RESUMEN Muchos psiquiatras se encuentran constantemente con pacientes cuyos síntomas incluyen trastornos o alteraciones de la conciencia. Infortunadamente, el significado del término conciencia es poco claro. Este artículo hace un repaso sistemático de varios significados atribuidos a dicho término, así como de diversos problemas filosóficos asociados. Asimismo, reconstruye varias teorías filosóficas y científicas de la conciencia, identificando sus ventajas y desventajas. Al final, ofrece algunas sugerencias para el uso del término conciencia en la psiquiatría. ABSTRACT Psychiatrists often encounter patients whose (...) symptoms include disorders or impairments of consciousness. Unfortunately, the meaning of the term consciousness is not altogether clear. This article presents a systematic review of various meanings attributed to this term, as well as of diverse associated philosophical problems. Likewise, it reconstructs some philosophical and scientific theories of consciousness, identifying their advantages and disadvantages. Finally, it offers some suggestions for the use of the term consciousness in psychiatry. (shrink)

In recent years, phenomenologically informed philosophers, psychologists and psychiatrists have attempted to import philosophical notions associated with the self into the empirical study of pathological experience. In particular, so-called ipseity disturbances have been put forward as generative of symptoms of schizophrenia, and several attempts have been made to operationalize and measure kinds and degrees of ipseity disturbances in schizophrenia. However, we find that this work faces challenges caused by the fact that the notion of ipseity is used ambiguously, both in (...) the philosophical and in the empirical discussion, and the methods employed to operationalize ipseity often portray a rather different understanding of the notion from that found in the literature that is cited as providing the philosophical foundation for the studies in question. In particular, according to the definitions found in the philosophical literature, while being phenomenologically available, the self is not represented in ipseity. However, when it comes to the empirical study of ipseity and its disturbances, the object of investigation is often a kind of explicit self-representation. As a result, it is unclear whether different researchers are really talking about the same thing. Future progress in this area will require more careful conceptual distinctions; the present article aims to contribute to this task. (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)

Schizophrenia as a pathology of self-awareness has attracted much attention from philosophical theorists and empirical scientists alike. I view schizophrenia as a basic self-disturbance leading to a lifeworld of solipsism adopted by the sufferer and explain how this adoption takes place, which then manifests in ways such as first-rank psychotic symptoms. I then discuss the relationships between these symptoms, not as isolated mental events, but as end-products of a loss of agency and ownership, and argue that symptoms like thought insertion (...) and other ego-boundary disorders are by nature a multitude of paradoxes created by a fragmented awareness. I argue that such fragmentation does not always require or lead to a delusional elaboration as the definitive feature of its phenomenology, and present reasons for the role of the first-person pronoun as a mere metaphor used to represent the patient’s bizarre experiences where sensory perception and thinking processes converge. Further, I discuss the initi... (shrink)

Se ha presentado mucha controversia, desde hace años, acerca de la capacidad de la psiquiatría para mantener estándares médico-científicos comparables a los de otras especialidades de la medicina. La tendencia más reciente, basada en una fuerte crítica a la última edición del dsm, hace un énfasis particular en tratar de caracterizar los trastornos mentales con base en las neurociencias y abandonar toda otra forma de abordarlos. Este artículo revisa dicha tendencia y propone un enfoque multidimensional, haciendo énfasis en la investigación, (...) con herramientas de la fenomenología, de la naturaleza experiencial de muchos trastornos psicopatológicos –especialmente las psicosis–, y mostrando su compatibilidad con el enfoque neurocientífico. (shrink)

Muchos psiquiatras se encuentran constantemente con pacientes cuyos síntomas incluyen trastornos o alteraciones de la conciencia. Infortunadamente, el significado del término conciencia es poco claro. Este artículo hace un repaso sistemático de varios significados atribuidos a dicho término, así como de diversos problemas filosóficos asociados. Asimismo, reconstruye varias teorías filosóficas y científicas de la conciencia, identificando sus ventajas y desventajas. Al final, ofrece algunas sugerencias para el uso del término conciencia en la psiquiatría.

