Psychopathology

This book explores how the human mind works through the lens of psychological disorders, challenging many existing theoretical constructs, especially in the fields of psychology, psychiatry and philosophy of mind. Drawing on the expertise of leading academics, the book discusses how psychopathology can be used to inform our understanding of the human mind. The book argues that studying mental disorders can deepen the understanding of psychological mechanisms such as reasoning, emotions, and beliefs alongside fundamental philosophical questions, including the nature of (...) the self, the universal aspects of morality, and the role of rationality and normativity in human nature. By crossing different domains, this book offers a fresh perspective on the human mind based on the dialogue between philosophy, cognitive science and clinical psychology. Mental disorders discussed include schizophrenia, anxiety disorders, major depression, obsessive-compulsive disorder, post-traumatic stress disorder and paranoia. This book caters to the increasing interest in interdisciplinary approach to solving some of the problems in psychopathology. Since this book treats psychological engagement with empirically informed philosophy of mind, this book is essential reading for students and researchers of cognitive psychology, clinical psychology, and philosophy, as well as being of interest to clinicians and psychiatrists. (shrink)

This book is based on a congress evaluating Jaspers' basic psychopathological concepts and their anthropological roots in light of modern research paradigms. It provides a definition of delusion, his concept of "limit situation" so much challenged by trauma research, and his methodological debate. We are approaching the anniversary of Jaspers seminal work General Psychopathology in 1913. The Centre of Psychosocial Medicine of the University with its Psychiatric Hospital where Jaspers wrote this influential volume as a 29 year old clinical assistant (...) hosted a number of international experts familiar with his psychiatric and philosophical work. This fruitful interdisciplinary discussion seems particularly important in light of the renewed interest in Jaspers’ work, which will presumably increase towards the anniversary year 2013. This volume is unique in bringing together the knowledge of leading international scholars and combining three dimensions of investigation that are necessary to understand Jaspers in light of contemporary questions: history, methodology and application. (shrink)

