inpp-2019-baner-partners

The list includes oral presentations, panel sessions and posters with biograms of registered participants.

It is still possible to submit a paper at INPP 2019. Click here to register!

Last update: September 21

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.

Konrad Banicki, PhD

Jagiellonian University – Institute of Applied Psychology

Lecture title: Personality disorders: towards an existential-phenomenological perspective

Recent developments in philosophy of psychiatry have usually been made with reference to psychotic disorders with a comparatively smaller attention directed at personality pathology other than antisocial personality disorder (for notable exceptions see Charland, 2006, 2007; Stanghellini, 2013, 2014). In order to make a modest contribution to this somehow neglected domain some 20^th century existential and phenomenological perspectives will be explored. More specifically, the conceptual apparatus provided by Józef Tischner’s (1978) essay People from Underground (Ludzie z kryjówek) and Paul Tillich’s (1952) work The Courage to Be will be employed to analyze Psychopathies (Psychopatie) by Antoni Kępiński (1977) as well as the fictional main character of Fyodor Dostoevsky’s (1864/1992) Notes from the Underground (Zapíski iz podpólʹya). The categories of anxiety and courage (Tillich) as well as those of experientially understood shelter/refuge, space and value (Tischner) will be then related to some recent investigations of the patients’ life-world (Stanghellini, 2013, 2014). Taken together the investigations conducted will serve as an illustration of the ways in which an existential-phenomenological perspective can advance and deepen our clinical understanding of this philosophically unexplored area.

Charland, L. C. (2006). Moral nature of the DSM-IV cluster B personality disorders. Journal of Personality Disorders, 20(2), 116–125.

Charland, L. C. (2007). Character: Moral treatment and the personality disorders. In J. Radden (Ed.), The Philosophy of Psychiatry: A Companion (pp. 64-77). Oxford: Oxford University Press.

Dostoevsky, F. (1864/1992). Notes from the Underground. Dover Publications Inc.

Kępiński, A. (1977). Psychopatie [Psychopathies]. Warszawa: PZWL.

Stanghellini, G. (2013). Emotions and Personhood. Oxford: Oxford University Press.

Stanghellini, G. (2014). The Therapeutic Interview in Mental Health. A Values-Based and Person Centered Approach. Cambridge: Cambridge University Press.

Tillich, P. (1952). The Courage to Be. Yale: Yale University Press.

Tischner, J. (1978). Ludzie z kryjówek [People from Underground]. Znak, 1(283), 57-72.

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.

Dr ANNA BERGQVIST

Manchester Metropolitan University

Dr Anna Bergqvist is an Associate Professor of Philosophy at Manchester Metropolitan University and Director of the Values-based Practice Theory Network at St Catherine’s College University of Oxford. Her principal research interests are value philosophy (metaethics and aesthetics), moral perception and philosophy of psychiatry. She is the editor of Evaluative Perception (Oxford University Press, 2018) and Philosophy and Museums (Cambridge University Press, 2016). She has also published on aesthetic and moral particularism, narrative, thick evaluative concepts and selected issues in philosophy of language and mind. She is interested the intersection between value philosophy and analytic psychology, currently preparing a monograph on particularism in medical epistemology.

Lecture title: The Hoping Gaze: Moral Perception and Relational Psychiatry in BPD

In this work, I deploy recent philosophical and empirical work on hope in healing relational crises, intrapsychic conflicts and identity disturbance, and explain why hope in narrative self-creation is central to the recovery process in adults diagnosed with Borderline Personality Disorder. My overall aim is to make a conceptual correction to the literature on selfhood in BPD by showing that lacking control over one’s own actions (and intrusions) and failing to see oneself as the subjective mental agent of the thoughts and feelings one undergoes in dissociation cases are two different situations. Two broad kinds of predicament are easily confused in understanding agency: propositional hope as an intentional state and pre-intentional ‘loss of hope’ in the subject’s orientation or existential feeling. Using the distinction between propositional hope and existential feeling, I argue that it is possible to lose one’s sense of agentic control (and experience severe despair from it) and yet retain another kind of access to the content of one’s mental agency in dissonance cases. The narrative agency that remains is something like a transcendental condition for experience by which other kinds of intentional states, including intentional hope, are intelligible. I end by showing how the phenomenon of resting in the hoping gaze of others shows an essentially relational dimension to subjectivity in these under-theorized, non-standard cases that is helpfully understood in terms of professional virtue. Herein lies also the moral and clinical significance of reappraising hope as a virtue in personality difficulties in times of despair.