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 paper offers a comparative investigation of anomalous self-experiences common in schizophrenia instrument) and those of normal individuals in an intensely introspective orientation. The latter represent a relatively pure manifestation of certain forms of exaggerated self-consciousness, one facet of the disturbance of core- or minimal-self postulated as central in schizophrenia. Significant similarities with schizophrenia-like experience were found but important differences also emerged. Affinities included feelings of passivity, fading of self or world, and alienation from thoughts, feelings, or lived-body. Differences involved (...) confusion between self and world and severe dislocation or erosion of first-person perspective, qualities unique to schizophrenia. The purpose is threefold: 1, place the putatively schizophrenic experiences of self-disorder in a broader, comparative context; 2, evaluate hypotheses concerning core processes in schizophrenia; 3, orient investigation of possible pathogenetic pathways as well as psychotherapeutic interventions. (shrink)

There has recently been emphasis put on providing two-factor accounts of monothematic delusions. Such accounts would explain (1) whether a delusional hypothesis (e.g. someone else is inserting thoughts into my mind) can be understood as a prima facie reasonable response to an experience and (2) why such a delusional hypothesis is believed and maintained given its implausibility and evidence against it. I argue that if we are to avoid obfuscating the cognitive mechanisms involved in monothematic delusion formation we should split (...) the first factor (1 above) into two factors: how abnormal experience can give rise to a delusional ‘proto-hypothesis’ and how a ‘proto-hypothesis’ in consort with normal experiences and background information, can be developed into a delusional hypothesis. In particular I will argue that a schizophrenic is faced with the unusual requirement of having to identify an introspectively accessible thought as one's own, and that this requirement of identification is the central experiential abnormality of thought insertion, auditory verbal hallucination, and alien control (i.e. passivity symptoms). Additionally, I will consider non-experiential factors which are required for the formation of a delusional hypothesis. (shrink)

In this comparative study, we examine experiential disruptions of embodiment and affectivity in Moebius Syndrome and schizophrenia. We suggest that using phenomenological resources to explore these experiences may help us better understand what it’s like to live with these conditions, and that such an understanding may have significant therapeutic value. Additionally, we suggest that this sort of phenomenologically-informed comparative analysis can shed light on the importance of embodiment and affectivity for the constitution of a sense of self and interpersonal relatedness (...) in normal conditions. (shrink)

One of the leading cognitive models of auditory verbal hallucinations (AVHs) proposes such experiences result from a disturbance in the process by which inner speech is attributed to the self. Research in this area has, however, proceeded in the absence of thorough cognitive and phenomenological investigations of the nature of inner speech, against which AVHs are implicitly or explicitly defined. In this paper we begin by introducing philosophical phenomenology and highlighting its relevance to AVHs, before briefly examining the evolving literature (...) on the relation between inner experiences and AVHs. We then argue for the need for philosophical phenomenology (Phenomenology) and the traditional empirical methods of psychology for studying inner experience (phenomenology) to mutually inform each other to provide a richer and more nuanced picture of both inner experience and AVHs than either could on its own. A critical examination is undertaken of the leading model of AVHs derived from phenomenological philosophy, the ipseity disturbance model. From this we suggest issues that future work in this vein will need to consider, and examine how interdisciplinary methodologies may contribute to advances in our understanding of AVHs. Detailed suggestions are made for the direction and methodology of future work into AVHs, which we suggest should be undertaken in a context where phenomenology and physiology are both necessary, but neither sufficient. (shrink)

The debate on personal persistence has been characterized by a dichotomy which is due to its still Cartesian framwork: On the one side we find proponents of psychological continuity who connect, in Locke’s tradition, the persistence of the person with the constancy of the first-person perspective in retrospection. On the other side, proponents of a biological approach take diachronic identity to consist in the continuity of the organism as the carrier of personal existence from a third-person-perspective. Thus, what accounts for (...) someone’s persistence over time, is the continuity of his mind on the one hand, and the continuity of his body on the other. In contrast to those views, the paper intends to show that bodily existence represents the basis of selfhood across time, both as the continuity of the experiential self and as the continuity of the autopoietic organism. On the one hand, the lived body conveys a continuity of the self from a first-person perspective, namely a pre-reflective feeling of sameness or a felt constancy of subjectivity. Moreover, an analysis of awakening and sleep shows that there is a continuous transition from full wakefulness to periods of deep sleep which may thus not be regarded as a complete interruption of subjective experience. On the other hand, this constancy converges with the continuity of the organismic life process as conceived from a third-person perspective. Thus, the experiential self of bodily subjectivity and the autopoietic self of the living organism should be regarded as two aspects of one and the same life process. Finally, the lived body also exhibits a specific form of memory that results from the continual embodiment of existence: it consists of all the affinities, capacities and experiences, which a person has acquired throughout his life. Thus, it provides a continuity of self that must not be actively produced through remembering, but rather integrates the person’s entire past in his present being and potentiality. (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)

