The phenomenological approach to schizophrenia has undergone something of a renaissance in Anglophone psychiatry in recent years. There has been a proliferation of works that focus on the nature of subjectivity in schizophrenia and related disorders, and that take inspiration from the work of such German and French philosophers as Husserl, Heidegger, and Merleau-Ponty, and such classical psychiatrists as Minkowski, Blankenburg, and Binswanger (Rulf 2003; Sass 2001a, 2001b). This trend includes predominantly theoretical articles, which typically incorporate clinical material as (...) well as reviews of empirical and experimental findings in psychopathology. Some very recent examples (since 2000) are studies of .. (shrink)

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)

In this article, I argue that phenomenological psychopathologists, despite their critical attitude toward mainstream psychiatry, still hold problematic prejudices about the nature of psychiatric conditions as illness or disorder. I suggest that phenomenological psychopathologists turn to resources in the neurodiversity and mad pride movements to critically reflect upon these prejudices and appreciate the methodological problems that they pose.

Musing for Puncta special issue "Critically Sick: New Phenomenologies Of Illness, Madness, And Disability.".

In this chapter, I provide an overview of phenomenological approaches to psychiatric classification. My aim is to encourage and facilitate philosophical debate over the best ways to classify psychiatric disorders. First, I articulate phenomenological critiques of the dominant approach to classification and diagnosis—i.e., the operational approach employed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-10). Second, I describe the type or typification approach to psychiatric classification, which I distinguish into (...) three different versions: ideal types, essential types, and prototypes. I argue that despite their occasional conflation in the contemporary literature, there are important distinctions among these approaches. Third, I outline a new phenomenological-dimensional approach. I show how this approach, which starts from basic dimensions of human existence, allows us to investigate the full range of psychopathological conditions without accepting the validity of current diagnostic categories. (shrink)

Memoirs and autobiographical accounts of mental illness have been widely utilized in phenomenological psychopathology and, in particular, in the investigation of depression (Fuchs 2013; Ratcliffe 2010; Ratcliffe 2015), mania (Binswanger 1960; Bowden 2013), schizophrenia (Binswanger 1957; Parnas and Henriksen 2016; Sass 1994), anorexia nervosa (Bowden 2012; Legrand 2010), and borderline personality disorder (Stanghellini and Rosfort 2013). In this article I will provide a critical illustration of the different ways in which self- narratives have been employed in this context (...) and I will advance some suggestions as to how the use of life stories could further enhance the phenomenological understanding of mental illness and the therapeutic process. (shrink)

Psychiatry has witnessed a new wave of approaches to clinical phenotyping and the study of psychopathology, including the National Institute of Mental Health’s Research Domain Criteria, clinical staging, network approaches, the Hierarchical Taxonomy of Psychopathology, and the general psychopathology factor, as well as a revival of interest in phenomenological psychopathology. The question naturally emerges as to what the relationship between these new approaches is – are they mutually exclusive, competing approaches, or can they be integrated (...) in some way and used to enrich each other? In this opinion piece, we propose a possible integration between clinical staging and phenomenological psychopathology. Domains identified in phenomenological psychopathology, such as selfhood, embodiment, affectivity, etc., can be overlaid on clinical stages in order to enrich and deepen the phenotypes captured in clinical staging (‘high resolution’ clinical phenotypes). This approach may be useful both ideographically and nomothetically, in that it could complement diagnosis, enrich clinical formulation, and inform treatment of individual patients, as well as help guide aetiological, prediction, and treatment research. The overlaying of phenomenological domains on clinical stages may require that these domains are reformulated in dimensional rather than categorial terms. This integrative project requires assessment tools, some of which are already available, that are sensitive and thorough enough to pick up on the range of relevant psychopathology. The proposed approach offers opportunities for mutual enrichment: clinical staging may be enriched by introducing greater depth to phenotypes; phenomenological psychopathology may be enriched by introducing stages of severity and disorder progression to phenomenological analysis. (shrink)

