At a time when different groups in society are achieving notable gains in respect and rights, activists in mental health and proponents of mad positive approaches, such as Mad Pride, are coming up against considerable challenges. A particular issue is the commonly held view that madness is inherently disabling and cannot form the grounds for identity or culture. This paper responds to the challenge by developing two bulwarks against the tendency to assume too readily the view that madness is inherently (...) disabling: the first arises from the normative nature of disability judgements, and the second from the implications of political activism in terms of being a social subject. In the process of arguing for these two bulwarks, the paper explores the basic structure of the social model of disability in the context of debates on naturalism and normativism; the applicability of the social model to madness; and the difference between physical and mental disabilities in terms of the unintelligibility often attributed to the latter. (shrink)

This paper addresses the phenomenology of bodily feeling in depersonalization disorder. We argue that not all bodily feelings are intentional states that have the body or part of it as their object. We distinguish three broad categories of bodily feeling: noematic feeling, noetic feeling, and existential feeling. Then we show how an appreciation of the differences between them can contribute to an understanding of the depersonalization experience.

How do artists share, translate, reveal their imagination by using different semiotic systems; how can the audience partake in this imagination receiving only images, words, notation, sounds? Starting from artwork of the novelist Italo Calvino and the composers Helmut Lachenmann and Gyorgy Kurtag, this article addresses the relation among imagination, perception, remembrance and expression. The ‘images’ used, be they visual, verbal, auditory or haptic, are much more than images. They concentrate in themselves layers of subjective and intersubjective perceptual, cognitive and (...) emotive experiences. I will argue that imagination relies upon sensory fluidity. This allows us (1) to integrate sensorial experiences from different perceptual origins — synaesthesia, (2) to link past, present and future by way of sensorial and embodied patterns of remembrance — embodied sedimentation, and (3) to share intersubjective patterns of affect and effect, bridging idiosyncratic and universal human experiences. (shrink)

Phenomenology is a useful methodology for describing and ordering experience. As such, phenomenology can be specifically applied to the first person experience of illness in order to illuminate this experience and enable health care providers to enhance their understanding of it. However, this approach has been underutilized in the philosophy of medicine as well as in medical training and practice. This paper demonstrates the usefulness of phenomenology to clinical medicine. In order to describe the experience of illness, we need a (...) phenomenological approach that gives the body a central role and acknowledges the primacy of perception. I present such a phenomenological method and show how it could usefully illuminate the experience of illness through a set of concepts taken from Merleau-Ponty. His distinction between the biological body and the body as lived, analysis of the habitual body, and the notions of motor intentionality and intentional arc are used to capture the experience of illness. I then discuss the applications this approach could have in medicine. These include narrowing the gap between objective assessments of well-being in illness and subjective experiences which are varied and diverse; developing a more attuned dialogue between physicians and patients based on a thick understanding of illness; developing research methods that are informed by phenomenology and thus go beyond existing qualitative methods; and providing medical staff with a concrete understanding of the impact of illness on the life-world of patients. (shrink)

In this study I explore from a phenomenological perspective the relationship between affectivity and narrative self-understanding in depression. Phenomenological accounts often conceive of the disorder as involving disturbances of the narrative self and suggest that these disturbances are related to the alterations of emotions and moods typical of the illness. In this paper I expand these accounts by advancing two sets of claims. In the first place, I suggest that, due to the loss of feeling characteristic of the illness, the (...) narratives with which the patients identified prior to the onset of depression are altered in various ways, thus leading to the weakening or abandonment of the narratives themselves. I then move to show that these autobiographical narratives are replaced by new stories which possess a distinctive structure and I argue that this is dependent upon specific configurations of affective experience, such as existential feelings of guilt, hopelessness, and isolation, and particular forms of temporal and spatial experience. (shrink)

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

This paper integrates personal narratives with the methods of phenomenology in order to draw some general conclusions about ‘what it means’ and ‘what it feels like’ to be depressed. The analysis has three parts. First, it explores the ways in which depression disrupts everyday experiences of spatial orientation and motility. This disruption makes it difficult for the person to move and perform basic functional tasks, resulting in a collapse or contraction of the life-world. Second, it illustrates how depression creates a (...) situational atmosphere of emotional indifference that reduces the person’s ability to qualitatively distinguish what matters in his or her life because nothing stands out as significant or important anymore. In this regard, depression is distinct from other feelings because it is not directed towards particular objects or situations but to the world as a whole. Finally, the paper examines how depression diminishes the possibility for ‘self-creation’ or ‘self-making’. Restricted by the illness, depression becomes something of a destiny, preventing the person from being open and free to access a range of alternative self-interpretations, identities, and possible ways of being-in-the-world. (shrink)

