows us to (...) contemplate the possibility of structurally different ways of ?finding oneself in the world?. Such a stance, I suggest, can be incorporated into an empathetic appreciation of others' experiences, amounting to what we might call ?radical empathy? (shrink)

The concept of locally specialized functions dominates research on higher brain function and its disorders. Locally specialized functions must be complemented by processes that coordinate those functions, however, and impairment of coordinating processes may be central to some psychotic conditions. Evidence for processes that coordinate activity is provided by neurobiological and psychological studies of contextual disambiguation and dynamic grouping. Mechanisms by which this important class of cognitive functions could be achieved include those long-range connections within and between cortical regions that (...) activate synaptic channels via NMDA-receptors, and which control gain through their voltage-dependent mode of operation. An impairment of these mechanisms is central to PCP-psychosis, and the cognitive capabilities that they could provide are impaired in some forms of schizophrenia. We conclude that impaired cognitive coordination due to reduced ion flow through NMDA-channels is involved in schizophrenia, and we suggest that it may also be involved in other disorders. This perspective suggests several ways in which further research could enhance our understanding of cognitive coordination, its neural basis, and its relevance to psychopathology. Key Words: attention; cerebral cortex; cognitive coordination; cognitive neuropsychiatry; cognitive neuropsychology; context disorganization; Gamma rhythms; Gestalt theory; glutamate; grouping; memory; NMDA-receptors; PCP-psychosis; perceptual organization; schizophrenia. (shrink)

This commentary elaborates on Gray's conclusion that his neurophysiological model of consciousness might explain how consciousness arises from the brain, but does not address how consciousness evolved, affects behaviour or confers survival value. The commentary argues that such limitations apply to all neurophysiological or other third-person perspective models. To approach such questions the first-person nature of consciousness needs to be taken seriously in combination with third-person models of the brain.

In this commentary, I point out some weaknesses in Gray's target article and, in the light of that discussion, I attempt to delineate the kinds of problem a cognitive neuroscience of consciousness faces on its way to a scientific understanding of subjective experience.

Because consciousness has an organizational, or functional, center, Gray supposes that there must be a corresponding physical center in the brain. He proposes further that since this center generates consciousness, ablating it would eliminate consciousness, while leaving behavior intact. But the center of consciousness is simply the product of the functional linkages among sensory input, memory, inner speech, and so on, and behavior.

Gray hypothesizes that the contents of consciousness correspond to the outputs of a subicular (hippocampal/temporal lobe) comparator that compares the current state of the organism's perceptual world with a predicted state. I argue that Gray has identified a key contributing system to conscious awareness, but that his model is inadequate for explaining how conscious contents are generated in the brain. An alternative model is offered.

After a brief perusal of the various meanings of phenomenology in psychopathology, the contributions to schizophrenia of phenomenological psychology in the European sense are reviewed. The last twenty years are deemed fruitful and productive. Following the central themes and motives of this literature allows us to come to a different and perhaps wider understanding of schizophrenia than that proposed currently by mainstream psychiatry. These diverse investigations converge in seeing as the core of schizophrenia the disorders related to inter-subjectivity and ipseity (...) , in turn related to what Bleuler had once called Autism. Finally, a critical discussion of the limitations and the strengths of the phenomenological approach is offered. (shrink)

Drawing on previous models of anxiety, intermediate memory, the positive symptoms of schizophrenia, and goal-directed behaviour, a neuropsychological hypothesis is proposed for the generation of the contents of consciousness. It is suggested that these correspond to the outputs of a comparator that, on a moment-by-moment basis, compares the current state of the organism's perceptual world with a predicted state. An outline is given of the information-processing functions of the comparator system and of the neural systems which mediate them. The hypothesis (...) appears to be able to account for a number of key features of the contents of consciousness. However, it is argued that neitherthis nor any existing comparable hypothesis is yet able to explain why the brain should generate conscious experience of any kind at all. (shrink)

This article seeks to clarify the way in which phenomenology is conceptualized and applied in empirical research in psychiatry and psychology, emphasizing the suitability of qualitative research. It will address the What, Why, and How of phenomenological interviews, providing not only preliminary answers but also a critical analysis, and pointing to future directions for research. The questions it asks are: First, what makes an interview phenomenological? What are phenomenological interviews used for in empirical research in psychiatry and psychology? Second, why (...) do we carry out phenomenological interviews with patients? Is merely contrasting phenomenological hypotheses or concepts enough to do justice to the patients’ involvement? Third, how should we conduct phenomenological interviews with patients? How can we properly perform analysis in empirical phenomenological research in psychiatry and psychology? In its conclusion, the article attempts to go a step beyond these methodological questions, highlighting the “bigger picture”: namely, the phenomenological scientific paradigm and its core philosophical claim of reality as mind-dependent. (shrink)

In this introduction we present the orthodox account of auditory verbal hallucinations, a number of worries for this account, and some potential responses open to its proponents. With some problems still remaining, we then introduce the problems presented by the phenomenon of thought insertion, in particular the question of how different it is supposed to be from AVHs. We then mention two ways in which theorists have adopted different approaches to voices and thoughts in psychosis, and then present the motivation (...) and composition of this special issue. (shrink)

Reflexivity and detachment: a discursive approach to women's depression This paper explores a discursive approach to understanding women's depression by presenting the results of research into women's narratives of their experiences. The discursive approach taken acknowledges women's immersion in cultural practices that determine the subject positions available to them and places a value on attributes of reflexivity and detachment that are not usually associated with their performance. The social and cultural context of the individual's experience is significant because if the (...) focus is simply on the individual this supposes that the problem lies solely with the individual. An understanding of cultural expectations and their relation to mental distress is important to mental health nursing practice. The psychotherapeutic relationship that is fundamental to mental health nursing practice requires an understanding of the meaning of individual's responses in their cultural context in order to provide facilitative and meaningful care for the women that they nurse. (shrink)

Gray unwisely melds together two distinguishable contributions of consciousness: one to epistemology, the other to evolution. He also renders consciousness needlessly invisible behaviorally.

Gray's neuropsychological model of consciousness uses a hierarchical feedback loop framework that has been extensively discussed by many others in psychology. This commentary therefore urges Gray to integrate with, or at least acknowledge previous models. It also points out flaws in his feedback model and suggests directions for further theoretical work.

Gray, like other recent authors, seeks a scientific approach to consciousness, but fails to provide a biologically convincing description, partly because he implicitly bases his model on a computationalist foundation that embeds the contents of thought in irreducible symbolic representations. When patterns of neural activity instantiating conscious thought are shorn of homuncular observers, it appears most likely that these patterns and the circuitry that compares them with memories and plans should be found distributed over large regions of neocortex.

Robust theories concerning the connection between consciousness and brain function should derive not only from empirical evidence but also from a well grounded inind-body ontology. In the case of the comparator hypothesis, Gray develops his ideas relying extensively on empirical evidence, but he bounces irresolutely among logically incompatible metaphysical theses which, in turn, leads him to excessively skeptical conclusions concerning the naturalization of consciousness.

It is accepted that “primary awareness” may emerge from the integration of two classes of information. It is unclear, however, why this cannot take place within the comparator rather than in conjunction with feedback to the perceptual systems. The model has plausibility in relation to the continuity of conscious experience in the normal waking state and may be extended to encompass certain aspects of the “sense of self” which are frequently disrupted in psychotic patients.