According to what we will call subjectivity theories of consciousness, there is a constitutive connection between phenomenal consciousness and subjectivity: there is something it is like for a subject to have mental state M only if M is characterized by a certain mine-ness or for-me-ness. Such theories appear to face certain psychopathological counterexamples: patients appear to report conscious experiences that lack this subjective element. A subsidiary goal of this chapter is to articulate with greater precision both subjectivity theories and the (...) psychopathological challenge they face. The chapter’s central goal is to present two new approaches to defending subjectivity theories in the face of this challenge. What distinguishes these two approaches is that they go to great lengths to interpret patients’ reports at face value – greater length, at any rate, than more widespread approaches in the extant literature. (shrink)

In this volume, leading philosophers of psychiatry examine psychiatric classification systems, including the Diagnostic and Statistical Manual of Mental Disorders, asking whether current systems are sufficient for effective diagnosis, treatment, and research. Doing so, they take up the question of whether mental disorders are natural kinds, grounded in something in the outside world. Psychiatric categories based on natural kinds should group phenomena in such a way that they are subject to the same type of causal explanations and respond similarly to (...) the same type of causal interventions. When these categories do not evince such groupings, there is reason to revise existing classifications. The contributors all question current psychiatric classifications systems and the assumptions on which they are based. They differ, however, as to why and to what extent the categories are inadequate and how to address the problem. Topics discussed include taxometric methods for identifying natural kinds, the error and bias inherent in DSM categories, and the complexities involved in classifying such specific mental disorders as "oppositional defiance disorder" and pathological gambling. -/- Contributors George Graham, Nick Haslam, Allan Horwitz, Harold Kincaid, Dominic Murphy, Jeffrey Poland, Nancy Nyquist Potter, Don Ross, Dan Stein, Jacqueline Sullivan, Serife Tekin, Peter Zachar. (shrink)

In this chapter, I provide an overview of phenomenological approaches to psychiatric classification. My aim is to encourage and facilitate philosophical debate over the best ways to classify psychiatric disorders. First, I articulate phenomenological critiques of the dominant approach to classification and diagnosis—i.e., the operational approach employed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-10). Second, I describe the type or typification approach to psychiatric classification, which I distinguish into three different (...) versions: ideal types, essential types, and prototypes. I argue that despite their occasional conflation in the contemporary literature, there are important distinctions among these approaches. Third, I outline a new phenomenological-dimensional approach. I show how this approach, which starts from basic dimensions of human existence, allows us to investigate the full range of psychopathological conditions without accepting the validity of current diagnostic categories. (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)

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)

Prior research has demonstrated that antisocial behavior, substance-use disorders, and personality dimensions of aggression and impulsivity are indicators of a highly heritable underlying dimension of risk, labeled externalizing. Other work has shown that individual trait constructs within this psychopathology spectrum are associated with reduced self-monitoring, as reflected by amplitude of the error-related negativity (ERN) brain response. In this study of undergraduate subjects, reduced ERN amplitude was associated with higher scores on a self-report measure of the broad externalizing construct that (...) links these various indicators. In addition, the ERN was associated with a response-locked increase in anterior theta (4–7 Hz) oscillation; like the ERN, this theta response to errors was reduced among high-externalizing individuals. These findings suggest that neurobiologically based deficits in endogenous action monitoring may underlie generalized risk for an array of impulse-control problems. (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)

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)

Despite increasing interest in the work of Tetsuro Watsuji, his discussion of intentionality remains underexplored. I here develop an interpretation and application of his view. First, I unpack Watsuji’s arguments for the inherently social character of intentionality, consider how they connect with his more general discussion of embodiment and betweenness, and then situate his view alongside phenomenologists like Husserl, Heidegger, and Merleau-Ponty. Next, I argue that Watsuji’s characterization of the social character of intentionality is relevant to current discussions in phenomenological (...) psychopathology. I consider how it can help illuminate the character and structure of some anomalous experiences in schizophrenia. I argue further that this application can enrich existing attempts to connect Watsuji and psychopathology, such as those found in the work of the psychiatrist Bin Kimura. (shrink)