A revival of the dialogue between phenomenology and psychiatry currently takes place in the best international journals of psychiatry. In this article, we analyse this revival and the role given to phenomenology in this context. Although this dialogue seems at first sight interesting, we show that it is problematic. It leads indeed to use phenomenology in a special way, transforming it into a discipline dealing with empirical facts, so that what is called “phenomenology” has finally nothing to do with phenomenology. (...) This so-called phenomenology tallies however with what we have always called semiology. We try to explain the reasons why phenomenology is misused in that way. In our view, this transformation of phenomenology into an empirical and objectifying discipline is explained by the role attributed to phenomenology by contemporary authors, which is to solve the problems raised by the Diagnostic and Statistical Manual of Mental Disorders. (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)

The objective of my paper is to present a psychopathological conception of psychopathy and compare it with the mainstream nosographic diagnosis. This theoretical essay is informed by clinical situations involving psychopaths who were interviewed in prison or in forensic centres. The method applied a phenomenological psychopathology analysis to the clinical material. I first compare Binswanger’s conception of mania with psychopathic functioning. Patients’ behaviour is similar but the difference relates to the dialectic between the ego and the alter ego. A patient (...) with mania has a fundamental crisis of the ego, which a psychopath does not have. A second finding concerns emotions and the adaptive dimension of psychopathy. An epistemological discussion of the concept of emotions reveals that psychopaths are competent at managing emotional stimuli, which confers a psychological advantage upon them. Finally, a reflection on empathy and sympathy clarifies the presentation of “psychopathic being-in-the-world”. Starting with the tension between clinical practice and critique of the dominant diagnostic scales, we can consider that the “essential characteristics” of the psychopathic disorder are reification of the alter ego without presenting an ego-related disorder, the adaptive benefits of emotional coldness, and empathic skills without sympathy. (shrink)

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

RESUMEN Una vez que el foco de la reflexión pasa de las teorías ideales a la aplicación de la justicia social, centrada en las instituciones de las sociedades democráticas, se requiere prestar especial atención a los estilos de vida. Estos tienen una alta incidencia en cómo la justicia es realizada y afectan tanto a la desigualdad económica como a la disponibilidad de los recursos naturales. En nuestras sociedades es posible establecer restricciones a los estilos de vida, especialmente en aquellos casos (...) en que, por el efecto de algunas dinámicas sociales, aquellos se desacoplan de las concepciones del bien. Se defiende que, en tales casos, la base normativa que permite exigir el respeto a los estilos de vida se disuelve y por ello es posible justificar su restricción. ABSTRACT Now that the focus of reflection has shifted from ideal theories to the application of social justice, centered on the institutions of democratic societies, it is necessary to pay special attention to lifestyles, since they not only influence the realization of justice, but also have an effect on economic inequality and the availability of natural resources. In our societies, it is possible to place restrictions on lifestyles, especially in those cases in which, influenced by certain social dynamics, they disengage from conceptions of the good. The article argues that, in those cases, the normative base grounding the demand that lifestyles be respected is dissolved, thus justifying their restriction. (shrink)

Often drawing on the phenomenological tradition, a number of philosophers and cognitive scientists working in the field of “embodied cognition” subscribe to the general view that cognition is grounded in aspects of its sensorimotor embodiment and should be comprehended as the result of a dynamic interaction of nonneural and neural processes. After a brief introduction, the paper critically engages Lakoff and Johnson’s “conceptual metaphor theory”, and provides a review of recent empirical evidence that appears to support it. Subsequently, the paper (...) underscores some of the limitations of CMT, points to some philosophical problems that require further attention, and explores possible implications for understanding and treating of mental disorders. (shrink)

In this paper, we draw on developmental findings to provide a nuanced understanding of background emotions, particularly those in depression. We demonstrate how they reflect our basic proximity (feeling of interpersonal connectedness) to others and defend both a phenomenological and a functional claim. First, we substantiate a conjecture by Fonagy & Target (International Journal of Psychoanalysis 88(4):917–937, 2007) that an important phenomenological aspect of depression is the experiential recreation of the infantile loss of proximity to significant others. Second, we argue (...) that proximity has a particular cognitive function that allows individuals to morph into a cohesive dyadic system able to carry out distributed emotion regulation. We show that elevated levels of psychological suffering connected to depressive background emotions may be explained not only in terms of a psychological loss, but also as the felt inability to enter into dyadic regulatory relations with others—an experiential constraint that decreases the individual’s ability to adapt to demanding situations. (shrink)