The relevance of a purely descriptive phenomenology to psychiatry is overshadowed by naturalistic approaches that are both explanatory and predictive. A naturalized transcendental phenomenology, however, carries with it the possibility of explaining and predicting not only the nature of normal subjective experience but also the origin of phenomenological psychopathology in a manner acceptable by scientific standards. A purely mathematical naturalized phenomenology remains in the phenomenological sphere, does not rely on neuroscientific data in its development, is consistent with (...) the Husserlian view of man as free and capable of using reason to influence behavior and focusses on temporality in its definition of normal subjective experience and phenomenological psychopathology. Because what is being naturalized is subjective experience and not any part of the physical world, the project it is not meant to replace the natural science’s understanding of psychopathology but to provide a complementary view that is acceptable by scientific standards. (shrink)

Recently, there have been calls to develop a more contextual approach to phenomenological psychopathology—an approach that attends to the socio-cultural as well as personal and biographical factors that shape experiences of mental illness. In this Perspective article, we argue that to develop this contextual approach, phenomenological psychopathology should adopt a new paradigm case. For decades, schizophrenia has served as the paradigmatic example of a condition that can be better understood through phenomenological investigation. And recent calls (...) for a contextual approach continue to use schizophrenia as their primary example. We argue, in contrast, that substance misuse provides a better paradigm case around which to develop a contextually sensitive phenomenological psychopathology. After providing a brief vignette and analysis of a case of substance misuse, we explain why this kind of condition requires considerable sensitivity and attention to context, better motivating the incorporation and development of new contextually sensitive approaches. (shrink)

This handbook is currently in development, with individual articles publishing online in advance of print publication. At this time, we cannot add information about unpublished articles in this handbook, however the table of contents will continue to grow as additional articles pass through the review process and are added to the site. Please note that the online publication date for this handbook is the date that the first article in the title was published online.

The article aims at expanding the horizon of phenomenological psychopathology of depression from a social theoretical perspective. Based on Merleau-Ponty’s phenomenological ontology, in the first section, depression is reinterpreted as a disruption of chiasm: it is not merely the illness of the body, the disorder of the mind, or a specific form of social suffering, but the interrelated distortion of time consciousness, agency, and interaffectivity. The phenomenological clarification of these components provides opportunity for connecting sociological and (...) psychopathological insight. In the second part, contemporary critical theories of acceleration, globalization, biopolitics, and system colonization are reinterpreted to highlight the structural and cultural context of late modern time consciousness, agency, and interaffectivity. In the third section, it is analyzed, how these social constituents shape the space of contemporary socialization processes, including the emergence of those intersubjective distortions, which potentially affect the entirety of chiasm in a depressive way. In the final section, the conclusions for therapy are explored, including the potentials for expanding the epistemological, substantive, and emancipatory horizon of phenomenological psychopathology. (shrink)

A critical commentary on the article “The Epistemic Harms of Empathy in Phenomenological Psychopathology” by Lucienne Spencer and Matthew Broome (2023) is presented. The authors committed the “fallacy of ambiguous or vague definition” by incorrectly interpreting Karl Jaspers’ conceptualizations, resulting in difficulties following logical arguments and arriving at reasonable conclusions. To overcome this fallacy, the commentary provides conceptual clarifications regarding Jaspers’ empathic understanding (einfühlendes Verstehen), conceived as the foundational concept of his project to develop a phenomenologically oriented (...) class='Hi'>psychopathology. Jaspers initially introduced this concept in the article “Die phänomenologische Forschungsrichtung in der Psychopathologie” [The Phenomenological Research Direction in Psychopathology], published in 1912, and extended in his magnum opus “Allgemeine Psychopathologie” [General Psychopathology], published in 1913. (shrink)

