PHILOSOPHICAL PSYCHOPATHOLOGY

The study of subjective experience as a scientific task for psychopathology

2012-01-22T06:56:00.000-08:00

Abstract: The debate on the scientific validity of mental disorders and psychopathological phenomena is considered in the broader context of the paradigmatic crisis occurring in nowadays psychiatry. The author comments a work of Stoyanov, Machamer and Schaffner appeared on this journal. There is a complete agreement on two basic assertions: a) practically, clinical interviews, structured interviews based on the DSM and psychometric scales are different but overlapping instruments exploring the same phenomenal level; b) psychiatry is not a unitary science but a multifaceted activity based on different domains of knowledge. However, the related assumption that instruments exploring psychopathological phenomenology are not enough scientific because they are too much subjective is questioned. At the epistemological level, it is shown that subjectivity is everywhere since all scientific observations are theory-laden. Nevertheless, it is suggested that this state of affairs does not necessarily lead to methodological anarchism and is compatible with a scientific stance. At the psychopathological level, it is shown that both mental disorders and symptoms are hermeneutical constructions and that Jaspers introduced phenomenology as the proper scientific equipment for the scientific study of subjective experience. In conclusion it is suggested that psychopathological phenomenology can be renewed to meet the present-day scientific needs, but psychopathology cannot work without the awareness that its scientific descriptions are always based on a semiotic activity.
The entire article can be freely downloaded at: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2753.2011.01794.x/full

THE EPISTEMOLOGICAL BASIS OF PSYCHIATRIC CONTROVERSIES

2012-01-22T06:48:00.001-08:00

D. Kecmanovic recently published a paper on the reasons of the endless psychiatric controversies. A debate followed. Among the others, M. Aragona focused on the epistemology of psychiatry. He reminds that “taken as a whole the disciplines concerned with the mind and with mental pathologies do not constitute a mature science. While the various branches of medicine are all subtended by a common basic science grounded on a unique and shared view of the human body functioning, the various disciplines studying the mental phenomena are based on different theoretical principles, see their field of study from different viewpoints, use different techniques of inquiry and presuppose interpretations and solutions which are widely heterogeneous” (Aragona M. Aspettando la rivoluzione. Editori Riuniti, Roma, 2006, p.34). However, the author notes that to define psychiatry as a pre-paradigmatic scientific activity risks to pass unnoticed a fundamental assumption. In fact, the implicit idea is that psychiatry should conform to this model and that its current position is that of an immature science that in the future will be based on a unique scientific paradigm. This process will let all the other perspectives on the matter to progressively disappear from the scientific debate, being reconceptualized as non-scientific or proto-scientific cultural forms. This is the faith accompanying from its beginning any somatological theory about mental illness but the risk is to covertly introduce here a reductionist assumption: there are many perspectives and many models only because psychiatry is not scientific yet. Is it a correct picture of psychiatry, or at the opposite the peculiar object of study of our discipline (the mental suffering of the human being) cannot in principle be fully reduced to the materialistic study of his brain? The plurality of models is a transient phenomenon, or the multi-perspectivist approach is intrinsic to psychiatry and thus unavoidable? The methodological pluralism of Karl Jaspers is used here to support a multiperspectivist stance. In conclusion, psychological perspectivism and pragmatism (intended as choosing this or that model depending on the relevance of specific scientific/clinical questions and on the most appropriate model to answer) are proposed. It is suggested that the basic epistemological tension underlying psychiatric controversuies is that between a realist model (that sounds scientific but is historically untenable) and a constructivist model which is better corroborated by the historical inquiry but that by acknowledging the unavoidable role of hermeneutics risks to be perceived as anti-scientific and radically relativistic.
The link to read this article and the entire debate is: http://www.hdbp.org/psychiatria_danubina/pdf/dnb_vol23_no3/dnb_vol23_no3_02.pdf