Over the last decades, childhood maltreatment has emerged as a major risk factor for the development and maintenance of transdiagnostic psychopathology. Notably, higher prevalence rates of maltreatment have been found for nearly all mental disorders, with particularly high numbers for post-traumatic stress disorder, depression, borderline personality disorder and anxiety disorders. Furthermore, childhood maltreatment has been associated with an earlier onset of mental disorders, a more severe and chronic course of disease as well as reduced rates of psychological treatment benefit. However, (...) the pathways that underlie this relationship are still unknown. It has been shown that various factors, for example biological alterations, play a role in the relationship between childhood maltreatment and mental disorders. Research investigating the influence of psychological factors, such as emotional reactivity and emotional regulation, attachment or post-traumatic stress symptoms is rare. These investigations are highly relevant in order to identify potential targets for psychological interventions. First approaches in this line of research examine specific transdiagnostic treatments for early traumatization, such as Imagery Rescripting. However, as childhood maltreatment is suspected to be associated with a broad array of mental disorders, it might not be explained by a single underlying mechanism. Instead, multiple pathways are probable to mediate the relationship between childhood maltreatment and transdiagnostic psychopathology. Therefore, the major aim of this thesis is to make a first step in filling this research gap by investigating the underlying psychological mechanisms between childhood maltreatment and psychopathology in clinical studies. Studies I and II were conducted with a clinical sample of patients with obsessive compulsive disorder. Preliminary research, though limited by small sample sizes and inconsistent findings, showed that childhood maltreatment might play a role in OCD. In order to replicate and expand on these findings we aimed to examine the association of childhood maltreatment and OCD more closely. Study I primarily examined the subtypes of childhood maltreatment influencing OCD and additionally the impact of childhood maltreatment on the success of psychological OCD treatment. We found three main results: First, increased prevalence rates of childhood maltreatment among our OCD patient sample in comparison to a general German population sample. Second, childhood maltreatment severity was related to greater OCD symptom severity, with the most robust relationship for the maltreatment subtype of emotional abuse. Third, individuals with higher levels of childhood maltreatment reported greater OCD symptoms at pre-treatment, post-treatment, and 6 months after their inpatient stay, compared to patients without maltreatment experiences. However, in contradiction of our hypothesis, childhood maltreatment did not influenced treatment benefit. Based on the findings, study II aimed to examine the underlying mechanisms of the detected association between childhood maltreatment and OCD symptoms. Potential mediating factors were chosen based on the following criteria: evidence for association with childhood maltreatment, evidence for association with OCD, and existing plausible theoretical explanation for this mediator as an underlying mechanism. Therefore, we predicted that, emotion regulation difficulties, rumination, an insecure attachment style, dissociation, and post-traumatic stress symptoms are potential mediators between the association of childhood maltreatment and OCD symptom severity. In line with our hypotheses, these factors all mediated the relationship between childhood maltreatment and OCD symptom severity. However, regarding insecure attachment styles, the subtype of avoidant attachment was not linked to either childhood maltreatment or OCD symptom severity, suggesting that in OCD an anxious attachment is more prominent. Study III investigated the specific role of emotional reactivity as an underlying mechanism between childhood maltreatment and major depression in a clinical sample of patients with major depression. Whereas in the literature for major depression the findings regarding heightened emotional reactivity are inconsistent, childhood maltreatment was widely associated with increased emotional reactivity. We therefore hypothesized that the severity of childhood maltreatment is related to higher emotional reactivity among depressive patients. Hence, self-reported and physiological emotional reactivity was measured while presenting audio recordings with neutral, negative and individualized childhood trauma-related scripts. In line with our hypothesis, depressive patients with higher levels of childhood maltreatment reported heightened emotional reactivity to the childhood trauma-related script and the negative script compared to the neutral script. In particular, they rated the negative script as more aversive and distressing. Additionally, they showed more re-experiencing and dissociation experiences in response to the negative script. Equally, the trauma-related script was perceived as more aversive and distressing. Furthermore, it resulted in greater levels of arousal and showed more avoidance as an emotional regulation strategy. In contrast to our hypothesis, no effect of childhood maltreatment on physiological responsiveness emerged. Overall, there is a growing body of literature showing that childhood maltreatment is a transdiagnostic risk factor for various mental disorders. However, few researchers have addressed the question of how this early vulnerability to psychopathology develops and persists. This thesis aimed to expand on current knowledge of the underlying pathways of the relationship between childhood maltreatment and psychopathology in two different mental disorders. The study findings presented in this thesis provide first evidence that heightened emotional reactivity and difficulties in emotion regulation, together with rumination might play a role. Moreover, post-traumatic stress symptoms, even those deemed subclinical, such as hyperarousal, avoidance and dissociative symptoms might be mediating factors between childhood maltreatment and transdiagnostic psychopathology. Since we found indications that re-experience might also play a role in mediating this relationship, future work will concentrate on exploring this factor in more detail. Additionally, further work is needed to investigate the cause of high divergence between self-report emotional reactivity and psychophysiological reactivity. From a methodological perspective, problems in assessing childhood maltreatment retrospectively with the childhood trauma questionnaire will be discussed. Moreover, implications for a theoretical transdiagnostic model and methodological approaches, as well as directions for future research on the underlying pathways of childhood maltreatment and psychopathology are outlined. (shrink)

Introduction to The Oxford Handbook of Phenomenological Psychopathology.

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)

Naturalistic accounts of mental disorder aim to identify an objective basis for attributions of mental disorder. This goal is important for demarcating genuine mental disorders from artificial or socially constructed disorders. The articulation of a demarcation criterion provides a means for assuring that attributions of 'mental disorder' are not merely pathologizing different forms of social deviance. The most influential naturalistic and hybrid definitions of mental disorder identify biological dysfunction as the objective basis of mental disorders: genuine mental...

Research in psychopathology is booming in an unprecedented way, at least, in terms of increasing number of publications. Yet, a few questions arise: Does quantity also give us quality? Are the collected data generally of sound quality? How are data typically collected in psychopathology? Are the applied methods of data collection appropriate for this particular field of study? This article explores three different methods of data collection in psychopathology, namely self-rating scales, structured interviews, and semi-structured, phenomenological interviews. To identify the (...) most adequate methodological approach, we first establish the nature of the object of psychopathology and then we critically assess each method’s appropriateness to this field of study. We emphasize fundamental issues that make self-rating scales and structured interviews unfit for the task of adequately examining psychopathology. By contrast, we propose that a semi-structured, phenomenological interview presents a more appropriate method. Finally, we describe two types of semi-structured, phenomenological interviews that can be applied to assess and explore psychopathology, respectively. (shrink)