This paper returns to a seminal case in the historical of phenomenological psychopathology, Ludwig Binswanger’s discussion of “Ellen West A woman with a long history of melancholia and disordered eating, Ellen West was treated at Binswanger’s Bellevue sanatorium in 1921, a two-and-a-half month-long stay that resulted in a diagnosis of schizophrenia and Ellen West’s suicide. Binswanger relied on West’s personal writings and clinical history to develop and apply an original approach to case analysis, Daseinsanalyse or “existential analysis.” This (...) paper takes up this case and Binswanger’s analysis to explore the origins of contemporary phenomenological psychopathology, the recent progress in this field, and areas for continued growth. The paper argues that new approaches to exploring the embedded or situated quality of psychopathology are needed for advancing clinical phenomenology, and that feminist and critical phenomenology are among the disciplines that can provide important methodological and theoretical foundations for this work. Without this, the field risks repeating Binswanger’s original mistakes and viewing psychiatric illness solely as the expression of a disturbed individual. (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)

This work begins with a brief review – from the _physical education_ movement that began in ancient Greece and is deeply rooted in 19th century Europe, to the _somatics_ movement alive today. The review captures primary historical and conceptual references, relevant to the therapeutic-embodied exploratory work. Then, G. Stanghellini’s mental health care model [ 2 ] is reviewed. This model is considered within reflexive self-awareness and spoken dialogue: the main vehicles in relation with alterity and its consequences in the realm (...) of psychotherapeutic encounter and intervention. This will highlight the individual’s bodily movement and inter-corporeal ‘proto-dialogue’ as a prior realm of therapeutic intervention. Next, a brief consideration of E. Strauss work [ 31 ] is presented. This paper’s hypothesis is that bodily qualitative dynamics highlighted by phenomenology are essential for an effective mental health therapeutic intervention. A ‘seed’ of a framework is proposed in this paper; this seed assesses some phenomenological assets of a positive conception of mental health, for which self-awareness education is key to develop skills such as _kinaesthetic intelligence_ and _attunement_ and to educate healthy persons who can promote edifying social relations and environments. (shrink)

Jaspers identifies empathic understanding as an essential tool for grasping not the mere psychic content of the condition at hand, but the lived experience of the patient. This method then serves as the basis for the phenomenological investigation into the psychiatric condition known as ‘Phenomenological Psychopathology’. In recent years, scholars in the field of phenomenological psychopathology have attempted to refine the concept of empathic understanding for its use in contemporary clinical encounters. Most notably, we have (...) Stanghellini’s contribution of ‘second-order’ empathy and Ratcliffe’s ‘radical empathy’. Through this paper, we reject the pursuit of a renewed version of ‘empathic understanding’, on the grounds that the concept is fundamentally epistemically flawed. We argue that ‘empathic understanding’ risks (1) error, leading to misdiagnosis, mistreatment and an overall misunderstanding of the experience at hand, (2) a unique form of epistemic harm that we call ‘epistemic co-opting’ and (3) epistemic objectification. To conclude, we propose that empathic understanding ought to be replaced with a phenomenological account of Fricker’s virtuous listening. (shrink)

Whether, and in what sense, research in phenomenology and phenomenological psychopathology has—in addition to its descriptive and hermeneutic value—explanatory power is somewhat controversial. This paper shows why it is legitimate to recognize such explanatory power. To this end, the paper analyzes two central concerns underlying the debate about explanation in phenomenology: (a) the warning against reductionism, which is implicit in a conception of causal explanation exclusively based on models of natural/physical causation; and (b) the warning against top-down generalizations, (...) which neglect the specificity of the individual. While acknowledging that these two caveats express serious concerns regarding the debate on explanatory models, I show that phenomenology has the resources to respond to them. These can be found in analyses of different types of causation relating to different regions of reality and in the structure of explanatory models based on exemplarity. On the basis of these analyses, I defend a pluralist account vis-à-vis explanatory models. (shrink)

Mental health research faces a suite of unresolved challenges that have contributed to a stagnation of research efforts and treatment innovation. One such challenge is how to reliably and validly account for the subjective side of patient symptomatology, that is, the patient’s inner experiences or patient phenomenology. Providing a structured, standardised semantics for patient phenomenology would enable future research in novel directions. In this contribution, we aim at initiating a standardized approach to patient phenomenology by sketching a tentative formalisation within (...) the framework of an applied ontology, in the broader context of existing open-source Open Biomedical Ontologies resources such as the Mental Functioning Ontology. We further discuss a number of prevailing challenges and observations bearing on this task. (shrink)