One of the tasks that recent philosophy of psychiatry has taken upon itself is to extend the range of understanding to some of those aspects of psychopathology that Jaspers deemed beyond its limits. Given the fundamental difficulties of offering a literal interpretation of the contents of primary delusions, a number of alternative strategies have been put forward including regarding them as abnormal versions of framework propositions described by Wittgenstein in On Certainty. But although framework propositions share some of the apparent (...) epistemic features of primary delusions, their role in partially constituting the sense of inquiry rules out their role in helping to understand delusions. (shrink)

This paper explores the question concerning the relationship between basic and higher layers of experience and self-experience. The latter distinction implicitly presupposes the idea of a univocal foundation. After explaining the formal ontological law of foundation, an attempt is made to clarify how the idea of foundation may be suitable to understand the relationship among moments, or layers, of self-experience. To this aim, the phenomenological descriptions of self- and world-experience in dementia and schizophrenia are compared. The comparison between these two, (...) in many ways radically different, pathologies allows us to highlight both the potentialities and the limits of resorting to the foundational relationship for the description of lived experience. Taking the challenges coming from the description of dementia and schizophrenia into serious consideration, the meaning of the “stratified” account of self-experience will be eventually reassessed, and a way to complement the idea of foundation among layers will be proposed. (shrink)

The psychiatric interview plays a critical role in clinical assessment and therapy. Problems with assessment reliability and validity that were apparent in nosological and diagnostic discrepancies plagued the field of psychiatry historically. Technical approaches including structured interviews were developed to address these problems. Although these approaches decreased diagnostic variance, they focused narrowly on eliciting signs and symptoms conforming to previously agreed diagnostic categories, necessarily restricting the range and richness of experiences and narratives that are elicited. This restriction inhibits the utility (...) of assessment in furthering the interpersonal rapport and exploration that is essential to the task of therapy. The author reviews critiques of technical approaches to psychiatric assessment and highlights critical, often unexamined, epistemological assumptions and questions. In light of these critiques, he proposes a phenomenological approach to psychiatric assessment focused on narratives that situate particular experiences in the broader life context. In this approach the assessor functions as a participant observer, relying on the same empathic skills that inform effective therapy. It is argued that without over turning the advances in assessment reliability gained through technical approaches to the psychiatric interview, a phenomenological approach can illuminate, enrich, and broaden psychiatric assessment, increasing its effectiveness in psychopathological understanding and in therapy. (shrink)

Here we consider interpersonal experience in schizophrenia, melancholia, and mania. Our goal is to improve understanding of similarities and differences in how other people can be experienced in these disorders, through a review of first-person accounts and case examples and of contemporary and classic literature on the phenomenology of these disorders. We adopt a tripartite/dialectical structure: first we explore main differences as traditionally described; next we consider how the disorders may resemble each other; finally we discuss more subtle but perhaps (...) foundational ways in which the phenomenology of these disorders may nonetheless be differentiated. These involve disruptions of common sense and conventionality, abnormalities of empathy, distinct forms of paranoia and the sense of personal centrality, and altered perceptions of intentionality, deadness, and artificiality. We end by considering some neurocognitive research relevant to these abnormal forms of subjectivity, including work on theory of mind, experience of human movement, and perception of faces. (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)

This paper draws on studies of the Capgras delusion in order to illuminate the phenomenological role of affect in interpersonal recognition. People with this delusion maintain that familiars, such as spouses, have been replaced by impostors. It is generally agreed that the delusion involves an anomalous experience, arising due to loss of affect. However, quite what this experience consists of remains unclear. I argue that recent accounts of the Capgras delusion incorporate an impoverished conception of experience, which fails to accommodate (...) the role played by ‘affective relatedness’ in constituting (a) a sense of who a particular person is and (b) a sense of others as people rather than impersonal objects. I draw on the phenomenological concept of horizon to offer an interpretation of the Capgras experience that shows how the content ‘this entity is not my spouse but an impostor’ can be part of the experience, rather than something that is inferred from a strange experience. (shrink)

