The clinical ethics propounded by Richard Zaner is unique. Partly because of his phenomenological orientation and partly because of his own daily practice as a clinical ethicist in a large university hospital, Zaner focuses on the particular concrete situations in which patients and their families confront illness and injury and struggle toward workable ways for dealing with them. He locates ethical reality in the clinical encounter. This encounter encompasses not only patient and physician but also the patients family and friends (...) and indeed the entire lifeworld in which the patient is still striving to live. In order to illuminate the central moral constituents of such human predicaments, Zaner discusses the often-overlooked features of disruption and crisis, the changed self, the patients dependence and the physicians power, the violation of personal boundaries and their necessary reconfiguring, and the art of listening. (shrink)

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 .. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 327-329 [Access article in PDF] Husserlian Comments on Blankenburg's "Psychopathology of Common Sense" Osborne P. Wiggins, Michael Alan Schwartz, and Jean Naudin In this essay, Wolfgang Blankenburg sketches his influential view that some of the disturbances of schizophrenia in particular can be interpreted as a pathology of common sense. We think it important at the outset, however, to avoid possible (...) misunderstandings of Blankenburg's point. It is perhaps unfortunate that this point is expressed by use of the phrase, "common sense." As Blankenburg's own essay shows, even among the learned, "common sense" has no definite or univocal meaning. Therefore, it is entirely possible to find many people who, under some conception of "common sense," appear to lack common sense and yet should not be deemed schizophrenic. Consequently, it is probably best to avoid the ambiguous phrase "common sense" altogether and seek to comprehend Blankenburg's point in other terms. That is precisely what we shall attempt here. We do endorse Blankenburg's view. Moreover, we shall pursue his suggestions that a Husserlian phenomenology of our experience of the life-world may provide the basis for developing the kind of psychopathology he seeks. Our ultimate aim, however, is for this phrase "common sense" to vanish into the Husserlian phenomenology we offer, so that all the other meanings of common sense will not threaten Blankenburg's position with misunderstandings.Our comments must remain a mere sketch. Since, however, Husserl's phenomenology is not well known, we shall have to devote some time to outlining those features of it that we deem relevant here.For Husserl, every mental process is an awareness of something. In his terminology, it is "intentional." No mental process occurs in isolation, however. It rather occurs within a concatenation of many other mental processes. Some of these co-occurring mental processes intend the same object; they intend other aspects of the object. For example, a woman may be aware of the color of a dress she is considering wearing. Hence, one process in her mental life is (visually) aware of the brown color. But another process in her mental life may be intending it as a "party dress." And yet another process in her mental life may be (tactually) intending the texture of the cloth. Because all of these mental processes (and many others) intend the same object, namely, the dress, Husserl says that they are synthesized with one another. "Synthesis," then, connotes a multiplicity of mental processes united with one another through intending the same object.Now Husserl believed that it is because the many processes occurring in our mental lives [End Page 327] synthetically intend the many objects we encounter that we experience ourselves as inhabiting a world of objects. If these syntheses failed to occur, we would not experience the world or ourselves as parts of this world. These syntheses make it possible for us to experience objects and events as related to one another in the manifold spatial, causal, temporal, social, political, religious, and other relationships that we do in fact experience. Husserl thus contends that our mental lives "constitute" the world for us. Mental life can accordingly be viewed as "world-constituting." Mental life is thus the condition for the possibility of there being a world of objects for us, to modify Kant's phrase. Husserl thought his notion of world-constituting consciousness sufficiently similar to Kant's for him to appropriate the latter philosopher's concept of "transcendental." Husserl also then spoke of "transcendental consciousness" and the study of this consciousness as "transcendental philosophy."Husserl made many distinctions among kinds of mental processes and their correlative objects. We shall here explicate only one such distinction. Mental processes must be distinguished as those that are actively generated by an ego and those that are not produced by an ego. The latter kind of mental process occurs automatically or, as Husserl writes, "passively." Husserl calls the first kind of mental process "active." Having mentioned him, however, we should also briefly characterize the "ego... (shrink)