Somogy Varga's criticisms and questions provide me with a welcome opportunity to clarify some key elements of my proposal. First, I briefly summarize my motivation and original proposal for a phenomenological–dimensional research program. Second, I address Varga's two challenges. Each challenge highlights an element of my proposal that was underdeveloped in the original article. I therefore provide a brief clarification of my proposal before responding directly to Varga's two challenges.My proposal is to shift phenomenological psychopathology toward a (...) broadly dimensional, rather than categorial, research program. This approach will allow phenomenologists to operate outside the constraints of... (shrink)

The article covers Erwin W. Straus’ views on the problem of time and temporal experience in the context of psychopathology. Beside Straus’ published scholarship, including his papers dealing exclusively with the subject of time, the sources utilized in this essay comprise several of Straus’ unpublished manuscripts on temporality, with the primary focus on the 1952 manuscript Temporal Horizons, which is discussed in greater detail and subsequently published for the first time in this journal. In the first part of the (...) article, the author introduces what he considers to be the central tension of the whole of Straus’ work on the issue of time, namely, the tension stemming from a dualistic account of time with its personal and impersonal dimensions. Interpretative developments of this tension are followed covering Straus’ early German works and his late American scholarship. The author presents Straus’ way of overcoming the dualistic account of time and his arguments in favour of what is termed here the “unified view of time”. Of critical importance for the unified view is Straus’ concept of “today”, which is extensively commented upon. In the second part of the article, the author focuses on the psychopathological consequences of the unified view as seen by Straus. A clear-cut boundary between a normal and a psychotic experience of time is supposed to lie in breaking the bond between the personal and the impersonal orders of time, leading to a fundamental estrangement. This view, it is claimed, is already present in a nutshell in Straus’ earliest work, and is elaborated upon later. In conclusion, both the merits and the weaknesses of Straus’ account of temporality are presented. A major advantage is that Straus abstains from a dualistic conception of time and reappraises the often-devalued clock time. A fundamental drawback is that Straus does not venture to explore the pathological varieties of temporal experience and fails to specify the acknowledged differences between, on the one hand, psychotic elements in depressive disorders, and, on the other hand, such elements in schizophrenic disturbances. (shrink)

Exploring phenomenological philosophy as it relates to psychiatry and the social world, this book establishes a common language between psychiatrists, anti-psychiatrists, psychologists and social workers. It is an inter-disciplinary work by phenomenological philosophers, psychiatrists, and psychologists to discover the essence and foundations of social psychiatry. Using the phenomenology of Husserl as a point of departure, the meanings of empathy, interpersonal understanding, we-intentionality, ethics, citizenship and social inclusion are investigated in relation to psychopathology, nosology, and clinical research. This (...) work, drawing upon the rich classical and contemporary phenomenological tradition, touching on a broad range of thinkers such as Deleuze, Levinas, and R.D. Laing, also explicates how phenomenology is a method capable of capturing the human condition and its intricate relation to the social world and mental illness. (shrink)

Can affordances help in understanding psychiatric illness and psychopathological experience? In recent work on the philosophy of psychiatry and phenomenology, the answer appears to be a clear ‘yes’, but some recent worries have emerged that the affordance-concept might be “insufficiently discerning” and thus ill-suited to make sense of psychiatric illness and experience. In this paper I briefly review recent attempts to use the affordance-concept to make sense of psychopathology, as well as the worries voiced by the critics. I argue (...) that much of this criticism is, in fact, best understood as a call for more research and offer some exploratory considerations on how this research might proceed. Specifically, I argue that an improved understanding of the self-referentiality that is inherent to experiencing affordances can be useful for psychiatry. (shrink)