Loneliness is a near-universal experience. It is particularly common for individuals with (so-called) psychopathological conditions or disorders. In this paper, we explore the experiential character of loneliness, with a specific emphasis on how social goods are experienced as absent in ways that involve a diminished sense of agency and recognition. We explore the role and experience of loneliness in three case studies: depression, anorexia nervosa, and autism. We demonstrate that even though experiences of loneliness might be common to many psychopathologies, (...) these experiences nevertheless have distinctive profiles. Specifically, we suggest that: (i) loneliness is often a core characteristic of depressive experience; (ii) loneliness can drive, and even cement, disordered eating practices and anorectic identity in anorexia nervosa; iii) loneliness is neither a core characteristic of autism nor a driver but is rather commonly experienced as stemming from social worlds, environments, and norms that fail to accommodate autistic bodies and their distinctive forms of life. We aim to do justice to the pervasiveness of loneliness in many — if not all — psychopathologies, while also highlighting the need to attend to psychopathology-specific experiences of loneliness, agency, and (non-)recognition. (shrink)

In Western societies many immigrants live in difficult social and working conditions. Together with other factors, this state of affairs represents a risk for the well being of their children. This article will consider the principle risk factors for child psychopathology and/or distress, with a distinction between temporary and permanent factors and with a peculiar attention to the interplay between risk and protective factors. Risk factors can be ordered in cultural, social, familiar/parental and individual factors. Some of these are (...) general risk factors, applying to child and adolescent psychopathology and distress independently from the status of immigrants’ offspring. Other factors are specific of migration, some of them being related to: a) different ways of immigrated families to situate themselves within the host society ; b) cultural/familiar attitudes in child’s nurture and education; c) the family role of women as well as factors specific of the pregnancy period in immigrants; d) the ability of the school system to enhance and support children’s abilities to integrate within the new society; e) the political/bureaucratic facilitation/impediment to the regularization of VISA, with the consequent effect on the sense of identity/rejection within/from the host society. In conclusion, the programs for monitoring immigrants’ living and health conditions should also include: the assessment of parental skills, the dynamic indicators of risk and protection indexes, the assessment of living conditions and social school environment, with a careful attention to those early signs of discomfort that might precede possible later onset of psychopathology and/or social distress. (shrink)

In Western societies many immigrants live in difficult social and working conditions. Together with other factors, this state of affairs represents a risk for the well being of their children. This article will consider the principle risk factors for child psychopathology and/or distress, with a distinction between temporary and permanent factors and with a peculiar attention to the interplay between risk and protective factors. Risk factors can be ordered in cultural, social, familiar/parental and individual factors. Some of these are (...) general risk factors, applying to child and adolescent psychopathology and distress independently from the status of immigrants’ offspring. Other factors are specific of migration, some of them being related to: a) different ways of immigrated families to situate themselves within the host society ; b) cultural/familiar attitudes in child’s nurture and education; c) the family role of women as well as factors specific of the pregnancy period in immigrants; d) the ability of the school system to enhance and support children’s abilities to integrate within the new society; e) the political/bureaucratic facilitation/impediment to the regularization of VISA, with the consequent effect on the sense of identity/rejection within/from the host society. In conclusion, the programs for monitoring immigrants’ living and health conditions should also include: the assessment of parental skills, the dynamic indicators of risk and protection indexes, the assessment of living conditions and social school environment, with a careful attention to those early signs of discomfort that might precede possible later onset of psychopathology and/or social distress. (shrink)

An attempt to answer four unsettled questions about the Stoic definition of passions. (I am no longer working on this paper, but have incorporated some of its thoughts into subsequent work.).

Musing for Puncta special issue "Critically Sick: New Phenomenologies Of Illness, Madness, And Disability.".

