Philosophy, Psychiatry, & Psychology

Among the many strengths of the article by Lorenzo Gilardi and Giovanni Stanghellini (2021) one can find its open-ended character most directly reflected by the fact that these are "questions for further research," rather than a set of definitive theses, that are provided as concluding remarks. But it is not the mere occurrence of such a setting that is crucial. After all, even if somewhat atypical, the latter does happen to be used in scholarly literature. What makes the open-endedness of the article and its somehow dialogical flavor so important is these features' full continuity with the method of dialectical psychopathology proposed. The form and the content, in other words, go hand in hand.

As far as formal characteristics are concerned it is the principle of dialectical recognition that is arguably the most significant contribution. And even if there are three easily recognizable meanings of the dialectics at hand; including Plato's method of division, Aristotle's logic of the probable, and Hegel's synthesis of the opposites; it'd be hard not to agree with the authors' claim that it is the last one that is of most direct clinical relevance. The notion of Aufhebung (or sublation), originally stemming from Hegel's (2010) "Science of Logic", is a very special form of negation metaphysically rooted in the idea of the opposition as a founding principle of "logicality and world." What is so special about this form of negation is that it is not "abolition or annihilation." Rather, it is the reconciliation of the thesis and antithesis and the retainment of "everything that was worth saving" in them that are its crucial properties.

And it is exactly such a non-classical logical foundation that constitutes the very condition of possibility of clinical practice aspiring to be something more than symptom reduction. What Lorenzo tries to communicate, importantly, is not only his diagnosis. Rather it is his overall existential condition transcending any set of descriptively formulated symptoms that he wants to share and find recognition for. It is for that reason, as it seems, that he prefers to say: "I think I am psychotic, I think I am schizophrenic!" [underlines added], rather than satisfies himself with a conventional phrase such as "I have the diagnosis of schizophrenia" (the use of the latter form is often motivated, and for good reasons, by a kind of an anti-reductionistic sensibility. What is exposed by Lorenzo's testimony, however, is that inadvertently it can have quite the opposite effect).

What he is after can be partly accounted for in broadly hermeneutic terms of "yearning for meaning" or "symptom deciphering." As such, however, it would create a misleading impression that it is nothing more than one another form of narrative psychotherapy that is proposed. In order to avoid such a misunderstanding and, respectively, to directly address the most specific message of the [End Page 19] article it is rather one another originally Hegelian (2018) notion: the one of the struggle for recognition (Anerkennung) that needs to be called for (for a detailed and clinically relevant discussion of recognition, see Rashed [2019]).

The real problem of Lorenzo, in his own words, was "not so much (or exclusively) what people call 'symptoms.'" Rather, it was the isolation connected with the fact that he was not believed or taken seriously: not recognized "as an autonomous self-consciousness" that haunted him most. And it is exactly at this point that the dialogical character of the whole proposal comes to the fore. The recognition sought, in particular, cannot be achieved by a separate and self-contained individual. Rather, it is the very nature of human self-consciousness that makes it necessary to tear it from the other in "a circle of reciprocal recognition." Self-consciousness, as Hegel (2018, p. 76) has it, "achieves its satisfaction only in another self-consciousness." It exists "in and for itself only as something recognized."

The depth of isolation imposed by schizophrenia, what is crucial, cannot be reduced to some external life circumstances like an exclusion from the circles of friends. Rather, it is a much more fundamental issue that makes...