The list includes oral presentations, panel sessions and posters with biograms of registered participants.
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Last update: August 7
JAIME ADAN, MD, PHD.
La Princesa Hospital, Madrid, Spain
He is a consultant psychiatrist based in La Princesa Hospital in Madrid. He is an associate professor at the Psychiatry Department in the Universidad Autonoma of Madrid.
Lecture 1. title: On psychopathological judgement and its pretension to truth
Psychiatric practice is legitimized by its adscription to a methodological approach that has represented a sure path towards true knowledge all throughout the modern era: the natural sciences. In spite of this, the history of psychiatry is scattered with theoretical, practical and conceptual inconsistencies that have demanded continuous efforts aimed at reaching a degree of stability that has never been more than transient. In the face of the natural sciences’ failure to offer a stable framework of knowledge for psychopathology and subjective experience, we shall address psychiatry’s object of study in order to shed some light on the reasons underlying its lack of progress, highlighting the illegitimacy of a natural-scientific approach towards subjective experience. We will find in hermeneutics an alternative methodological approach that will set the basis for a systematic approach towards an analysis of subjective experience. We will further describe the notion of hermeneutic objectivity as an epistemic device aimed at legitimizing psychiatry’s pretension to truth without resorting to a positivistic methodology, which has already proved to be inadequate when dealing with psychopathological phenomena.
Lecture 2. title: On the Notion of Psychosis. Semantic and Epistemic Concerns
In spite of its frequent and apparently unproblematic use, the meaning of the term „psychosis” remains largely unclear. We attempt to approach some of the reasons underlying psychiatry’s failure to define the notion of psychosis in a clear and unambiguous fashion, highlighting the inadequacy of a natural-scientific framework (inherited by psychiatry through its development as a medical discipline) when dealing with subjective experience. Following a longstanding trend in psychopathology, we argue for the need to follow a hermeneutical approach, which is both perspectival and theory-laden. In order to prevent arbitrariness or a crude relativism, we will describe the notion of „hermeneutic objectivity” as an epistemic construct aimed at legitimising psychiatric judgement and its pretension to truth.
ADRIANNA BECZEK, BA
Jagiellonian University; Jagiellonian University Collegium Medicum
She holds a bachelor’s degree in ethnology and cultural anthropology. She is a 5th-year medicine student and is in her 1st year of the Master’s Programme in Individual Interfaculty Studies in Humanities at the Jagiellonian University.
Lecture title: Boundary situations in clinical practice
Boundary situations, as Karl Jaspers called them, „show [people their] ultimate defeat” or „prove the absence of the absolute.” However, they should not be qualified as absolutely hopeless: in borderline situations our understanding can lead to despair, but reality is also experienced most strongly – in spite of and beyond all „frail human being in the world.” Medicine is quite unusual when it comes to boundary situations – people who practice medicine experience passing away, death or the randomness of their own and of others’ fate more often and probably more severely than representatives of most other professions. This results in specific attitudes towards everyday reality and the development of certain mechanisms to deal with these situations. This presentation offers an overview of such attitudes and mechanisms in the form in which they appear in the medical environment as well as their analysis in the context of the philosophical writings of Karl Jaspers.
JEFFREY BEDRICK, M.A., M.D.
Department of Psychiatry, Drexel University College of Medicine
A Clinical Associate Professor in the Department of Psychiatry, Drexel University College of Medicine, Philadelphia, PA, USA.
Lecture title: Are we the experts on ourselves?
It is commonly assumed that we are the experts on ourselves. After all, we know much more about ourselves than anyone else does. When I am meeting someone for medication management I often tell them that for our work together to be successful we have to collaborate, because while I have expertise on the medications, they are the experts on themselves, on how they are feeling, and on how they are responding to the medication.
Further, the idea has gained hold that the study of communities from the outside, by sociologists, anthropologists, or psychologists and psychiatrists, without active input from the individuals or communities being studied, is unaware or patronizing at best, colonialist or authoritarian at worst. “Nothing about us without us” is seen as a necessary organizing principle.
And yet, a central part of Freudian theory is that much of what drives us is unconscious and not accessible to our conscious awareness. Even non-analytic psychotherapies, such as cognitive behavioral therapy, believe that the person coming to us for help is caught up in patterns of thought and behavior that they are not fully consciously aware of. I would not say to a person who came to me to start psychotherapy that we need to collaborate because they are the expert on themselves. The mental status examination asks us to evaluate the insight of the person coming to us for help, with the recognition that we might decide their insight is poor.
Can we reconcile these two perspectives that at first glance seem so at odds with each other?
I believe that a careful examination of the phenomenology of conscious experience and of the sort of lacunae seen in the pathologies of consciousness, from those of everyday life to those seen in what are usually thought of as more severe mental illnesses, an examination that I will sketch the outlines of, can help to bring these two seemingly irreconcilable perspectives into a fruitful conversation and dialectic, one that preserves some of the sense we have of being the experts on ourselves while recognizing that our conscious experience itself points out the limitations of that expertise.
MIA BITURAJAC, BA, MA
BA and MA magna cum laude University of Rijeka. She is a first year doctoral student in the PhD programme “Philosophy and Contemporaneity” at the University of Rijeka and her doctorate is financed by the Croatian Science Foundation (grant DOK-2018-09-5165). Her areas of research include bioethics, ethics and philosophy of psychiatry. She works as a doctoral researcher in the project “Responding to antisocial personalities in democratic societies” funded by the Croatian Science Foundation (grant IP-2018-01-3518.)
Lecture title: The Notion of Harm in Mental Disorders
The notion of harm can be viewed as a ubiquitous concept in the discussion on mental disorders, whether it is presented as integral to an account of mental illness (Glover 1972, Wakefield 1992, Reznek 1987, Cooper 2002), or rejected and accounted for in other ways (Amoretti & Lalumera, 2018.) In this paper I explore harm in so far as it applies to the discussion of mental illness. Harm has been usually tied to the distress criterion, just like in the DSM III (1980), DSM IV (1994) and DSM V (2013.) However, there are (at least) two senses of harm we need to differentiate between: harm in the sense of injury/impairment and harm in the prudential sense (Campbell & Stramondo 2017.) I argue that distress falls under the view of harm as injury/impairment but that we should also consider harm in the prudential sense – as that which negatively impacts someone’s well-being. I consider the desiderata a theory of harm should adhere to by discussing Bradley (2012) who presents the following desiderata for a theory of harm – extensional adequacy, axiological neutrality, ontological neutrality, amorality, unity, prudential importance, normative importance. Inspired by Tiberius’s (2018) desiderata for a theory of well-being, namely descriptive, normative and empirical adequacy, I argue that a theory of harm in the context of mental illness should, besides some of the Bradley’s (2012) criteria which roughly cover descriptive and normative adequacy, also pay significant attention to empirical adequacy.
