From the Problem of the Nature of Psychosis to the Phenomenological Reform of Psychiatry. Historical and Epistemological Remarks on Ludwig Binswanger’s Psychiatric Project, Medicine Studies, N. 3, Issue 4, 2012, pp. 415-432. (DOI) 10.1007/s12376-012-0076-x (original) (raw)
Related papers
A Step Beyond Psychopathology: A New Frontier of Phenomenology in Psychiatry
Philosophy, Psychiatry, & Psychology, 2019
ritical-philosophical commentary on theses defended in scientific articles may be guided by two distinct perspectives, each leading to inquiries and styles of responses that are both distinct and complementary: an internal perspective and an external perspective. The internal commentator belongs to the same epistemological field of the authors and, as such, shares the same categorical assumptions and the same Weltanschauung explored in the text. The dialogue with this commentator emphasizes the minutiae of the observation of the shared scientific reality and points out the frontiers toward which the discussion of a scientific branch must advance. The external commentator, in contrast, emphasizes the categorical contrasts and semantic differences between the scientific field to which this commentator belongs and the one to which the authors belong. Their inquiries summon the authors to an explanation of their concepts. The valuable comments of Daker and Dalgalarrondo to the article "Principles for pharmacological treatment of schizophrenia in light of phenomenological psychopathology" correspond with internal and external criticisms, respectively. Both allow
ABSTRACT: The present paper clarifies key issues in phenomenology and phenomenological psychopathology (especially of schizophrenia) through a critique of a recent article that addresses these topics. Topics include: 1, Phenomenology’s role in clarifying issues not amenable to purely empirical methods. 2, The relationship between a phenomenological approach (focusing on the subjective life of the patient) and empirical science, including neuroscience. 3, The nature of self-experience, especially in its pre-reflective form (“ipseity”—involving “operative intentionality”), and its possible disturbance in schizophrenia (“hyperreflexivity” and “diminished self-affection”). 4, The relationship between self disturbance in schizophrenia and disorders of both temporality and (what Husserl termed) “passive syntheses.” 5, The role of intentional or quasi-volitional processes in the perceptual (and other) disorders in schizophrenia. 6, The nature and diversity of phenomenology’s potential contribution to the enterprise of “explanation.” 7, The meaning of several concepts: “hermeneutic” or “existential” approach; phenomenological “reflection”; “negative symptoms.”
Binswanger and phenomenology applied to mania
Revista Psicopatologia Fenomenológica Contemporânea
Binswanger has a fundamental appreciation: he refuses to accept the so-called “Faculty Psychology”, and his thoughts and arguments are especially interesting for focusing at this point. We employ the analyses made by the author as an example of this and also as a focus of study of the maniac subjectivity. I would like to especially highlight the concept of “Ideenflucht”, the «flight of ideas», that later became pathognomonic of mania. It is also interesting to pay attention to the use that Binswanger made of Heidegger’s ideas, mainly taken from “Sein und Zeit”, because in this exceptional case, in which – as in many others – a psychiatrist supports his theoretical developments in a philosopher, Heidegger himself criticized the use that Binswanger made of his concepts. The place where we can circumscribe these issues is the “Zollikon Seminars”, given by Heidegger in Switzerland between 1959 and 1969 at the invitation of Dr. M. Boss.
Phenomenological Psychopathology and Schizophrenia: Contemporary Approaches and Misunderstandings
The present paper clarifies key issues in phenomenology and phenomenological psychopathology (especially of schizophrenia) through a critique of a recent article that addresses these topics. Topics include (1) Phenomenology's role in clarifying issues not amenable to purely empirical methods; (2) The relationship between a phenomenological approach (focusing on the subjective life of the patient) and empirical science, including neuroscience; (3) The nature of self-experience, especially in its pre-reflective form ("ipseity"-involving "operative intentionality"), and its possible disturbance in schizophrenia ("hyperreflexivity" and "diminished self-affection"); (4) The relationship between self-disturbance in schizophrenia and disorders of both temporality and (what Husserl termed) "passive syntheses"; (5) The role of intentional or quasi-volitional processes in the perceptual (and other) disorders in schizophrenia; (6) The nature and diversity of phenomenology's potential contribution to the enterprise of "explanation"; and (7) The meaning of several concepts: "hermeneutic" or "existential" approach, phenomenological "reflection," and "negative symptoms."