In this article, I argue that phenomenological psychopathologists, despite their critical attitude toward mainstream psychiatry, still hold problematic prejudices about the nature of psychiatric conditions as illness or disorder. I suggest that phenomenological psychopathologists turn to resources in the neurodiversity and mad pride movements to critically reflect upon these prejudices and appreciate the methodological problems that they pose.

How comes that two organisms can interact with each other or that we can comprehend what the other experiences? The theories of embodiment, intersubjectivity or empathy have repeatedly taken as their starting point an individualistic assumption (the comprehension of the other comes after the self-comprehension) or a cognitivist one (the affective dimension follows the cognitive process). The thesis of this book is that there are no two isolated entities at the origin which successively interact with each other. There is, rather, (...) an impersonal stratum – the original affectivity (Gefühlsdrang) – which lets the living organisms be constitutively attuned with the expressive dimension of the life from the very beginning. The book aims to rethink the issue of corporality on the basis of a biosemiotics of the interaction between lived body (Leib) and environment (Umwelt). The human emotions reveals themselves as devices that experiment further attunement levels and expose the human being – because of her ex-centricity – to the alienation in various forms of the psychopathological existence. This is an unprecedented perspective that turns to psychopathology to reread against the light the watermark weaving the structure of personal singularity. What emerges is an intermediate territory confining both with philosophy and psychiatry: the psychopathology of ordo amoris. The author advances the project of a new psychopathology of ordo amoris, not only tackling with the 19th-century tradition of psychiatry and phenomenological psychopathology, but also with the contemporary disputes on intersubjectivity in phenomenology and with those on schizophrenia as disruption of aida or as disembodiment process in psychiatry. What results from his project is the first systematic study on the international level showing the relevance of Schelerian concepts of body schema (Leibschema) and order of feeling (ordo amoris) to understand the disruptions of emotional regulation on the psychopathological dimension as well as on the formation process of the singularity. (shrink)

Affordances are action-possibilities, ways of relating to and acting on things in our world. They help us understand how these things mean what they do and how we have bodily access to our world more generally. But what happens when this access is ruptured or impeded? I consider this question in the context of psychopathology and reports that describe this experience. 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 consequences, of affective disorders and diminished spatial agency in self-world disturbances. It also highlights some under-explored ethical and political dimensions of these issues that need further attention. (shrink)

“On the Subject Matter of Phenomenological Psychopathology” provides a framework for the phenomenological study of mental disorders. The framework relies on a distinction between (ontological) existentials and (ontic) modes. Existentials are the categorial structures of human existence, such as intentionality, temporality, selfhood, and affective situatedness. Modes are the particular, concrete phenomena that belong to these categorial structures, with each existential having its own set of modes. In the first section, we articulate this distinction by drawing primarily on the work (...) of Martin Heidegger—especially his study of the ontological structure of affective situatedness (Befindlichkeit) and its particular, ontic modes, which he calls moods (Stimmungen). In the second section, we draw on a study of grief to demonstrate how this framework can be used when conducting phenomenological interviews and analyses. In the concluding section, we explain how this framework can be guide phenomenological studies across a broad range of existential structures. (shrink)

Recently, there have been calls to develop a more contextual approach to phenomenological psychopathology—an approach that attends to the socio-cultural as well as personal and biographical factors that shape experiences of mental illness. In this Perspective article, we argue that to develop this contextual approach, phenomenological psychopathology should adopt a new paradigm case. For decades, schizophrenia has served as the paradigmatic example of a condition that can be better understood through phenomenological investigation. And recent calls for a contextual (...) approach continue to use schizophrenia as their primary example. We argue, in contrast, that substance misuse provides a better paradigm case around which to develop a contextually sensitive phenomenological psychopathology. After providing a brief vignette and analysis of a case of substance misuse, we explain why this kind of condition requires considerable sensitivity and attention to context, better motivating the incorporation and development of new contextually sensitive approaches. (shrink)