Amoretti, M. C., & Lalumera, E. (2018, May). A potential tension in DSM-5: general definition of mental disorder versus some specific diagnostic criteria. In The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine (Vol. 44, No. 1, pp. 85-108). US: Oxford University Press.
Bradley, B. (2012). Doing Away with Harm 1. Philosophy and Phenomenological Research, 85(2), 390-412.
Campbell, S. M., & Stramondo, J. A. (2017). The complicated relationship of disability and well-being. Kennedy Institute of Ethics Journal, 27(2), 151-184.
Cooper, R. (2002). Disease. Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences, 33(2), 263-282.
Glover, J. (1970). Responsibility. New York: Humanities.
Reznek, L. (1987). The nature of disease. Routledge & Kegan Paul.
Tiberius, Valerie (2018). Well-Being as Value Fulfillment: How We Can Help Each Other to Live Well. Oxford University Press.
Wakefield, J. C. (1992). Disorder as harmful dysfunction: a conceptual critique of DSM-III-R’s definition of mental disorder. Psychological review, 99(2), 232.
Chair of panel:
ASSISTANT PROF. FRANCESCA BRENCIO
University of Seville, Department of Philosophy
Panel title: Disruptions. Moods, feelings and atmospheres in affective disorders and schizophrenia
Heidelberg University Hospital
Clinic University of Heidelberg, Department of General Psychiatry and Psychotherapy, Section of Phenomenology
This panel aims to explore moods, feelings and atmospheres and how their disruptions can affect psychopathological phenomena, such as affective disorders and schizophrenia. To reach our aims, we intend to propose a panel consisting of three oral presentations.
The first one will show how the human existence’s constitution is grounded on an original “pathic” dimension, which consists of both the capacity of being affected and being situated within moods and atmospheres. This “pathic” element represents a plurality of possible meanings through which we discover alterity: the how of experiences (relation) merges with the what (the content) and with another how, in which the relational meaning is enacted (enactment). In this process moods are central: they are the means of accessing the world as we comprehend and signify it as it is. Moods and feelings characterise a broad range of disclosive affectivity. What happens when a mood or a feeling is disrupted? The talk will shed light on how impairment in one or more components of emotional life disrupts ordinary affective states and the achievement of adaptive emotion functions.
The second oral presentation elaborates on the concept of atmosphere and interaffectivity. Following the Greek etymology, the term “atmosphere” evokes a circular dimension filled by something fleeting. The phenomenon of atmosphere inhabits a pre-personal and pre-linguistic aesthetic dimension that human beings experience mainly in collective spaces. Atmospheres are the “in-between” phenomenon par excellence; they fuse together environmental qualities and human feelings, merging in a space where persons resonate with the ambiance in an absolute and irreversible way. The recent literature at the intersection of philosophy and psychopathology has produced interesting pieces of work on the concept of atmosphere. One of the most famous accounts of atmosphere has been given by Gernot Böhme, who argues that atmosphere is an “ecstatic-transformative” phenomenon (2009), which eschews from a systematic categorization into a specific set of things. Atmosphere is a pure pathic emanation: it lies between the subject and the object, in the midst of production and reception, emanating from things, persons, situations.
The third oral presentation is focused on schizophrenia, a severe psychiatric disease which impairs a person’s ability to think clearly, handle emotions and relate to others. The subject experiences what has been defined as an anguishing “delusional atmosphere”, or Wahnstimmung (Fuchs, 2005), in which the world begins to appear bizarre, unfamiliar, uncanny and threatening. We believe that this is not only a disorder of the “we-intentionality” domain (Salice & Henriksen, 2015), but also a disturbance that arises well before the intentional level of experience and involves the atmospheric dimension of affectivity (Conrad, 1958). The subject loses the capacity to pathically modulate the increased atmospheric im-pression of the world on him. We will focus in particular on the “embodied features” of affective experience, and we will emphasize the link between lived body and atmospheric affectivity, which seem to be intrinsically related to each other.
G. Böhme, Atmosphere as the Fundamental Concept of a New Aesthetics, in Thesis Eleven, 36, 1993, 113–126.
K. Conrad: Die beginnende Schizophrenie. Versuch einer Gestaltanalyse des Wahns. Stuttgart, Psychiatrie Verlag, 1958;
P. L. Coriando, Affektenlehre und Phänomenologie der Stimmungen: Wege einer Ontologie und Ethik des Emotionalen, Frankfurt am Main, Klostermann Verlag, 2002.
T. Fuchs, Delusional mood and delusional perception— A phenomenological analysis, Psychopathology 38: 133–139 2005;
Salice, M. G. Henriksen, The Disrupted ‚We’. Schizophrenia and Collective Intentionality, Journal of Consciousness Studies, 22, (7–8) 2015, pp. 145–71;
University of the Mediterranean – Marseille
Resident in psychiatry; a doctoral student at the Medical University of Marseille.
Poster title: Implantation of crisis teams in France, a transdisciplinary issue
We will present the results of a qualitative study on the implementation of crisis teams in France, whose emergence may raise questions about clinical practices and interdisciplinary imperatives.
How can French crisis teams play such a modest role in responding to acute psychiatric episodes?
As the expectations of both the users and political authorities seem to converge towards the reduction of complete hospitalisation, alternative measures to inpatient care are still an incipient practice in France.
It is clear that the evolution of Bonnafe’s idea of a mental health reform proposed more than 60 years ago has not followed a linear trajectory, and that the return to a resolutely hospital-based approach, favouring the provision of psychiatric hospital care over community mental health development, seems to have limited the evolution of practices outside the walls and in the city.
It is perhaps due to the French specificity of the sector itself, designed and built on the primacy of subjectivity and on a will to break with asilar practices or medical institutions, that we paradoxically resist the establishment of these .
Crisis teams might also highlight the evolution towards community-oriented practices, as one of the social phenomena reflecting the change of dominant relationships, and as a signal of an epistemological crisis.
Eventually, it may be because the solutions to the quest for well-being and responses to situations of suffering are gradually escaping psychiatry, as illustrated by the social and recovery oriented psychiatry that anchors mental health innovations in the domain of public health and the community field.
Dr. GEORGIA MARTHA GKOTSI
University of Athens, Greece. Law
A post-doctoral researcher currently based at the National and Capodistrian University of Athens, where she conducts research and teaches in the Departments of Philosophy of Law and Criminology. She has a legal and philosophical background and her research interests include neuroethics, mental health law ethics, philosophy of psychiatry and forensic psychiatry.