This paper clarifies Merleau-Ponty’s original account of “higher-order” cognition as fundamentally embodied and enacted. Merleau-Ponty’s philosophy inspired theories that deemphasize overlaps between conceptual knowledge and motor intentionality or, on the contrary, focus exclusively on abstract thought. In contrast, this paper explores the link between Merleau-Ponty’s account of motor intentionality and his interpretations of our capacity to understand and interact productively with cultural symbolic systems. I develop my interpretation based on Merleau-Ponty’s analysis of two neuropathological modifications of motor intentionality, the case (...) of the brain-injured war veteran Schneider, and a neurological disorder known as Gerstmann’s syndrome. Building on my analysis of Schneider’s sensorimotor compensatory performances in relation to his limitations in the domains of algebra, geometry, and language usage, I demonstrate a strong continuity between the sense of embodiment and enaction at all these levels. Based on Merleau-Ponty’s interpretations, I argue that “higher-order” cognition is impaired in Schneider insofar as his injury limits his sensorimotor capacity to dynamically produce comparatively more complex differentiations of any given phenomenal structure. I then show how Merleau-Ponty develops and specifies his interpretation of Schneider’s intellectual difficulties in relation to the ambiguous role of the body, and in particular the hand, in Gerstmann’s syndrome. I explain how Merleau-Ponty defends the idea that sensorimotor and quasi-representational cognition are mutually irreducible, while maintaining that symbol-based cognition is a fundamentally enactive and embodied process. (shrink)

Research in psychopathology is booming in an unprecedented way, at least, in terms of increasing number of publications. Yet, a few questions arise: Does quantity also give us quality? Are the collected data generally of sound quality? How are data typically collected in psychopathology? Are the applied methods of data collection appropriate for this particular field of study? This article explores three different methods of data collection in psychopathology, namely self-rating scales, structured interviews, and semi-structured, phenomenological interviews. To identify the (...) most adequate methodological approach, we first establish the nature of the object of psychopathology and then we critically assess each method’s appropriateness to this field of study. We emphasize fundamental issues that make self-rating scales and structured interviews unfit for the task of adequately examining psychopathology. By contrast, we propose that a semi-structured, phenomenological interview presents a more appropriate method. Finally, we describe two types of semi-structured, phenomenological interviews that can be applied to assess and explore psychopathology, respectively. (shrink)

When interacting with other people, we assume that they have their reasons for what they do and believe, and experience recognizable feelings and emotions. When people act from weakness of will or are otherwise irrational, what they do can still be comprehensible to us, since we know what it is like to fall for temptation and act against one’s better judgment. Still, when someone’s experiences, feelings and way of thinking is vastly different from our own, understanding them becomes increasingly difficult. (...) Delusions and psychosis are often seen as marking the end of intelligibility. In this paper, I argue first for the importance of seeing other people as intelligible as long as this is at all possible. Second, I argue, based on both previous literature and my own lived experience, that more psychotic phenomena than previously thought can be rendered at least somewhat intelligible. Besides bizarre experiences like illusions, hallucinations and intense feelings of significance, I also explain what it is like to lose one’s bedrock, and how this loss impacts which beliefs one has reason to reject. Finally, I give an inside account of some disturbances of reason, and show that there are important similarities between certain psychotic reasoning problems and common non-pathological phenomena. (shrink)