People suffering from Obsessive-Compulsive Disorder (OCD) do things they do not want to do, and/or they think things they do not want to think. In about 10 percent of OCD patients, none of the available treatment options is effective. A small group of these patients is currently being treated with deep brain stimulation (DBS). Deep brain stimulation involves the implantation of electrodes in the brain. These electrodes give a continuous electrical pulse to the brain area in which they are implanted. (...) It turns out that patients may experience profound changes as a result of DBS treatment. It is not just the symptoms that change; patients rather seem to experience a different way of being in the world. These global effects are insufficiently captured by traditional psychiatric scales, which mainly consist of behavioural measures of the severity of the symptoms. In this article we aim to capture the changes in the patients’ phenomenology and make sense of the broad range of changes they report. For that we introduce an enactive, affordance-based model that fleshes out the dynamic interactions between person and world in four aspects. The first aspect is the patients’ experience of the world. We propose to specify the patients’ world in terms of a field of affordances, with the three dimensions of broadness of scope (‘width’ of the field), temporal horizon (‘depth’), and relevance of the perceived affordances (‘height’). The second aspect is the person-side of the interaction, that is, the patients’ self-experience, notably their moods and feelings. Thirdly, we point to the different characteristics of the way in which patients relate to the world. And lastly, the existential stance refers to the stance that patients take towards the changes they experience: the second-order evaluative relation to their interactions and themselves. With our model we intend to specify the notion of being in the world in order to do justice to the phenomenological effects of DBS treatment. (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)

In lieu of an abstract, here is a brief excerpt of the content:“An Equivocal Couple Overwhelmed by Life”A Phenomenological Analysis of PregnancySara HeinämaaTwo conceptions of human generativity prevail in contemporary feminist philosophy. First, several contributors argue that the experience of pregnancy, when analyzed by phenomenological tools, undermines several distinctions that are central to Western philosophy, most importantly the subject-object distinction and the self-other and own-alien distinctions. This line of argument was already outlined by Iris Marion Young in her influential essay (...) “Pregnant Embodiment: Subjectivity and Alienation” (1984). The other dominant argument is related to the first one, and it states that organic birth is the event that establishes the first experiential separation between the self and the other. On this understanding, the mother-fetus relation would not involve any relations between two corporeal selves; all such relations would be postnatal. This notion has been defended, for example, by Christine Schües (1997; 2000) and Johanna Oksala (2003).1On the other hand, classical phenomenology is dominated by the idea that the rigorous first-person methodology that is essential to phenomenology dictates that the sense of birth must be studied primarily by reflection on the structures of our own recollection or memory. Consequently, the primary sense of human birth would be that of an unattainable limit. This is argued on the basis of the existential fact that we all are born but cannot recall our own birth, or else on the basis of the transcendental fact that the structure [End Page 31] of retention ties each living present to an earlier one and implies that the transcendental ego cannot be subject to generation.2 From this perspective, all analyses and reflections of the experiences of labor, gestation, and pregnancy would be secondary since the sense of birth that these experiences involve is the nativity of another human being and not the nativity of the reflecting self.This paper challenges both the feminist and the classical phenomenological approach. I maintain that careful phenomenological analyses of the experience of pregnancy undermine both notions. Such analyses show, on the one hand, that pregnancy does not imply a nondistinction or self-other fusion but on the contrary involves a specific self-other divide. At the same time, they demonstrate that the sense of birth is more complex than the classical recollection-paradigm suggests and that it includes more components than the signification of an unattainable limit. A proper phenomenology of birth must take into account not only the universal fact that we all are born, but also the equally universal fact that each of us is born from another human being, that is, some other human subject.3 This other human being who “gave” us birth or “from whose flesh we were born” provides us with a unique perspective on our own past, beyond the limits of our own recollection. Her perspective is incomparable to any other external perspective; rather than simply giving us an additional third-person viewpoint on our own organic birth, this one person is able to open a second-person perspective on our pre- and postnatal life and the transition between them—all of which is beyond our own recollection.My argument proceeds by the following steps:First, I develop a fresh discourse on the experience of pregnancy, by studying a set of remarks to be found in Julia Kristeva’s postphenomenological discourse on maternity, on the one hand, and in Simone de Beauvoir’s existential-phenomenological discourse on feminine embodiment, on the other hand. I use these remarks as leading clues for a novel phenomenological study of the experience of pregnancy.4 Contra Young’s influential account mentioned above, I argue that gestation, as experienced by women who live it in the first person, includes a separation between two sensory-motor beings in a nesting relation: the pregnant self and the embryonic other. The alternative account that I provide hinges on my analysis of the experience of fetal movements and the role of touch-sensations and kinesthetic sensations in such experiences. Ultimately, I argue that pregnancy does not erode the self-other boundary or the own-alien boundary but reestablishes both divisions.Second, I compare my account of the experience of pregnancy to Merleau... (shrink)