After graduating with a law degree from the University of Athens, Greece, she pursued a Master’s in philosophy of Law at the same University, specializing in moral philosophy, and completed a second Master in Comparative Law at Université Paris 1 – Sorbonne. After her Master’s studies, she completed her doctoral research in the Faculty of Biology and Medicine at the University of Lausanne, funded by the Swiss Confederation, in which she examined from an ethical and legal perspective some current uses of neuroscientific evidence in criminal trials introduced through psychiatric testimony.
From 2012 until 2016 she worked as a researcher at the Institute of Forensic Psychiatry of the Lausanne University Hospital.
She recently finished her post-doctoral research on “Neuroimaging in criminal trials and dangerousness assessments”, funded by the National Scholarship’s Foundation in Greece and she is currently conducting research on “Personal Identity Theories and Dissociative Identity Disorders.”
Lecture title: [will be published soon]
Instances of apparent multiplicity in abnormal psychology, such as dissociative identity disorder (DID) and the cyclical personality changes associated with manic-depressive disorder seem to invite us to speak of more than one self concurrently or sequentially housed within the same body. If one body can house multiple personalities, then our rules for counting such personalities must be re-examined. These developments have given rise to ethical dilemmas and new legal issues because they challenge traditional philosophical theories of personal identity as well as the ethics of therapy and law.
If people change radically as a result of mental disturbance or disease, how should we acknowledge that change in the way in which we respond to them?
This puzzle is present in the clinical context as well, in the form of issues arising in the psychotherapeutic context. How should a therapist properly treat patients who go through personality changes?
Some variants of this question have public-policy implications. When someone commits a crime and subsequently undergoes a personality change, are they still being rightly punished for that crime? The first legal cases in the century involving such arguments have been heard in the last two decades.
What links these questions together are deeply abstract and contested philosophical ideas about the self, about personal responsibility, about the unity of the self at a given time and about what philosophers call personal identity, the notion that the self or the person remains one and the same, singular and unvarying through time.
But our understanding of the self’s disunity and discontinuity vary according to the introspective and public perspectives and these different perspectives yield different understandings of the notions of disunity and discontinuity and of the self. What subjectively feels like a divided mind may seem like a united one from a public perspective; what publicly looks disunited or discontinuous may subjectively feel like one or like a series of normal changes. Which perspective should be honored?
We will try to explore some of the most common criteria for personal identity and their relation to mental illness, especially DID, and then based on these criteria we will try to answer some questions concerning the therapeutic approach towards this disease as well as the moral and criminal responsibility of patients suffering from this disease. We will find that, while metaphysically possible, these criteria of personal identity don’t offer the pragmatic solutions needed for these questions and are, thus, facing serious challenges.”
WOJCIECH KOSMOWSKI, MD, PH.D., S.T.D.
Department of Psychiatry, Collegium Medicum, Nicolaus Copernicus University, Toruń, Poland
S.T.D in pastoral theology, MD, PhD in medicine.
He has written over a 100 articles and chapters in medical textbooks and about a 100 articles aimed at popularizing liturgy, among others in magazines Oaza and Wieczernik, and also many works in the field of pastoral theology.
He works as a psychiatrist and a child and adolescent psychiatrist and a lecturer at the Department of Psychiatry at Collegium Medicum in Toruń, Poland. He is also a lecturer at the Faculty of Pedagogy and Psychology at the Casimir the Great University in Bydgoszcz, Poland.
Lecture title: Ethical aspects of animal research in psychiatry
Medical experiments in medicine have been conducted for ages. They’ve been called into question on a broad scale in the 20th century, among others because of the actions undertaken by various organizations (e.g. PETA = People for the Ethical Treatment of Animals) fighting in defense of the so-called animal rights. Clinicians, basic science researchers, as well as animal rights activists, philosophers and scientists have been discussing a wide range of issues. Sometimes, unfortunately, their discussions are very similar to wars. The impact of these actions on the law and everyday practice is substantial.
Clinical point of view
Clinical aspects of animal studies can be perceived in two categories. The aim of basic research is to gain a better understanding of psychological and neural processes. The aim of applied research is to model human psychiatry in order to enable therapeutic drugs development or to conduct various preclinical tests of new compounds. The latter of these two applications of animal experiments is mandatory, in accordance with international standards, in some circumstances (Good Clinical Practice – Principle 3, the Nuremberg Code, the Helsinki Declaration.) It can be examined in terms of different animal behaviors: negative and positive valence, cognitive, social, sleep and arousal.
Philosophical points of view
A classic book written by P. Singer on animal liberation and their rights still has a big impact on the way of thinking about animals and on scientific reflection on this issue. In classical philosophy, however, we have no speciesism, but instead a discussion regarding the different nature of beings. The results of philosophical models’ testing can be different depending on their assumptions. While testing some utilitarian models of thinking, a researcher can find, surprisingly, that the value of life of an incapacitated human is lower than that of a healthy primate. These conclusions would not be possible in different philosophical schools, e.g. personalism could not perceive this problem in this way.
To seek cooperation and a common point of view, we have to exclude both extreme statements: “tests on animal subjects cannot be carried out at all” and “tests on animal subjects can always be carried out with no special procedures.” The debate should concern special precautions and conditions. In addition, the discussion has to be based on rational arguments, not on attempts to exert pressure on either side.
Poster title: Classical metaphysics and contemporary psychiatry
To solve modern problems, we can use all applicable methods: derived from both past and recent research. This way, we can avoid past mistakes and practice science based on proven methods. Classical philosophy based on Aristotle’s metaphysics can be one of these proven models. At the John Paul II Catholic University of Lublin, Poland, philosophers such as M. A. Krąpiec and S. Kamiński prepared a special methodology consisting of the following elements: the objective way of cultivating philosophy, historicism, awareness of methodological autonomy of general metaphysics and many particular metaphysics, the use of integrated language, the use of objective explanation (the “decontradictifying” method), providing philosophical tools for a realistic interpretation of the human being and the world.
The aim of this study is to present the application of metaphysics based on the works of the Lublin Philosophical School in modern psychiatry.
The theory of being can be used to better understand a disease as a dysfunction of the whole being – a human being. This statement has far-reaching humanistic consequences that help to avoid the dehumanization of medicine. The openness of classical metaphysics to the Supreme Being – God – can help to better understand the spiritual needs of humanity. Metaphysical separation can facilitate the diagnostic process in medicine, especially in psychiatry. The method of explanation in metaphysics can be useful in constructing a diagnostic system (or describing an existing one). This method consists of a scientific description, explanation, understanding and valuation. The process of translating these philosophical methods and models into psychiatry requires joint projects focused on different parts of psychiatry (e.g. psychopathology, ethics, treatment, the diagnostic system.)
