The subjective experience of schizophrenia, its cause, and its course have been consistent topics of interest within the phenomenological tradition since its inception. After 80 years of study and the efforts of many investigators, however, phenomenological contributions have so far had only a modest impact on current understandings of this disorder. In this article, the author reviews the methodological and theoretical issues involved in the development of a phenomenological approach to understanding schizophrenia. Drawing examples from his own empirical research, the (...) author illustrates the three steps of description, understanding, and explanation required by an application of the phenomenological method to this empirical domain. He then considers obstacles to the acceptance of insights generated through this method by the mainstream psychiatric community. In conclusion, he suggests that the promise offered by a phenomenological approach will most likely be fulfilled when investigators appeal to the phenomenological conviction in intentionality to provide the guidelines for an empirical science of subjective life. (shrink)

The last in a series of examinations, this paper articulates Husserl's mature position on the nature of a phenomenologically informed human science. Falling between the naïve positivity of a naturalistic approach to psychology and the transcendental view of consciousness at the base of phenomenological philosophy, we argue that a human scientific psychology—while not itself transcendental in nature needs to re-arise upon the transcendental ground as an empirical—but no longer transcendentally naïve—discipline through Husserl's notion of the "return to positivity." This notion (...) of the return allows us to avoid "transcendental psychologism," differentiating psychological from transcendental subjectivity but from a transcendental, rather than naïve perspective. In this way, the return to positivity reclaims psychology as a worldly, but no longer naïve, discipline. To facilitate an understanding of the different perspectives in question, and the process of leaving the naturalistic perspective in order to return to it once armed with a transcendental understanding and its associated tools, we continue to develop the illustrative example of anorexia provided in the first part of this series. In conclusion, we discuss the implications of this framework for transcendental reforms both of clinical practice and of psychological research. (shrink)

Schizophrenia has historically been considered a severe psychiatric disorder with a chronic and progressive course; an assumption that has shaped both clinical research and public policy. Recent studies have suggested, however, that many people recover from this disorder to varying degrees, prompting new research approaches that focus on factors influencing improvement as well as pathology. An empirical-phenomenological approach appears especially promising as an avenue to investigating the active role the person may play in improvement. The dimensions of everyday life that (...) are discussed as providing a conceptual framework for investigations of the active role of the person are intentionality, temporality, and meaning. Within this framework a four-step process of recovering and reconstructing the self in schizophrenia is then delineated, with concrete illustrations of each step drawn from interviews with one young woman with schizophrenia. The findings are taken to represent the kinds of valuable insights that may be garnered from an empirical-phenomenological approach to research built upon a recognition of the importance of the dimensions of intentionality, temporality, and meaning in the everyday life of those afflicied with severe mental illness. There is only the fight to recover what has been lost And found and lost again and again. T. S. Eliot. (shrink)