In this paper we focus on what is referred to as the ‘mineness’ of experience, that is, the intimate familiarity we have with our own thoughts, perceptions, and emotions. Most accounts characterize mineness in terms of an experiential dimension, the first-person givenness of experience, that is subsumed under the notion of minimal self-consciousness or a ‘minimal self’. We argue that this account faces problems and develop an alternative account of mineness in terms of the coherence of experiences with what we (...) label an ‘embodied biography’. Building on a near consensus among consciousness researchers over the function of consciousness as integrating infor- mation, we argue that the phenomenology of mineness consists in the absence of any further thought on top of the experience itself. Finally we argue that this non-phenomenological account of mineness fits well with existing data on pathologies of mineness such as delusions of thought insertion. (shrink)

It is not necessarily the case that we ever have experiences of self, but human beings do regularly report instances for which self is experienced as absent. That is there are times when body parts, mental states, or actions are felt to be alien. Here I sketch an explanatory framework for explaining these alienation experiences, a framework that also attempts to explain the “mental glue” whereby self is bound to body, mind, or action. The framework is a multi-dimensional model that (...) integrates personal and sub-personal components, psychological and neural processes. I then proceed to show how this model can be applied to explain the action-related passivity experiences of persons suffering from schizophrenia. I argue that a distinctive phenomenological mark of these experiences is that they are vividly felt, unlike ordinary actions (those taken to belong to self), and I seek to explain these heightened sensory experiences from within the proposed framework. I also propose hypotheses concerning such phenomena as thought insertion and anarchic hand syndrome that are motivated by this framework. Finally, I argue that the proposed model and view of self-experiences is consistent with several aspects of and theories of consciousness, especially theories which indicate that consciousness is more likely to be engaged when we are dealing with novelty or error—e.g. when self seems to have gone missing. I conclude by recommending that if we wish to learn about self, we would be well advised to attend closely to those times when it seems absent. (shrink)

According to Millian Descriptivism, while the semantic content of a linguistically simple proper name is just its referent, we often use sentences containing such expressions “to make assertions…that are, in part, descriptive” (Soames 2008). Against this view, I show, following Ted Sider and David Braun (2006), that simple sentences containing names are never used to assert descriptively enriched propositions. In addition, I offer a diagnosis as to where the argument for Millian Descriptivism goes wrong. Once we appreciate the distinctive way (...) in which this account fails, we can better appreciate the very modest role that associated descriptive information plays in the pragmatics of proper names. (shrink)

Philosophical and scientific investigations of the proprietary aspects of self—mineness or mental ownership—often presuppose that searching for unique constituents is a productive strategy. But there seem not to be any unique constituents. Here, it is argued that the “self-specificity” paradigm, which emphasizes subjective perspective, fails. Previously, it was argued that mode of access also fails to explain mineness. Fortunately, these failures, when leavened by other findings (those that exhibit varieties and vagaries of mineness), intimate an approach better suited to searching (...) for an explanation. Having an alternative in hand, one that shows promise of achieving explanatory adequacy, provides an additional reason to suspend the search for unique constituents. In short, a negative and a positive thesis are developed: we should cease looking for unique constituents and should seek to explain mineness in accord with the model developed here. This model rejects attempts to explain the phenomenon in terms of either a narrative or a minimal sense of self; it seeks to explain at a “molecular” level, one that appeals to multiple, interacting dimensions. The molecular-level model allows for the possibility that subjective perspective is distinct from a stark perspective (one that does not imply mineness). It proposes that the confounding of tacit expectations plays an important role in explaining mental ownership and its complement, disownership. But the confounding of tacit expectations is not sufficient. Because we are able to be aware of the existence of mental states that do not belong to self, we require a mechanism for determining degree of self-relatedness. One such mechanism is proposed here, and it is shown how this mechanism can be integrated into a general model of mental ownership. In the spirit of suggesting how this model might be able to help resolve outstanding problems, the question as to whether inserted thoughts belong to the patient who reports them is also considered. (shrink)