Dr MAJA BIAŁEK

University of Białystok

She is a lecturer in philosophy of psychiatry and cognitive science at the University of Białystok. Her research interests focus on 4E approaches to depression and schizophrenia and animal studies.

Lecture title: Disturbance of self, self-protection and selflessness: the conundrum of schizophrenic delusions

In my talk I would like to point out an interesting tension in the philosophical understanding of schizophrenic delusions. On the one hand, many philosophers recognize their value: they can play a protective role and Lisa Bortolotti even defends the view that at least some schizophrenic delusions may be ‘epistemically innocent’ – that is, that they bring significant epistemic benefit when there are no other accessible beliefs that could bring such benefit. On the other – both in the phenomenological tradition and in the now flourishing family of enactive and embodied approaches to schizophrenia it is explained that schizophrenic delusions result from a disturbance of ipseity, our embodied basic sense of self, our embeddedness in the environment. Although it is often conceived that certain delusions are resulting from reflective attempts to make up for the loss of the embodied self, they are, in themselves, making it explicit. I will argue that it is fundamentally impossible to reconcile the phenomenological understanding of schizophrenic delusions with Bortolotti’s claim about their epistemic innocence.
In doing so, I will also reference a different philosophical (and phenomenological) defense of schizophrenic delusions: that of Antoni Kępiński whose controversial account focuses on their specific content. Kępiński emphasizes that schizophrenic patients often adopt a fascinating, selfless attitude – they lose touch with everyday life but at the same time concentrate on deep ethical issues concerning the wellbeing of humanity, eschatological matters, good and evil. Although Kępiński may be (and has been) accused of an overly enthusiastic approach to this phenomenon, this observation offers an interesting insight into the specific epistemic link between the loss of embodied self and the subject and content of resulting delusions. Understanding this link is, in my opinion, necessary in order to reflect on the precise nature of the benefits of schizophrenic delusions.

Krystyna Bielecka, PhD

University of Warsaw

I am doctor of Philosophy, wrote my thesis on mental representations. Now I continue my interests while realizing a grant on psychopathologies and mental representations (NCN SONATA).

Lecture title: Explanatory models in psychiatry. A case of schizophrenia

(together with Marek Pokropski)

Explanatory models in psychiatry span between two extremes (Gerrans 2014). First, the meaning rationalism apprehends the subject as rational agent and reduce symptoms such as delusions to false beliefs, which need further explanation. Second, neurological eliminativism sees mental diseases as brain diseases reducing the aspect of first-person experience to a minimum. Mental maladies are, however, extremely complex and context dependent phenomena. Often their complete understanding requires bringing together different fields of research covering such aspects as the psychological, social, phenomenological and, last but not least, neurobiological (e.g. Engel 1977, Kendler 2008). The latter approach, called integrative, tries to integrate all essential aspects of a mental malady. However, there is no consensus how such integration should proceed. In the paper, we focus on explanatory models for schizophrenia. First, we argue that models proposed by rationalistic psychology (Campbell 2002), phenomenology (Sass 2014), as well as neurobiology (Andreasen 1999) cannot themselves deliver a complete explanation of the mental malady. All of these approaches share similar fault of ignoring one or more essential levels of the malady. Second, we argue for integrative and multilevel approach to explanation of schizophrenia. Integrative approach would integrate essential levels, on which factors for schizophrenia occur, including levels such as biological (including evolutionary), psychological, phenomenological, and social. Third, as a candidate for integrative framework we consider a model called mechanistic property cluster (MPC) (Kendler, Zachar, Craver 2011). Accordingly, a mental malady is a cluster of interrelated causes, properties and symptoms produced by underlying causal mechanisms. Importantly, mechanisms are thought to be multilevel, moreover, no single mechanism can explain the complex cluster of a malady. MPC approach is a compromise between reductive approaches, it seeks for causal explanation but also tries to capture the multiplicity and heterogeneity of symptoms.