The diverse essays in this volume speak to the relevance of phenomenological and psychological questioning regarding perceptions of the human. This designation, human, can be used beyond the mere identification of a species to underwrite exclusion, denigration, dehumanization and demonization, and to set up a pervasive opposition in Othering all deemed inhuman, nonhuman, or posthuman. As alerted to by Merleau-Ponty, one crucial key for a deeper understanding of these issues is consideration of the nature and scope of perception. Perception defines (...) the world of the perceiver, and perceptual capacities are constituted in engagement with the world – there is co-determination. Moreover, the distinct phenomenology of perception in the spectatorial mode in contrast to the reciprocal mode, deepens the intersubjective and ethical dimensions of such investigations. -/- Questions motivating the essays include: Can objectification and an inhuman gaze serve positive ends? If so, under what constraints and conditions? How is an inhuman gaze achieved and at what cost? How might the emerging insights of the role of perception into our interdependencies and essential sociality from various domains challenge not only theoretical frameworks, but also the practices and institutions of science, medicine, psychiatry and justice? What can we learn from atypical social cognition, psychopathology and animal cognition? Could distortions within the gazer’s emotional responsiveness and habituated aspects of social interaction play a role in the emergence of an inhuman gaze? -/- Perception and the Inhuman Gaze will interest scholars and advanced students working in phenomenology, philosophy of mind, psychology, psychiatry, sociology and social cognition. -/- Table of Contents -/- Introduction -/- Part I. The Gaze in Classical Phenomenology: Perspectives on Objectification -/- 1. Defending the Objective Gaze as a Self-transcending Capacity of Human Subjects -/- Dermot Moran -/- 2. Two Orders of Bodily Objectification: The Look and the Touch -/- Sara Heinämaa -/- 3. On Eliminativism’s Transient Gaze -/- Timothy Mooney -/- 4. Not wholly human. Reading Maurice Merleau-Ponty with Jacques Lacan. -/- Dorothée Legrand -/- 5. Disclosure and the Gendered Gaze in Simone de Beauvoir's Ethics -/- Christinia Landry -/- Part II. Vision, Perception and Gazes -/- 6. Inside the gaze -/- Shaun Gallagher -/- 7. Perception and its Objects. -/- Maurita Harney -/- 8. Technological Gaze: Understanding How Technologies Transform Perception -/- Richard Lewis -/- 9. The Inhuman Gaze and Perceptual Gestalts: The Making and Unmaking of Others and Worlds -/- Anya Daly -/- Part III. Psychiatry, Psychopathology and Inhuman Gazes -/- 10. Values and Values-based Practice in Psychopathology: Combining Analytic and Phenomenological Approaches -/- G Stanghellini and K.W.M. (Bill) Fulford -/- 11. The Inhuman and Human Gaze in Psychiatry, Psychopathology and Schizophrenia. -/- Matthew Broome -/- 12. Overcoming the Gaze: Psychopathology, Affect, and Narrative. -/- Anna Bortolan -/- 13. From excess to exhaustion : The rise of burnout in a post-modern achievement society. -/- Philippe Wuyts -/- 14. Blackout Rages: The Inhibition of Episodic Memory in Extreme Berserker Episodes -/- John Protevi -/- Part IV. Beyond the Human: Divine, Posthuman and Animal Gazes -/- 15. Wondering at the Inhuman Gaze -/- Sean. D. Kelly -/- 16. What Counts as Human/ Inhuman Right Now? -/- Rosi Braidotti -/- 17. Beyond Human and Animal: Metamorphosis in Merleau-Ponty -/- Dylan Trigg -/- Part V. Sociality and Boundaries of the Human -/- 18. Voice and gaze considered together in ‘languaging’. -/- Fred Cummins -/- 19. Ethics Beyond the Human: Disability and The Inhuman -/- Jonathan Mitchell -/- 20. Social Invisibility and Emotional Blindness -/- James Jardine -/- 21. What are you looking at? Dissonance as a window on the autonomy of participatory sense-making frames. -/- Mark James. (shrink)

English abstract: On last day of the year 1999, Russia has entered another era of despotism, that of Vladimir Putin. During his reign, the Putin‘s clan has undermined and infiltrated the mass media, the parliament and the judicial system. Deliberate violation of basic citizen‘s rights, compulsory acquisition of property, government-funded racket, misuse of mass media to scarify and to disinform the peoples belong to the diabolic methods of self-constituted disposers. All this lawlessness has led to exorbitant corruption, mass poverty, economic (...) stagnation, and escalation of crimes. The actual manuscript investigates the roots of Putinism putting the person of Vladimir Putin in the focus of investigation. -/- Russian abstract: В 1999 году, в последний день столетия и тысячелетия, Россия вступила в новую эру деспотизма, эру Владимира Путина. В продолжение его правления, клан Путина коррумпировал и инфильтрировал средства массовой информации, парламент, правовую систему. Умышленное нарушение основных гражданских прав, конфискация собственности, государственный рэкет, злоупотребление средств массовой информации с целью запугивания и дезинформации населения стали дьявольскими методами самоназванных правителей. Всё это привело к безмерной продажности, массовой бедности, экономической стагнации и взрыву преступности. Данный манускрипт исследует корни Путинизма, помещая личность Владимира Путина в центр исследования. (shrink)