The structure of human embodiment is fundamentally characterized by a polarity or ambiguity between Leib and Körper, the subjective body and the objectified body, or between being-body and having-a-body. This ambiguity, emphasized, above all, by Helmuth Plessner and Maurice Merleau-Ponty, is also of crucial significance for psychopathology. Insofar as mental illnesses disturb or interrupt the unhindered conduct of one’s life, they also exacerbate the tension within embodiment that holds between being-body and having-a-body. In mental illnesses, there is a failure of (...) tacit mediations upon which one’s bodily being-toward-the-world is based. Instead of serving as a medium of relating to the world, the body makes .. (shrink)

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

Autistic-spectrum conditions and psychotic-spectrum conditions (mainly schizophrenia, bipolar disorder, and major depression) represent two major suites of disorders of human cognition, affect, and behavior that involve altered development and function of the social brain. We describe evidence that a large set of phenotypic traits exhibit diametrically opposite phenotypes in autistic-spectrum versus psychotic-spectrum conditions, with a focus on schizophrenia. This suite of traits is inter-correlated, in that autism involves a general pattern of constrained overgrowth, whereas schizophrenia involves undergrowth. These disorders also (...) exhibit diametric patterns for traits related to social brain development, including aspects of gaze, agency, social cognition, local versus global processing, language, and behavior. Social cognition is thus underdeveloped in autistic-spectrum conditions and hyper-developed on the psychotic spectrum.;>We propose and evaluate a novel hypothesis that may help to explain these diametric phenotypes: that the development of these two sets of conditions is mediated in part by alterations of genomic imprinting. Evidence regarding the genetic, physiological, neurological, and psychological underpinnings of psychotic-spectrum conditions supports the hypothesis that the etiologies of these conditions involve biases towards increased relative effects from imprinted genes with maternal expression, which engender a general pattern of undergrowth. By contrast, autistic-spectrum conditions appear to involve increased relative bias towards effects of paternally expressed genes, which mediate overgrowth. This hypothesis provides a simple yet comprehensive theory, grounded in evolutionary biology and genetics, for understanding the causes and phenotypes of autistic-spectrum and psychotic-spectrum conditions. (shrink)

Understanding alterations of selfhood (termed self-disorders or self-disturbances) that are considered typical of the schizophrenia-spectrum is a central focus of phenomenological research. The currently most influential way of phenomenologically conceiving self-disorders in schizophrenia is as disorders of the so-called most basic or “minimal self”. In this paper, we first highlight some challenges for the minimal self-view of self-disorders, focusing on (1) problems arising from the supposedly “essential” or “universal” nature of minimal self with respect to phenomenal awareness and (2) the (...) critical implications of alterations of self-experience in schizophrenia that involve heightened or exaggerated sense of self. In the second part, we tentatively explore how a (non-egological) transparency-view of consciousness may offer an alternative way of understanding the experiential abnormalities involved in self-disorders in schizophrenia. We discuss how such a transparency-view (1) may account for loss-of-self experiences; (2) is compatible with the key notion of “hyper-reflexivity”; and (3) can help explain instances of self-disorder involving increased sense of self. In conclusion, we consider some possible advantages of this alternative view for research on self-disorders and clinical approaches. (shrink)

