Can affordances help in understanding psychiatric illness and psychopathological experience? In recent work on the philosophy of psychiatry and phenomenology, the answer appears to be a clear ‘yes’, but some recent worries have emerged that the affordance-concept might be “insufficiently discerning” and thus ill-suited to make sense of psychiatric illness and experience. In this paper I briefly review recent attempts to use the affordance-concept to make sense of psychopathology, as well as the worries voiced by the critics. I argue (...) that much of this criticism is, in fact, best understood as a call for more research and offer some exploratory considerations on how this research might proceed. Specifically, I argue that an improved understanding of the self-referentiality that is inherent to experiencing affordances can be useful for psychiatry. (shrink)

In 1910, Karl Jaspers wrote a seminal essay on morbid jealousy in which he laid the foundation for the psychopathological phenomenology that through his work and the work of Hans Gruhle and Kurt Schneider, among others, would become the ...

From 1959 until 1969, Heidegger lectured to psychiatrists and psychiatry students at the University of Zurich Psychiatric Clinic and in Zollikon. The transcriptions of these lectures were published as the Zollikon Seminars. In these seminars Heidegger is highly critical of psychoanalysis, because of its causal and objectifying approach to the human being. In general, Heidegger considers it an objectification or even an elimination of the human being to approach a patient from a causal perspective. In our view Heidegger has overlooked (...) the peculiar nature and complexity of psychotherapy and psychiatry, namely that psychiatry is not just a discipline that combines a hermeneutical approach and a natural science approach on a theoretical level, but it also deals with psychopathology in practice. We argue, also referring to Strawson and Gadamer, that in psychiatric practice causal explanation and hermeneutic understanding are no mutually exclusive approaches. We conclude that the encounter of philosophy and psychiatry in matters of causality and motivation could be particularly fruitful when the practical situation is addressed, recognizing the special character of psychopathology. (shrink)

Many prisoners in solitary confinement experience adverse psychological and physical effects such as anxiety, paranoia, insomnia, headaches, hallucinations and other perceptual distortions. Psychiatrists call this SHU syndrome, named after the Security Housing Units [SHU] of supermax prisons. While psychiatric accounts of the effects of supermax confinement are important, especially in a legal context, they are insufficient to account for the phenomenological and even ontological harm of solitary confinement. This paper offers a phenomenological analysis of the lived experience of space in (...) supermax confinement by drawing on Merleau-Ponty’s account of intercorporeal depth. I argue that the prolonged deprivation of concrete experiences of spatial depth in a shared world is a form of violence against the relational structure of embodied (inter)subjectivity, and that it threatens to undermine the prisoner’s capacity for a meaningful relation to the world, to others, and even to herself. Nevertheless, some prisoners have developed strategies for resisting this psychopathology of space. (shrink)

The phenomenological approach to schizophrenia has undergone something of a renaissance in Anglophone psychiatry in recent years. There has been a proliferation of works that focus on the nature of subjectivity in schizophrenia and related disorders, and that take inspiration from the work of such German and French philosophers as Husserl, Heidegger, and Merleau-Ponty, and such classical psychiatrists as Minkowski, Blankenburg, and Binswanger (Rulf 2003; Sass 2001a, 2001b). This trend includes predominantly theoretical articles, which typically incorporate clinical material as well (...) as reviews of empirical and experimental findings in psychopathology. Some very recent examples (since 2000) are studies of .. (shrink)

According to the "enactive" approach in philosophy of mind and cognitive science, mental states are neither identical with, nor reducible to, brain activity. Rather, the mind is enacted or brought forth by the whole situated living organism in virtue of its specific structure and organization. Although increasingly influential in cognitive science, the enactive approach has had little to do with psychopathology so far. This chapter first outlines this approach in some detail, and then illustrates its conceptual and methodological connections (...) to psychopathology. It also provides some indications on how to develop a more explicitly "enactive psychopathology.". (shrink)