Psychiatry has witnessed a new wave of approaches to clinical phenotyping and the study of psychopathology, including the National Institute of Mental Health’s Research Domain Criteria, clinical staging, network approaches, the Hierarchical Taxonomy of Psychopathology, and the general psychopathology factor, as well as a revival of interest in phenomenological psychopathology. The question naturally emerges as to what the relationship between these new approaches is – are they mutually exclusive, competing approaches, or can they be integrated in (...) some way and used to enrich each other? In this opinion piece, we propose a possible integration between clinical staging and phenomenological psychopathology. Domains identified in phenomenological psychopathology, such as selfhood, embodiment, affectivity, etc., can be overlaid on clinical stages in order to enrich and deepen the phenotypes captured in clinical staging (‘high resolution’ clinical phenotypes). This approach may be useful both ideographically and nomothetically, in that it could complement diagnosis, enrich clinical formulation, and inform treatment of individual patients, as well as help guide aetiological, prediction, and treatment research. The overlaying of phenomenological domains on clinical stages may require that these domains are reformulated in dimensional rather than categorial terms. This integrative project requires assessment tools, some of which are already available, that are sensitive and thorough enough to pick up on the range of relevant psychopathology. The proposed approach offers opportunities for mutual enrichment: clinical staging may be enriched by introducing greater depth to phenotypes; phenomenological psychopathology may be enriched by introducing stages of severity and disorder progression to phenomenological analysis. (shrink)

Having a body is one of those unquestionable certainties of which we could not really understand the negation: the latter would not be a legitimate doubt in our linguistic, and therefore the epistemic game. In facts, according to Wittgenstein, contravening certain cornerstones of our language game implies that the used combination of words is being excluded from the game, withdrawn from circulation. The idea of this paper is that the external labelling of a behaviour as a mental illness, prima facie, (...) comes from here. Seriously questioning whether someone else controls my actions or my thoughts or whether I am actually dead, then, are not just doubts, as Wittgenstein's critique of G.E. Moore shows: such believes are constitutively excluded from our way of seeing the world and characterized as illnesses, anomalies; otherwise, it would the complete destruction of the language game we inhabit and therefore of the world as we know it, because we would not know on which bases something could be said truthfully or falsely if we did not even know that "this one is my hand". Therefore, even if mental illnesses objectify themselves in correlative physiological dysfunctions, such a discovery comes only after the external recognition of some symptoms, and to recognize the external symptoms of an illness we have to treat them as such; hereby is suggested that we do treat something this way when it threatens the certainties around which the language game we play revolves. (shrink)

In Disturbed Consciousness, philosophers and other scholars examine various psychopathologies in light of specific philosophical theories of consciousness. The contributing authors—some of them discussing or defending their own theoretical work—consider not only how a theory of consciousness can account for a specific psychopathological condition but also how the characteristics of a psychopathology might challenge such a theory. Thus one essay defends the higher-order thought (HOT) theory of consciousness against the charge that it cannot account for somatoparaphrenia (a delusion in (...) which one denies ownership of a limb). Another essay argues that various attempts to explain away such anomalies within subjective theories of consciousness fail. -/- Other essays consider such topics as the application of a model of unified consciousness to cases of brain bisection and dissociative identity disorder; prefrontal and parietal underconnectivity in autism and other psychopathologies; self-deception and the self-model theory of subjectivity; schizophrenia and the vehicle theory of consciousness; and a shift in emphasis away from an internal (or brainbound) approach to psychopathology to an interactive one. Each essay offers a distinctive perspective from the intersection of philosophy, consciousness research, and psychiatry. -/- Contributors Alexandre Billon, Andrew Brook, Paula Droege, Rocco J. Gennaro, Philip Gerrans, William Hirstein, Jakob Hohwy, Uriah Kriegel, Timothy Lane, Thomas Metzinger, Erik Myin, Inez Myin-Germeys, Myrto Mylopoulos, Gerard O’Brien, Jon Opie, J. Kevin O’Regan, Iuliia Pliushch, Robert Van Gulick . (shrink)

This paper is a loose commentary on Marcinów’s book (2017). The commentary is focused on the objects of psychopathological investigations and the role of psychology / psychiatry tension in the process of singling out, tracking, and describing them. As a consequence, there are limitations of collaborative and integrative efforts between psychologists and psychiatrists where questions of psychopathology are concerned.

