Affordances are action-possibilities, ways of relating to and acting on our world. A theory of affordances helps us understand how we have bodily access to our world and what it means to enjoy such access. But what happens to bodies when this access is somehow ruptured or impeded? This question is relevant to psychopathology. People with psychiatric disorders often describe feeling as though they’ve lost access to affordances that others take for granted. Focusing on schizophrenia, depression, and autistic spectrum disorder, (...) I argue that thinking about the bodily consequences of losing access to everyday affordances can help us better understand these reports. An affordance-based approach to psychopathology can illuminate some of the causes, as well as the experiential character and content, of affective disorders in psychopathology. It can also draw our attention to some under-explored ethical and political dimensions of these issues needing further consideration. (shrink)

Currently, anomalous lived temporality is not included in the main diagnostic criteria or standard symptom checklists. In this article, we present the Transdiagnostic Assessment of Temporal Experience, a structured interview that can be used by researchers and clinicians without a comprehensive phenomenological background to explore abnormal time experiences in persons with abnormal mental conditions regardless of their diagnosis. When extensive data gathered by this scale are available, it will be possible to delineate well-defined anomalous lived temporality profiles for each psychopathological (...) disorder. This instrument may also prove useful for clinicians by providing a more refined assessment of relevant psychopathological symptoms and an in-depth understanding of the patient’s abnormal behaviour as related to specific types of time experience. In the first part of the article, we provide a brief overview of the phenomenological concept of temporality, including pre-phenomenal and phenomenal time, synthesis, conation and synchronization, and of abnormal time experiences in persons affected by psychopathological conditions. In the following part, we describe the basic structure of the interview that comprises seven categories corresponding to the abnormal features of lived temporality: anomalies of synchrony, of time structure, of implicit time flow, of explicit time flow, and anomalous experiences of the past, the present and the future. The paper also includes a section on administration and scoring of the TATE scale, the complete interview and a Likert table for quantifying the frequency, intensity and interference with daily life of the phenomena explored. (shrink)

Mental health research faces a suite of unresolved challenges that have contributed to a stagnation of research efforts and treatment innovation. One such challenge is how to reliably and validly account for the subjective side of patient symptomatology, that is, the patient’s inner experiences or patient phenomenology. Providing a structured, standardised semantics for patient phenomenology would enable future research in novel directions. In this contribution, we aim at initiating a standardized approach to patient phenomenology by sketching a tentative formalisation within (...) the framework of an applied ontology, in the broader context of existing open-source Open Biomedical Ontologies resources such as the Mental Functioning Ontology. We further discuss a number of prevailing challenges and observations bearing on this task. (shrink)

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

So far, the value dimension underlying affectivity disorders has remained out of focus in phenomenological psychopathology. As early as at the beginning of the 20th century, however, German phenomenologist Max Scheler examined in depth the relationship between affectivity and value dimension through the concept of valueception (Wertnehmung). In this sense, a recent noteworthy contribution has been provided by John Cutting, who has drawn attention to the importance of Scheler’s analyses for psychiatry. In this work I take into consideration only two (...) aspects of Cutting’s proposal: 1) the relationship between the impairments of valueception and the perception of certain value classes; and 2) the interpretation of Scheler’s phenomenological reduction and its juxtaposition with the modus vivendi of schizophrenia. According to Cutting, in the modus vivendi of schizophrenia the valueception impairment entails putting vital values in brackets and focusing on personal values, with a process that recalls Scheler’s phenomenological reduction. Regarding the first aspect, I share Cutting’s starting point, but then shift the focus on how important the valueception is for the intersubjective dimension. In particular, I maintain that rather than compromising the perception of vital values, valueception impairments in the modus vivendi of schizophrenia interfere with the intersubjective dimension and are interwoven with a process of disembodiment. My thesis is that the modus vivendi of schizophrenia involves a disturbance of the intersubjective dimension that arises from the level of valueception and that determines the person’s self-referential closure. With regard to the second point, by analyzing Scheler’s phenomenological reduction, I sustain that its main objective is to increase both the interaction with otherness and the openness to the world (Weltoffenheit). As a consequence, the modus vivendi of schizophrenia, in my opinion, is not comparable, as Cutting claims, with Scheler’s phenomenological reduction, but goes in a different direction. (shrink)