This chapter briefly discusses the history of the notion of "cure" in relation to serious mental illnesses from Pinel to the present day, including both theories on the nature of the illnesses and the nature of presumed therapeutic agents and mechanisms. The chapter then gives a brief overview of the notion of "recovery" in relation to serious mental illnesses, also from Pinel to the present day, and describes various definitions and forms of recovery as they have emerged over time. With (...) this historical and conceptual background in place, the chapter then takes up the present state-of-the-art in psychiatry in relation to both concepts of cure and recovery, considers the empirical and neuroscientific evidence available relative to each concept, and then suggests several directions for research and philosophical reflection as the field continues to evolve. Two guiding principles that shape this discussion are that mental illnesses are not one-dimensional phenomena, but may be made up of several loosely related components which each have their own natural course, and that mental illnesses do not typically take over the entirety of a person's functioning, but also leave other aspects of functioning relatively intact. The combination of these principles suggests that cure and recovery are not likely to be binary functions in relation to serious mental illnesses, but will more likely be more a matter of degree across multiple domains. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.2 (2002) 131-136 [Access article in PDF] Language, Logic, and Recovery:A Commentary on van Staden Paul Falzer and Larry Davidson Keywords: analytic philosophy, experience, Frege, ordinary language, psychosis, psychotherapy. VAN STADEN'S PAPER, "Linguistic Markers of Recovery," takes on a formidable task. As he explains it, findings from a previously conducted empirical study suggest that recovery from a psychiatric condition can be predicted by certain patterns (...) of first person pronoun usage. His current paper explains how these patterns follow the mathematical logic of Gottlob Frege. van Staden's attempt to systematize the link between language and treatment outcome shows promise. We want to support his effort by raising a few caveats about the application of foundational systems in psychiatry and psychology, particularly the advisability of employing a logical system to explain recovery from mental illness. Along the way, we will be identifying related issues that the author may elect to take up in his future work.van Staden's proposal is inspired by Frege's logical system, but the paper is, at the very least, an innovative adaptation. There are various points where we are left to wonder just how much of this proposal is really Frege's. Nevertheless, the genesis of van Staden's ideas is so dependent that one would expect a fuller account of Frege's pivotal role in the development of modern logic, how his work precipitated what is known commonly as the linguistic turn, and why a logical system that was so well received when first articulated was eclipsed so quickly by Russell's Principia (1963) and Wittgenstein's Tractatus. (1981) These issues can be addressed separately and perhaps they should, because lacking an account of how Frege's philosophy developed and evolved makes the presentation appear somewhat sketchy and incomplete.Frege is portrayed in philosophical lore as the founder of modern logic and a pioneer of the movement that later became known as analytic philosophy. Dummett (1991) regards Frege's Foundations of Arithmetic (1968) as analytical philosophy's first work (p. 111). According to Quine (1955), "All modern logic owes an incalculable debt to Frege. If anyone can be singled out as the founder of mathematical logic, it is by all odds he" (p. 158). Rorty (1967) notes that analytic philosophy's tack of construing philosophical questions as turning on language use and construction challenges the entire tradition, from Parmenides forward. However, the challenge reaches fruition not in Frege, but in works of Moore, Wittgenstein, and Austin. Rather than [End Page 131] sharing the limelight with the great analytic philosophers, Frege has become somewhat of a peripheral figure, whose contribution is usually portrayed as transitional. In some respects, analytic philosophy was moving against Frege's, and later, Russell's logical systems as it was concomitantly countering the various strands of idealism expounded principally by Bradley and McTaggart (see Hacker 1996, 5-12). Almost from the outset, Fregean logic was caught in a cross fire, and the author is obligated to tell us why we should be attending to the pristine version and not the more fully developed approaches that came soon after.Such a justification undoubtedly would begin with the dictum most central to Frege's philosophical thought, that propositions are primary. For Kemp (1998), this declaration carries two interrelated implications: Logical propositions are the real bearers of truth and falsity, and reasoning is a movement from one judgment to another (see p. 218). Frege posits that propositions are independent of mind, grammar, and language use. Knowledge and cognition are embodied in, but do not predicate, judgment. Frege adamantly rejects the notion that philosophical concepts are grounded in psychological phenomena, such as perception, sense impression, and some traditional accounts of meaning. This is the doctrine known as psychologism, and Frege abjures the suggestion that psychology can contain the sciences or adjudicate their findings (Frege 1956; for a discussion of this doctrine, see Notturno 1989; Davidson 1988; Davidson and Cosgrove 1991). The dictum that propositions are primary dispels the commonly held idea that reasoning begins with perception and proceeds... (shrink)

Emerging action perspectives on psychopathology depict individuals as actively shaping those environmental conditions that then impact on their risk for psychopathology, resilience in the face of it, and successful recovery from it. This view, although having important implications for research and clinical practice, has yet to be articulated in terms of its underlying philosophical framework. To begin to address this challenge, we situate action theory in the context of the writings of Deleuze and Guattari, who, in their seemingly anti-psychiatric series (...) entitled Capitalism and Schizophrenia, argue for the central role of human agency as a fundamentally active force in determining subjective life. Within this context, they propose an alternative approach to the current deficit focus of much psychopathology research, replacing the notion of deficit with a fundamentally productive notion of desire (what they call “desiring-production”). After our exposition of this philosophical perspective on human agency, implications of this approach for action-informed research and clinical practice are discussed. (shrink)