Despite technological innovations, clinical expertise remains the cornerstone of psychiatry. A clinical expert does not only have general textbook knowledge, but is sensitive to what is demanded for the individual patient in a particular situation. A method that can do justice to the subjective and situation-specific nature of clinical expertise is ethnography. Effective deep brain stimulation for obsessive-compulsive disorder involves an interpretive, evaluative process of optimizing stimulation parameters, which makes it an interesting case to study clinical expertise. The aim of (...) this study is to explore the role of clinical expertise through an ethnography of the particular case of DBS optimization in OCD. In line with the topic of the special issue this article is a part of, we will also use our findings to reflect on ethnography as a method to study complex phenomena like clinical expertise. This ethnography of DBS optimization is based on 18 months of participant observation and nine in-depth interviews with a team of expert clinicians who have been treating over 80 OCD patients since 2005. By repeatedly observing particular situations for an extended period of time, we found that there are recurrent patterns in the ways clinicians interact with patients. These patterns of clinical practice shape the possibilities clinicians have for making sense of DBS-induced changes in patients’ lived experience and behavior. Collective established patterns of clinical practice are dynamic and change under the influence of individual learning experiences in particular situations, opening up new possibilities and challenges. We conclude that patterns of clinical practice and particular situations are mutually constitutive. Ethnography is ideally suited to bring this relation into view thanks to its broad temporal scope and focus on the life-world. Based on our findings, we argue that clinical expertise not only implies skillful engagement with a concrete situation but also with the patterns of clinical practice that shape what is possible in this specific situation. Given this constraining and enabling role of practices, it is important to investigate them in order to find ways to improve diagnostic and therapeutic possibilities. (shrink)

Despite severe amnesia, some studies showed that Alzheimer Disease patients with moderate to severe dementia keep a consistent, but impoverished representation of themselves, showing preservation of the sense of identity even at severe stages of the illness. Some studies suggest that listening to music can facilitate the reminiscence of autobiographical memories and that stimulating autobiographical memory would be relevant to support the self of these patients. Consequently, we hypothesized that repeated participation to reminiscence workshops, using excerpts of familiar songs as (...) prompts would participate to the enrichment of autobiographical memories, self-representation and sense of identity. We included a group of 20 AD patients with severe dementia residing in nursing homes. Their performances were compared to a control group of 20 matched healthy residents living in the same institutions. The experiment was conducted in three phases over a 2-week period. On phase 1, an individual assessment of sense of identity was proposed to each participant. On phase 2, participants joined musical reminiscence workshops. During the third phase, individual evaluation of autobiographical memory and a second assessment of sense of identity were proposed. Our results showed that, despite their massive amnesia syndrome, autobiographical memories of AD reached at the end of the 2 weeks the number and quality of those of matched controls. Moreover, we confirmed a continuity of self-representation in AD patients with a stable profile of the answers between the first and second individual assessments of sense of identity. However, the increase in number and episodic quality of autobiographical memories was not accompanied by an enrichment of the sense of identity. In a complementary study, new patients participated in the same paradigm, but using movie extracts as prompts, and showed very similar effects. We discuss all of these results with regard to the literature showing the significant impact of repetition on the reactivation of memory traces even in very amnestic AD patients at severe stages of the disease. (shrink)

Research suggests that the ability to understand one’s own and others’ minds, or mentalizing, is a key factor for mental health. Most studies have focused the attention on the association between global measures of mentalizing and specific disorders. In contrast, very few studies have analyzed the association between specific mentalizing polarities and global measures of mental health. This study aimed to evaluate whether self and other polarities of mentalizing are associated with a multidimensional notion of mental health, which considers symptoms, (...) functioning, and well-being. Additionally, the level or depth of mentalizing within each polarity was also analyzed. A sample of 214 adolescents was evaluated on measures of self- and other- mentalizing, multi-informed measures of psychopathology and functioning based on Achenbach’s system, and measures of psychological well-being. Results revealed no association between mentalizing polarities and higher-order symptom factors. Self-mentalizing was associated with self-esteem and motivation to life goals, and other-mentalizing was associated to general, social and role functioning. This association between aspects of self-other mentalizing and self-other function has important implications for treatment and prevention. Deeper mentalizing within each polarity revealed stronger associations with functioning and well-being. Because mentalizing polarities are associated with functioning and well-being but not with symptoms, a new hypothesis is developed: mentalizing does not contribute to resiliency by preventing symptoms, but by helping to deal with them, thus improving functioning and well-being independently of psychopathology. These findings support that promoting mentalizing across development may improve mental health, even in non-clinical population. (shrink)

