Wednesday 18 April 2012

Towards a new epistemology of psychiatry - Prof. German Berrios at the Roman Circle of Psychopathology

On February 16, 2012 the Roman Circle of Psychopathology was honoured to meet Prof. German E. Berrios (Cambridge University) who lectured on Towards a new epistemology of psychiatry.
The lecture was co-organized with the Association Crossing Dialogues that supports the interdisciplinary dialogue between philosophy and psychopathology. The organizers thank the University of Rome La Sapienza for the hospitality, and Dr. Giorgio Kotzalidis for his kind help with the translation.
Abstract of the lecture
Prof. Berrios started his lecture by drawing a difference between macroepistemological and microepistemological questions concerning psychiatry. The last are about mental symptoms (e.g., What is their nature? What's their meaning? What kind of structure do they have? What kind of typology? Are they homogeneous or heterogeneous?), about mental disorders (How are they defined? Are they historical entities? What's their cultural impact? What's their ontology?), and about generators and configurators (Reductionism, Localisationism, Psychogenesis, Semantic Space, Reasons vs Causes, etc.).
The historical perspective shows that the primary phenomena are the mental symptoms, which are currently considered as the 'objects of psychiatry'. Against this predominant assumption, Prof. Berrios showed that mental symptoms originated and were constructed in a particular historical and cultural context and that they were from the start constructed as hybrid objects.
Mental symptoms are hybrid objects because they exhibit the following features: a physical kernel regularly subjected to cultural configuration, and a dense semantic wrapper or envelope. According to the Cambridge model of symptom formation, an original brain signal can reach the awareness domain. In this case the subjective experience is initially indefinite (the author talks of a "primordial soup"). Here a first semantic level is involved when the patient, on the basis of his own characteristics (i.e. styles of talking about the body: personal, familial, social, cultural, etc.) tries to define and denominate his experience. A second level is that of symptom expression, when symptom-formation occurs within a "dialogical encounter" between the patient and the psychopathologist. It is only after this "negotiation of meaning" that the originally indistinct experience becomes a recognized, delimited and denominated mental symptom.
In conclusion, according to the Cambridge model mental symptoms are brain signals configured by cultural codes. One signal may give rise to different mental symptoms and different signals can be configured as the same mental symptom.
In sum, this model challenges the opposition nature-culture in a way that reconciles dynamically the brain activity and the semantic sphere.

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