In the "Republic," Plato has Socrates attack poetry’s use of mimēsis, often translated as ‘imitation’ or ‘representation.’ Various scholars (e.g. Blondell 2002; Frank 2018; Halliwell 2009; K. Morgan 2004) have noticed the tension between Socrates’ theory critical of mimēsis and Plato’s literary practice of speaking through various characters in his dialogues. However, none of these scholars have addressed that it is not only Plato the writer who uses mimēsis but also his own character, Socrates. At crucial moments in several dialogues, (...) Socrates takes on a role and speaks as someone else. I call these moments “Socratic mimēsis.” While previous commentators have noticed some of these moments, they have either overstated their rarity or they have not studied them collectively. My dissertation is the first in-depth investigation of this phenomenon in the dialogues. Socrates’ dramatic imitation of others is way of teaching in a voice separate from his own, and it is also a way for Plato to speak to, and to educate, different kinds of audiences. Although “Socratic mimēsis” occurs throughout the Platonic corpus, I focus on three passages from three different dialogues, which are paradigm instances: [1] in the "Crito" Socrates plays the part of ‘the Laws’ (50a-54c); [2] in the "Theaetetus" he acts the part of ‘Protagoras’ (166a-168c); and [3] in the "Menexenus" he recites a funeral speech learned from ‘Aspasia’ (236d-249c). Instead of one-sidedly reading the dialogues as either only literary works of art or as only a series of philosophical arguments, this study gleans philosophic insights from the literary and dramatic details of the dialogues. In chapter one I argue that in the "Crito" Socrates tries to convince Crito of a universal and absolute ethics based on never committing injustice, but Crito is not able to understand. In order to make Crito more just—but not yet at the level of Socratic ethics—Socrates creates ‘the Laws’ to persuade Crito to expand his personal notion of justice. Socrates instills a political obedience in place of Crito’s existing lawlessness as a second-best recourse. Plato expects the astute listener or reader to see the contrast between Socrates’ earlier ethical principles, said in his own voice, with what he says in the voice of ‘the Laws.’ In chapter two I argue that in the part of the "Theaetetus" where Socrates defends Protagoras (often called ‘the Defense’), Socrates, by imitating ‘Protagoras,’ is actually criticizing Protagorean relativism. The Protagorean theory cannot account for mimēsis and Socrates’ mimetic act performatively contradicts the identity of appearance and reality, which the theory presupposes. Finally, in chapter three I argue that in the Menexenus the funeral oration that Socrates recounts for Menexenus that he heard from ‘Aspasia’ is actually a disguised criticism of political rhetoric and of Athenian imperialism. Although the speech is never interrogated within the dialogue, Plato provokes the listener or reader outside the dialogue to question its message and to see how it conflicts with many of Socrates’ positions in other dialogues. Beyond reconsidering the long-standing and persistent view that Plato was against poetry and mimetic performance, I re-examine the role that performance and role-playing can have in philosophy and pedagogy more generally. Actors, by taking on other personas, and audience members, in observing actors and their actions, are both involved in acts of imagination that can expand their horizon of thinking and feeling. (shrink)

In the history of philosophy, the concept of self has been perennially elusive. The philosophical quest to understand the self is rife with phenomenological and metaphysical analyses, often overlooking other kinds of selves present in the biological realm. To systematically explore this question of non-human selves, I categorize the literature on philosophical and biological notions of self into the biogenic, the zoogenic, and the anthropogenic approaches to self. This article attempts to chart the genesis, the continuum, and the lowest bound (...) of the self. Further, I enumerate challenges in developing a biogenic approach to self or taking the concept of self all the way down in the phylogenetic tree. (shrink)

Delirium has conventionally been considered a disorder of consciousness, but this remains a relatively unexamined precept. First, a review of the role of consciousness disruption in delirium is revised from an historical and diagnostic perspective. Second, consciousness measurement in routine assessment of delirium is considered. Conscious levels, comprising alertness and arousal, are most commonly used but are not representative of the multidimensionality of consciousness. Third, a justification for the exploration of phenomenal consciousness is presented. Three candidate dimensions of phenomenal consciousness (...) are identified as the pre-reflective state, phenomenal experience, and reflective thought. Finally, the clinical implications of a deeper understanding of delirium through measurement of phenomenal consciousness is considered. (shrink)

The long-standing tradition of phenomenological psychopathology has been historically concerned with the nature of mental disorders, with a special focus on their basic experiential core. In the same way, much of the recent phenomenologically-inspired work in psychopathology consists in providing precise and refined tools for diagnosis, classification, and nosology of mental disorders. What is striking, however, is the lack of therapeutic proposals in this tradition. Although a number of phenomenological approaches refer positively to psychotherapeutic practices, psychopharmacological intervention has been mostly (...) neglected as a relevant field of attention. This work aims to fill this gap. We maintain that the convergence of phenomenological psychopathology and psychopharmacology exhibit a rich potential for mutual enlightenment, which unfolds into a more adequate psychopharmacological practice. Initially, after discussing Joanna Moncrieff’s drug-centered model of drug action we review some of the major findings in phenomenological literature regarding psychopharmacological treatment. Next, we suggest that Moncrieff’s drug-centered model can be seen as an important tool for improving clinical decision-making, by elucidating its inherent epistemic advantage when compared to mainstream models of drug action. As a result, the drug-centered model proves to be also patient-centered, by focusing on experiential alterations and helping to improve treatment outcomes. (shrink)

The concept of rational suicide argues that suicide could be a rational choice, in certain circumstances. Such an argument faces criticism when there is an accompanying mental illness, as many view suicide as a symptom of mental illness rather than as a rational choice about one's life. More specifically, the rational suicide debate has mostly excluded individuals with schizophrenia, as it is widely seen as a disorder that impairs rational decision making. This paper aims to examine the concept of rational (...) suicide in schizophrenia: Could it be possible that some acts of suicide are driven from a rational choice by patients suffering from schizophrenia? This paper does not include discussions related to physician-assisted dying in schizophrenia. (shrink)

