Psychopathology

Con il termine psicoterapia è d'uso riferirsi al trattamento del "disagio" mentale attraverso mezzi psichici, ma l'ovvietà "tautologica" della definizione tende a svanire se si affronta un esame più approfondito dei termini "psiche", "mezzi psichici" e "disagio mentale". Una definizione non può in linea generale che assumere un significato ed un valore limitato nel tempo e nello spazio, ma il sostanziale polimorfismo teorico, metodologico, tecnico e linguistico che contraddistingue la psicoterapia ne rende ancora più ardua una chiara ed univoca definizione. (...) Vi è un sostanziale accordo, che però lascia inalterati i problemi sottostanti, su definizioni che sono sulla stessa linea di quelle ad esempio di Wolberg o di Frank. Wolberg(1) parla di: «trattamento, con mezzi psicologici, di problemi di natura psichica, in cui una persona appositamente qualificata stabilisce deliberatamente una relazione professionale con il paziente con lo scopo di rimuovere, di modificare e di attenuare i sintomi esistenti, di mediare modi di comportamento disturbato e di promuovere la crescita e lo sviluppo positivo della personalità». (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.

Why do thoughts involving harm and damage trigger guilt in certain individuals and not in others? The significance of this question comes into view when considering the medical and psychological literature on patients with obsessive-compulsive disorder (OCD). Patients with OCD feel guilt in response to having certain recurring, negative thoughts whose content evoke scenarios of harm and damage. This, however—at least in most readings of what those thoughts consist of—is puzzling. The transition from having a thought about being the source (...) of harm popping up in one’s mind to feeling guilty is not straightforward, and it calls for explanation. Indeed, OCD appears to challenge a traditional picture of what guilt is all about... (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)

Does the concept of “subject” still have any logical-scientific consistency that could give it some relevance in the contemporary demands of rationality? Or is it rather a kind of fossil of metaphysical speculation that should be completely ruled out? Judging from the course of the history of philosophy, which for nearly 400 years has been devoted to the criticism of the subject’s conception directly deriving from the Cartesian cogito, it is amazing the stimulant power of this phantom that has so (...) productively haunted our thinking throughout the centuries.From a critical and deconstructive perspective of subjectivity and selfhood, neurosciences could be seen as the definitive blow to the “I,” conceived in Cartesian... (shrink)

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Drawing on a conception of scientists and community members as partners in the construction of ethically responsible research practices, this article urges investigators to seek the perspectives of teenagers and parents in evaluating the personal and political costs and benefits of research on adolescent risk behaviors. Content analysis of focus group discussions involving over 100 parents and teenagers from diverse ethnic and socioeconomic backgrounds revealed community opinions regarding the scientific merit, social value, racial bias, and participant and group harms and (...) benefits associated with surveys, informant reports, intervention studies, blood sampling, and genetic research on youth problems. Participant comments highlight new directions for socially responsible research. (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)

In Possibilities of Misidentification, Ashwell contends that the immunity principle developed and defended in my Pathologies of Thought and First Person Authority "doesn't show us anything about introspection or the first person—which should make us wonder whether it really captures that's at stake in discussions of IEM". Ashwell's argument hinges on two claims: IP turns on features that are not unique to introspection, to the first person, or to "subject matter that is thought to have IEM", and IP does not (...) yet capture "the standard claim of IEM for introspective self-attribution". Ashwell thereupon contends that the immunity furnished by IP "might be merely contingent"... (shrink)

Reports of patients with schizophrenia show a fragmented and anomalous subjective experience. This pathological subjective experience, we suggest, can be related to the fact that disembodiment inhibits the possibility of intersubjective experience, and more importantly of common sense. In this paper, we ask how to investigate the anomalous experience both from qualitative and quantitative viewpoints. To our knowledge, few studies have focused on a clinical combination of both first- phenomenological assessment and third-person biological methods, especially for Schizophrenia, or ASD therapeutics (...) and diagnosis. We will thus attempt to bring forward a second-person scientific design, accounting for both the first-person subjective experiential aspects, and respective third-person neurobiological correlates of embodied aesthetics in anomalous experience. From this proposal, we further explore the consequences to clinical and research practice. (shrink)