It is argued that philosophers can contribute indirectly to the cure of psychopathology by helping to resolve problems that impede the development of effective treatments. Two such problems are discussed. The first arises because different schools of therapy use conflicting criteria in evaluating therapeutic outcomes. A theory of Defective Desires is developed to deal with this problem. The second issue, which divides the field of psychotherapy, concerns the need for experiments, especially in validating claims of therapeutic efficacy. An epistemological (...) foundation is developed to support the need for experiments. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.4 (2003) 361-367 [Access article in PDF] Psychopathology and Two Kinds of Narrative Account of the Self Tim Thornton Keywords self, narrative, reductionism, embodiment, Dennett, Strawson, McDowell The self plays an important role in psycho pathology. Conditions such as dementia raise the question of how much loss of memory and awareness there can be before there is, if ever, also a loss of the (...) self. Syndromes such as Dissociative Identity Disorder (DID) or Multiple Personality Disorder (MPD) raise the possibility of a fragmentation of one self into a number of selves. Depersonalization disorder suggests a kind of diminution both of the sense of self and the reality of the world. Symptoms such as thought insertion suggest a different kind of fragmentation of the coherence of thought within a self.At the same time there is something prima facie paradoxical about the very idea of the fragmentation or loss of self. It seems to be one thing for a self to suffer loss, quite another to think of the self as being lost. Although the experiences or beliefs had or entertained by a self might be disordered or chaotic, how can a self be anything other than whole and seem real and whole to itself?The narrative approach to the self looks like a tool purpose built to shed light on some aspects of psychopathology. The papers in this issue have examined its application to four revealing case histories and questioned its effectiveness in accounting for features of psychopathology. But in this short note I wish to stand back from the particular cases discussed in previous papers and to shed light on the general approach by setting out two contrasting versions of it. Crudely put, the first forges a connection between the concepts of self and personality; the second between the concepts of self and person. I will use the contrast between these two to draw some general lessons for the philosophy of psychopathology. Dennett's Austere Narrative Account I will start with Dennett's influential version of a narrative account of the self. His central idea is that the very idea of a self should be understood as dependent on a particular kind of interpretative strategy. Roughly, this contrasts with the idea that it is a more basic datum calling out for notice prior to adopting a specific theoretical perspective.Dennett suggests an analogy with centers of gravity both to outline the consequences of this view for the reality of selves, and the connection between the self and the interpretative strategy involved. [End Page 361] A center of gravity is just an abstractum. It's just a fictional object. But when I say it's a fictional object, I do not mean to disparage it; it's a wonderful fictional object, and it has a perfectly legitimate place within serious, sober, echt physical science. (Dennett 1992) The concept of a center of gravity is deployed within a branch of physics to describe and predict the behavior of physical systems acting under physical forces. It is the theoretical context that determines the nature of centers of gravity; at the same time, they contribute to that broader context. Dennett stresses that they are abstract or calculation-bound theoretical objects to contrast with objects that are also theoretically posited but causally interactive, such as microphysical particles (Dennett 1987, 53).Dennett has also used the analogy with abstracta to account for mental states such as beliefs, desires, and other propositional attitudes, which he suggests are ascribed using a particular interpretative strategy: the "Intentional Stance" (Dennett 1987, 13-42). The suggestion is that by showing the necessity of adopting that stance to make sense of human behavior he can defend a form of objectivity about mental states even while rejecting the industrial-strength realism that requires identifying mental states with physical, and thus causally interactive, internal states.Selves are given similar treatment. Like centers of gravity or mental states, they are theoretical, even fictional, entities articulated within an interpretative theoretical stance: A self is also an abstract object, a theorist's fiction... (shrink)

Memoirs and autobiographical accounts of mental illness have been widely utilized in phenomenological psychopathology and, in particular, in the investigation of depression (Fuchs 2013; Ratcliffe 2010; Ratcliffe 2015), mania (Binswanger 1960; Bowden 2013), schizophrenia (Binswanger 1957; Parnas and Henriksen 2016; Sass 1994), anorexia nervosa (Bowden 2012; Legrand 2010), and borderline personality disorder (Stanghellini and Rosfort 2013). In this article I will provide a critical illustration of the different ways in which self- narratives have been employed in this context and (...) I will advance some suggestions as to how the use of life stories could further enhance the phenomenological understanding of mental illness and the therapeutic process. (shrink)