This paper explores the status of language and suffering in recovery from psychosis from a transcendentally-informed phenomenological perspective. We suggest that each of these concepts can apply both to the illness itself and to the person with the illness. The relationship between the two will be one focus of this discussion. The other focus will be on the various ways in which phenomenological approaches to psychopathology have understood the nature of this relationship; a relationship characterized by different (...) meanings of the term "immanence." Drawing inspiration from a Borges poem and from Husserl's debate with Heidegger over the content of his "Phenomenology" article for the Encyclopedia Britannica, we argue that it is misleading, as well as unhelpful, to continue to focus on deficits and dysfunction while ignoring the person's hopes, strengths, assets, and agency. As long as there remains no cure for psychosis, we conclude that it is more effective to promote recovery among people with psychosis than to remain focused on reducing, minimizing, or eliminating their disorder. (shrink)

Many methodologies for systematic study of lived experience have been proposed in recent decades. These methods are typically calibrated in terms of the depth and complexity of data collection, and whether they consider reports on pre-reflective experience admissible. Even though it has been shown that lived experience occurs at different timescales (elementary, integrative, narrative), contemporary methods tend to focus on momentary experience. We trace the focus on momentary experience to the current cultural milieu and attitudes in the history of psychology. (...) We point out the need for studying temporally extended experiences in the field of psychopathology. We propose that lived experiences at different timescales are nested within each other and that this principle can be used to organize data collected with qualitative methods for the study of experience. We suggest that temporally extended experiences occur at the narrative level of description (i.e. they consist of experiential reports and sense-making). (shrink)

This paper, on the psychopathology and phenomenology of schizophrenia, presents a selective summary of the work of the French psychiatrist, Eugene Minkowski (1985-1972), one of the first psychiatrists of an explicitly phenomenological persuasion. Minkowki believed that the phenomenological essence of schizophrenia (what he called the "trouble générateur") consists in a loss of "vital contact with reality" (VCR) and manifests itself as autism. Loss of vital contact with reality signifies a morbid change in the temporo-spatial structure of experiencing, (...) particularly in the diminishment and modification of temporal-dynamic aspects and a corresponding predominance of spatial-static factors. The patient tries to compensate for this primary morbid process through a variety of affective-cognitive preoccupations (rich autism) or sterile intellectuoid attitudes (autisme pauvre). Autism signifies a morbidly modified existential pattern that affects the domains of experience and expression as well as action. Minkowski's psychopathological analyses are illustrated by brief clinical vignettes of his patients. (shrink)

Contemporary perspectives on delusions offer valuable neuropsychiatric, psychoanalytic, and philosophical explanations of the formation and persistence of delusional phenomena. However, two problems arise. Firstly, these different perspectives offer us an explanation “from the outside”. They pay little attention to the actual personal experiences, and implicitly assume their incomprehensibility. This implicates a questionable validity. Secondly, these perspectives fail to account for two complex phenomena that are inherent to certain delusions, namely double book-keeping and the primary delusional experience. The purpose of this (...) article is to address both problems, by offering an understanding “from the inside”. Our phenomenological approach is a form of “radical empathy”, and crosses the Jaspersian limits of understanding. It compares delusional experiences with variations of reality experience in everyday life, and makes use of the structure of imagination. Six factors influencing the experience of reality are discussed and illustrated by clinical and non-clinical examples. These factors are: continuity, materiality and resistance, multiplicity of sensations and perceptions, intensity, the sense of authorship, and the complex role of intersubjectivity. I suggest that experiences of hypo- and hyperreality are not restricted to pathology, but have their place in everyday life as well. Delusional phenomena can be better understood by investigating the interplay of these six factors. With this framework, the two complex phenomena consequently prove to be better understandable to us. Our approach remains within the phenomenal experience and might thereby contribute to the validity of psychopathology. (shrink)