In this startling look at evil behavior, a UCLA sociologist tries to get inside the criminal psyche to understand what it means or feels, signifies, sounds, tastes, or looks like to do any particular crime.

The concept, benefits and recommendations for the cultivation of compassion have been recognized in the contemplative traditions for thousands of years. In the last 30 years or so, the study of compassion has revealed it to have major physiological and psychological effects influencing well-being, addressing mental health difficulties, and promoting prosocial behavior. This paper outlines an evolution informed biopsychosocial, multicomponent model to caring behavior and its derivative “compassion” that underpins newer approaches to psychotherapy. The paper explores the origins of caring (...) motives and the nature and biopsychosocial functions of caring-attachment behavior. These include providing a secure base and safe haven for offspring along with physiological regulating functions, which are also central for compassion focused therapy. Second, it suggests that it is the way recent human cognitive competencies give rise to different types of “mind awareness” and “knowing intentionality” that transform basic caring motives into potentials for compassion. While we can care for our gardens and treasured objects, the concept of compassion is only used for sentient beings who can “suffer.” As psychotherapy addresses mental suffering, cultivating the motives and competencies of compassion to self and others can be a central focus for psychotherapy. (shrink)

The experiences described in the VIP transcripts are incredibly varied and yet frequently explicitly labelled by participants as "voices." How can we make sense of this? If we reflect carefully on uses of the word "voice", we see that it can express at least two entirely different concepts, which pick out categorically different phenomena. One concept picks out a speech sound (e.g. "This synthesizer has a "voice" setting"). Another concept picks out a specific agent (e.g. "I hear two voices: one (...) is a ten year-old boy…"). This chapter explores how these two concepts are related to one another in the context of voice-hearing. (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)

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)

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. (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)

One of the most remarkable implications of psychological medicine in the transition from the 18th to the 19th century was the advent of a new way of looking at the human being and new tools for analysing not only behaviour and individual experience, but also historical events, collective behavioural patterns or complex cultural achievements. Unsurprisingly, the deployment of this gaze could not advance without there being a series of disputes and controversies about its reach and the limits to its indiscriminate (...) application. Focusing on the figure of French alienist Alexandre Brierre de Boismont and on the controversial cases of hallucinations and suicide, this article addresses the conflicts generated by the use of certain emblematic concepts and categories present in French psychological medicine throughout the central decades of the 19th-century, as well as the essentially ambivalent relationship of the psychopathological point of view with the criticism of a culture that was made responsible, then, as now, for a great number of psychological disorders and illnesses. (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)

This article is concerned with theories and therapeutic practices that interpret post-traumatic combat stress as a ‘moral injury’ produced by the shock of carrying out lethal violence in uncertain battlefield conditions. While moral injury is said to share many symptoms with post-traumatic stress disorder, its proponents – military and Veterans Health Administration clinical psychologists, chaplains, and some psychiatrists – are concerned by PTSD’s inability to account for the meaning-based moral and ethical distress that counterinsurgency battlefields in Iraq and Afghanistan are (...) allegedly especially prone to produce in US soldiers. Moral injury theorists seem to want to describe a phenomenon that is both more profound than PTSD but which, as clinical psychologists Shira Maguen and Brett Litz state, is not itself a mental disorder. In this article, I examine the links between moral injury theory’s fringe diagnostic status and the fringe status of the kinds of violence it understands as uniquely injurious to soldiers’ psyches. Moral injury valorizes war-fighting and military culture while casting war as a source of almost inevitable psychopathology. I argue that moral injury theory represents an effort to carve out a distinct domain of psychological expertise but also a negotiation of the tension between war violence’s ‘normal’ practice and its excessive or morally hazardous manifestations – both of which link mental illness directly to the politics of war violence and post-war care. (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)