General psychopathology and cognition are likely to have a bidirectional influence on each other. Yet, the relationship between brain structure, psychopathology, and cognition remains unclear. This brief report investigates the association between structural properties of the cerebral cortex [surface area, cortical thickness, intracortical myelination indexed by the T1w/T2w ratio, and neurite density assessed by restriction spectrum imaging (RSI)] with general psychopathology and cognition in a sample of children from the Adolescent Brain Cognitive Development (ABCD) study. Higher levels (...) of psychopathology and lower levels of cognitive ability were associated with a smaller cortical surface area. Inter-regionally—across the cerebral cortex—the strength of association between an area and psychopathology is strongly correlated with the strength of association between an area and cognition. Taken together, structural deviations particularly observed in the cortical surface area influence both psychopathology and cognition. (shrink)

Accounts of mental disorders focusing either on the brain as neurophysiological substrate or on systematic connections between symptoms are insufficient to account for the multifactorial nature of mental illnesses. Recently, multiplexes have been suggested to provide a holistic view of psychopathology that integrates data from different factors, at different scales, or across time. Intuitively, these multi-layered network structures present quite appealing models of mental disorders that can be constructed by powerful computational machinery based on increasing amounts of real-world data. (...) In this paper, I systematically examine what challenges psychopathology models face and to what extent different species of psychopathology models can address them. My analysis highlights that while multiplexes, as they are usually conceived, appear promising, they suffer from the same problems as other approaches. To remedy this, I suggest, we must go a step further and combine different kinds of multiplexes into 4D models. Once we embrace 4D multiplexes and identify appropriate ways to constrain them, we might unlock the true potential of multiplexes for making headway in psychopathology research. (shrink)

It is important for a field to occasionally take stock of where it is, which Annemarie Köhne has done with her exploration of different frames of thought on psychopathology currently in play. As an advocate for thinking of psychiatric constructs as practical kinds that are often calibrated to serve different, even competing purposes, I am in agreement with her concerns about relying on a one-size-fits-all model. Between her and I there are slight differences of emphasis with respect to essentialism (...) and the role and scope of symptom-based descriptive psychopathology. In what follows I explicate these differences.Köhne competently elucidates how a categorical, disease-based model of disorder... (shrink)

This article examines the role of time as a methodological tool and pathological focus of clinical psychiatry and psychology in the first half of the 20th century. Contextualizing ‘psychopathologies of time’ developed by practitioners in Europe and North America with reference to the temporal theories implicit in Freudian psychoanalysis and Henri Bergson’s philosophy of durée, it illuminates how depression, schizophrenia, and other mental disorders such as obsessive-compulsive behaviours and aphasia were understood to be symptomatic of an altered or disturbed ‘time-sense’. (...) Drawing upon a model of temporal synthesis whereby in healthy individuals, a subjective temporal sense ( Ichzeit, durée, or personal lifetime) was perceived and understood in relation to objective time frameworks ( Weltzeit, clock-time, or quantitative time models like historical chronology), clinicians argued that mentally ill patients were unable to synthesize Ichzeit and Weltzeit, using variations in this disturbance to define specific pathological conditions. (shrink)

Recently Kenneth Kendler and Peter Zachar have raised doubts about the correspondence theory of truth and scientific realism in psychopathology. They argue that coherentist or pragmatist approaches to truth are better suited for understanding the reality of psychiatric disorders. In this article, I show that rejecting realism based on the correspondence theory is deeply problematic: It makes psychopathology categorically different from other sciences, and results in an implausible view of scientific discovery and progress. As an alternative, I suggest (...) a robustness-based approach that can accommodate the significance of coherence and pragmatic factors without rejecting scientific realism and the correspondence theory of truth. (shrink)

Psychiatric literature about when instances of voice hearing should be regarded as religiously inflected psychopathology and when they should be regarded as religious experiences sometimes presupposes that a person’s experience can only be either psychopathological, or else a genuine religious experience. In this paper I will consider an alternative: the possibility of a both–and account. A both–and account might involve the idea that a religious experience causes psychopathology, or is psychopathology, or that people open to religious experiences (...) may also be susceptible to psychopathology. After arguing that these are either problematic or under-evidenced, I will argue for another version of a both–and account: that genuine religious experience can arise out of situations involving psychopathology. I will also point to some of the clinical and pastoral implications of my view. (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)