Dialogues in Philosophy, Mental and Neuro Sciences 2011; Vol.4, Issue 2

2012-01-22T06:10:00.000-08:00

The new issue of Dialogues in Philosophy, Mental and Neuro Sciences is online. Two articles focus on phenomenological psychopathology.
In the first one, Maria Luísa Figueira and Luís Madeira (Lisbon University) discuss the role of time and space in the phenomenology of bipolar disorders, particularly in mania. Theories by Heidegger, Husserl and Merleau-Ponty as well as by Minkowsky, Binswanger, Fuchs, Parnas, and Sass are reviewed in relation to euphoric and dysphoric manic and hypomanic states.
This article can be freely downloaded at: http://www.crossingdialogues.com/Ms-A11-01.pdf
In the second paper, Paola Gaetano discusses a previous paper published on a past issue of Dial Phil Ment Neuro Sci (Kraus A. Existential a prioris and the phenomenology of schizophrenia). She argues that the current diagnostic systems have inadvertently resulted in an impoverished clinical practice; From their purely descriptive point of view schizophrenic symptoms that would appear bizarre and senseless. On the contrary, Gaetano suggests that there is substantial meaning underlying psychotic phenomena and that an Heideggerian conception of human existence (the existence is always 'in the world', 'near the things' and 'with the others' in the unity of the Dasein) may help understand the subjective experience of a schizophrenic patient and increase diagnostic accuracy and treatment adequacy. This article is at this link: http://www.crossingdialogues.com/Ms-A11-02.pdf
A third article (Mari Stenlund: Involuntary antipsychotic medication and freedom of thought) deals with a complex issue in applied ethics: what is the relationship between the use of involuntary antipsychotic medication and a delusional person's freedom of thought? The author shows that clinical practice strictly depends on the way we conceive freedom. Accordingly, she discuss different stances in the psychopharmacological approach in the light of three different views of freedom, namely, freedom as negative freedom, freedom as having an autonomous mind and freedom as capability. Download at: http://www.crossingdialogues.com/Ms-C11-02.pdf
Another paper discusses the classic antipsychiatric text of Thomas Szasz (The myth of mental illness) from a semiotic point of view. It is shown that Szasz’s revolution is to consider the hysterical symptoms as a foreign language, thus allowing a semiotic analysis. Accordingly, the somatic language of the hysteric person is discussed as an iconic protolanguage. The conclusion is that the hysterical symptom speaks its proper language and our ethical commitment is primarily to empathically listen to it (Valeria Lelli: The body language: a semiotic reading of Szasz' Anti-psychiatry). The link to read this contribution is: http://www.crossingdialogues.com/Ms-C11-03.pdf
Finally, Sofia Siwecka presents the epistemological ideas of a great figure in the early philosophy of medicine: Ludwik Fleck. Fleck anticipated many ideas later defended by the “new philosophy of science” (e.g. Thomas Kuhn) but is only rarely cited because his main contributions are in Polish. Siwecka directly translated Fleck’s texts and introduces the reader to his theory of knowledge. Applied to psychiatry, the ideas of Fleck shed light on how psychiatric diagnoses are influenced by a specific thought style that directs the observations and affects the development of knowledge and the formation of connections between concepts. This article is at: http://www.crossingdialogues.com/Ms-C11-04.pdf

Melancholia and Arts

2011-11-24T08:21:00.000-08:00

What is a melancholy from psychopatological perspective?
How has melancholia been interpreted through history?
Why does melancholia "pervade every arts" (Lars von Trier)?
Is melancholia connected with narcissim?
Some books on this topic?
These are the questions from an interview appeared on SATELLITE VOICES
To read it, the link is: http://www.satellitevoices.com/rome/culture/1790/melancholia-iii-massimiliano-aragona

Program of the 2011-2012 Seminars of the Roman Circle of Psychopathology

2011-11-22T05:04:00.001-08:00

Does phenomenological psychiatry have a future? September 3, 2011

2011-10-05T07:56:00.000-07:00

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.

An introduction to Philosophy of Psychopathology

2008-09-12T23:35:00.000-07:00

Philosophy of Psychopathology is not intended to be a new specialized discipline, but rather a “meeting point” conceived to answer to an undelayable need for the sciences dealing with mental phenomena. Its major aims are to enhance the dialogue from different points of view on this topic, and to put in contact scientists that work on it from the inside of their disciplines.
The starting point is to be found in Karl Jaspers’ General Psychopathology: it is intrinsic to psychopathology that it needs a rigorous philosophical basis that must allow at the same time:
a) The emergence of implicit prejudices, since “If anyone thinks he can exclude philosophy and leave it aside as useless he will eventually be defeated by it in some obscure form or other. From this springs the mass of bad philosophy in psychopathological studies. Only he who knows and is in possession of his facts can keep science pure and at the same time in touch with individual human life which finds its expression in philosophy” (Jaspers, 1963, p.770).
b) The clear and explicit foundation of the unavoidable and necessary philosophical premises of psychopathological practice with philosophy intended in its proper methodological role: “In psychology as in psychopathology there are very few, perhaps no, assertions which are not somewhere and at some time under dispute. If we wish to raise our statements and discoveries to firm ground, above the daily flood of psychological notions, we shall almost always be forced to reflect on our methodology” (Jaspers, 1963, p.5).
Psychopathology is psycho(patho)logy. In Minkowski’s sense, it is both “pathology of the psychological” and “psychology of the pathological”, and it is also the overcoming of these points of view. Indeed it is an area that traditionally links psychology and psychiatry, and that nowadays it is opening to the contribution of cognitive sciences, philosophy of mind, neurosciences and so on.
At the same time, due to its methodological role and its heuristic contribution, the philosophy involved herein is, above all, philosophy of science and epistemology. Yet, psychopathology is the science that studies mental phenomena, therefore the cooperation with a rigorously scientific form of phenomenology is essential. Moreover, language is one of the privileged instruments of the psychopathological work, and comprehension and interpretation are incorporated as essential parts of psychopathological activities; therefore, philosophy of language and semiotics are essential too.
Finally, mental phenomena under study in psychopathology are inherent to the human being that express them, and in turn the person constructs his/her identity from the inside of a larger system that is familiar, social, and cultural. Systemic theory, sociology and anthropology are thus main parts of the psychopathological frame.
Philosophy of Psychopathology refers to all these knowledge contexts establishing connections between them and putting all these contributions in a common framework that aims to be coherently scientific.

Massimiliano Aragona
Chair of Philosophy of Psychopathology
Sapienza University, Rome, Italy

Please, cite this paper as follows:
Aragona M. (2008) An introduction to Philosophy of Psychopathology. http://philosophicalpsychopathology.blogspot.com