Classical metaphysics can be an inspiration in many fields of applied sciences, including psychiatry. The application of certain methods might be a long process, but it might turn out to be very fruitful.
Prof. ALAIN LEPLEGE
University Paris 7 Denis Diderot
Alain Leplège MD-PhD, Director of the PRSM-HP is a Psychiatrist, Professor of Universities, Institute Humanity Sciences Society, University Paris 7 Denis Diderot – Sorbonne Paris Cité; Statutory researcher: SPHERE Laboratory, UMR 7219 (CNRS – Paris Diderot University), Head of the Perceived Health, Chronic Disease and Disability Axis; Associate Researcher: APEMAC (University Research Team 4360), Adaptation, Measurement and Evaluation in Health. Interdisciplinary Approaches, MICS Team: Measurement and Complex Interventions in Health; Adjunct Professor: Person Centred Research Center, Division of Rehabilitation and Occupational Studies, Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand (2010-18); Member of the scientific council of the National Solidarity Fund for Autonomy (CNSA, 2010-14, 2014-2018).
His current research is at the interface of the methodological reflection inherent in scientific research and epistemology, in connection with empirical research projects. On the one hand, there are the methodological and epistemological problems posed by the establishment of health service research and the evaluation of complex interventions and on the other hand the conceptual and practical problems posed by disability situations which affect people with psychiatric disorders. In this context he coordinates the development of the PRSM-HP.
Lecture title: The Platform for Research on Mental Health and Psychic Disability (PRSM-HP): position paper on an innovative approach
People living with severe psychiatric conditions are suffering from chronic diseases which are strongly stigmatized. This and the social exclusions which ensue constitute what is called in France Psychic Disability (Handicap Psychique). These subjects need medical care and various forms of social support.
Currently, many subjects are oriented from the health care sector to the medico-social or social sector. This evolution leads to many problems:
- The place of medical care is ill-defined in medico-social facilities, and the need for medical care is underestimated, because historically most of the medico-social sector has been developed to meet the needs of disabled people who were not chronically ill (e.g. people with ID).
- There is a lack of training of medico-social professionals regarding the specific care and treatment needs of people with severe psychiatric disorders.
- Last but not least, not only is quality research in psychiatry underfunded in the health sector and deals with issues that are often remote from field concerns but, moreover there is a lack of research culture and skills in the social and medico-social sectors: the need for methodological support is very important.
In this context, the objective of the PRSM-HP is to promote, facilitate and support the development, implementation and enhancement of collaborative/participative research projects on mental health and psychic disability, the results of which will be directly useful and transferable for the professional in the field and publishable in scientific literature.
The 3-year experimentation phase of this innovative approach began in Sept. 2017. It consists of two types of nested actions:
- The establishment of an innovative transversal research facility in the field of mental health and psychic disability (a not-for-profit organisation involving several public psychiatric hospitals and several private not-for-profit associations managing medico-social institutions or other devices.)
- The realization of concrete operations along three axes: a research axis (main axis), practice sharing and communication (secondary axes.)
The original and innovative elements of the project are as follows:
- a bottom-up approach to identifying research topics
- a transversal approach to health, medico-social and social issues
- the establishment of long-lasting working relationships between professionals from the research community and the field professionals from the sectors already mentioned (in the form of a scientific committee)
In 2018 we submitted 4 projects. One project on smoking prevention in medico-social facilities has been awarded a grant. This project will be presented briefly. The three others have been rejected but with an invitation to resubmit.
It is expected that the improvement of the relevance and effectiveness of field practices will be the result not only of improved research projects but also the result of the process of field professionals (and to some extent concerned subjects) being fully involved from the beginning in participative research projects.
Many other areas of care, social action and public health interventions could benefit from the implementation of devices similar to PRSM-HP. The external evaluation of the PRSM-HP experiment will investigate this point.
PROF. MAREK MACIEJCZAK
Warsaw University of Technology
He is a professor (2012) at the Warsaw University of Technology, Faculty of Administration and Social Sciences. He conducts research in philosophy of language and phenomenology, especially in the theory of meaning and consciousness. The author of books: The World According To the Body Proper. Merleau-Ponty’s Theory of Perception (1995, second ed. 2001); Brentano and Husserl – Epistemological Question (2001); Consciousness and Sense. Kant, Brentano, Husserl, Merleau-Ponty. Philosophy As a Critique of Language. From Frege to Wittgenstein (2015).
Lecture title: Henri Ey’s concept of the mind as a conceptual model of the world
The concept of a world model was used by the outstanding psychiatrist and French philosopher Henri Ey in his work La conscience, where he defined being conscious as having a personal model of the world. The model is created along with the personal history of the subject. In the case of animals, it is innate structures that guarantee the survival of the individual and the preservation of the species. In the case of humans, to a large extent, its functioning does not require the participation of consciousness; however, in the part of the available reflection, the model is constructed and shaped consciously, through the inclusion of objective media, i.e. language, concepts, values and goals.
The concept of the world model covers a number of aspects that make up the phenomenon of being conscious. Their inclusion requires a combination of multiple research perspectives: neurophysiology, cognitive psychology, cognitive science, analytical philosophy and phenomenology. The current state of research allows to formulate a suggestion that the above mentioned aspects constitute a systemic and hierarchical unity. The concept of the world model may contribute to overcoming a certain one-sidedness of naturalistic and computational mind theories. Such a need can be seen especially in the works concerning the relationship between perception and language, the meaning of linguistic expressions, conceptual schema, mental representation, intentionality and rationality. Therefore, it is not only an opportunity, but also a current need.
It seems that it is only when starting from the totality marked with the name „model of the world” that we will be able to show how experience and knowledge are created, what we directly experience and the semantic (conceptual) representation of experience, and also to explain how a specific autonomy of a conscious being and its personal character are created in the course of personal experience and in the social context of communication. Today, despite the enormous progress of knowledge, we are still far from explaining the rationality of human existence. The conceptual model is the structural equivalent of the system of consciousness resp. experience. In its hierarchical structure, perception serves as a basis for a subject’s orientation in the world and for the formation of concepts and meanings that objects of experience have for us, including „real or false” qualifications. Only the system of consciousness as a historical and personal identity provides a permanent and certain distinction from the surrounding world.