_Psychopathology at School_ provides a timely response to concerns about the rising numbers of children whose behaviour is recognised and understood as a medicalised condition, rather than simply as poor behaviour caused by other factors. It is the first scholarly analysis of psychopathology which draws on the philosophers Foucault, Deleuze, Guattari and Arendt to examine the processes whereby children’s behaviour is pathologised. The heightened attention to mental disorders is contrasted with education practices in the early and mid-to-late twentieth century, (...) and the emergence of a new conceptualization of childhood is explored. Taking education as a central component to the contemporary experience of growing up, the book charts the ways in which mental disorders have become commonplace in childhood and youth, from birth through to college and university, but also offers examples of where professionals have refused to pathologise children’s behaviour. The book examines the extent of the influence of psychopathology on the lives of children and young people, as well as the practices that infiltrate education and the possibilities for alternative educational responses that negate the diagnosis of mental disorder. Psychopathology at School is a must read for anyone concerned about the growing influence of psychopathology in education and will be of particular interest to educated readers and to scholars, students and professionals in education, psychiatry, psychology, child studies, youth studies, nursing, social work and sociology. (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)

Phenomenological Psychopathology: Who, What and How? An analysis of key figures, advancements and challenges 2024, Frontiers in Psychology - Special Issue Ed. by S. Ferrarello, F. Brencio, V. Bizzari, M. Englander.

The psychopathological profile of patients with medication overuse headache appears to be particularly complex. To better define it, we evaluated their performance on a targeted psychological profile assessment. We designed a case-control study comparing MOH patients and matched healthy controls. Headache frequency, drug consumption, HIT-6, and MIDAS scores were recorded. All participants filled in the following questionnaires: Beck Depression Inventory-II Edition, trait subtest of State-Trait Anxiety Inventory, Difficulties in Emotion Regulation Scale, Barratt Impulsiveness Scale, Toronto Alexithymia Scale. The primary endpoint (...) was to establish if MOH patients have an altered psychopathological profile. The secondary endpoint was to establish whether the worst profile correlates with the worsening of headache and disability measures. We enrolled 48 consecutive MOH patients and 48 HC. MOH patients showed greater difficulty in recognition/regulation of emotions, depression, anxiety, and impulsiveness. We found a positive correlation among DERS, BDI-2, STAI-Y, and BIS scores and MIDAS and HIT-6 scores and among DERS and headache frequency and drug consumption. MOH patients showed a high rate of emotion regulation difficulties, depression, and anxiety, which may negatively affect their headaches. The ability to regulate/recognize emotions may play a central role in sustaining medication overuse. (shrink)

A benchmark volume for an emerging field where mental disorders serve as the springboard for philosophical insights.

In this paper I wish to address the question of the nature of psychopathology. It might naturally be felt that we already know a great deal about psychopathology, and thus that such a paper would be primarily a review and discussion of the literature; I will argue, however, that the most fundamental form of the question concerning the nature of psychopathology is rarely posed in the literature, that it is prevented from being posed by presuppositions inherent in (...) standard theoretical approaches, and that, on those rare occasions when it does get addressed, it has received inadequate answers. Therefore, the paper will have more of the character of a conceptual explication and theoretical exegesis than it will of a review of the literature. (shrink)

The boundary between spiritual experience and mental disorder remains unclear and should invite collaboration between psychiatry and other disciplines, including theology. Jackson and Fulford (1997), using the tools of analytic philosophy, have proposed a model allowing principled differentiation between spiritual experience and psychotic symptoms based on the personal values of the subject, a cognitive problem-solving model. Spiritual experience is described as positively evaluated psychotic experience, which enables the subject to do more than he or she normally does. In the present (...) paper, it is claimed that values and actions cannot alone always discriminate between religious experience and psychopathology. With reference to three case studies, drawn from the practice of one of us, it is argued that spirituality is not all about experience and that it cannot be understood without reference to the subject's personal history and spiritual tradition, however implicit or fragmented. This approach would allow an account of ordinary religious experience in those who have suffered ego disablement during mental illness. Drawing primarily on the Christian tradition, we argue that the use of theological criteria may allow levels of discrimination between spiritual experience and mental disorder not allowed for by philosophical psychopathology. (shrink)