Self-disorders in depression and schizophrenia have been the focus of much recent work in phenomenological psychopathology. But little has been said about the role the material environment plays in shaping the affective character of these disorders. In this paper, we argue that enjoying reliable (i.e., trustworthy) access to the things and spaces around us — the constituents of our material environment — is crucial for our ability to stabilize and regulate our affective life on a day-today basis. These things and (...) spaces often play an ineliminable role in shaping what we feel and how we feel it; when we interact with them, they contribute ongoing feedback that " scaffolds " the character and temporal development of our affective experiences. However, in some psychopathological conditions, the ability to access to these things and spaces becomes disturbed. Individuals not only lose certain forms of access to the practical significance of the built environment but also to its ​ regulative​ significance, too — and the stability and organization of their affective life is compromised. In developing this view, we discuss core concepts like " affordance spaces " , " scaffolding " , and " incorporation ". We apply these concepts to two case studies, severe depression and schizophrenia, and we show why these cases support our main claim. We conclude by briefly considering implications of this view for developing intervention and treatment strategies. (shrink)

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

This 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 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)

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

Borderline personality disorder (BPD) is characterized by severe disturbances in a subject’s sense of identity. Persons with BPD suffer from recurrent feelings of emptiness, a lack of self-feeling, and painful incoherence, especially regarding their own desires, how they see and feel about others, their life goals, or the roles to which they commit themselves. Over the past decade or so, clinical psychologists, psychotherapists, and psychiatrists have turned to philosophical conceptions of selfhood to better understand the borderline-specific ruptures in the sense (...) of identity, which are frequently associated with severe affective instability and turbulence in interpersonal relationships. Fuchs (2007) has suggested that these disturbances in self-experience can best be described and explained by using notions—widely discussed in philosophy and psychology—ofnarrativityandnarrative identity. On such a narrative view, key features of BPD present significant modifications of proto-narrative structures and inhibit the development of a narrative identity, resulting in a disturbed sense of identity. Although the role of narrativity in BPD has been acknowledged by many researchers, some have voiced dissatisfaction with what they take to be limitations of a narrativistic understanding of the disorders of identity characterizing BPD, and have proposed alternative, allegedly non-narrativistic, accounts. In this paper, we critically examine an example of the latter, viz. Gold and Kyratsous’ (2017) account ofthe person as an intrapersonal team reasoner. We defend a narrativistic understanding of BPD identity disorder against their objections. To this end, we propose a broader, and more finely-differentiated, concept of narrativity. On this account, four aspects of narrativity are distinguished, the disordering of which can affect those with BPD. As it turns out, our account implies that even Gold and Kyratsous—in order to ground their approach—must either make use of these aspects or propose an as-yet unarticulated alternative. This casts doubt upon whether their approach is non-narrativistic after all. (shrink)

In this paper, I wish to explore the contribution of the phenomenological reduction to a distinct form of empathy, which has been identified and called by Ratcliffe :473–495, 2012) radical empathy. This form of empathy brings to light the sense of reality experienced by the subject rather than a mere mental state. However, I shall consider whether and how the phenomenological reduction allows different interpretations of the same experience, thereby impacting on our understanding of another’s sense of reality. Far from (...) dismissing the role of the reduction, I propose a reconsideration of its relevance for radical empathy. In order to spell out my argument, I propose a case ex negativo that looks at Sartre’s and Merleau-Ponty’s different analyses of the sense of reality experienced by obsessive patients. I argue that this interpretative difference ultimately depends on two opposite uses of the reduction itself, and that Merleau-Ponty’s account offers a promising perspective to reintegrate and contextualize the phenomenological reduction into radical empathy. (shrink)

In this paper we have two main aims. First, we present an account of mood-congruent delusions in depression (hereafter, depressive delusions). We propose that depressive delusions constitute acknowledgements of self-related beliefs acquired as a result of a negatively biased learning process. Second, we argue that depressive delusions have the potential for psychological and epistemic benefits despite their obvious epistemic and psychological costs. We suggest that depressive delusions play an important role in preserving a person’s overall coherence and narrative identity at (...) a critical time, and thus can be regarded as epistemically innocent. (shrink)

