Giovanni Stanghellini

René Rosfort

Emotions and personhood are important notions within the field of mental health care. How they are related is less evident. This book provides a framework for understanding the important and complex relationship between our emotional wellbeing and our sense of self, drawing on psychopathology, philosophy, and phenomenology.

Exploring Fragility - Making Sense of Vulnerability

Emotions and Personhood

How can we better understand and treat those suffering from schizophrenia and manic-depressive illnesses? This important new book takes us into the world of those suffering from such disorders. Using self descriptions, its emphasis is not on how mental health professionals view sufferers, but on how the patients themselves experience their disorder. A new volume in the International Perspectives in Philosophy and Psychiatry series, this book will be of great interest to all those working with sufferers from such disorders - helping them to better understand their mental lives, and providing important insights into how best to treat them.

The Psychopathology of Common Sense

Disembodied Spirits and Deanimated Bodies

To be human means to be in dialogue. Dialogue is a unitary concept used by the author to address, in a coherent way, three essential issues for clinical practice: 'What is a human being?', 'What is mental pathology'?, and 'What is care?'. In this book Stanghellini argues that to be human means to be in dialogue with alterity, that mental pathology is the outcome of a crisis of one's dialogue with alterity, and that care is a method wherein dialogues take place whose aim is to re-enact interrupted dialogue with alterity within oneself and with the external world. This essay is an attempt to re-establish such a fragile dialogue of the soul with herself and with others. Such an attempt is based on two pillars: a dialectic, person-centered understanding of mental disorders and values-based practice. The dialectic understanding of mental disorders acknowledges the vulnerability constitutive of human personhood. It assumes that the person is engaged in trying to cope, solve and make sense of new, disturbing, puzzling experiences stemming from her encounter with alterity. Values-based practice assumes that the forms of human life are inherently plural. Value-pluralism and recognition are the basis for care. This statement reflects the ideal of modus vivendi that aims to find terms in which different forms of life can coexist, and learn how to live with irreconcilable value conflicts, rather than striving for consensus or agreement. Care is a method wherein dialogues take place whose aim is to re-enact interrupted dialogue with alterity within oneself and with the external world. It includes practices that belong both to logic - e.g., the method for unfolding the Other's form of life and to rescue its fundamental structure - and empathy - e.g., the readiness to offer oneself as a dialoguing person and the capacity to resonate with the Other's experience and attune/regulate the emotional field.

Anthropology, Psychopathology, and Care

Lost in Dialogue

Andrea Raballo

Vittorio Gallese

Mariateresa Sestito

Since the beginning of the 20th Century, phenomenology has developed a distinction between lived body (Leib) and physical body (Koerper), a distinction well known as body-subject vs. body-object (Hanna and Thompson 2007). The lived body is the body experienced from within - my own direct experience of my body lived in the first-person perspective, myself as a spatiotemporal embodied agent in the world. The physical body on the other hand, is the body thematically investigated from a third person perspective by natural sciences as anatomy and physiology. An active topic affecting the understanding of several psychopathological disorders is the relatively unknown dynamic existing between aspects related to the body-object (that comprises the neurobiological substrate of the disease) and the body-subject (the experiences reported by patients) (Nelson and Sass 2017). A clue testifying the need to better explore this dynamic in the psychopathological context is the marked gap that still exists between patients’ clinical reports (generally entailing disturbing experiences) and etiopathogenetic theories and therapeutic practices, that are mainly postulated at a bodily/brain level of description and analysis. The phenomenological exploration typically targets descriptions of persons’ lived experience. For instance, patients suffering from schizophrenia may describe their thoughts as alien (‘‘thoughts are intruding into my head’’) and the world surrounding them as fragmented (‘‘the world is a series of snapshots’’) (Stanghellini et al., 2015). The result is a rich and detailed collection of the patients’ qualitative self-descriptions (Stanghellini and Rossi, 2014), that reveal fundamental changes in the structure of experiencing and can be captured by using specific assessment tools (Parnas et al. 2005; Sass et al. 2017; Stanghellini et al., 2014). The practice of considering the objective and the subjective levels of analysis as separated in the research studies design has many unintended consequences. Primarily, it has the effect of limiting actionable neuroscientific progress within clinical practice. This holds true both in terms of availability of evidence-based treatments for the disorders, as well as for early diagnosis purposes. In response to this need, this collection of articles aims to promote an interdisciplinary endeavor to better connect the bodily, objective level of analysis with its experiential corollary. This is accomplished by focusing on the convergence between (neuro) physiological evidence and the phenomenological manifestations of anomalous bodily experiences present in different disorders.

