Clinicians constantly shift the focus of their attention when seeing a patient who presents psychopathological phenomena. Arguably, it is not possible to tell in advance (that is, before quite a while in the diagnostic assessment process) where the problem lies, whether it is necessary to zoom in and look into the patient’s brain (or genes), or if we have to zoom out and pay special attention to his/her relational (or social) world, or if we should concentrate on his/her own subjective experience. In psychiatry, we deal with embodied subjects and their actions under description and within context, not merely bodily dysfunctions. However, if we reject reductionism, i.e., the very idea that there is a single fundamental level of explanation for all mental disorders, and adopt instead a multilevel model within a pluralist explanatory stance, it remains to be determined whether or not such changes of explanatory levels that take place in everyday clinical practice can be fully codified or, in other words, to which extent they inevitably rely on tacit knowledge. If that is the case, then no algorithm, however sophisticated, can fully capture clinical reasoning.
Keywords: Multilevel models; Explanatory pluralism; Clinical judgment
Recent biosemiotic research highlights the fact that “human individuation is (…) a double-tracked process, consisting in an incessant reconciliation or negotiation between the virtual reality that we have constructed in our minds and mind-independent reality as it impresses itself upon our lives. Human life cannot therefore be defined by its uniqueness as a particular genetic combination, but must instead be defined by its uniqueness as a temporal outcome of semiotic individuation” (Hoffmeyer, 2015b). Semiotic individuation was at the core of Ernst Cassirer’s “Philosophy of Symbolic Forms” (1923/25/29). His unique approach to view ‘symbolic formations’ like magic, myth, religion, law, science, the arts and others as universal ‘mediators’ within the variable and developing levels of human worldmaking (which define the make-up of language and consciousness) was to philosophically anticipate the very idea which biosemiotic research is confirming today. A synthesis of psycho/biosemiotics and Cassirer’s symbol-theories can open up an entirely different approach to human interaction and consciousness, thus setting a different compass point for our theoretical attitude to psychopathology. This may help in opening up those hidden fundaments and secretly determining factors within the puzzling and contradictory phenomenology of psychiatric symptoms.
Keywords: Psychiatry; Biosemiotics; Psychosemiotics; Psychopathology; Symbol.
“Praecox Feeling” (“Praecox Gefühl”) was a notion introduced by the Dutch psychiatrist H.C. Rümke as an attempt to emphasize schizophrenic gestalt as a key feature for diagnosis. Our purpose is to decrypt Rümke’s work and to offer a critique based on a case study. From a phenomenological framework, we attempt to show the relevance and the limits of this concept in order to enlighten contemporary nosographic issues. Rümke suggested that symptoms themselves are not reliable for a rigorous diagnosis of schizophrenia. He proposed the term of Praecox Feeling to describe the bizarreness experimented by the clinician from the first minutes of the encounter with a person with schizophrenia. This notion refers to Karl Jaspers “radical incomprehensibility” of mental disorder. Our point is to take seriously this incomprehensibility to think a second person approach to diagnosis. To explore this track, we will focus our interest on the clinician subjective experience of schizophrenic encounter. In this regard, we will not think bizarreness as polarized on the patient’s side, but rather as an in-between event. Since then psychopathologic comprehension call for an epistemology of human contact and minimal-social space. Schizophrenic encounter needs then to be revisited in a more dynamic and embodied way.
Keywords: Schizophrenia spectrum; Praecox feeling; Phenomenology; Embodied Intersubjectivity
Have emerged in recent times in the area of psychology many questions and discussions that aim to problematize the field of psychological sciences. These questions run mainly professionals from the phenomenological questioning the current trend of prioritizing technical rather than a qualitative conception of the human being by psychology. The aim of this paper is to discuss the theory formulated by Edith Stein about the structure of the human person within the phenomenological perspective. It appears that Edith Stein focuses on the essential structure of the human being and indicates a methodological approach to make rigorous psychology in its philosophical foundations, and even more sensitive to its subject, the human being. Finally, it is considered that the phenomenological conception of Edith Stein contributes to understanding the complexity of human beings and also helps to enhance human psychology specifically, making it more human in their purposes.
Keywords: Psychology; Edith Stein; Phenomenology; Structure of the human person.
The first generation of Daseinsanalists is well known. Daseinsanalysis is inaugurated by Ludwig Binswanger, who takes Heidegger´s description of existence in Being and Time to interpret psychopathologies as world-projects, and later developed by Medard Boss with the philosopher´s help in the Zollikon Seminars. This article aims to present reformulations proposed by swiss daseinsanalist Alice Holzhey-Kunz (1943 – ), Boss´ ex-student. She interprets psychopathologies as modes of “suffering one´s own being”, i.e., they are modes of being in which the existential condition erupts and reveals itself. In psychopathological experiences, ontological understanding of one´s own being (pre-ontological inclusion), usually screened out by occupation, makes daily existence difficult and demanding ‘ontic maneuvers’ – behaviors and mechanisms aiming to neutralize ontological aspects, but bound to fail from the start. To better illustrate it, I present and discuss Holzhey-Kunz´s interpretation of Borderline Personality Disorder articulated with a clinical case.
Keywords: Daseinsanalysis; Borderline Personality Disorder; Psychopathology.