Traumatisierte Menschen haben mit vorübergehenden oder anhaltenden Symbolisierungsschwierigkeiten zu kämpfen. Diese treten entweder in psychisch eingekapselter, umgrenzter Form in Erscheinung oder als psychische Funktionsabläufe, die sich in umfassenderer Weise auf die Lebensprojekte, politischen Einstellungen und kulturellen Normvorstellungen der Person auswirken, und zeigen sich in ihrer Körper-Welt-Beziehung, ihrer Individuum-Gruppen-Beziehung und/oder ihrer Individuum-Diskurs-Beziehung. Die Schwierigkeiten können in imaginativen und symbolischen Funktionsmodi auftreten. Gravierende Störungen der Symbolisierung lassen sich aus psychoanalytischer Sicht beschreiben als Begleiterscheinungen der paranoid-schizoiden und der autistisch-berührenden Position (Ogden), als Evakuierung (...) von Beta-Elementen in den Körper (Bion), als Verwerfung (Lacan) und als Urverdrängung (Freud). Der vorliegende Beitrag stellt einige psychoanalytisch fundierte semiotische Überlegungen vor, die dem Forschungsfeld Trauma und Psychose entstammen. Anhand von Fallbeispielen werden der Zusammenbruch der Symbolisierung, Fixierungen auf den nichtsymbolischen Modus der psychischen Repräsentation und die Re-Symbolisierung erläutert, die sich dank der kreativen transformativen Intervention des Analytikers vollzieht. (shrink)

Depersonalization/derealization disorder is classified as a dissociative disorder in the DSM5. It is noteworthy that the symptoms of depersonalization and derealization are commonly found in many other psychological disorders, including schizophrenia spectrum disorders, while phenomenological features of schizophrenia are commonly found in DPDR. The current study attempts to clarify these apparent similarities via highly detailed phenomenological interviews with four persons diagnosed with DPDR. The data revealed four interrelated facets: 1, Loss of resonance, 2, Detachment from experience, 3, Loss of self, (...) and 4, Commitment to reality. These facets point to a felt loss of immediate and familiar engagement in experience as a basic organizing Gestalt which permeates the various symptoms and signs of our participants with DPDR. Close consideration of this disruption allows their experiences to be more easily distinguished from those of schizophrenia-spectrum disorders. (shrink)

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

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)

Research in psychopathology is booming in an unprecedented way, at least, in terms of increasing number of publications. Yet, a few questions arise: Does quantity also give us quality? Are the collected data generally of sound quality? How are data typically collected in psychopathology? Are the applied methods of data collection appropriate for this particular field of study? This article explores three different methods of data collection in psychopathology, namely self-rating scales, structured interviews, and semi-structured, phenomenological interviews. To identify the (...) most adequate methodological approach, we first establish the nature of the object of psychopathology and then we critically assess each method’s appropriateness to this field of study. We emphasize fundamental issues that make self-rating scales and structured interviews unfit for the task of adequately examining psychopathology. By contrast, we propose that a semi-structured, phenomenological interview presents a more appropriate method. Finally, we describe two types of semi-structured, phenomenological interviews that can be applied to assess and explore psychopathology, respectively. (shrink)

Temporal experience and its radical alteration in schizophrenia have been one of the central objects of investigation in phenomenological psychopathology. Various phenomenologically oriented researchers have argued that the change in the mode of temporal experience present in schizophrenia can foreground its psychotic symptoms of delusion. This paper aims to further the development of such a phenomenological investigation by highlighting a much-neglected aspect of schizophrenic temporal experience, i.e., its non-emotional affective characteristic. In this paper, it denotes the type of an experience (...) wherein an afflicted individual experiences a pervasive pull or attraction coming from the past, present, and future. By employing Husserl’s account of affection, I argue that such an affectively prominent temporal experience is not yet another abnormality that happens to be present in schizophrenia. Instead, it is indicative of the core disturbance that underpins the schizophrenic temporal mode of experience. I identify such a disturbance as ‘affective modification dysfunction’ and employ it as a core concept with which I synthesize and organise heterogeneous components of schizophrenic temporal experience in their conceptual unity. For the sake of clear description, I organise those components into the following categories: 1.) Time Stop 2.) Ante-festum 3.) Déjà vu/vécu and 4.) Time Fragmentation. I conclude by demonstrating how approaching schizophrenic temporal experience from its affective dimension can further help us better understand its pre-psychotic phase known to precipitate schizophrenic primary delusion, i.e., delusional mood. (shrink)