Some psychopathologic experiences have as one of their structural aspects the experience of restructured temporality. The general argument is that one of the universal microstructures of experience, namely, lived time offers a particular perspective relevant to certain psychopathologic experiences. Lived time is connected with the experience of the embodied human subject as being driven and directed towards the world in terms of bodily potentiality and capability. The dialectical relationship between the embodied human subject and the world results in a sense (...) of lived time (personal time), a lived time that is intimately synchronized with the time of others (intersubjective time). Some experiences of acute suffering, and in particular acute melancholic suffering, can dramatically alter the temporal microstructure of experience to the extent that personal lived time becomes disordered. Normally, past and future withdraw on their own according with their nature of "not being." The future is characterized as openness to change and movement. The absence of this openness is the closing of the future; without this openness, the future appears static and deterministic. When the future is experienced as static, then one longer has the possibility of "things getting better," nor does one have any possibility of relinquishing or escaping from the past because a static future does not allow openness to change and movement. In short, both past and future become static. With the presence of melancholic suffering and the absence of temporal movement, a sense of hopelessness may arise in the individual because suffering without temporal movement becomes, from the sufferer's perspective, eternal suffering. (shrink)

When philosophers want an example of a person who lacks the ability to do otherwise, they turn to psychopathology. Addicts, agoraphobics, kleptomaniacs, neurotics, obsessives, and even psychopathic serial murderers, are all purportedly subject to irresistible desires that compel the person to act: no alternative possibility is supposed to exist. I argue that this conception of psychopathology is false and offer an empirically and clinically informed understanding of disorders of agency which preserves the ability to do otherwise. First, I (...) appeal to standard clinical treatment for disorders of agency and argue that it undermines this conception of psychopathology. Second, I offer a detailed discussion of addiction, where our knowledge of the neurobiological mechanisms underpinning the disorder is relatively advanced. I argue that neurobiology notwithstanding, addiction is not a form of compulsion and I explain how addiction can impair behavioural control without extinguishing it. Third, I step back from addiction, and briefly sketch what the philosophical landscape more generally looks like without psychopathological compulsion: we lose our standard purported real-world example of psychologically determined action. I conclude by reflecting on the centrality of choice and free will to our concept of action, and their potency within clinical treatment for disorders of agency. (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)

Metaphysical realism about mental disorder is the thesis that mental disorder exists mind-independently. There are two ways to challenge metaphysical realism about mental disorder. The first is by denying that mental disorder exists. The second is by denying that mental disorder exists mind-independently. Or, differently put, by arguing that mental disorder is mind-dependent. The aim of this paper is three-fold: (a) to examine three ways in which mental disorder can be said to be mind-dependent (namely, by being causally dependent on (...) the human mind, by being weakly dependent on human attitudes, and by being strongly dependent on human attitudes), (b) to clarify their differences, and (c) to discuss their implications regarding metaphysical realism about mental disorder. I argue that mental disorder being mind-dependent in the first two senses is compatible with metaphysical realism about mental disorder, whereas mental disorder being mind-dependent in the third sense is not. (shrink)

In this article, we investigate how distressing background feelings can be subject to social injustice. We define background feelings as enduring feeling states that condition our perceptions of everyday situations, interpersonal dynamics, and the broader social milieu. While phenomenological psychopathology has long addressed such affective phenomena, including anxiety, guilt, and feelings of not belonging, the intersection with social injustice remains largely unexplored within the framework. To address this gap, we introduce the concept of existential injustice into phenomenological psychopathology. (...) Existential injustice pertains to the unjust formation, perpetuation, and treatment of background feelings. We contend that distressing alterations in these feeling states can stem from, or be perpetuated by, unjust social structures and practices. Existential injustice manifests as a felt inadequacy of one’s background feelings, reflecting broader societal disparities and inequities. Drawing on themes from social psychiatry, we illustrate the utility and explanatory power of the concept through two concrete examples. By shedding light on the ways in which societal dynamics shape distressing affective experiences our analysis underscores the importance of integrating aspects of social injustice into the study of affective phenomena in phenomenological psychopathology. (shrink)

