Wednesday 5 October 2011

Does phenomenological psychiatry have a future? September 3, 2011


As part of the 14th International Conference for Philosophy and Psychiatry Crossing Dialogues Association organized a symposium of the most important, both for numbers of visitors and for the relevance of the topics covered.
The symposium, entitled "Does phenomenological psychiatry have a future?", was opened by a report by Massimiliano Aragona on the recurring crises in psychopathology and the future of phenomenology in psychopathology. He showed that phenomenology was introduced by Karl Jaspers as a reaction against those systems based only on neurology, which he termed "mythologies of the brain". Then, the phenomenology of Jaspers and that of Binswanger were compared, stressing the problems arising in both approaches.
It was then described the current crisis of descriptive psychopathology (due to the crisis of the DSM). The conclusion was that we need to go back to a phenomenology that takes into account that symptoms are constructs emerging through a donation of significance within the relationship patient - psychiatrist - cultural and social context.
In the second report Alfred Kraus, professor emeritus at the University of Heidelberg, illustrated the relationship between Jaspers understanding and eidetic phenomenology analyzing in particular the Jaspers' characterization of delusion.
Kraus recalled the formal characteristics of delusion and the criticisms about these addressed on Jaspers, in particular the concept of incomprehensibility and incorrigibility of delusion. Nevertheless, Professor Kraus has shown convincingly that Jaspers himself considered these characteristics as general and superficial, and that in his General Psychopathology he analyzes in greater detail the essential aspect of the delusion, which is found in the primary delusional experience of the Wahnstimmung in particular in the imposition of significance of the delusional experience. On this basis, the conclusion was that Jaspers had an eidetic approach in its own way which is not far from the psychopathological phenomenology typical of Daseinsanalysis.
The last report was given by German E. Berrios, professor emeritus of Epistemology of Psychiatry at the University of Cambridge, who addressed the issue of whether or not phenomenology and biological psychiatry are compatible. After illustrating the richness and epistemological complexity of the concept of compatibility, Prof. Berrios has distinguished between a narrow and a broad way to define both phenomenology and biological psychiatry.
Strictly speaking, the biological psychiatry is a reductionist research project incompatible with any form of phenomenology. In a widest sense biological psychiatry asserts that there is a neurobiological basis of mental illness, and yet that there are levels not completely reducible to a mere mechanism. Taken in this broad sense, biological psychiatry would be compatible with phenomenology. But at this level everything cannot be compatible, because the phenomenology in the strict sense (e.g. in the original project by Husserl) is radically different.
Phenomenology would be compatible with biological psychopathology considering both from a wide point of view. The risk here is to reduce phenomenology to mere descriptive psychopathology, thus losing the most interesting part of the contribution to psychiatry by European phenomenological psychopathology.
The discussion was very lively, with a series of questions about the role of validity in phenomenological research, the need to update descriptive psychopathology and to liberalize the way to make the diagnosis in psychiatry. Questions were arisen as well about whether theories and methods of treatment in psychiatry may comply in a single scientific model, or if the multiperspectivism is inevitable and inherent to psychopathology.

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