Andreasen, N. (1999) A unitary model of schizophrenia: Bleuler’s” fragmented phrene” as schizencephaly. Archives of General Psychiatry, 56, 781.
Campbell, J. (2002). Rationality Meaning and the Analysis of Delusion. Philosophy, Psychiatiry and Psychology, 8, 89-100.
Gerrans, P. (2014) The Measure of Madness. MIT Press.
Kendler, K.S. (2008) Explanatory Models for Psychiatric Illness. The American Journal of Psychiatry 165:6.
Kendler, K.S., Zachar P., Craver C. (2011) What kinds of things are psychiatric disorders?. Psychological Medicine, 41, 1143–1150.
Sass, L. A. (2014). Explanation and description in phenomenological psychopathology. Journal of Psychopathology, 20, 366-376.

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

Together with:

VALERIA BIZZARI

Heidelberg University Hospital

VERONICA IUBEI

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;

Bernice Brijan, MA

Tilburg University, The Netherlands

Bernice Brijan holds a BA and MA in Theology and Religious Studies (cum laude). She graduated in the field of spiritual care. Currently, she is a PhD student at Tilburg University in philosophy of religion and philosophy of psychiatry.

Lecture title: Existential loneliness: perspectives on recovery in psychiatry

One of the clearest articulations of the thought that loneliness is the core of psychiatric illness is Van den Berg’s famous citation in ‚A different existence’ (1972, pp. 105-6). He states that “Loneliness is the nucleus of psychiatry.” The lonely man in fact experiences a loss: of contact with himself, with other people, and with the world. This type of loss could be called existential. It influences the way in which one finds oneself in the world and how one relates to it. However, it is questionable to what extent existential loneliness is actually being addressed as a core element in mental health care. The most holistic model available for psychiatry – the well-known biopsychosocial (BPS) model – does not explicitly acknowledge the existential dimension. In this context, the movement of recovery introduces a different perspective: one that leaves space for personal, authentic and unpredictable processes. With cognitive self-regulation and empowerment as central elements, however, current models of recovery mostly have an individual focus instead of a relational one. In this paper presentation it will be discussed what phenomenology has to offer in this regard. With the help of Matthew Ratcliffe’s concept of existential feeling it will be argued that existential loneliness can be regarded as a loss of trust. It will then be elaborated how reexperiencing a state of being surrounded, or being included, being held is a necessary part of recovery, which has to be enabled by interpersonal encounters. This adds an existential or religious dimension (in the broadest sense) to what is otherwise often thought of as “providing enough social support” for patients. The aim of this paper is therefore twofold: (1) to arrive at a better understanding of what existential loneliness entails, and (2) to further develop perspectives on recovery in psychiatry.

RAYMOND CACCIATORE

Concordia University

Raymond Cacciatore is working towards the completion of a master’s degree in philosophy at Concordia University. Cacciatore’s current research is focused on developing a phenomenological account of the role time plays in experiences related to suicidality. Since the age of 16, Cacciatore has devoted his work to helping those suffering from physical and mental disorders. It was through his time spent as a peer support worker that Cacciatore gained a strong appreciation for the impact that a phenomenological understanding of mood disorders can have on one’s capacity to help those who are suffering.

Lecture title: Exploring Obstacles in Psychiatric Research: An Analysis of The Structure of Mood And its Affective Temporality

Psychiatry has reached a tipping point at which a radical methodological shift looms as an inevitable consequence. Since the American Psychiatry Association (APA) began publishing the Diagnostic Statistics Manual (DSM), psychiatry has been led astray by an inadequate symptom-based nosology. Due to the APA’s inability to appropriately integrate a dimensional model into the DSM’s fifth edition, the National Institutes for Mental Health (NIMH) restricted their funding for research centered around neural circuits, as outlined by the Research Domain Criteria (RDoC). While the RDoC matrix has the potential to improve psychiatry by investigating the various cognitive processes involved in psychopathology, it is not clear how this research can be translated into clinical practice. It is for this reason that some people, such as Robyn Bluhm, have refuted the NIMH’s claim that the RDoC will lead researchers towards forming a complete picture of mental illness and have suggested that researchers and clinicians should adopt distinct ontologies. I will argue, using Maurice Merleau-Ponty’s Structure of Behavior, that the development of distinct ontologies for researchers and for clinicians would produce two incomplete pictures of mental health that could not result in a complete picture when juxtaposed. What is needed in psychiatry’s continued attempt to better understand and treat mood disorders is an analysis of mood as a structure and the emergence of mood disorders as stabilized disruptions in a patient’s affective processes. In this way, mood disorders can be understood as potential changes in the form mood can take. Such an understanding provides the opportunity for the development of a descriptive nosology capable of facilitating psychiatric research applicable within clinical settings.