This paper explores the phenomenology of touch and proposes that the structure of touch serves to cast light on the more general way in which we 'find ourselves in a world'. Recent philosophical work on perception tends to emphasize vision. This, I suggest, motivates the imposition of a distinction between externally directed perception of objects and internally directed perception of one's own body. In contrast, the phenomenology of touch involves neither firm boundaries between body and world nor perception of bodily (...) states in isolation from perception of everything else. I begin by arguing that touch does not involve two distinct feelings, a feeling of the body and a feeling of something external to the body. Rather, these are inextricable aspects of the same unitary experience, with one or the other occupying the experiential foreground. Then I suggest that tactile experience does not always respect a clear boundary between body and world. In touch, bodily and worldly aspects are experienced in a number of different ways and, in many instances, there is no clear experiential differentiation between the two. Finally, I draw these two points together in order to consider the contribution made by touch to our sense of being situated in a world. (shrink)

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)

It is generally maintained that emotions consist of intentional states and /or bodily feelings. This paper offers a phenomenological analysis of guilt in severe depression, in order to illustrate how such conceptions fail to adequately accommodate a way in which some emotional experiences are said to be deeper than others. Many emotions are intentional states. However, I propose that the deepest emotions are not intentional but pre-intentional, meaning that they determine which kinds of intentional state are possible. I go on (...) to suggest that pre-intentional emotions are at the same time feelings. In so doing, I reject the distinction that is often made between bodily feelings and the world-oriented aspects of emotion. (shrink)

The centenary of Karl Jaspers' General Psychopathology was recognised in 2013 with the publication of a volume of essays dedicated to his work. Leading phenomenological-psychopathologists and philosophers of psychiatry examined Jaspers notion of empathic understanding and his declaration that certain schizophrenic phenomena are ‘un-understandable’. The consensus reached by the authors was that Jaspers operated with a narrow conception of phenomenology and empathy and that schizophrenic phenomena can be understood through what they variously called second-order and radical empathy. This article offers (...) a critical examination of the second-order empathic stance along phenomenological and ethical lines. It asks: Is second-order empathy possible? Is the second-order empathic stance an ethically acceptable attitude towards persons diagnosed with schizophrenia? I argue that second-order empathy is an incoherent method that cannot be realised. Further, the attitude promoted by this method is ethically problematic insofar as the emphasis placed on radical otherness disinvests persons diagnosed with schizophrenia from a fair chance to participate in the public construction of their identity and, hence, to redress traditional symbolic injustices. (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)

Alterations in consciousness are among the most common transdiagnostic psychopathological symptoms. Therefore clinical practice would benefit from a clear conceptual framework that guides the recognition, comprehension, and treatment of consciousness disorders. However, contemporary psychopathology lacks such a framework. We describe how pathology of consciousness is currently being addressed in clinical psychology and psychiatry so far, and how the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and International Classification of Diseases, Tenth Edition (ICD-10) refer to this subject. A (...) brief review of the literature on consciousness is then given. After describing psychological perspectives on consciousness and discussing theoretical issues involved in exploring consciousness, we offer a practical clinical working definition of consciousness and we illustrate its connections with a variety of diagnoses. Making use of Jean-Paul Sartre’s distinctions among: states, functions, qualities, and structure, provide a conceptual framework to understand consciousness, to refine diagnostics and to guide the development of therapeutic possibilities in clinical practice. (shrink)

There has been a recent growth in philosophy of psychiatry that draws heavily (although not exclusively) on analytic philosophy with the aim of a better understanding of psychiatry through an analysis of some of its fundamental concepts. This 'new philosophy of psychiatry' is an addition to both analytic philosophy and to the broader interpretation of mental health care. Nevertheless, it is already a flourishing philosophical field. One indication of this is the new Oxford University Press series International Perspectives in Philosophy (...) and Psychiatry seven volumes of which (by Bolton and Hill; Bracken and Thomas; Fulford, Morris, Sadler, and Stanghellini; Hughes, Louw, and Sabat; Pickering; Sadler; and Stanghellini) are examined in this critical review. (shrink)

Worrying is the central feature of generalized anxiety disorder . Many people worry from time to time, but in GAD the worrying is prolonged and difficult to control. Worrying is a specific way of coping with perceived threats and feared situations. Meanwhile, it is not considered to be a helpful coping strategy, and the phenomenological account developed in this paper aims to show why. It builds on several phenomenological notions and in particular on Michael Wheeler's application of these notions to (...) artificial intelligence and the cognitive sciences. Wheeler emphasizes the value of 'online intelligence' as contrasted to 'offline intelligence'. I discuss and apply these concepts with respect to worrying as it occurs in GAD, suggesting that GAD patients overrate the value of detached contemplation , while underrating their embodied-embedded adaptive skills . I argue that this phenomenological account does not only help explaining why worrying is used as a coping strategy, but also why cognitive behavioral therapy is successful in treating GAD. (shrink)