Many prisoners in solitary confinement experience adverse psychological and physical effects such as anxiety, paranoia, insomnia, headaches, hallucinations and other perceptual distortions. Psychiatrists call this SHU syndrome, named after the Security Housing Units [SHU] of supermax prisons. While psychiatric accounts of the effects of supermax confinement are important, especially in a legal context, they are insufficient to account for the phenomenological and even ontological harm of solitary confinement. This paper offers a phenomenological analysis of the lived experience of (...) space in supermax confinement by drawing on Merleau-Ponty’s account of intercorporeal depth. I argue that the prolonged deprivation of concrete experiences of spatial depth in a shared world is a form of violence against the relational structure of embodied (inter)subjectivity, and that it threatens to undermine the prisoner’s capacity for a meaningful relation to the world, to others, and even to herself. Nevertheless, some prisoners have developed strategies for resisting this psychopathology of space. (shrink)

Psychopathology has two styles. On the one hand, a tradition of phenomenological inquiry, associated in particular with the work of Karl Jaspers, that may be considered as the continental way of approaching psychopathology. On the other hand, an empirical approach more associated with the English-speaking world, which emphasizes the need for objectivity of measurement, and is as close as psychiatry gets to dustbowl empiricism. Stanghellini’s book, Disembodied Spirits and Deanimated Bodies (2004), is undoubtedly in the first tradition. (...) It is part of the growing International Perspectives in Philosophy and Psychiatry series, the success of which suggests some recognition that much of importance in .. (shrink)

In this response to Wiggins and Schwartz, Ratcliffe, and Stanghellini, we first wish to express our gratitude to Philosophy, Psychiatry, and Psychology for providing us the space to clarify our views and to overcome certain misunderstandings. Ratcliffe notes that our critique is "harsh," whereas Wiggins and Schwartz lament the fact that the debate "has taken the form of sometimes acid formulations and rejoinders . . . that lack the tone of mutual appreciation" (2011, 31). We deplore the fact that this (...) exchange was at all necessary, and we share Wiggins and Schwartz's concerns. However, we need to recall here and emphasize that our article originated as a response. It originated as a response to an article that was .. (shrink)

Time and Body promotes the application of phenomenological psychopathology and embodied research to a broad spectrum of mental disorders. In a new and practical way, it integrates the latest research on the temporal and intersubjective constitution of the body, self and its mental disorders from phenomenological, embodied and interdisciplinary research perspectives. The authors investigate how temporal processes apply to the contribution of embodiment and selfhood, as well as to their destabilization, such as in eating disorders and borderline (...) personality disorders, schizophrenia, depression, social anxiety or dementia. The chapters demonstrate the applicability of phenomenological psychopathology to a range of illnesses and its relevance to treatment and clinical practice. (shrink)

In this article I offer a critical analysis and evaluation of Thomas Fuchs' concept of corporealization, as well as the Leib/Körper distinction (i.e. the distinction between the lived and corporeal body) that it is founded upon. First, I show that the foundational concepts -- Leib and Körper -- are problematically heterogeneous, each including a diverse set of phenomena requiring further delineation and clarification. Second, I consider the historical origins of this heterogeneity and ambiguity within Fuchs' work. I show that Fuchs' (...) Leib/Korper distinction, while owing more to Plessner than Merleau-Ponty, is to a great extent his own development. Third, I delineate five senses of the body, or of embodiment. These senses of the body are meant to (1) clarify the diverse phenomena included under Fuchs' label of corporealization and (2) offer examples of features of embodiment that challenge Fuchs' Leib/Körper polarity. Fourth, I argue that the concepts of Leib, Körper, and corporealization will need to be more rigorously defined before they can adequately illuminate the phenomena to which they are applied. (shrink)

I discuss Watsuji’s characterization of aidagara or “betweenness”. First, I develop a phenomenological reading of aidagara. I argue that the notion can help illuminate aspects of our embodied subjectivity and its interrelation with the world and others. Along the way, I also indicate how the notion can be fruitfully supplemented by different sources of empirical research. Second, I put aidagara to work in the context of psychopathology. I show how disruptions of aidagara in schizophrenia not only affirm the (...) foundational role it plays in organizing our experience of self and world in everyday life. Additionally, I suggest the notion can, in this context of application, potentially enhance our understanding of and empathy for those living with schizophrenic disorders. (shrink)