Embodying the Self: Neurophysiological Perspectives on the Psychopathology of Anomalous Bodily Experiences

Drozdstoy Stoyanov

Bill Fulford

Werdie Van Staden

Michael TH Wong

This open access book offers essential information on values-based practice (VBP): the clinical skills involved, teamwork and person-centered care, links between values and evidence, and the importance of partnerships in shared decision-making. Different cultures have different values; for example, partnership in decision-making looks very different, from the highly individualized perspective of European and North American cultures to the collective and family-oriented perspectives common in South East Asia. In turn, African cultures offer yet another perspective, one that falls between these two extremes (called batho pele). The book will benefit everyone concerned with the practical challenges of delivering mental health services. Accordingly, all contributions are developed on the basis of case vignettes, and cover a range of situations in which values underlie tensions or uncertainties regarding how to proceed in clinical practice. Examples include the patient’s autonomy and best interest, the physician’s commitment to establishing high standards of clinical governance, clinical versus community best interest, institutional versus clinical interests, patients insisting on medically unsound but legal treatments etc. Thus far, VBP publications have mainly dealt with clinical scenarios involving individual values (of clinicians and patients). Our objective with this book is to develop a model of VBP that is culturally much broader in scope. As such, it offers a vital resource for mental health stakeholders in an increasingly inter-connected world. It also offers opportunities for cross-learning in values-based practice between cultures with very different clinical care traditions.

Case Studies and Commentaries

International Perspectives in Values-Based Mental Health Practice

Paolo Fusar-Poli

Anthony Vincent Fernandez

Matthew Broome

The field of phenomenological psychopathology (PP) is concerned with exploring and describing the individual experience of those suffering from mental disorders. Whilst there is often an understandable emphasis within psychiatry on diagnosis and treatment, the subjective experience of the individual is frequently overlooked. Yet a patient's own account of how their illness affects their thoughts, values, consciousness, and sense of self, can provide important insights into their condition - insights that can complement the more empirical findings from studies of brain function or behaviour. The Oxford Handbook of Phenomenological Psychopathology is the first ever comprehensive review of the field. It considers the history of PP, its methodology, key concepts, and includes a section exploring individual experiences within schizophrenia, depression, borderline personality disorder, OCD, and phobia. In addition it includes chapters on some of the leading figures throughout the history of this field. Bringing together chapters from a global team of leading academics, researchers and practitioners, the book will be valuable for those within the fields of psychiatry, clinical psychology, and philosophy.

The Oxford Handbook of Phenomenological Psychopathology

Massimiliano Aragona

This book introduces the reader to a clear and consistent method for in-depth exploration of subjective psychopathological experiences with the aim of helping to restore the ability within psychiatry and clinical psychology to draw qualitative distinctions between mental symptoms that are only apparently similar, thereby promoting a more precise characterization of experiential phenotypes. A wide range of mental disorders are considered in the book, each portrayed by a distinguished clinician. Each chapter begins with the description of a paradigmatic case study in order to introduce the reader directly to the patient’s lived world. The first-person perspective of the patient is the principal focus of attention. The essential, defining features of each psychopathological phenomenon and the meaning that the patient attaches to it are carefully analyzed in order to “make sense” of the patient’s apparently nonsensical experiences. In the second part of each chapter, the case study is discussed within the context of relevant literature and a detailed picture of the state of the art concerning the psychopathological understanding of the phenomenon at issue is provided. An Experiential Approach to Psychopathology, and the method it proposes, may be considered the result of convergence of classic phenomenological psychopathological concepts and updated clinical insights into patients’ lived experiences. It endorses three key principles: subjective phenomena are the quintessential feature of mental disorders; their qualitative study is mandatory; phenomenology has developed a rigorous method to grasp “what it is like” to be a person experiencing psychopathological phenomena. While the book is highly relevant for expert clinical phenomenologists, it is written in a way that will be readily understandable for trainees and young clinicians.

What is it like to Suffer from Mental Disorders?

An Experiential Approach to Psychopathology

Martin Davies

Tim Thornton

Richard Gipps

George Graham

KWM Fulford

Philosophy has much to offer psychiatry, not least regarding ethical issues, but also issues regarding the mind, identity, values, and volition. The Oxford Handbook of Philosophy and Psychiatry offers the most comprehensive reference resource for this area every published - one that is essential for both students and researchers in this field.

The Oxford Handbook of Philosophy and Psychiatry

Christian Tewes

This book advances the development of phenomenological psychopathology and demonstrates its applicability to a spectrum of mental disorders.

Phenomenological and Psychopathological Approaches

Time and Body

The field of phenomenological psychopathology (PP) is concerned with exploring and describing the individual experience of those suffering from mental disorders. The Oxford Handbook of Phenomenological Psychopathology is the first ever comprehensive review of the field.

Giovanni Stanghellini

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