Stephens and Graham maintain that in cases of thought insertion, the sense of ownership is preserved, but there is a defect in the sense of agency. However, these theorists overlook the possibility that subjectivity might be preserved despite a defect in the sense of ownership. The claim that schizophrenia centers upon a loss of a sense of ownership is supported by an examination of some of the other notable disownership symptoms of the disorder, such as bodily alienation and experiences of (...) “unworlding.” Is there a way to make sense of the “underlying characteristic modification” that ties together the various symptoms of schizophrenia and disrupts subjects’ “hold” on their own bodies and surroundings? I will argue that what accounts for subjects’ usual sense of ownership are fully embodied processes of causal-contextual information integration, which are made possible by subjects’ affective framing patterns. Attenuated affective framings lead to a loss of a sense of ownership and cause subjects to lose their “grip” on bodily sensations and mental states, which ultimately can result in experiences of thought insertion. I will conclude with some brief remarks about implications for treatment, and point to several body-centered intervention methods that might help to restore subjects’ sense of ownership. (shrink)

One of humans’ distinctive cognitive abilities is that they develop an array of capacities through an enculturation process. In “Cognition as a Social Skill,” Sally points to one of the dangers associated with enculturation: ideological oppression. To conceptualize how such oppression takes root, Haslanager appeals to notions of mindshaping and social coordination, whereby people participate in oppressive social practices unthinkingly or even willingly. Arguably, an appeal to mindshaping provides a new kind of argument, grounded in philosophy of mind, which supports (...) the claims that feminist and anti-racist want to defend. However, some theorists worry that Haslanger’s account does not shed much light on how individuals could exert their agency to resist oppression. I argue that enactivist conceptions of mindshaping and habit can help us to make sense of the power of social influences and how they have the potential to both enable and undermine cognition and agency. This moves us toward increased understanding of the workings of social oppression—distinguishing between constructive and enabling forms of heteronomy, and overdetermining and pernicious modes that lead to atrophied moral cognition and a narrowing of the field of affordances. (shrink)

Auditory verbal hallucinations (AVHs) are a highly complex and rich phenomena, and this has a number of important clinical, theoretical and methodological implications. However, until recently, this fact has not always been incorporated into the experimental designs and theoretical paradigms used by researchers within the cognitive sciences. In this paper, we will briefly outline two recent examples of phenomenologically informed approaches to the study of AVHs taken from a cognitive science perspective. In the first example, based on Larøi and Woodward (...) (Harv Rev Psychiatry 15:109–117, 2007 ), it is argued that reality monitoring studies examining the cognitive underpinnings of hallucinations have not reflected the phenomenological complexity of AVHs in their experimental designs and theoretical framework. The second example, based on Jones (Schizophr Bull, in press, 2010 ), involves a critical examination of the phenomenology of AVHs in the context of two other prominent cognitive models: inner speech and intrusions from memory. It will be shown that, for both examples, the integration of a phenomenological analysis provides important improvements both on a methodological, theoretical and clinical level. This will be followed by insights and critiques from philosophy and clinical psychiatry—both of which offer a phenomenological alternative to the empiricist–rationalist conceptualisation of AVHs inherent to the cognitive sciences approach. Finally, the paper will conclude with ideas as to how the cognitive sciences may integrate these latter perspectives into their methodological and theoretical programmes. (shrink)

In my general aim to probe a non-reductionist Philosophy of Cognitive Enhancement, considering social self-other relations and the epistemic 2PP in social syn-aesthetic tuning-ins, synchronisations and tuning-outs, this paper amplifies the Aristotelian common sense concept κοινὴ αἲσθησις2 by analysing the concept and metaphor of “resonance”3 in contemporary debates on >resonance< as acoustic and multimodal figure of thought. Resonance as shown in scientific models derived from acoustics will be applied to an aesthetic comunity of sensing and making music together as explored (...) in Alfred Schütz, as well as in social relations in social psychology. Finally, this paper puts resonance to test as well in technical atunements of social relations and closes with the necessary resistance to imposition of social resonance, introduced in this paper as xenoresonance. (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)

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)

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)

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)

This is a commentary on Humpston, C. S. (2022). “Isolated by Oneself: Ontologically Impossible Experiences in Schizophrenia.” Philosophy, Psychiatry, & Psychology 29(1), 5–15. It is published with an additional commentary by H. Green and Humpston’s response.