Many psychopathological disorders – clinical depression, borderline personality disorder, schizophrenia and autistic spectrum disorder (ASD) – are commonly classified as disorders of the self. In an intuitive sense this sort of classification is unproblematic. There can be no doubt that such disorders make a difference to one’s ability to form and maintain a coherent sense of oneself in various ways. However, any theoretically rigourous attempt to show that they relate to underlying problems with say, such things as minimal selves or, (...) even, so-called narrative selves – where these latter constructs are invoked to do genuine explanatory work – would require, inter alia, philosophical clarification of what it is that one is precisely committed to in talking of such things (if things they be). It would also require justification for believing in selves of these various kinds. I have elsewhere put on record some of my worries about proposed justifications for believing in minimal selves (Hutto 2008b). But – lest I be accused of favouritism – it should be noted that I also have concerns about the very idea of narrative selves. Several authors have made strong claims about the role of narratives in self constitution (e.g. Dennett 1991, Flanagan 1996, Schechtman 1996). Under standard interpretations these proposals are ambiguous, underdeveloped in key respects, embed obvious tensions or generate puzzles. For these reasons I think we should be cautious of lax talk of selves that are woven from narrative cloth. This is not to say that I agree with Strawson (2004) that adopting a narrative perspective might not be essential for being a self (or at least being a self of a certain sort – even an ethically interesting sort).1 It is rather that I think that before we get around to assessing such claims we need a better understanding of just what we are committed to in talking of selves in general. This is a major philosophical programme, and not one with which I will attempt to engage in this paper – not even in passing.. (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 article analyzes the problems of diagnostic and psychotherapeutic use of AI in the field of mental health. The problem of the paradigmatic foundations of programming an AI algorithm, the problem of the quality of Big Data on the basis of which AI is trained, the problem of eliminating human-AI differences in psychiatric discourse, as well as the key importance of subjectivity in psychotherapy are considered. The prospects for studying the differences between intersubjective contact and subject-AI contact, the problem of (...) the impact of AI on the subject and the ability of the subject to recognize the imitation of subjectivity are also outlined. (shrink)

In his account of phenomenological psychopathology, Karl Jaspers advocates for the central role of subjective experience, something which he maintains cannot be accessed through intellectual effort, but through “empathic understanding” alone. In contradistinction to Jaspers’ account, I propose that phenomenology, as a process of inquiry and investigation, is fundamentally epistemological. Accordingly, I offer an intellectual virtue characterization of phenomenological psychopathology, using open-mindedness to illustrate the close conceptual links between the phenomenological endeavor and the intellectual virtues. By introducing the (...) intellectual virtue lexicon into the phenomenological psychopathology discourse, I then offer three preliminary recommendations for the training and education of phenomenological clinicians. Centering the educational recommendations on the psychiatric interview, I suggest that good questioning, listening, and reflecting necessarily require cultivation for intellectually virtuous phenomenological inquiry. (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)

Those who turn to phenomenological psychopathology as an answer to problems in psychiatric healthcare may find a philosophical tradition rooted in the early-mid 20th century that has done little to adapt to modern ideas in psychiatric healthcare and psychiatric research. The Renewing Phenomenological Psychopathology project, funded by the Wellcome Trust and led by Professor Matthew Broome and Professor Giovanni Stanghellini, calls for reflection, revitalization and reconstruction of this discipline, diversifying global scholarship and working with lived experience scholars, so (...) that it can pave new paths in psychiatric understanding. The contributions of the current special issue aim to breathe new life into a vital method in psychopathology and to chart its future trajectory. (shrink)

Psychopathology has two styles. On the one hand, a tradition of phenomenological inquiry, associated in particular with the work of Karl Jaspers, that may be considered as the continental way of approaching psychopathology. On the other hand, an empirical approach more associated with the English-speaking world, which emphasizes the need for objectivity of measurement, and is as close as psychiatry gets to dustbowl empiricism. Stanghellini’s book, Disembodied Spirits and Deanimated Bodies (2004), is undoubtedly in the first tradition. It (...) is part of the growing International Perspectives in Philosophy and Psychiatry series, the success of which suggests some recognition that much of importance in .. (shrink)