Schizophrenia is usually described as a fragmentation of subjective experience and the impossibility to engage in meaningful cultural and intersubjective practices. Although the term schizophrenia is less than 100 years old, madness is generally believed to have accompanied mankind through its historical and cultural ontogeny. What does it mean to be “mad”? The failure to adopt social practices or to internalize cultural values of common sense? Despite the vast amount of literature and research, it seems that the study of schizophrenia (...) and of the psychoses is suffering from a generic disintegration. In this introduction, we offer an historical overview of the variety of theories and approaches to schizophrenia. We also provide an overview of how the authors in this volume attempt an integrative account where training, practice, theory and research are considered as parts of a larger whole. This is a varied and pluralistic volume, and it is up to the readers to make use of different chapters according to their own needs. (shrink)

From Minkowski and Jaspers to Blankenburg, phenomenological psychopathology has assumed that lost or diminished experience of ‘realness’ is related to an impairment of tacit level intersubjectivity. This paper develops a theoretical framework for this hypothesis by drawing mainly on the phenomenological tradition and the works of Wittgenstein. The argument, in return, contributes to recent discussions regarding depersonalization and intersubjectivity. In addition, the approach suggests some interesting implications for psychopathology.

In this book we offer a theory of the self, whose core ideas are that the self is a process of self-representing, and this process aims mainly at defending the self-conscious subject against the threat of its metaphysical inconsistence. In other words, the self is essentially a repertoire of psychological manoeuvres whose outcome is a self-representation aimed at coping with the fundamental fragility of the human subject. Our picture of the self differs from both the idealist and the eliminative approaches (...) widely represented in contemporary discussion. Against the idealist approach, we deny that the self is something primitive and logically prior. Rather, we take it to be the result of a process of construction that starts with subpersonal unconscious processes. On the other hand, we also reject the anti-realistic, eliminative argument that, from the non-primary, derivative nature of the self, infers its status as an illusory by-product of real neurobiological events, devoid of any explanatory role. (shrink)

This brief article is concerned with an aspect of Jonathan Glover's book, Alien Landscapes?. After reflecting a little on the book as a whole, the question that is taken up is, ‘Why might a book that seeks to help those without mental disorders understand what they are like “from the inside” be of interest to laymen and practitioners in the criminal law?’. One answer lies in part in the way that ‘what it is like from the inside’ might interact with (...) judgements of criminal responsibility. Taking its cue from examples used by Glover the article considers, and puts pressure on, the ‘dual view’ he proposes: that when dealing with those with mental disorders we should treat them as responsible agents in the sense of not withholding from them Strawson's ‘reactive attitudes’, while nevertheless accepting that their personalities and behaviours are the results of large doses of ‘bad luck’. (shrink)

The mind is not unitary. Despite enduring Cartesian influences, the idea that mental activity is the work of an assortment of processes remains one of the more plausible guiding assumptions of psychological research. Freud endorsed a distinctive variant of this broader explanatory commitment. Beginning with his earlier metapsychological works, he slowly developed a view of the mind as a collection of closely related systems. Famously, these ultimately became known as the id, ego, and super-ego. Like much of Freud’ s work, (...) the structural model was largely based on observation of fractures in the mental edifice resulting from various forms of psychopathology. The etiology of such cases was traced to destructive conflicts between the three central components. But while conflict is indeed definitional of these relations, it need not lead inexorably to the deployment of primitive defenses or to pathological outcomes. Freud described the workings of relatively typical minds in this way, with the constant tension between systems resolvable by way of ongoing negotiation. The model thus aspired to a full explanation of the varieties of mental life. All told, it is probably fair to say that it has had limited influence on psychological research outside the psychoanalytic tradition, although there is continuing interest in its relation to contemporary work in the cognitive sciences, including neuroscience. (shrink)