This paper explores the status of language and suffering in recovery from psychosis from a transcendentally-informed phenomenological perspective. We suggest that each of these concepts can apply both to the illness itself and to the person with the illness. The relationship between the two will be one focus of this discussion. The other focus will be on the various ways in which phenomenological approaches to psychopathology have understood the nature of this relationship; a relationship characterized by different meanings of the (...) term "immanence." Drawing inspiration from a Borges poem and from Husserl's debate with Heidegger over the content of his "Phenomenology" article for the Encyclopedia Britannica, we argue that it is misleading, as well as unhelpful, to continue to focus on deficits and dysfunction while ignoring the person's hopes, strengths, assets, and agency. As long as there remains no cure for psychosis, we conclude that it is more effective to promote recovery among people with psychosis than to remain focused on reducing, minimizing, or eliminating their disorder. (shrink)

This special issue reconsiders the contributions that phenomenology can make to the development and practice of a clinicat science of psychology. In it, we suggest that earlier attempts to apply phenomenological principles were influenced heavily by psychoanalysis, with few, if any, alternative versions of a "depth" psychology available on which to draw in reframing the nature of psychopathology and its treatment. We suggest that this lingering presence of psychoanalysis runs counter to the founding principles of phenomenological method and offer a (...) few examples of a constructive alternative grounded in Husserl's transcendental phenomenology. Borrowing from Mohanty, we offer this approach as a respectful-as opposed to suspicious-phenomenology, and begin to outline ways in which a transcendental ly-grounded psychology reconceptualizes both clinical research and practice, from the initial intake interview and interpretation of interview data to the aims and strategies of psychological interventions. (shrink)