To demonstrate this, I will begin by outlining some observations made by Merleau-Ponty regarding the structure of behavior and its forms, while drawing attention to the fact that current research and diagnostic methods in psychiatry fail to grasp the lived meaning of a subject’s suffering and, thus, the significance of the emergent relations between a subject and its environment. I will then briefly discuss why taking a step back in order to study the structure of mood would be beneficial for the future development of psychiatric research. Approaching mood as a structure can shed light on where psychiatry has gone wrong by challenging some of its methodological assumptions (namely that mood disorders can be understood, through symptomology and biology, as discrete states) while refining our understanding of mental health. Finally, I will conclude with some thoughts on how a phenomenological exploration of mood’s dynamic structure provides insight into how psychiatry can develop a practical and descriptive nosology.

Dr. RODRIGO CARRILLO

Universidad San Francisco de Quito

Rodrigo Carrillo is a doctor of philosophy and a psychotherapist; He works at the Universidad San Francisco de Quito. His academic interests are phenomenology, psychodynamics and also cultural expressions of art.

Lecture title: How emotions configure our prereflective experience of the world

(together with dr Esteban Laso)

The aim of this presentation is to bring to reflection how our emotional states could articulate the experience that we have of the world and also our interpersonal relations in a prereflective way (Grunderfahrungen.)
We would also like to sketch how our emotional states influence empathy in an intercorporal based experience, we want to put to discussion concepts like, among others, lived body, emotional resonance, mentalization.

It is also important for our work to signalize how emotions in a perdurable mood and also a part of our personality (Feeling of Self) generate some psychopathologies like depression and anxiety, but also a Grundstimmung that performs all the way through our lives. We naturally want to show what possible therapeutic applications and consequences our approach may have when it comes to treating affective disorders.
We pursue to give a very important place to affects and emotions because we have seen that emotions are not assigned an important weight in therapy plans. We are not talking about emotions understood as in EFT, but in a way that establishes our experiences in an implicit way.
We pursue to give emotions a central position in the constitution of personality as well as in the therapeutic work.

ANASTASIOS DIMOPOULOS

CNWL NHS Foundation Trust

Complex adaptive systems and mental health practice; The role of philosophy in the future of medical education in mental health

Until now philosophy has arguably had a marginal role in medical education in mental health, even if the various debates within its corpus were casting their shadow on it. Medical education has embraced fully, often uncritically, in recent decades the positivist tradition characterized by its reliance on the scientific method and evidence-based practice. Medical curricula still maintain an approach based on achieving competencies and philosophy is unfortunately considered by most practitioners to be a discipline with marginal relevance to everyday practice. However, everyday practice in the real world is far more complex and cannot be entirely captured in terms of scientific language. Recent proposals on how to move forward with the delivery of mental health services, such as the King’s Fund report of 2017 and the NHS 10 year forward plan, emphasize the importance of delivering services in the community through a transdisciplinary approach. Complexity and uncertainty have been recognized as central aspects of practice that need to be addressed by the forthcoming curriculum redesign of the Royal College of Psychiatry. As a result, an educational linguistic trend emphasizing the development of capabilities and not just the achievement of competencies is gaining traction. The time is ripe for philosophy to gain its rightful place in everyday mental health practice. Unfortunately, the impressive amount of philosophically-informed articles, books, and conferences produced in recent decades struggles to gain traction with policymakers and educators that would allow it to achieve a significant scale of implementation. This partly reflects the fact that philosophically inspired positions, coming both from analytic philosophy or phenomenology, often are too concerned with staying faithful to their respective academic tribes, thus failing to grasp the need to go beyond their respective traditions and expose themselves to the multitude of discourses that underlie the complexity of everyday practice. A different approach is probably needed. We will propose an educational framework that can successfully integrate seminal philosophical ideas and dispositions, which will help mental health practitioners both as individual professionals and as members of a multispecialty team. Reflective practice, team and individual resilience, the ability to communicate with different stakeholders, coordinated care based on local needs and the creation of sustainable learning environments responsive to current and future challenges, are some of the expected benefits.

Dr Sam Fellowes

University of Lancaster

I am a post-doctoral researcher at Lancaster University. I am interested in the ontological and epistemological status of psychiatric diagnoses. I draw upon philosophy of science on models, scientific perspectivism and neo-Kantianism to argue that psychiatric diagnoses, when meeting various epistemic criteria, should be seen as fitting a moderate, metaphysically minimal notion of scientific realism.