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)

Short papers on OCD, philosophy, psychopathy, psychopathology generally, and their interrelations.

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)

The objective of this study is to present a theoretical paper about a clinical issue. Our aim is to propose some clinical and semiological considerations for a psychopathological conception of psychopathy. We will discuss several major theoretical works dedicated to this nosographic entity. We will also examine a significant issue raised by Cooke et al., namely whether psychopathic functioning is consistently related to antisocial behavior. This theoretical essay is informed by clinical situations. The method applied a phenomenological psychopathology analysis (...) to the clinical material. We first compare Binswanger’s conception of mania with psychopathic functioning. Patients’ behavior is similar but there is a difference related 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 of our investigations concerns emotions and the adaptive dimension of the psychopathic disorder. An epistemological discussion of the concept of emotions reveals that psychopaths are competent in the management of emotional stimuli, which confers a psychological advantage upon them. (shrink)

The paper deals with two central issues in the philosophy of neuroscience and psychiatry, namely those of the nature and the major kinds and types of psychopathological mechanisms. Contrary to a widespread view, I argue that mechanisms are not kinds of systems but kinds of processes unfolding in systems or between systems. More precisely, I argue that psychopathological mechanisms are sets of actions and interactions between brain-systems or circuits as well as between the latter and other systems in one's body (...) and external environment, both physical and social, involved in human psychopathology. According to the kinds of properties of the interacting systems or their component-parts, psychopathological mechanisms may be physical, chemical, biological, psychological, social, or, typically, mixed ones. Furthermore, I focus on two main kinds of psychopathological mechanisms involved in the causation of mental disorders, namely the pathogenetic and pathophysiological ones, stressing the importance of their careful distinction for the integrative understanding of otherwise disparate and apparently incommensurable psychiatric research findings. I illustrate my analysis with an example drawn from contemporary research on the mechanisms of acute psychosis. Finally, I stress the relevance of psychopathological mechanisms to a more scientifi cally-grounded classifi cation of mental disorders. (shrink)

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

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)

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)

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

Max Scheler’s Formalism – and other of his essays on the philosophy of psychology, such as The Idols of Self-Knowledge and Ressentiment – continues to be in dialogue with contemporary philosophers of mind, psychiatrists and neuroscientists. Moving essentially from Formalism and essays from the same period, this paper provides an outline of a genuine Schelerian philosophy of psychopathology, investigating the close connection between “identity” and “freedom”. Not only did Scheler contribute to phenomenological psychology, but he also took an original (...) approach to psychopathology. From this point of view, it is possible to shed further light on his fruitful cooperation with Kurt Schneider and to understand so-called ‘emotional blindness’ from a new perspective. Within this framework, what emerges is the crucial role, in the formation of certain affective disorders, of the modification of pulsions and tendencies. Insofar as it allows for the development of a Schelerian model of delusion and (self)-deception, this approach also has implications for the debate on delusion in the context of contemporary philosophy of psychiatry. (shrink)

Historical evidence shows that mental symptoms were constructed in a particular historical and cultural context (19th Century alienism). According to the Cambridge model of symptom-formation, mental symptoms are mental acts whereby sufferers configure, by means of cultural templates, information invading their awareness. This information, which can be of biological or semantic origin, is pre-conceptual and pre-linguistic and to be understood and communicated requires formatting and linguistic collocation. Mental symptoms are hybrid objects, that is, blends of inchoate biological or symbolic signals (...) and cultural configurators. "Culture" plays a very deep role in symptom-formation because templates can attenuate or abolish the specificity of the biological signals involved. This means that signals from different brain sites can be configured as the same symptom and signals from the same site as different symptoms. Although always present, the neurobiological substratum is not fundamental in the understanding and management of mental symptoms. These can only be comprehended in relation to the manner of their construction and the cognitive and emotional biographies of each patient. Direct interference with the brain sites involved may dull mental symptoms but is unlikely to offer long-term cure. If the configuratory style and needs of the patient are not understood and dealt with, he is likely to keep re-constituting or replicating his symptoms in relation to other biological signals. In summary, mental symptoms are not passive happenings but genuine mental acts. Hence, the manner and motivation of their construction may be more important than the signal of brain distress that might have provoked them in the first place. (shrink)