This paper will philosophically extend Julian Leff’s Avatar therapy paradigm (AT) for voice-like hallucinations that was initially proposed for treatment-resistant Schizophrenia patients into the realm of gesture-enhanced embodied cognition and Virtual Reality (VR), entitled g+TA (gesture-enhanced Avatar Therapy). I propose an philosophy of technology approach of embodied rhetorics of triadic kinetic “actions” in the sense of Charles Sanders Peirce that transforms the voice hallucination incorporated by an avatar- and that can confront acousmatic voice-like hallucinations with a method of gesture synchronization (...) and dyssynchronization and gestural refusal of interaction that the player with the Avatar can resist in full embodiment. This paper therefore introduces a gesture-enhanced, extended version of Cybertherapy with Avatars that tackle multimodal bodily experience of voice-like hallucinations beyond mere visual or auditory stimulation. This is put forward theoretically in a 4E-cognition approach that expands Avatar Therapy with gestures into VR. (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)

The question “What is the relationship between the self and mental disorder?” is especially important for mental health professionals interested in understanding and treating patients, as most mental disorders are intimately tied to self‐related concerns, such as loss of self‐esteem and self‐control, or diminished agency and autonomy. Philosophy, along with the cognitive and behavioral sciences, offers a wealth of conceptual and empirical resources to answer this question, as the concepts of the self and psychopathology have occupied a central place in (...) these fields since their inception. Interestingly, and unfortunately, however, scientific psychiatry, in its approach to mental disorder as primarily a cluster of signs and symptoms has been slow in acknowledging the advances in conceptualizing and investigating mental disorders in relation to the self. The article addresses this problem and offers solutions for better cross‐fertilization between empirical and philosophical inquiry into the self and psychiatric research on mental disorders. The first part evaluates what empirically informed philosophical inquiry and philosophically informed empirical inquiry offer to the examination of the relationship between the self and mental disorders. The second part argues that scientific psychiatry has missed opportunities to find effective treatments for mental disorders because of its insularity from debates in naturalistic philosophy and cognitive and behavioral sciences. Psychiatry has much to gain from the conceptual, scientific, and clinical resourcefulness of philosophy's collaboration with the cognitive and behavioral sciences. (shrink)

Despite a recent surge in publications on Tourette Syndrome, we still lack substantial insight into first-personal aspects of “what it is like” to live with this condition. This is despite the fact that developments in phenomenological psychiatry have demonstrated the scientific and clinical importance of understanding subjective experience in a range of other neuropsychiatric conditions. We argue that it is time for Tourette Syndrome research to tap into the sophisticated frameworks developed in the philosophical tradition of phenomenology for describing experience (...) in a way that integrates discrete symptoms into an overarching experiential framework concerning the self, the body, and its modes of experience. Following a historical introduction that contextualises the pertinence of phenomenology to psychopathology, we distinguish this approach from the existing, psychologically oriented studies on TS that are also qualitative. We then outline gaps and opportunities for future research, including the sorts of questions that might be utilised in phenomenological interviews and why they are of potential benefit to research programs in philosophy, psychology, and neuroscience. In conclusion we address some of the broader implications for phenomenology of the body and philosophy of action. (shrink)

Orthodox neurocognitive accounts of the bodily sense of agency suggest that the experience of agency arises when action-effects are anticipated accurately. In this paper, I argue that while successful anticipation is crucial for the sense of agency, the role of unsuccessful prediction has been neglected, and that inefficacy and uncertainty are no less central to the sense of agency. I will argue that this is reflected in the phenomenology of agency, which can be characterized both as the experience of efficacy (...) and effort. Specifically, the “sense of efficacy” refers to the perceptual experience of an action unfolding as anticipated. The “sense of effort”, in contrast, arises when an action has an uncertain trajectory, feels difficult, and demands the exertion of control. In this case, actions do not unfold as anticipated and require continuing adaptation if they are to be efficacious. I propose that, taken individually, the experience of efficacy and effort are insufficient for the sense of agency and that these experiences can even disrupt the sense of agency when they occur in isolation from each other. I further argue that a fully-fledged sense of agency depends on the temporally extensive process of prediction error-cancelation. This way, a comparator account can accommodate both the role of accurate prediction and prediction error and thus efficacy and effort. (shrink)