Abstract:This article brings together considerations from philosophical work on standpoint epistemology, feminist philosophy of science, and epistemic injustice to examine a particular problem facing contemporary psychiatry: the conflict between the conceptual resources of psychiatric medicine and alternative conceptualizations like those of the neurodiversity movement and psychiatric abolitionism. I argue that resistance to fully considering such alternative conceptualizations in processes such as the revision of the Diagnostic and Statistical Manual of Mental Disorders emerges in part from a particular form of epistemic (...) injustice (hermeneutical ignorance) leveled against a particular social group (which I call the "psychopathologized"). Further, insofar as the objectivity which psychiatry should aspire to is a kind of "social objectivity" which requires incorporation of various normative perspectives, this particular form of epistemic injustice threatens to undermine its scientific objectivity. Although many questions regarding implementation remain, this implies that psychiatry must grapple substantively with radical reconceptualizations of its domain if it is to achieve legitimate scientific objectivity. (shrink)

Focusing on four cases presented by Lloyd Wells, M.D., this paper addresses the relationship of clinical psychopathology to the philosophical concept of narrative identity. The paper begins with a review of the debate among historians, literary critics, and philosophers over the referential status of narrative identity, that is, whether the narrative self is a fictive structure unrelated to lived life or whether ordinary life is in fact lived narratively. Agreeing with those philosophers who argue for the reference of narrative (...) identity to actual life, the author analyzes the four cases from the perspective of narrative identity to determine what light this philosophical concept sheds on the various psychopathologies. Then, having used the philosophical concept to illuminate psychopathology, he reverses direction and questions what psychopathology has to offer philosophy and its notion of narrative identity. The author argues both that the philosophical concept of narrative identity contributes to our understanding of psychopathology and that psychopathology offers challenges to the philosophical notion of narrative identity. (shrink)

It is well established by psychopathological research that disorders of self-experience are among the main features of schizophrenic prodromes in a pathogenetic sense. Disorders of the phenomenal self, as "lack of ipseity" (the vanishing of the feeling of being embedded in oneself and of distinctiveness between the self and the outer world) and "hyper-reflexivity" (the monitoring of one's own life entailing the tendency to objectify parts of one's own self in an outer space) are considered key phenomena of schizophrenic vulnerability. (...) In this paper, I argue that the analyses of the disorders of phenomenal self catch only some dimensions of schizophrenic vulnerability, since they mainly focus on the pathological changes in subjective experience of an isolated self and disregard the fact that the self is not purely personal. Because our existence is fundamentally tied to a social existence, the feeling of one's own self and the sense of "reality" of an experience are products of intersubjectivity and not only a private process based on introspection or reflexivity in which one is engaged in an idiosyncratic way. Building on, and extending, contributions of the phenomenological tradition, I attempt to demonstrate that intuitive attunement is the basic prerequisite for establishing one's sense of "reality" (feeling familiarly related to one's environment) and for establishing one's sense of "ipseity" (the sense of existing as a subject of awareness). In the last part of the paper, I show the importance of the concepts "lack of attunement" and "antagonomia" (the rejection of conventional knowledge and intuitive attunement, experienced as dangerous sources of loss of individuality) to establish a comprehensive theory of schizophrenic vulnerability. I finally discuss the implications of this view for empirical research and clinical management of schizophrenic vulnerability. (shrink)

Psychopathology is the study of the signs and symptoms of psychiatric disorders - delusions, hallucinations, phobias, depression, for example. This book gives an account of the terms currently in use and attempts an in-depth analysis of the nature of each. The matter is examined both from a philosophical perspective and from the point of view of what is known about the function of the hemispheres of the brain.

Intersubjectivity impairment has been considered the main pathogenic nucleus of schizophrenia. Enriching this concept with references to Scheler’s phenomenology, our hypothesis is that schizophrenic subjects are affected by a deeper impairment: the inability to resonate with unipathic affectivity. Fragmentation of the Leibschema, valueception impairment, and the lack of vital impulse are, in our hypothesis, the original alterations of the schizophrenic bodily experience from which all relational impairments originate. Our proposal is, therefore, to enhance a psychotherapy that does not only focus (...) on the verbal level, but endeavors to touch the patient’s Leib, focusing on emotional sharing and on the development of a sense of cohesion of one’s body as the starting point for accessing intersubjectivity. (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)