WOJCIECH MACKIEWICZ, PhD
Wroclaw Medical University
Lecture title: Hermeneutics and Medicalization. The Schizophrenic Body
Schizophrenia as one of the most mysterious diseases vividly influences the imagination of doctors on the one hand and culture (especially popular culture) on the other. It leaves almost no one indifferent, so it is difficult to pass over the schizophrenic indifferently: as a social disorder schizophrenia draws attention, creates attitudes, as well as methods of work and therapy, and, in the longer term , cultural patterns, forms of social relations, and language. In my speech, I would like to focus on the language of the schizophrenic body. I am interested in the nature of expressing the self in various cases: in the interest in my own body (simple schizophrenia), in hyperactivity (hebephrenia), fear (paranoia) and in rage-stupor (catatonia). The questions that arise on this ground are fundamental to understanding what consciousness is. To what extent can we talk about ourselves in the case of a fission of consciousness? What is the nature of the relationship „schizophrenic body – environment”? How does the split of consciousness create the split of the body? How does the disease of consciousness translate into a disease of the body? The speech aims to criticize the imagery of the schizophrenic body. For this purpose, I will use some selected methods of philosophical research and the research tools they offer: Gilles Deleuze and Félix Guattari’s concept of schizoanalysis, and Paul Ricoeur’s philosophy of being one’s own body / possessing (one’s own) body. These methods will be helpful for me in order to conduct psychiatric hermeneutics of the human body’s language.
MAURO PALLAGROSI, PhD
Sapienza University of Rome
A child and adult psychiatrist, with a PhD in clinical and experimental neuroscience and psychiatry. He is the clinical coordinator of the acute psychiatric inpatient ward at the Policlinico Umberto I Hospital in Rome, and is an adjunct professor of psychiatry at the School of Nursing, Sapienza University of Rome. He has over twenty years of clinical experience in mental health services, particularly with acute and severe inpatients. His main research topics are psychiatric diagnosis, phenomenological psychopathology and epistemological issues in psychiatry. He is the author of several book chapters and 15 papers published in international peer-reviewed journals.
Evaluating the intersubjective dimension in the psychiatric diagnostic process through the Assessment of Clinician’s Subjective Experience (ACSE)
Abstract: Psychiatric patients share a specific impairment in the structure of intersubjectivity, and they also present with disturbances of other a priori structures in ways that are specific to particular diagnostic entities. The intersubjective dimension of consciousness might thus represent a key domain, whose exploration in clinical settings may prove to be valuable for diagnostic purposes.
I will discuss the theoretical background, the development and the structure of the Assessment of Clinician’s Subjective Experience (ACSE), a psychometric instrument which explores this domain. I will focus my discussion on the intersubjective phenomena occurring during the clinical encounter with psychotic patients.
Chairmnan: John Sadler, Michael Musalek
Title of the panel: Social Aesthetics of Well-being
Panel includes the following lectures:
Michael Musalek: Mental Health and Well-being – Social-aesthetic Perspectives
Werdie van Staden: Well-being in Person-Centred Practice
John Sadler: Aesthetics of Burnout
This symposium aims at explicating the role of the connections and interactions between social aesthetics of well-being and mental health. The primary goal of all medical approaches, including the classic biomedical and humanistic or humane approaches, is to restore or create health, whereby medical approaches that include prevention go beyond the mere restoration of health to include the preservation of health. By bringing Social aesthetics into the health discourse, we are entering the field of psycho-social well-being and wellness. To reach social aesthetic goals in the treatment of mental disorders a further development of a human-based medicine is needed, a medicine that focuses not on a disease construct but which places a human being as a whole, with all his potential and limitations at the heart of diagnostic and therapeutic efforts. The noblest therapeutic goal of this kind of medicine can only be the restoration or preservation of a comprehensive state of health in the sense of complete physical, mental and social well-being, in the sense of openening up the possibility for a mostly autonomus and joyful life.
East London NHS Foundation Trust/ Royal College of Psychiatrists
He is a consultant psychiatrist working in the East London NHS Foundation Trust in London, UK. He is also the Chair of Philosophy Special Interest Group of the Royal College of Psychiatrists. He has suffered from tics for 42 years!
Lecture title: Do my tics make me an expert? An exploration of the concept of expert by experience
What is an “expert by experience”? In this talk I rely on my personal experience of Tic Disorder to explore the concept.
There has been an increase in participation of experts by experience in mental health. In the United Kingdom, experts by experience contribute to the inspection of the NHS services by the Care Quality Commission CQC. There has been a movement promoting increased coproduction in designing and running services along with experts by experience. This is seen as a positive move, which it truly is. Nevertheless there are questions of how meaningful the contribution of patients is and how to avoid making it a tokenistic exercise.
I have been suffering from tics for more than 40 years. In a conversation that I had with a world-class scholar in Tic Disorder syndrome I found out that because of the presence of vocal tics in the past I might in fact have Tourette’s syndrome. The contrast between my long experience and the expertise of that scholar made me think about the concept of expertise by experience. How did my expertise compare to that scholar’s expertise when it came to Tic Disorder? That made me ask about the nature of “expertise”. Could it be that because I have privileged access to my mental states I know something about Tic Disorder that she couldn’t know? Ludwig Wittgenstein in his seminal book Philosophical Investigations, when discussing private language, questions whether in fact one can have privileged access to their mental state and above that whether one can talk about such privileged access. I agree with Wittgenstein on that point and argue that if I have any expertise in that matter it is not because of my privileged access.
Nevertheless my personal experience of Tic Disorder helps me in a different way. By living with Tic Disorder I gain a specific knowledge by acquaintance of how it is to live with Tic Disorder. In addition it gives me a different understanding of volition, which enabled me to empathise more with people who suffer from conditions which are fixed on volition in the same way. I give the example of people who engage in self-harm and the way my Tic Disorder has helped me interact with them.
I also discuss the concept of expertise, using the works of Harry Collins, and whether what I have gained from my condition could be called “expertise”. However, regardless of how we call it, I can see how it has helped me and I shall finish the talk by emphasising how patient involvement will help us improve the care and that hopefully one day we’ll have more patients on executive boards of health organisations.
Service Universitaire de Psychiatrie de l’Adolescent, Argenteuil Hospital Centre, 69 rue du LTC Prud’hon, 95107, Argenteuil, France 2. ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France
A child and adolescent psychiatrist, he holds a PhD in public health and is an expert in qualitative health research. He has been part of the team of Prof. Revah-Levy since its creation.
Anne Révah- is a professor of child and adolescent psychiatry (University of Paris.) For the past 15 years she’s played a major role in the field of qualitative research. Founder of IPSE and director of the IPSE team of research.