Phenomenology and the Crisis of Contemporary Psychiatry: Contingency, Naturalism, and Classification
My dissertation contributes to the contemporary field of phenomenological psychopathology. The work has two major aims. First, I show how a phenomenological approach can clarify and illuminate the nature of mental disorder, providing helpful distinctions between psychopathological conditions that can facilitate psychiatric research, classification, and diagnosis. Second, I argue that when psychopathological disturbances are taken seriously by phenomenologists, they have the potential to challenge both phenomenology’s status as a transcendental philosophy and its corresponding anti-naturalistic outlook. In the opening chapter, I articulate the subject matter of phenomenological research, arguing that phenomenologists study three distinct layers of human existence, which I refer to as “existentials,” “modes,” and “prejudices.” While each layer contributes to what we might call the “structure” of human existence, they do so in different ways, and to different degrees. Existentials—also referred to as transcendental, essential, or ontological structures—are the basic, categorial features of human existence, such as temporality, affectivity, and intersubjectivity. Modes are the particular manifestations of existentials; affectivity, for example, might manifest through the modes of joy, sorrow, or guilt. Prejudices, in contrast, are the tacit biases or presuppositions that determine how we interpret and understand our objects of experience. Because phenomenological psychopathology—and applied phenomenology in general—aims to characterize how the structure of human existence can change, I argue that these layers must be distinguished and defined before investigating psychopathological disturbances. This chapter has been published as “The Subject Matter of Phenomenological Research: Existentials, Modes, and Prejudices,” in Synthese. In chapters two through five, I conduct hermeneutic and phenomenological investigations of the psychopathological phenomena typically labeled as major depressive disorder and bipolar disorder. I employ hermeneutic studies of psychiatric language and terminology (chap. 2) to expose poorly defined categories of disorder, preparing the way for phenomenological investigations of the affective aspects of depression (chap. 3) and mania (chap. 4), and the embodied aspects of melancholic depression (chap. 5). Furthermore, I argue that these psychopathological conditions involve changes in the most fundamental layer of human existence—what I have referred to as the layer of existentials. As I argue, many of the classical phenomenologists (including Husserl and Heidegger) believed that these structural features were necessary, unchanging, and universal. However, examining psychopathological and neuropathological conditions challenges this presupposition, undermining the extent to which phenomenology is accurately characterized as transcendental philosophy. These chapters have been published in the Journal of Psychopathology (chaps. 2 & 4), Phenomenology and the Cognitive Sciences (chap. 3), and the Journal of Consciousness of Studies (chap. 5). In chapters six and seven I articulate these challenges in more detail in order to achieve two distinct ends: a defense of phenomenological naturalism and a phenomenological approach to psychiatric classification. In chapter six I argue that psychopathology and neuropathology not only challenge phenomenology’s status as a transcendental philosophy, but also supply a key to developing a phenomenological naturalism (which I contrast with a naturalized phenomenology). Phenomenological naturalism, as I articulate it, is a position in which phenomenology is not subsumed by the metaphysical and methodological framework of the natural sciences, but maintains the capacity to investigate the relationship between nature and human subjectivity. A portion of this chapter has been published as “Contaminating the Transcendental: Toward a Phenomenological Naturalism,” in the Journal of Speculative Philosophy. In chapter seven I argue that the kinds of contingency and variation articulated in the preceding chapters provide a framework for a dimensional approach to psychiatric classification. Such an approach dispenses with distinct categories of disorder, instead beginning from core features of human subjectivity, such as selfhood, affectivity, and temporality, showing how these features can alter or vary in degree. Such an approach, I argue, has strong parallels with recent developments in psychiatry, and would reduce the obstacles to fruitful dialogue and collaboration between psychiatrists and phenomenologists. For example, by paralleling the dimensional framework of contemporary psychiatry, phenomenologists will be able to draw conceptual distinctions that can guide new research into neurobiological and genetic substrates. This chapter has been published as “Phenomenology and Dimensional Approaches to Psychiatric Research and Classification,” in Philosophy, Psychiatry, & Psychology. By offering applied investigations of psychopathological conditions as well as foundational studies of phenomenology’s metaphysical presuppositions, my dissertation has both a contemporary and a historical component. The dissertation secures a sound footing for phenomenological psychopathology by clarifying its subject matter and proposing new avenues for interdisciplinary collaboration. But in so doing, it also initiates a return to the classical texts, reinterpreting the work of Husserl, Heidegger, and Merleau-Ponty in light of the implications of psychopathology.