As a text in use by mental health practitioners, policy makers, and ordinary individuals, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes a variety of mental, psychological, and emotional experiences on a wide spectrum of disorders. Many common experiences are described there as symptoms, chiefly for the purposes of identifying, diagnosing, and treating disorders. “Disorientations” are not (yet) categorized as a stand-alone disorder in the DSM, but involve a cluster of experiences that border on and overlap with experiences (...) already categorized as symptoms of other disorders. Where experiences of disorientation appear in the DSM, they are, for the most part, still understood as .. (shrink)

Section 2 of the 1957 Homicide Act is indefensible: the concept of 'mental responsibility' is a hybrid which turns the psychiatrist witness either into a thirteenth juryman or a spare barrister. But reform does not lie along the lines suggested by the Butler Committee or the Criminal Law Revision Committee. The latter leaves the jury with insufficient guidance; the former returns to the bad eighteenth century policy of treating mental illness not as a factor in determining responsibility but as a (...) status exempting from responsibility. The much criticised McNaughton rules provide a sounder basis for deciding where responsibility should be assigned in criminal cases. (shrink)

Reviews the book, The death of desire. A study in psychopathology by M. Guy Thompson. Thompson has written an amiable book, filled with the spirit of ecumenism. A practising clinical psychologist, his thesis is that desire is the "foundation of the human subject," that it is "located in the heart of the unconscious," that, if once "situated in phenomenology," this unconscious can reveal "the nature of intersubjective relations." Accordingly, pathological phenomena would be attributable to the deadening of this desire—hence, the (...) book's title. Thompson clearly intends a dialogue between phenomenology and psychoanalysis. The result is an attempt at synthesis that takes R. D. Laing on the one hand and Jacques Lacan on the other—two rather strange bedfellows—as his chief sources of inspiration. Taken as a whole, this book's reach outstretches its grasp. It really does not offer a cogent, coherent synthesis of phenomenology and psychoanalysis but seems rather to offer a congenial amalgam of the many insights experienced by a highly intelligent, versatile and sensitive man during the long, fecund years of his training. As such it is endlessly stimulating, if never quite convincing, and offers singular promise for the future work of its author. 2012 APA, all rights reserved). (shrink)

Reviews the book, Hermeneutics and psychological theory: Interpretive perspectives on personality, psychotherapy, and psychopathology edited by S. B. Messer, L. A. Sass, and R. L. Woolfolk. This book is the result of the Second Symposium on Applied Psychology sponsored by the Graduate School of Applied and Professional Psychology of Rutgers University, focussing on the epistemological foundations of psychology. The book operates on several levels simultaneously: theory and research, overview presentations and concrete investigations, clinical and experimental research. It covers a wide (...) spectrum of topics represented by distinguished recognized scholars in each area in personality, psychotherapy, psychopathology, methodological, and it dialogues a variety of theoretical approaches including psychoanalysis, cognitive behaviorism, existentialism, hermeneutic phenomenology, Marxism, social constructionism, and history of ideas. The editors of this book succeed in providing us with a coherent and inviting introduction, and they make many valuable connections with current American psychological work. 2012 APA, all rights reserved). (shrink)

The correlation between psychopathology and hermeneutics has long been at the forefront of philosophic discussion. In recent years a number of thinkers, particularly in France, have advanced the claim that all hermeneutic acts are themselves part of an intrinsic pathology which makes it impossible to arrive at neutral and binding interpretations. The so-called hermeneutics of suspicion has served to undermine those interpretive norms which guided the depth psychology coming out of Freud and Jung. This hermeneutic and semiotic anarchy derives its (...) impetus from a misreading of the nature and scope of a general psychopathology. Rather than locating psychopathology under the more generic analysis of the self and its relation to the various modes of the encompassing, whether these modes pertain to the self or its world, the hermeneutics of suspicion equates psychopathology with the self in all of its dimensions. Any contrast between the authentic or inauthentic, or the normal and the abnormal, is held to impose a form of privileging on the vast fabric of a self which has no center or circumference. The epoch making work of Freud and Jung is distorted and their basic commitment to hermeneutic norms is undermined. This not only represents a profound misreading of the history of depth psychology but stands as a threat to the drive for transcendence which lives at the heart of the human self. 2012 APA, all rights reserved). (shrink)