Lecture title: Symptoms, like psychiatric diagnoses, are ‚constructed’: methodological and epistemic consequences

Critics who are concerned over the epistemological status of psychiatric diagnoses often describe them as being constructed. Those same critics usually see symptoms as relatively epistemologically unproblematic. In this paper I show that symptoms are just as constructed as diagnoses are.

I demarcate between behaviour and symptoms. I draw upon Bogen and Woodward’s distinction between data and phenomena, portraying behaviour as data and symptoms as phenomena. Phenomena are understood as abstracted and generalised, missing a lot of detail present in data. Similarly, symptoms lack the detail which is specific to particular manifestations of behaviour. That detail has been abstracted away. Consequently, symptoms are much more generalisable. It is not the case that there is one symptom of low social skills for talking to your boss and a different symptom of low social skills for talking to your parents. Rather, such details are abstracted away. This means symptoms are more generalisable and applicable to multiple situations. Given the abstracted and generalised nature of symptoms I argue that symptoms are not ready made portions of the world which are out there waiting to be found. Rather, choices need be made over how to formulate symptoms from the behaviour which people exhibit, deciding which behaviour should be considered an instance of which symptom. On this basis, symptoms should not be seen as ‘things’ which are out there in the world, rather, symptoms should be seen as constructed. I show the epistemic problems with psychiatric diagnoses are also applicable to symptoms. Firstly, psychiatric diagnoses typically cover heterogeneous groupings of symptoms. Parallel worries can be raised about symptoms. Symptoms typically cover heterogeneous groupings of behaviour. Two instances of behaviour may be instances of the same symptom yet differ from one another quite significantly. Secondly, in many cases numerous, often contestable, judgements have to be made when psychiatric diagnoses are formulated. Similar concerns are true of symptoms. There are also choices in how they can be formulated. Symptoms can be formulated to cover a wider range of behaviours or a narrower range of behaviours. Thirdly, psychiatric diagnoses appear to typically cover causally heterogeneous individuals. The same is true of many symptoms. The causal influence on a particular instance of behaviour can be quite different to the causal influences on a different instance yet both instances of behaviour can constitute instances of the same symptom. This account of symptoms has consequences for the epistemic status of psychiatric diagnoses. Symptoms are usually seen as relatively unproblematic whereas there is much concern over the epistemic status of psychiatric diagnoses. However, common epistemic concerns over psychiatric diagnoses are also applicable to symptoms. Consequently, I suggest that critics of psychiatric diagnoses should extend their criticism to symptoms or, if they still believe symptoms are relatively epistemologically unproblematic, should rethink their concerns over psychiatric diagnoses. I favour the latter approach, suggesting my argument helps support the epistemic status of psychiatric diagnoses.

MICHAEL FRENCH

University of New Haven

Trying on the Noose: A Phenomenology of Suicide

R.D. Laing gave an existential phenomenology of the schizophrenic person in The Divided Self. In this work, Laing developed a greater level of engagement with his schizophrenic patients through this method. Laing describes the goal and purpose of the method: “Existential phenomenology attempts to characterize the nature of a person’s experience of his world and himself. It is not so much an attempt to describe particular objects of his experience as to set all particular experiences within the context of his whole being-in-his-world. The mad things said and done by the schizophrenic will remain essentially a closed book if one does not understand their existential context.” While Laing uses his method in order to understand the schizophrenic, this project will make use of his method for engaging with the suicidal person. What I hope to accomplish in this essay is a phenomenological journey along the path of the suicidal mind, examining how the questions the suicidal person attempts to answer can be answered, and the way in which their relation to themselves and their world guide these answers. This will allow us a better opportunity to study and engage with the suicidal person as we attempt to join them on their journey towards the noose, gun, pills, lake, or bridge. We will begin by examining the phenomenological situation the suicidal individual finds themselves in. From there, we will examine their phenomenological bonds freezing, what I term Ontological Petrification, to describe suicidal hopelessness. Suicide then becomes the hope for impactful action, an action that is able to change their phenomenological relations. If an individual reaches this point and has other necessities (outlined by Thomas Joiner), only then is a person able to enact their death. These theories will be examined against suicide notes, testimonies of practitioners, and journal entries of suicidal individuals. By using a phenomenological method, a common experience can be found in a relational hopelessness.