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

The past twenty years have seen an increase in the importance of the body in psychology, neuroscience, and philosophy of mind. This 'embodied' trend challenges the orthodox view in cognitive science in several ways: it downplays the traditional 'mind-as-computer' approach and emphasizes the role of interactions between the brain, body, and environment. In this article, I review recent work in the area of embodied cognitive science and explore the approaches each takes to the ideas of consciousness, computation and representation. Finally, (...) I look at the current relationship between orthodox cognitive science and the study of mental disorder, and consider the implications that the embodied trend could have for issues in psychopathology. (shrink)

The present thesis surveys different philosophical approaches to the nature of delusions: specifically, their ontology. However, since none of the various theories of the nature of delusions succeeds, I argue that there must be something problematic about the form of the analyses commonly offered. My general conclusion is that one cannot characterize delusions without taking away what it is distinctive about them.

This dissertation is a contribution to the contemporary field of phenomenological psychopathology, or the phenomenological study of psychiatric disorders. The work proceeds with two major aims. The first is to show how a phenomenological approach can clarify and illuminate the nature of psychopathology—specifically those conditions typically labeled as major depressive disorder and bipolar disorder. The second is to show how engaging with psychopathological conditions can challenge and undermine many phenomenological presuppositions, especially phenomenology’s status as a transcendental philosophy and its corresponding (...) anti-naturalistic outlook. In the opening chapter, I articulate the three layers of the subject matter of phenomenological research—what I refer to as “existentials,” “modes,” and “prejudices.” As I argue, while each layer contributes to what we might call the “structure” of human existence, they do not do so in the same way, or to the same degree. Because phenomenological psychopathology—and applied phenomenology in general—aims to characterize how the structure of human existence can change and alter, it is paramount that these layers be adequately delineated and defined before investigating these changes. In chapters two through five, I conduct hermeneutic and phenomenological investigations of psychopathological phenomena typically labeled as major depressive disorder or bipolar disorder. These investigations address the affective aspects of depression and mania, and the embodied aspects of depression. In addition to clearly articulating the nature of these phenomena, I show how certain psychopathological conditions involve changes in the deepest or most fundamental layer of human existence—what I refer to as existentials. As I argue, many of the classical phenomenologists (including Husserl and Heidegger) believed that these structural features were necessary, unchanging, and universal. However, this presupposition is challenged through the examination of psychopathological and neuropathological conditions, undermining the status of phenomenology as a transcendental philosophy. While this challenge to classical phenomenology is only sketched in the early chapters, in chapters six and seven I develop it in more detail in order to achieve two distinct ends. In chapter six I argue that psychopathology and neuropathology not only challenge phenomenology’s status as a transcendental philosophy, but also supply a key to developing a phenomenological naturalism (which I contrast with a naturalized phenomenology). Phenomenological naturalism, as I articulate it, is a position in which phenomenology is not subsumed by the metaphysical and methodological framework of the natural sciences, but nonetheless maintains the capacity to investigate how the natural world stands independent of human subjectivity (and how events in the natural world can bring about changes in the most fundamental structures of human existence). In the seventh chapter I argue that a phenomenology in which existentials are contingent and variable rather than necessary and unchanging allows phenomenologists to contribute to new dimensional approaches to psychiatric classification. Rather than begin from distinct categories of disorder, these approaches begin from distinct core features of human existence. These features, referred to as either dimensions or constructs, can vary in degree and are studied in both normal and pathological forms. (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)

[Przekład] W artykule tym opowiadam się za zunifikowaną kognitywistyką, przyjmując dla swej argumentacji niecodzienny punkt wyjścia: stanowisko określane czasem jako „teza o kontinuum życia-umysłu”. Zamiast więc traktować jako pewnik powszechnie akceptowane założenia początkowe, a następnie proponować odpowiedzi na pewne dobrze określone pytania, muszę najpierw dowieść, że koncepcja kontinuum życia-umysłu może w ogóle stanowić właściwy punkt startowy. Zacznę zatem od oceny pojęciowych narzędzi, odpowiednich do budowania teorii umysłu na tej podstawie. Czerpiąc spostrzeżenia z wielu różnych dziedzin – szczególnie z połączenia egzystencjalistycznej (...) fenomenologii ze skoncentrowaną na organizmie biologią – dowodzę, że można pojmować umysł jako zakorzeniony w życiu, ale tylko wtedy, gdy równocześnie zgodzimy się, że interakcja społeczna gra konstytutywną rolę w naszych zdolnościach poznawczych. (shrink)

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

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