Lecture title: IPSE, a new method in qualitative research to gain access to the patient’s experience
In the field of medicine, the past decade has been characterized by movement from a doctor-centred to a patient-centred approach to treatment outcomes, in which doctors try to see the illness through their patients’ eyes. It requires considering the patients as experts of their own experience and this paradigm shift appears to be more challenging in psychiatry. Qualitative methods are the gold standard for exploring the patients’ perspectives as they aim to describe, understand and deepen an observed phenomenon, and to capture what a person says about her lived-experience. Since 2011, our qualitative health research team has developed expertise in the use of qualitative methods to explore complex issues in psychiatry. Within a constructivist paradigm and through a phenomenological approach, we have progressively developed our own qualitative method specifically designed to gain access that is as close as possible to the patient’s experience, during all phases of the research, from its conception through the concrete proposals for improving care: IPSE (Inductive Process to Analyze the structure of lived-Experience). In this inductive process, research hypotheses are not initially formulated; instead, they emerge from the material and, since the participants are considered to be experts when it comes to their own experience, the data-collection system has been carefully designed so as to give them the opportunity to relate it. Using several published studies in the field of adolescent psychiatry as illustrations, this lecture will cover in-depth all the aspects – methodological, practical and epistemological – of the method and its specific contribution to the field of mental health.
University of York
Angelos Sofocleous holds a BA in Philosophy and Psychology and a MA in Philosophy from the University of Durham. He is currently pursuing a PhD in Philosophy at the University of York, focusing on the phenomenology of psychiatric illnesses, in particular depression, PTSD, and schizophrenia. His interests in philosophy lie in the fields of phenomenology, existentialism, and philosophy of religion. He regularly writes opinion articles in the areas of philosophy, psychology, politics, and culture.
Lecture title: The phenomenology of depression: the depressed individual as a spectator
In the field of phenomenology of depression, the depressed individual has often been described as alienated from the world (Paskaleva, 2011), feeling disembodied (Fuchs and Schlimme, 2009), disconnected from other people (Ratcliffe, 2018), imprisoned (Skodlar, 2008), and isolated (Kiehl, 2005). I suggest that the above descriptions suggest that the depressed individual functions as a spectator in the world. In this research paper, I explore ways in which the experience of the depressed individual can be compared to the experience of an individual who is a spectator at a theatre play. In particular, I assess the theatre spectator’s self-experience and world-experience during a play and find aspects which are identical to the experience of the depressed individual. In addition, I comment on how possibilities present themselves in a similar manner towards the theatre spectator and towards the depressed individual. I argue, for example, that both the theatre spectator and the depressed individual face a lack of possibilities in the world: possibilities-for-her are absent while possibilities-for-others remain. Moreover, I examine experiences of depression through the Capgras syndrome, Cotard’s syndrome, and depersonalization disorder, in order to demonstrate how depression affects the individual’s relation to the world, other people, her body, and her own self. I suggest that perceiving the depressed individual as a spectator will help in developing a better understanding of the illness.
Fuchs, T., & Schlimme, J. (2009). Embodiment and psychopathology: a phenomenological perspective. Current Opinion In Psychiatry, 22(6), 570-575.
Ratcliffe, M. (2018). The interpersonal structure of depression. Psychoanalytic Psychotherapy, 32(2), 122-139.
MARTA SZABAT, PH.D.
Jagiellonian University – Medical College
She studied philosophy and literature at the University of Wrocław in Poland, philosophy at the University Jean Moulin Lyon 3 in France and Medical Law and Bioethics at the Jagiellonian University (Postgraduate Certificate in Bioethics and Medical Law). She obtained her doctorate in 2008 for her research on Maurice Merleau-Ponty’s philosophy. She was a visiting fellow at the University Paris 1 Panthéon Sorbonne in France (2012, séjour de recherche, French Government Fellowship). In 2015 she participated in SKILLS-Coaching, a program financed by the Foundation for Polish Science.
Since 2008 she’s been working at the Department of Philosophy and Bioethics at the Jagiellonian University, Medical College. In her work she focuses mainly on the philosophy of death and dying, thanatology, palliative care, French philosophy and bioethics.”
Lecture title: Hope in End-of-Life Issues: Methodologies, Perspectives, Consequences
Hope can be studied as a phenomenon, a feeling, an attitude or even as a decision to maintain positive expectations towards one’s circumstances. The main purpose of this paper is to analyze the consequences of different methodologies used to study hope in end-of-life issues, including hope of adults, the elderly and parental hope for terminally ill children.
The main research question is: Why is it necessary to study hope in an interdisciplinary fashion?
Based on different methodologies, such as: a) the Visual Analogue Scale (Berterö 2008) and the Basic Hope Inventory (BHI-12) (Myślińska 2016); b) methodologies with a phenomenological background, including Colaizzi’s method and several phenomenological approaches influenced by Husserl’s and Heidegger’s philosophy (Bertero 2008, Nafratilova 2018); c) grounded theory (Barrera 2010), semi-structured focus group interviews (Zelcer 2010), and questionnaire studies (Janvier 2016), I will develop arguments confirming the thesis that only interdisciplinary research on hope allows us to gain a deeper understanding of hope’s status in the perspective of end-of-life issues.
Initial study results show that it is possible to consider the measurement of hope not only from an objective standpoint, but also in patients’ personal statements (phenomenological methods as well as focus group interviews or questionnaire studies.) Hope cannot be reduced to an objective measure on a scale because of its deeply human experience. Only interdisciplinary research allows us to encounter as many aspects of hope as possible, which I intend to show in my paper.
Barrera M. et al. 2009. The emerging notion of hope and the complex journey for parents of children with cancer. Psycho-Oncology 18 (2).
Berterö C. et al. 2008. Receiving a diagnosis of inoperable lung cancer: Patients’ perspectives of how it affects their life situation and quality of life. Acta Oncologica 47: 865.
Janvier A. et al. 2016. Parental hopes, interventions, and survival of neonates with trisomy 13 and trisomy 18. American Journal of Medical Genetics, Part C: Seminars in Medical Genetics 172 (3): 279-287.
Myślińska A. et al. 2016. Types of hope and action styles of adolescents. The Person and the Challenges 6(1): 179–206.
Nafratilova M. et al. 2018. Still hoping for a miracle: Parents’ experiences in caring for their child with cancer under palliative care. Indian J Palliat Care 24:127-30.
Zelcer S et al. 2010. Palliative Care of Children With Brain Tumors. A Parental Perspective. Arch Pediatr Adolesc Med 164(3): 225-230.
Since 1997 is active in the user/survivor-movement. He was board member of the European Network of Users and Survivors of Psychiatry and since 2008 is the board member of Autism Europe. He studied also science of religion and in 2014 got the master degree in philosophy of psychiatry.