This paper asks what it means to say that a disorder is a “real” disorder and then considers whether culture-bound syndromes are real disorders. Following J.L. Austin I note that when we ask whether some supposed culture-bound syndrome is a real disorder we should start by specifying what possible alternatives we have in mind. We might be asking whether the reported behaviours genuinely occur, that is, whether the culture-bound syndrome is a genuine phenomenon as opposed to a myth. We might (...) be wondering whether the condition should rightly be considered a disorder, as opposed to some sort of non-disorder condition. We might want to know whether the culture-bound syndrome is really a distinct disorder, in the sense that scientific classification systems should include it as a separate category, or whether it is just a variant of a universally occurring disorder. I argue that some specific difficulties can arise with determining whether a culture-bound syndrome is a real disorder in each of these three senses. However, the frequent assumption that real disorders will necessarily occur universally, and that those that occur only in certain environments are suspicious is not generally justified. (shrink)

The study of pragmatic disorders is of interest to speech-language pathologists who have a professional responsibility to assess and treat communication impairments. However, these disorders, it will be argued in this paper, have a significance beyond the clinical management of clients with communication impairments. Specifically, pragmatic disorders can now make a contribution to the diagnosis of a range of clinical conditions in which communication is adversely affected. These conditions include attention deficit hyperactivity disorder, the autistic spectrum disorders, schizophrenia and the (...) dementias. Pragmatic disorders are already among the criteria used to diagnose some of these conditions, although they are not described in these terms. In other conditions, pragmatic disorders have potential diagnostic value in the absence of reliable biomarkers of these conditions and similar initial presenting symptoms. Using clinical data, and the findings of empirical studies, the case is made for the inclusion and/or greater integration of pragmatic disorders in the formal classificatory systems that are used to diagnose a range of disorders. A previously unrecognised role for pragmatic impairments in the nosology and diagnosis of clinical disorders is thereby established. (shrink)

The dominant philosophical conceptions of obsessive-compulsive behavior present its subject as having a deficiency, usually characterized as volitional, due to which she lacks control and choice in acting. Compulsions (mental or physical) tend to be treated in isolation from the obsessive thoughts that give rise to them. I offer a different picture of compulsive action, one that is, I believe, more faithful to clinical reality. The clue to (most) obsessive-compulsive behavior seems to be the way obsessive thoughts, which are grounded (...) in an irrational cognitive style in matters of risk, danger, and responsibility, motivate compulsions through bizarre means–end reasoning. I show that the patient with obsessive-compulsive disorder (OCD) is not weak and passive with regard to the compulsive act; rather, the act is voluntary and regarded by the patient as an instrument of control. I also defend the idea that OCD-related cognitions are either beliefs or mental states with relevantly similar functional roles. (shrink)

Hübner and White argue that we should not administer DBS to psychopathic prisoners. While we are sympathetic to their conclusion, we argue that the authors’ two central arguments for this conclusion are problematic. Their first argument appeals to an overly restrictive conception of individual medical benefit: namely, that an individual medical benefit must alleviate subjective suffering. We highlight cases that clearly constitute individual medical benefits although there is no relief of subjective suffering. The second argument depends on an overly restrictive (...) conception of the sort of motivation needed to ground consent to a medical procedure. It is also too quick to treat it as unproblematic to consider psychopaths as fully competent. We argue that this view overlooks certain kinds of internal motivation. It also overlooks the possibility that after successful activation of underactive brain-regions, a former psychopath might become a better representative of his or her “true self.” -/- . (shrink)