In this essay I address the question, “What is the subject matter of phenomenological research?” I argue that in spite of the increasing popularity of phenomenology, the answers to this question have been brief and cursory. As a result, contemporary phenomenologists lack a clear framework within which to articulate the aims and results of their research, and cannot easily engage each other in constructive and critical discourse. Examining the literature on phenomenology’s identity, I show how the question of phenomenology’s subject (...) matter has been systematically neglected. It has been overshadowed by an unending concern with phenomenology’s methodological identity. However, an examination of recent contributions to this literature reveals that a concern with articulating phenomenology’s subject matter has gradually increased, although such articulations remain preliminary. In light of this, I delineate, define, and illustrate three layers of phenomenological research, which I term “existentials,” “modes,” and “prejudices.” While the delineation of these layers is drawn primarily from classical phenomenological texts, they are defined and illustrated through the use of more contemporary literature. Following the articulation of this subject matter, I briefly consider some of the debates—both foundational and applied—that can be facilitated by the adoption of this framework. (shrink)

In this paper, I draw on Heidegger’s phenomenology of “moods” (_Stimmungen_) to interpret loneliness as a diffused and atmospheric feeling-state that often undergirds the lives of older adults, shaping the ways in which they are attuned to and make sense of the world. I focus specifically on residents in long-term care facilities to show how the social isolation and lockdown measures of the COVID-19 pandemic dramatically intensified the mood. The aim is to shed light on how profound and totalizing the (...) experience has been for residents. Making use of Heidegger’s account of the affective “collapse” or “breakdown” (_Zusammenbruch_) of meaning, I argue that when older adults are functionally locked in their rooms for months at a time and cut off from the orienting routines and rhythms of the relational world, the result is a crumbling of the fundamental meaning-structures that constitute subjectivity. The global sense of abandonment and disconnection strips away the possibility for self-understanding, and residents are often left confused and abandoned to an existence that has been drained of meaning and significance. (shrink)

There is a need for inner recollection opposed to our everyday distraction. Our distraction is partly based on anthropological features and partly on social and cultural features. As well as feelings of distraction, we know experiences of being focussed from everyday life. As feelings in which distraction is absent, and as feelings in which we are partly and temporarily released from our own egocentric perspective, they remind us that a different kind of relation to ourselves and the world is possible. (...) Therefore, they can motivate a process of self-transformation aiming at a mystical state of mind, which is of a more profound and enduring kind than ordinary experiences of being focussed. The mystical state of mind is a state in which we transcend ourselves in the face of the universe and thereby relativize our own affective involvement. It is a feeling of an all-encompassing unity which ultimately concerns us; and it is a feeling of love, joy, and peace of mind. Mystical feelings thus shape and restrict spaces of possibilities, and they comprise an altered sense of what it means to be real. Therefore, they can be classified as existential feelings. Still, the mystical state of mind differs from prototypical existential feelings because it is a positive feeling, necessarily comprises active as well as passive moments, and presupposes an explicit way of attending to the world as world. (shrink)

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

It is often emphasised that persons diagnosed with borderline personality disorder show difficulties in understanding their own psychological states. In this article, I argue that from a phenomenological perspective, BPD can be understood as an existential modality in which the embodied self is profoundly saturated by an alienness regarding the person’s own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through, e.g., psychotherapy. Following this line of thought, I present the idea (...) that narrativising experiences can play an important role in processes of appropriating such embodied self-alienness. Importantly, the notion of narrative used is that of a scalar conception of narrativity as a variable quality of experience that comes in degrees. From this perspective, narrative appropriation is a process of gradually attributing the quality of narrativity to experiences, thereby familiarising the moods, affects, and responses that otherwise govern ‘from behind’. Finally, I propose that the idea of a narrative appropriation of embodied self-alienness is also relevant to the much-debated question of personal responsibility in BPD, particularly as this question plays out in psychotherapeutic contexts where a narrative self-appropriation may facilitate an increase in sense of autonomy and reduce emotions of guilt and shame. (shrink)

Recent work on the relation between narrative and selfhood has emphasized embodiment as an indispensable foundation for selfhood. This has occasioned an interesting debate on the relation between embodiment and narrative. In this paper, I attempt to mediate the range of conflicting intuitions within the debate by proposing a scalar approach to narrative and an accompanying concept of a split-self. Drawing on theoretical developments from contemporary narratology, I argue that we need to move away from a binary understanding of narrative (...) as something an entity strictly is or is not; rather, we need to see narrative as an attribute admitting of degrees. I suggest that the relation between narrative and embodiment should be seen along these lines, proposing three levels of the narrativity of embodied experiencing: 1) the unnarratable, 2) the narratable and 3) the narrative. Finally, I discuss the implications this framework has for the general question of the narrative constitution of selfhood. (shrink)