Lecture title: “Film versus photo”: Dialectical philosophy to address fundamental problems of biological reductionism in psychiatry
My research question is:how can the theoretical perspective and method of dialectical philosophy help to improve the analysis and understanding of complex, multi factorial, embodied and contextual situated psychiatric mental health problems such as psychosis?This question is important because there is a fundamental problem with the current dominant theoretical scientific model of biological reductionism in medical science in general and psychiatry in particular.
1. The approach of biological reductionism only works for simple, single-factor, linear, cause-effect problems. However, it does not scale to complex problems.
2. The perspective of biological reductionism obscures from sight many other factors which play an important contribution to psychiatric health problems.
3. Biological reductionism is based on a scientific model which is static as a photo, and does not capture the dynamic nature of reality for which a film, consisting of many multiple successive picture frames offer a more apt metaphor.
All these three fundamental problems of biological reductionism can be addressed by developing a theoretical framework based on dialectical philosophy for understanding psychiatric problems in their context, such as people suffering from psychosis in a city environment.To answer my research, firstly I build on the dialectical philosophy tradition, in which the German philosopher Hegel (1770 -1831) in modern times for science is the most important. He pioneered a scientific model based on the millennia old tradition of dialectical philosophy. Secondly, I build on the more recent oeuvre of the French philosopher Catharine Malabou. She shows how fruitful it is to apply the dialectical concept of plasticity from Hegel in the context of neuroscience. Thirdly, also the tradition of psychodynamic theory and practice is rooted in the history of dialectical thinkingalthough not directly based on the work of Hegel.
Maria Curie-Skłodowska University in Lublin
Maciej Wodziński, philosophy student, Faculty of Philosophy and Sociology at the Maria Curie-Skłodowska University in Lublin.
Lecture title: Autism spectrum disorders – social stereotypes and limits of expert knowledge
Since the 1940s, not only the scope of research and social campaigns devoted to autism has been systematically growing, but also the number of people diagnosed with disorders from this spectrum. The observed increase in issued diagnoses has become so significant, that the problem has become a challenge on a social scale and has been present in the broadly understood social awareness (see: CDC report: Baio et.al. 2014). Despite the continuous deepening of the knowledge about this type of disorders, their causes are still undetermined.
However this increasing „popularity” of autism combined with the lack of definitive conclusions as to its origins and also with the insufficient level of knowledge among experts – midwives, paediatricians, psychologists, psychiatrists, etc. – has caused an occurrence of a significant number of negative stereotypes, myths, simplified reasonings and cognitive errors around it (see e.g. CBOS Report „Social Image of Autism”, March 2018).
The aim of the lecture is a) to draw attention to the problem of unreliable opinions issued, among others, by medical examiners and court experts in cases concerning persons with ASD and b) to analyze the possible causes of this state of affairs. It is suspected that this state can be caused by the presence of the aforementioned stereotypes in the inferences of these experts and in the existence of the negative impact of heuristics and intuitive judgments on their cognitive disposition.
Due to the very limited time usually available for the examination of each case, opinions issued by these specialists have to be largely based on intuitive decisions (cf. e.g. Chase, Simon 1973; Simon 1992; Kahneman, Klein 2009; Kahnemann 2012). Regardless of what perspective on intuitive judgements will be accepted, researchers agree that the prerequisite for obtaining inappropriate cognitive disposition, necessary for these judgements’ correctness, is a long-term practical application of the possessed expertise and obtaining good quality feedback on the decisions taken (e.g. Damasio 2006, Ericsson 2008, Kahneman, Klein 2009).
Failure to meet these conditions by experts may result in committing systematic cognitive errors resulting from, among others, basing intuitive decisions on stereotypes existing in the expert’s mind. This situation may have a significant, negative impact on the further development of a person with ASD, as opinions issued by experts condition subsequent access to the state’s systemic support – including therapeutic support.
During the lecture, a scientific project aiming to examine the above mentioned issues will also be presented.
Baio, Jon, Wiggins, Lisa, Christensen, Deborah, et al., “Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014”, MMWR Surveill Summ 2018; 67(No. SS-6):1–23. DOI: http://dx.doi.org/10.15585/mmwr.ss6706a1.
Omyła-Rudzka, Małgorzata (opr.), Komunikat z badań, nr 44/2018, Fundacja CBOS, Warszawa, marzec 2018.
Chase, William G., Simon, Herbert A. “The mind’s eye in chess”. W: red. Chase W. G., Visual information processing. New York: Academic Press, (1973): 215–281.
Damasio, Antonio Rosa. Descartes’ Error, London: Vintage, 2006.
Ericsson, K. Anders. “Deliberate Practice and Acquisition of Expert Performance: A General Overview”. W: Academic Emergency Medicine (2008), 15: 988–994, https://doi.org/10.1111/j.1553-2712.2008.00227.x.
Kahneman Daniel, Klein Gary. “Conditions for intuitive expertise: a failure to disagree”, American Psychologist, 64/6, (September 2009): 515-526. DOI: 10.1037/a0016755.
Kahneman, Daniel, Pułapki myślenia, tłum. Szymczak P., Poznań: Wyd. Media Rodzina, 2012.
Simon, Herbert A., “What is an explanation of Behaviour?”, Psychological Science. 3(3), (May 1992):150-61, https://doi.org/10.1111/j.1467-9280.1992.tb00017.x.
PAWEŁ ZAGOŻDŻON, MD, PHD
Medical University of Gdansk
Dr Pawel Zagozdzon is an epidemiologist at the Medical University of Gdansk and a psychiatrist at an outpatient clinic. Dr. Zagozdzon’s research focuses on psychosocial and clinical factors that underlie the risk of death and the quality of life. He undertakes observational research which includes national surveys of mental health in Poland, research using clinical data bases, and large cohort studies on unemployment and mortality in diverse populations to understand the risks for disorders. His main interests are observational research methodology, risk prediction in cardiovascular diseases; the mental health of patients with somatic diseases; and the role of religious and spiritual beliefs in mental well-being.