In response to criticisms of phenomenology as being a solipsistic approach to psychological research and theory, this paper examines the interplay of both the creative/active and receptive/passive constituents of subjective experience identified in Husserl's exposition of intentional analysis. By delineating the ways in which intentional constitution requires passive as well as active processes, we come to see in the first part of this paper how experience and personal identity are as much formed and informed by the social and historical world (...) as they are created by individual subjects. Once we have established the non-solipsistic nature of phenomenology, we then apply it in the second part of this paper to open a window onto the disorder of self long considered to be integral to schizophrenia. Through an exploration of the constitution of sense of self in the experiences of two people with schizophrenia, we see how cognitive disruptions, auditory hallucinations, and delusional ideation may be related to fundamental peculiarities in a person's experiences of intentionality and his/her resulting sense of agency and identity. In conclusion, we suggest that while phenomenology may not be able to provide a complete account of psychosis, it may be used to shed valuable, descriptive light on subjective aspects that provide a conceptual base for the consideration of other factors. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introducing a “Deleuze Effect” into PsychiatryLarry Davidson (bio) and Golan Shahar (bio)Keywordsdesire, intentionality, psychopathology, agency, action theory, desiring-production, active and reactive forcesYou have to keep small rations of subjectivity in sufficient quantity to enable you to respond to the dominant reality.(Deleuze and Guattari 1987160)We are very pleased with the variety of responses our article has generated thus far and hope that it continues to provoke dialogue. That was, we (...) think, our in tent—should we be allowed to hold on to any such “thing” as an intention. We also take the diversity of these responses to reflect one of our key challenges in using Deleuze’s thought to reform (as op posed merely to inform) psychiatric practice: How to make a radical philosophy accessible enough to a broad enough audience for it to bring about substantive, real change in an existing culture in the hic et nunc, the here and now. That is why we chose the quotation above from Mille Plateaux. Even Deleuze (with Guattari) encourages us to keep “small rations” of subjectivity at hand if we are interested in responding to the “dominant reality.” And that has been our main agenda; to engage with the dominant reality of deficit-based psychiatric theory and practice to overturn it, or, in Clegg’s terms, “explode” it from within.In this regard, we certainly agree with Evangelista and Clegg that much more remains to be done, both in developing our position and in exploring its implications for practice. We view our “Deficit to Desire” paper as simply a first step in this direction (e.g., Shahar and Davidson, in press). We thought it necessary first, as we wrote in the original paper, to articulate the theoretical underpinnings of an action model for clinical understanding and practice “at a philosophical level of discourse on the one hand, but also in such a way that they provide a concrete, substantially different point of departure for empirical studies of psychopathology, on the other.” But why is this important, and what implications does it have for our response to these three thoughtful commentaries?A first implication is that our primary aim is not to provide a comprehensive exposition of Deleuze’s thought. In our opinion, even attempting to give a comprehensive exposition of Deleuze’s thought would actually go directly against its main thrust, which we view as to ignite and propagate ever new and creative lines of flight which carry desiring-production into “a small plot of new land at all times” (Deleuze and Guattari 1987, 161). “Experiment,” entreats Deleuze, “don’t interpret” (Deleuze and Guattari 1987, 139). We would guess, in fact, that Deleuze no more wanted to [End Page 243] produce Deleuzeans than Kierkegaard wanted disciples going around the Danish countryside after his death spreading the word that Kierkegaard did not want disciples going around the Danish countryside after his death (one of our favorites among his many ironies). So although we agree that there is much more in Deleuze’s thought than what is contained in our paper, we think that to some degree it misses its point. In Deleuzean fashion, we want to use the “Deleuze effect” to bring radical change to psychiatry (and we appreciate the irony of that too). Although both Evangelista and Clegg seem to welcome this effort, despite their misgivings, Weiner clearly is worried. Weiner also seems to have had the most intimate experience of the psychiatric system—that is, is most familiar with the world we are trying to change—so we focus in particular on his very understandable concerns.It also happens to be the case that focusing on Weiner’s concerns brings us immediately back to the nature of the effect we were hoping to have. Weiner explains that people with serious mental illnesses are “oppressed from within” and that their affliction seems to be coming “from a seemingly autonomous place” that is “within us, but not ultimately of us.” We could not agree more, and appreciate the lucidity and eloquence with which he makes this astute and important point. Several years ago, one of us even attempted a Husserlian-inspired analysis of how a person... (shrink)

The purpose of this paper was to provide an example from phenomenological research of moving from rich descriptive interview data to coherent revelatory descriptions employing empathic bridges within the narrative structure of storytelling. We used transcribed data from two interviews concerning recovery from severe mental illness: one with an American woman in her early thirties, and the other with a Swedish man in his mid-thirties. Five investigators analyzed the transcribed data into individual first-person narrative descriptions according to existing empirical phenomenological (...) methods including an independent reading, identification of themes relevant to processes of recovery from severe mental illness, temporal ordering of themes meaningfully reflecting the sequence of the recounted events, and consensus development. Our findings support the use of empathic bridges as a methodological tool with the narrative structure of firstperson storytelling, as well as the viability and importance of employing this tool to better understand processes of recovery for persons with severe mental illness. (shrink)

This paper explores the role of friendship in the lives of people with psychiatric disabilities through the use of narrative. We suggest that the use of phenomenologically based investigation in experimental or other traditional research designs provides a more in-depth and complex view of the lives of people with serious mental illness. We offer the example of the Partnership Project, which provides people with psychiatric disabilities a consumer or non-consumer "partner" with whom to enjoy community activities and spend a weekly (...) stipend. Through the lens of narrative, we examine the ways that friendship differs between people matched with either a consumer or non-consumer partner and delve into the importance of connection and friendship in the lives of people with psychiatric disabilities. (shrink)