Eating disorders and gender dysphoria can be conceptualized as psychopathological conditions of post-modernity, mirroring the transformations of our society and the differences between cultures across the world. They both move from a crisis of the taken for granted self-identity. Furthermore, from a phenomenological perspective, the clinical manifestations are based on a disorder of lived corporeality. In this sense. The present paper is theoretically grounded in the field of the phenomenological concepts of lived body and physical body. Furthermore, I took into (...) consideration the Sartrean dimension of livedbody-for-others, which is related to the experience of the revelation that body can be an object for the other. In both eating disorders and gender dysphoria, the external reality of the body and the inner subjective perception do not match, and the harmonious relationships between the internal representation of the body and the body itself has not been achieved, which results in a consequent feeling of estrangement within itself. In both these conditions, the main psychological disturbances are impairments in overall identity development and the failure to establish multiple and diverse domains of self-definition, especially in the crucial period of adolescence. The questions about the body are intimately related to the nature of relationships with others, the degree to which we are coherent with others. In other words, they concern the issue of distinctiveness. In finding the answers to these questions, adolescents build a sense of self and mark their own identities in a way that makes sense to themselves. (shrink)

In this thesis I propose a new way of understanding depressive illness as not exclusively harmful, but as related to particular, empirically evidenced, epistemic and pragmatic benefits for the subject, alongside the associated costs. For each of the benefits considered, I provide and concisely analyse the empirical evidence both in its favour and against it, suggest ways in which these benefits could apply in the circumstances presented, discuss some outstanding problems for that application as stated, and describe potential implications. The (...) issues discussed involve topics in cognitive psychology as well as in ethics, which I regard as complementary to the debate. I take the view that depression related phenomena such as low mood, low self-esteem, and mood-congruent delusions offer potential benefits to a subject under certain circumstances, but not under others. In discussing the hypotheses presented, I argue for a more complex view of depression, which includes its potential epistemic and pragmatic benefits as well as its costs and I propose possible directions for future research. (shrink)

Lectio praecursoria 25.10.2017: Mitä henkilö on? Mitä psykiatria on? Dialektisessa filosofiassa nämä peruskäsitteet eivät jää annetuiksi, sellaisinaan pysyviksi, kuten eksaktit analyyttisen filosofian käsitteet usein jäävät, vaan tulevat ymmärretyiksi kuvauksina muodostumistensa prosesseissa. Dialektinen prosessi ei kuvaa vain tietämisen kohdetta, vaan asian olemista kokonaisena tiedostuksen prosessina. Henkilön perusprosessi vie yksilön ja persoonan kautta tiedostettuun henkilön käsitteeseen. Siis dialektisessa kieltämisen kieltämisen prosessissa käsitteet eivät vain ehdottomasti erotu toisistaan, vaan ne prosessissa myös muuntuvat toisikseen. Yksilö ja persoona eivät ehdottoman ’musta–valkoisesti, joko–tai’ erotu henkilöstä, vaan (...) sisältyvät henkilön prosessiin. Eikä alkuna ollutta käsitettä voi toistaa samamerkityksisenä prosessin tuloksena. Psykiatrian itsetietoisuus muodostuu henkilön kohtaamisessa akuuttihoidossa – pitkäaikaishoidossa – kuntoutuksessa; sitten psykiatrian filosofiassa henkilön sosiopsykiatriassa – kehityspsykiatriassa – autonomian psykiatriassa. Lopuksi vielä, henkilön psykiatrian ja hengenfilosofian suhdetta pohdittaessa, henkilössä toteutuvaa subjektillisuuden prosessia kuvataan kieltämisen kieltämisenä: kiintymyssuhde – tunnustussuhde – sivistys. Näistä prosesseista ei pyritä muodostamaan dialektista järjestelmää, mm. Hegelin ja Snellmanin esikuvan mukaan, vaan pyritään säilyttämään prosessien avoimuus ja menetelmällinen heuristisuus. (shrink)

In a series of famous experiments, Benjamin Libet claimed to have shown that there is no scientific basis for our commonsensical understanding of freedom of the will. The actions we are about to undertake register in our brains before they register in our conscious minds. And yet, all that Libet may have shown is that long-invoked notions such as “the will” and “freedom” are poor explanations of how actions are initiated. Actions take place as we respond to the call of (...) the mood of the situation in which we find ourselves. Action is a way of attuning ourselves. Simple actions happen as long established habits kick in, and complex actions happen as the mood of a situation comes to correspond to the mood of a story we have been telling ourselves. When it feels right, we just act. (shrink)