Philosophy, Psychiatry, & Psychology

This article by Louis Sass, Josef Parnas, and Dan Zahavi takes us into the midst of a debate over recent developments in phenomenological psychiatry. In "Phenomenological Psychopathology and Schizophrenia: Contemporary Approaches and Misunderstandings" (Sass et al. 2011), Sass et al. are responding to criticisms of their position lodged by Aaron L. Mishara in "Missing Links in Phenomenological Clinical Neuroscience: Why We Are Still Not There Yet" (Mishara 2007). In their reply, Sass et al. offer several helpful clarifications and justifications of their position, a position they have advanced in numerous important articles and books in the past. We are grateful for these clarifications and additional justifications of their wide-ranging views, just as we appreciate Mishara's clarifications and extensions in "Missing Links in Phenomenological Clinical Neuroscience: Why We Are Still Not There Yet" (Mishara 2007) of his earlier insightful proposals. However, we do lament the fact that these enhancements in our understanding of their respective positions by these authors have taken the form of sometimes acid formulations and rejoinders, formulations and rejoinders that lack the tone of mutual appreciation that one would hope to find among investigators who work in the same field and within the same conceptual and methodological framework, and who, in our view, share far more positions than not.

In fact, in reading both Sass et al. and Mishara we are struck by an odd discrepancy in their presentations of their ideas. On the one hand, both parties emphasize the provisional and hypothetical status of their own theses and stress the need for further discussion and testing. In other words, each party conveys the sense that the views they are propounding about the deficits involved in schizophrenia are more or less in their early scientific stages. They call for additional investigation, more refined confirmatory instruments, and in general more careful study. On the other hand, the two parties criticize one another's positions in a tone that might be fully warranted if their own results had been definitively established. Only in looking back from a standpoint at which the questions had been conclusively answered would one be vindicated in criticizing alternative claims with such linguistic force.

We suggest that phenomenological psychiatry would progress more assuredly if those who work in this area looked upon their own assertions and those of others as claims proposed only at the beginning, not at the end. In fact, only the future will sort out who was right and who wrong or [End Page 31] whose views were in need of refashioning. Those of us who labor in this field today can never be our own judges.

To indicate how these two essays raise problems that phenomenological psychiatry has yet to resolve satisfactorily, we select just three pertinent sorts of puzzles.

1. 1. What is the relationship of neuroscientific studies of various aspects of schizophrenia to phenomenological accounts of them? These two ways of illuminating schizophrenia differ in several major respects. First, the vocabularies of the two fields differ enormously. Second, the methods of inquiry and evidence-gathering diverge significantly. Third, a reliable way of joining the claims of one domain to those of the other such that they are both addressing or referring to the "same" reality (despite the terminological and methodological differences) remains quite elusive.

2. 2. Assertions that some constituent of schizophrenia is a "core" or "central" one are problematic. The sense of such assertions, we take it, is that this "core" constituent renders intelligible several other constituents of schizophrenia, either by explaining them or by rendering them understandable. It seems to us, however, that distinctions between the "core" and less central features of the disorder require a form of substantiation that has yet to be convincingly provided.

3. 3. Any phenomenological psychiatry is obligated to justify how or in what respects this psychiatry can be called "phenomenological." If the psychiatry is thought to be phenomenological because it utilizes concepts (and perhaps methods) of Edmund Husserl, then it must be explained how Husserl's own "transcendental" and "eidetic" philosophy can somehow subserve an empirical and factual science such as psychopathology...