Lecture title: Religious values in psychiatric treatment
Results from observational studies showed that a belief in God was significantly associated with reduced levels of depression and increased psychological wellbeing, higher levels of clients’ treatment expectancies and perceptions of treatment credibility, and improved psychiatric care outcomes. A religious worldview has implications for understanding human nature, health, sickness, sanity, and insanity. In this paper I will try to discuss what are the religious-based values that can be relevant to diagnosis, psychotherapy, and compliance with psychiatric pharmacotherapy (Fulford, 2004). The set of values rooted in the biblical tradition is expressed in Galatians 5:22-25, which reflect the core of a healthy personality (love, joy, peace, patience, kindness, goodness, faithfulness, gentleness and self-control) as embodied in the person of Jesus from Nazareth. These virtues represent not only ethical ideas, but emotion-informed, concern-based construals. Issues of motivation, goals, moral judgment and relationships in the context of psychiatric treatment are frequently found in therapeutic dialogue (Roberts, 2007). One model of the nature of illness is the idea of a failure of proper function. A religious person believes that human beings have been designed and created by God, and created in the image of God. When a system or organ (the brain?) functions the way God intended then it functions properly; when it functions in a way incompatible with the way God intended, then it malfunctions (Plantinga, 1993). I will discuss how to improve religious patients’ adherence to treatment when the notion of proper function in the model of health is accommodated. Although some religious and spiritual beliefs may be empowering, some beliefs may be unhelpful. Epidemiological studies found that when people believe that God has abandoned them, or when they question God’s love for them, they tend to experience greater emotional distress, and even face an increased risk of an earlier death (Pargament, Koenig, Tarakeshwar, & Hahn, 2001). Some additional examples of harmful religious beliefs will be presented.
Fulford, K. W. M. (2004). Facts/values: Ten principles of values-based medicine. In The philosophy of psychiatry: A companion. (pp. 205-234). New York, NY, US: Oxford University Press.
Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2001). Religious struggle as a predictor of mortality among medically ill elderly patients: a 2-year longitudinal study. Arch Intern Med, 161(15), 1881-1885.
Plantinga, A. (1993). Warrant and Proper Function: Oxford University Press.
Roberts, R. C. (2007). Spiritual emotions: A psychology of Christian virtues. Grand Rapids, MI, US: William B Eerdmans Publishing Co.
Panel title: Intersubjective phenomena in the Clinical Setting. Approaches by E. Minkowski, H.C. Rümke and contemporary studies.
Chair: Jonathan Veliz Uribe
Universidad de Chile
Medical Doctor, resident in Psychiatry at the University „L. Vanvitelli”, Napoli
Department of Philosophy, University of Warsaw
Poznan University of Medical Sciences, University of Oxford
Pontifical Catholic University of Chile
Intersubjectivity has been a most relevant issue concerning the study of psychopathology, emphasizing the problems and questions of the dynamics of subjective experience through a focus on the situation of encounter, describing and analyzing the phenomena that appear in this context and thus shifting the view from an objective, third-person, clinical account, to an idea of shared experience, stressing the relevance of the presence of the interviewer in clinical settings.
The objective of this panel is to present philosophical and clinical issues of this concept through the approaches made by E. Minkowski, H.C. Rümke and contemporary studies, aiming towards promoting the reflection on not only the methodological but also ethical implications of the clinical practice and investigation.
This panel will be divided in three parts. The first is a review, by Felipe Crocco and Jonathan Véliz Uribe, of the contribution of Eugène Minkowski on this subject. Being one of the most relevant authors on structural phenomenology in psychiatry, his influence has been primarily related to the clinical study of schizophrenia, yet the scope of his research is much broader, even addressing philosophical issues. The objective of this part is to highlight this author’s view on intuition, linking it with the idea of intersubjectivity, putting forth epistemological, ontological and psychopathological questions on the concepts of being, self and the other in the clinical setting.
The second part reviews the concept of Praecox feeling in the work of H.C. Rümke. Agnieszka Brejwo, Marcin Moskalewicz.
The third part exposes the studies of Raffaele Vanacore who is currently working with phenomenologically oriented examinations (ASE, AWE and ACSE) researching their usefulness as a methodology for early detection of schizophrenic prodromal stages. Aiming to assess the relationship between basic pre-psychotic anomalies and the clinician’s incapacity to implicitly share an intersubjective space with the patient, Raffaele proposes that developing an interactive psychotherapeutic field could play a crucial role in ameliorating the prognosis of these prodromal phases; and, moreover, he argues that the constitution of a shared intersubjective space is the foundation for the recovery of basal anomalies and for possible further interventions (pharmacological, familiar or social.)
Panel title: Psychoanalysis and expertise – a difficult relationship
Chair of panel: Mira Marcinów
Polish Academy of Sciences
Maria Curie-Skłodowska University
PhD student at the Maria Curie-Skłodowska University Department of Philosophy and Socjology. Currently working on a doctoral dissertation on subjectivity in Lacan’s work. Author of several articles about psychoanalysis.
psychotherapist in process of certification, member of Cracow Circle of New Lacanian School, PhD student at the Jagiellonian University Department of Psychology.
Is a psychoanalyst an expert? If so, what kind of expert? The status of the psychoanalyst is ambiguous. It is certain that he is in a position, which legitimizes his practice of psychoanalysis, but the status of his expertise and his knowledge is to a large extent unclear. An “expert” in common opinion is someone who has mastered a certain field, preferably scientific or professional. Since the status of psychoanalysis as a science or profession is quite ambiguous, the position of the psychoanalytic as a medical expert is just as unspecified.
Supposedly, the reason for this ambiguous epistemological status of psychoanalysis can be traced down to the object of its alleged expertise, the unconscious. In spite of the ambitions of multiple psychoanalytic theories to elaborate and provide some knowledge on this peculiar ‘object’, in the frame of the psychoanalytic treatment a psychoanalyst cannot assume anything in advance about his patient’s unconscious. It gets even more problematic when we consider that at the beginning of psychoanalysis a patient on his own can never know anything about it. Maybe it implicates that the psychoanalyst is located in a paradoxical position of an expert in non-knowledge.
If that’s the case, it could be possible to correlate this specific position with the peculiarities of psychoanalytic training, which cannot be reduced to a process of gaining mere theoretical knowledge and practical, procedural skills to carry out a treatment. First of all, in the process of becoming an analyst one of the most important requirements is to undergo one’s own psychoanalysis, when it would be unimaginable for example in the case of a surgeon that undergoing his own surgery would be required for practicing his profession. It is also worthwhile to consider the obligation of a psychoanalyst to frequently supervise his work with an experienced supervisor. Maybe one of the reasons is the lack of a universal fit-for-all standard procedure of psychoanalytic treatment, which many times needs to be invented anew with each new case. Those are only a few examples of the traits of psychoanalytic practice, which supposedly illustrate the difference between psychoanalytic expertise and its standard version.
Considering the above, we want to discuss, among others, the problem of the use of psychoanalysis in the clinical field (especially in medical facilities like hospitals or care centres.) Is it possible to use psychoanalysis in hospitals, taking into account that such places function in accordance with strictly defined bureaucratic procedures?