This paper deals with a classical issue that remains at the core of the contemporary philosophical debate: the fact that the meaning of life is interlaced—in both negative and positive ways, with respect to morality—with happiness. On some historical conceptions, individual happiness must be sacrificed for the moral (universal, objective) good of a life, where the good fundamentally coincides with the meaning of life. On other approaches, happiness and flourishing (where flourishing is understood in terms of life’s meaningfulness) consist in (...) good action and a good life. On still other views, happiness, while equated with the meaning of life, is reduced to mere pleasure, to a sensorial state that can be influenced by outside forces. In the current literature, the prevailing interpretations of this question are largely deontological, eudaimonic or hedonic in character. Moving from the Schelerian theory of the stratification of the emotional life, and emphasizing the affective side of this broadly ethical question, this paper intends to examine this issue through the lens of phenomenology. From this perspective, the connection between happiness and the meaning not only of life but also of existence can be understood in light of what appears to underlie both phenomena: the entire existence of the individual, which is revealed most clearly in an act of personal love. Since this paper considers the condition humaine in all its complexity, that is to say, even in its fragility and vulnerability, within this framework I will also consider possible abnormal manifestations of happiness. Following Rümke’s clinical observations of pathological frameworks in which the feeling of happiness manifests itself, this paper shows how the deepest feeling of happiness, understood as a Schelerian personality feeling, can remain untouched by pathology. In his classic (but largely unappreciated) enquiry into the happiness syndrome, Rümke engages in a fruitful dialogue with Scheler, whose theory of the stratification of emotional life plays a crucial role in the former’s study of the phenomenology and the clinical aspects of happiness. Not only is Rümke’s Zur Phänomenologie und Klinik des Glücksgefühls an excellent example of applied phenomenology, but it also confirms the results of Scheler’s research on affective life. (shrink)

Sometimes it happens that the same concept is discussed independently but, at the same time, in different disciplinary fields. The recent dominance of neuroscientific research has reintroduced into the experimental realm the importance of the experimental subject’s self-evaluation to be correlated to detectable changes into brain activity. For example, the experimental subjects are instructed to press a button or move a finger when they perceive or feel something, or they fill questionnaires supposed to measure their experience; all these “data” are (...) then statistically correlated to measures of brain functioning. (shrink)

According to the cognitive model of psychopathology, maladaptive beliefs about oneself, others, and the world are the main factors contributing to the development and persistence of various forms of mental suffering. Therefore, the key therapeutic process of Cognitive Behavioral Therapy (CBT)—a therapeutic approach rooted in the cognitive model—is cognitive restructuring, i.e., a process of revision of such maladaptive beliefs. In this paper, I examine the philosophical assumptions underlying CBT and offer theoretical reasons to think that the effectiveness of belief (...) revision in psychotherapy is very limited. This is the case, I argue, because the cognitive model wrongly assumes that our body of beliefs is unified, while it is in fact fragmented. (shrink)

Introduction to The Oxford Handbook of Phenomenological Psychopathology.

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)

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)

Karl Jaspers was the first major author who emphasized empathy as the proper method of the phenomenological approach to human psychopathology (“static understanding”). He divided mental symptoms into subjective and objective ones, stressing the crucial importance of the former. Subjective symptoms are mainly those expressing patients’ emotions as well as those experienced by them and verbally communicated during the diagnostic interview. Whereas the expressive symptoms can be grasped immediately by clinicians, the understanding of the experienced ones is mediated by (...) patients’ verbal communications as re-experienced or actualized in clinicians’ own consciousness. Thus, jaspersian empathic understanding is mediated by two distinct processes: the first is a direct and automatic one, whereas the second is an effortful process of “feeling oneself into other’s condition” or of “immersing oneself in other people’s self-description” which has to be learned by systematic and rigorous training. Both processes provide the core of what Jaspers called “static understanding”. This paper aims to show that Jaspers’ static understanding prefigures two main types of empathy emerging from contemporary scientific research in neuroscience and social psychology, namely “automatic emotional empathy” and “cognitive empathy”. (shrink)

, Looping Effects, the Self, Psychopathology.