Karl Jaspers' phenomenology remains important today, not solely because of its continuing influence in some areas of psychiatry, but because, if fully understood, it can provide a method and set of concepts for making new progress in the science of psychopathology. In order to understand this method and set of concepts, it helps to recognize the significant influence that Edmund Husserl's early work, Logical investigations, exercised on Jaspers' formulation of them. We trace the Husserlian influence while clarifying the main components (...) of Jaspers' method. Jaspers adopted Husserl's notions of intuition, description, and presuppositionlessness, transforming them when necessary in order to serve the investigations of the psychopathologist. Jaspers also took over from Wilhelm Dilthey and others the tools of understanding (Verstehen) and self-transposal. The Diltheyian procedures were integrated into the Husserlian ones to produce a method that enables psychiatrists to define the basic kinds of psychopathological mental states. (shrink)

Understanding the mental life of persons with psychosis/schizophrenia has been the crucial challenge of psychiatry since its origins, both for scientific models as well as for every therapeutic encounter between persons with and without psychosis/schizophrenia. Nonetheless, a preliminary understanding is always the first step of phenomenological as well as other qualitative research methods addressing persons with psychotic experiences in their life-world. In contrast to Rashed's assertions, in order to achieve such understanding, phenomenological psychopathologists need not necessarily adopt the transcendental-phenomenological attitude, (...) which, however, is often required if performing phenomenological philosophy. Additionally, in the course of these scientific endeavors, differences between persons with psychosis/schizophrenia and so-called normal people seem to have a methodological function and value driving the scientist in her enterprise. Yet, these differences do not extend to ethical dimensions, and therefore, do not by any means touch ethical equality. (shrink)

Basing ourselves on the writings of Hans Jonas, we offer to psychosomatic medicine a philosophy of life that surmounts the mind-body dualism which has plagued Western thought since the origins of modern science in seventeenth century Europe. Any present-day account of reality must draw upon everything we know about the living and the non-living. Since we are living beings ourselves, we know what it means to be alive from our own first-hand experience. Therefore, our philosophy of life, in addition to (...) starting with what empirical science tells us about inorganic and organic reality, must also begin from our own direct experience of life in ourselves and in others; it can then show how the two meet in the living being. Since life is ultimately one reality, our theory must reintegrate psyche with soma such that no component of the whole is short-changed, neither the objective nor the subjective. In this essay, we lay out the foundational components of such a theory by clarifying the defining features of living beings as polarities . We describe three such polarities: 1) Being vs. non-being: Always threatened by non-being, the organism must constantly re-assert its being through its own activity. 2) World-relatedness vs. self-enclosure: Living beings are both enclosed with themselves, defined by the boundaries that separate them from their environment, while they are also ceaselessly reaching out to their environment and engaging in transactions with it. 3) Dependence vs. independence: Living beings are both dependent on the material components that constitute them at any given moment and independent of any particular groupings of these components over time. We then discuss important features of the polarities of life: Metabolism; organic structure; enclosure by a semi-permeable membrane; distinction between "self" and "other"; autonomy; neediness; teleology; sensitivity; values. Moral needs and values already arise at the most basic levels of life, even if only human beings can recognize such values as moral requirements and develop responses to them. (shrink)

Schizophrenia, like other pathological conditions of mental life, has not been systematically included in the general study of consciousness. By focusing on aspects of chronic schizophrenia, we attempt to remedy this omission. Basic components of Husserl’s phenomenology (intentionality, synthesis, constitution, epoche, and unbuilding) are explicated and then employed in an account of chronic schizophrenia. In schizophrenic experience, basic constituents of reality are lost and the subject must try to explicitly re-constitute them. “Automatic mental life” is weakened such that much of (...) the world that is normally taken-for-granted cannot continue to be so. The subject must actively re-lay the ontological foundations of reality. (shrink)

Husserlian reduction is a rigorous method for describing the foundations of psychiatric experience. With Jaspers we consider three main principles inspired by phenomenological reduction: direct givenness, absence of presuppositions, re-presentation. But with Binswanger alone we refer to eidetic and transcendental reduction: to establish a critical epistemology; to directly investigate the constitutive processes of mental phenomena and their disturbances, freed from their nosological background; to question the constitution of our own experience when facing a person with mental illness. Regarding the last (...) item, we suggest a specific kind of reduction, typically intersubjective from the start, which we call the ‘looking-glass reduction'. The schizophrenic experience -- understood as a ‘loss of taken-for-grantedness’ implying the constitutions of the body, of the other, and of internal time -- is a real ‘epochal provocation’ for the psychiatrist. As the horizon it opens seems to be both corporeal and narrative, this ‘provoking’ of an epoche in the attitude of the psychiatrist himself and the resistances it implies raise important issues regarding the general constitution of human experience. (shrink)