Actas espanolas de psiquiatria, 2013
The epistemological underpinnings of psychiatric theory and practice have always been unstable. This reflects the essential contradiction existing between the task (the description and individuation of speech and behavior as psychopathological symptoms) and tools (semiotics). As a result of this contradiction, the history of psychiatry is one of permanent crisis in which there are moments of temporary stability as approaches that aim at organizing this mismatch between tasks and tools gain prevalence. However, these approaches can only offer a false sense of unity, consistency and progress. In this sense, a narrow perspective on a particular period may lead us to believe that psychiatry is just another medical specialty with its own specific theoretical framework like others. However, any such perspective overlooks the coexistence of different schools, disagreements, contradictions, global alternatives, etc. For a certain period of time, phenomenology was assumed to be as the soluti...
Phenomenological understanding of psychosis
Existential Analysis, 2008
What characterizes any phenomenological approach is the attempt to conceptualize in as close connection with the actual experience of the phenomena as possible. Thus, we have to look for the intentionality in the psychosis, the wild and chaotic structuring of meaning as angst. For psychosis basically has to do with angst in a sense that has been explicated by existentialism, psychoanalysis and phenomenology. The seemingly meaningless expressions of intentionality in psychosis are not so very surprising on the background of Merleau-Ponty's explications of corporeal intentionality. In his close investigations of intentionality in perception, the body, and language Merleau-Ponty laid open a structuring of meaning which, however incoherent it may be, is sociocultural structuring and which we never escape in our own experience and practice. It is possible to apply different kinds of phenomenological understanding and conceptualization in accord with Merleau-Ponty's philosophical position. We may distinguish between a structural, a generative and a dialectic understanding of human experience and practices. The application of these approaches implies a constructive criticism of traditional phenomenological views of psychosis and points towards a new understanding of intentionality in psychosis.
Mind and Madness: New Directions in the Philosophy of Psychiatry
Royal Institute of Philosophy Supplement, 1994
These are exciting times for philosophy and psychiatry. After drifting apart for most of this century, the two disciplines, if not yet fully reconciled, are suddenly at least on speaking terms. With hindsight we may wonder why they should have ignored each other for so long. As Anthony Quinton pointed out in a lecture to the Royal Institute of Philosophy a few years ago, it is remarkable that philosophers, in a sense the experts on rationality, should have had so little to say about the phenomena of irrationality (Quinton, 1985, ch. 2). There have been partial exceptions, of course. Descartes and Kant both touched on madness; and there were, notably, important philosophical influences on the development of modern psychiatry in the late nineteenth and early twentieth centuries (Zilboorg and Henry, 1941). Yet even John Locke, who was a doctor as well as philosopher, confined himself to a fair-l y superficial distinction between what we should now call mental illness and mental defect—...
Phenomenological psychopathology in contemporary psychiatry
Due to growing skepticism about the current psychiatric model, psychopathology has once again aroused interest in the psychiatric field. This article intends to examine the current perspectives of the phenomenological approach of psychopathology in the context of psychiatry. To this end, we will situate phenomenology along the historical course of psychopathology, presenting the particularities of its understanding of the psychiatric object, and finally, we will defend, in general terms, the affinity of the phenomenological approach with the aspirations and practical needs of the field of psychiatry.
Generating Sense: Schizophrenia and Phenomenological Praxis
Schutzian Research 3 (2011): 121-132
The aim of phenomenology is to provide a critical account of the origins and genesis of the world. This implies that the standpoint of the phenomenological reduction is properly extramundane. But it remains an outstanding task to formulate a credible account of the reduction that would be adequate to this seemingly impossible methodological condition. This paper contributes to rethinking the reduction accordingly. Building on efforts to thematize its intersubjective and corporeal aspects, the reduction is approached as a kind of transcendental practice in the context of generativity. Foregrounding the psychotherapeutic encounter with persons suffering schizophrenic delusion as paradigmatic of the emergence of shared meaning, it is argued that this is where we may best come to terms with the methodological exigencies of phenomenology’s transcendental aim. It follows that phenomenologists across all disciplines may have something important to learn from how phenomenology has been put into practice in the psychotherapeutic domain.