Categorization-based diagnosis, which endeavors to be consistent with the third-person, objective measures of science, is not always adequate with respect to problems concerning diagnostic accuracy, demarcation problems when there are comorbidities, well-documented problems of symptom amplification, and complications of stigmatization and looping effects. While psychiatric categories have proved useful and convenient for clinicians in identifying a recognizable constellation of symptoms typical for a particular disorder for the purposes of communication and eligibility for treatment regimes, the reification of these categories has (...) without doubt had negative consequences for the patient and also for the general understanding of psychiatric disorders. We argue that a complementary, integrated framework that focuses on descriptive symptom-based classifications (drawing on phenomenological interview methods and narrative) combined with a more comprehensive conception of the human subject (found in the pattern theory of self), can not only offer a solution to some of the vexed issues of psychiatric diagnosis but also support more efficacious therapeutic interventions. (shrink)

This essay is a response to proposals to integrate patient-subjective or idiographic data into future versions of nosologies such as the DSM and the ICD. It argues that a nosology is not a suitable vehicle for disseminating psychopathological-phenomenological research results throughout the field. Drawing on the work of Ludwig Binswanger, it examines, on the basis of four postulates, how he applies the Husserlian concept of intentionality in psychiatry and thus arrives at a psychopathological phenomenology. For each individual postulate, we (...) then look in depth at the implications for the current debate around DSM. The conclusion we come to is that, both because of the objective of phenomenological research and because of the complexity of the kind of information involved in findings based on that research, it is impossible to integrate these findings into a nosology without deviating from either them or the nosology itself. (shrink)

Traditionally, phenomenological theories of schizophrenia have emphasized disturbances in self-experience, with relatively little acknowledgement of the surrounding world. However, epidemiological research consistently demonstrates a strong relationship between traumatic and stressful life events and the development of schizophrenia, suggesting that encounters in the world are highly relevant for many people diagnosed with this disorder. This paper reviews foundational texts in phenomenology and phenomenological psychopathology on the nature of subjectivity and its disturbances, finding support for broadening contemporary phenomenological (...) models of schizophrenia to incorporate world events and their subjective meaning as essential aspects of this disorder. This contextual approach to phenomenology emphasizes the relationship between self and world, one that is especially unstable, unclear, and untrustworthy in schizophrenia. Both epidemiological and phenomenological research can benefit from this approach: in epidemiology, researchers might consider the ways that various risk factors are experienced by persons vulnerable to schizophrenia, while phenomenologists are encouraged to inquire about the environmental and social context in which altered experiences occur and incorporate these considerations into their explanatory models. (shrink)

In 1910, Karl Jaspers wrote a seminal essay on morbid jealousy in which he laid the foundation for the psychopathological phenomenology that through his work and the work of Hans Gruhle and Kurt Schneider, among others, would become the ...

The centenary of Karl Jaspers' General Psychopathology was recognised in 2013 with the publication of a volume of essays dedicated to his work. Leading phenomenological-psychopathologists and philosophers of psychiatry examined Jaspers notion of empathic understanding and his declaration that certain schizophrenic phenomena are ‘un-understandable’. The consensus reached by the authors was that Jaspers operated with a narrow conception of phenomenology and empathy and that schizophrenic phenomena can be understood through what they variously called second-order and radical empathy. This (...) article offers a critical examination of the second-order empathic stance along phenomenological and ethical lines. It asks: Is second-order empathy possible? Is the second-order empathic stance an ethically acceptable attitude towards persons diagnosed with schizophrenia? I argue that second-order empathy is an incoherent method that cannot be realised. Further, the attitude promoted by this method is ethically problematic insofar as the emphasis placed on radical otherness disinvests persons diagnosed with schizophrenia from a fair chance to participate in the public construction of their identity and, hence, to redress traditional symbolic injustices. (shrink)