This contribution consists of two parts. The first aims to clarify the structure of the nosology of psychopathologies that Kant proposes in the "Versuch über die Krankheiten des Kopfes". Such nosology consists of two series, arranged in ascending order, one relating to the social manifestations of madness, the other to its individual manifestations, which specifically concern the faculties of the soul. We will try to demonstrate the existence of a connection between these two series, and to illustrate how this occurs. (...) The second part of the contribution, on the other hand, intends to question the thesis according to which Kant in his "Versuch" provided a social aetiology of psychopathologies. We will show, in spite of this thesis, how society creates conditions only for the manifestation of these pathologies, and not for their production, which must instead be sought in the body. (shrink)

In this chapter, we explain how Karl Jaspers’ concept of empathy can be expanded by drawing upon the tradition of philosophical phenomenology. In the first section, we offer an account of Jaspers' concepts of empathy and incomprehensibility as he develops them in General Psychopathology and “The Phenomenological Approach in Psychopathology.” In the second section, we survey the recent literature on overcoming Jaspers' notion of incomprehensibility and expanding his concept of empathy. In the third section, we outline the levels (...) of investigation at which phenomenological inquiries into psychopathology may proceed. These levels of human existence are, in descending order of depth, (1) phenomenal experiences, (2) interpretive frameworks, (3) modes of existence, and (4) existentials. In the fourth and final section, we argue that to fully empathically comprehend patients with schizophrenia and other mental disorders, the possibility of alterations at all four levels of existence must be acknowledged. (shrink)

Psychedelic-Assisted Psychotherapy is being investigated as a treatment for a range of psychiatric illnesses. Current research suggests that the kinds of subjective experiences induced by psychedelic compounds play key roles in producing therapeutic outcomes. To date, most knowledge of therapeutic psychedelic experiences are derived from psychometric assessments with scales such as the Mystical Experience Questionnaire. While these approaches are insightful, more nuanced and detailed descriptions of psychedelic-induced changes to subjective experience are required. Drawing on recent advancements in qualitative methods arising (...) from the interdisciplinary field of phenomenological psychopathology, we propose a systematic and comprehensive investigation into how Psychedelic-Assisted Psychotherapy alters subjective experience. This research program aims to characterise the nature of therapeutic psychedelic experiences by drawing on concepts from philosophical phenomenology. Such characterisations should, moreover, contribute to our understanding of the mechanisms of psychedelic therapy, the role of integration therapy, and related philosophical debates. (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)

Delusions have traditionally been considered the hallmark of mental illness, and their conception, diagnosis and treatment raise many of the fundamental conceptual and practical questions of psychopathology. One of these fundamental questions is whether delusions are understandable. In this paper, we propose to consider the question of understandability of delusions from a philosophy of language perspective. For this purpose, we frame the question of how delusions can be understood as a question about the meaning of delusional utterances. Accordingly, we (...) ask: “what meaning(s) can delusional utterances possibly have?”. We argue that in the current literature, there is a standard approach to the meaning of delusional utterances, namely the descriptive account which assumes that a delusional utterance “p” means that p is the case. Drawing on Speech Act Theory, we argue that solely relying on the descriptive account disregards essential ways of how linguistic meaning is constituted. Further, we show that Speech Act Theory can prove a helpful addition to the theoretical and clinical “toolbox” used for attempting to understand delusional utterances. This, we believe, may address some of the theoretical and clinical shortcomings of using only the currently predominant descriptive account. (shrink)