MARTIN FRITSCH

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.”

Antoni Grzybowski, MA

Jagiellonian University

Psychotherapist in process of certification, member of Cracow Circle of New Lacanian School, PhD student at the Jagiellonian University Department of Psychology.

Paradoxes of psychoanalytic expertise. Psychoanalysis as „liberal art”?

„The whole trend of your previous education and all your habits of thought are inevitably bound to make you into opponents of psychoanalysis” claimed Freud (1916/2010) at the beginning of his Introductory Lectures on Psycho-Analysis. In opposition to standard medical practice, psychoanalysis does not involve a body but speech and words of a patient, but it would be mistaken to think that because of it psychoanalyst should be some kind of expert in linguistics. The technique of psychoanalysis situates psychoanalyst rather in the paradoxical position of abstinence from any ready-made knowledge because any knowledge cannot be transmitted to a patient without unwanted side-effects on a psychoanalytic process (Freud, 1910/2007). It is linked to the process of so-called „free associations” considered by Freud (1913/2007) the fundamental rule of psychoanalytic treatment, which is to speak as freely as possible on the side of the patient. A psychoanalyst cannot be the one who limits patient’s speech on a basis of any previous assumptions and as a consequence, even a duration of the psychoanalytic treatment cannot be decided in advance (Freud, 1913/2007). All of it can be considered a matter of subjective measure of each individual undergoing his own psychoanalysis (Lacan, 1996). The theme of the relation of man to his measure was the basis of so-called „liberal arts”; arts considered in antiquity and medieval times to be autotelic wisdom of free man in opposition to profit-oriented repetitive techniques, procedures or recipes. (Seneka, 2010) However, when liberal arts sought universal measures for the human language, speech and thought, it is debatable if any of such measures can be found in the field of psychoanalysis. It is more likely that measure, which is sought in psychoanalytic treatment is always particular to each subject, which is due to the domain of sexuality as its fundamental field of concern. Sexuality is on the one hand most subjective and related to our self-expression field of human activity, nonetheless, it is also domain of most intimate relation with the other and consequently domain of our vulnerability. Within such a conflictual realm, own measure must be invented case by case for each subject without any pregiven coordinates.

Freud, S. (1910/2007) O „dzikiej” psychoanalizie. [in:] Freud, S. Technika terapii, Warszawa: Wydawnictwo KR.

Freud, S. (1913/2007) W kwestii wprowadzenia do terapii. [in:] Freud, S. Technika terapii. Warszawa: Wydawnictwo KR.

Freud, S. (1916/2010) Wykłady. Warszawa: Wydawnictwo KR.

Lacan, J. (1996) Funkcja i pole mówienia i mowy w psychoanalizie. Warszawa: Wydawnictwo KR.

Seneka, L. (2010) Listy moralne do Lucyliusza. Warszawa: Wydawnictwo Naukowe PWN.

JOSEPH HOULDERS

The University of Birmingham

Poster title: Merleau-Ponty, Indeterminacy and Obsessive-Compulsive Disorder

Merleau-Ponty’s analysis of indeterminacy in both ‘Phenomenology of Perception’ and ‘Signs’ can be used to conceptualise the experience of a sub-type of Obsessive-Compulsive Disorder (‘OCD’), known colloquially as ‘Pure O’. I illustrate this by developing the following three points:

(1) Merleau-Ponty’s view that a reaction to indeterminacy in self-experience leads to a desire for ‘total manifestation’, describes what appears to happen in some cases of ‘Pure O’: people with the disorder react to intrusive thoughts and images which challenge their self-conception, by trying to find definite answers about their ‘true nature’, e.g. by monitoring physiological responses to ideas, images and real-life situations.

(2) Merleau-Ponty argues that indeterminacy is inherent in our experience. This thought can be used to explain at least in part why people with OCD are unable to give a definitive account of themselves – which would, in theory, cause the endless checking and doubting to cease.
(3) Merleau-Ponty’s philosophical stance regarding indeterminacy in our experience is that it is ‘positive’. This is a more extreme version of contemporary psychotherapy’s view that the most effective approach to treating OCD is to help sufferers to learn to tolerate indeterminacy. By ‘tolerate’ I mean: not trying to correct; letting the indeterminacy exist unchallenged. Both stances, the philosophical and the psychotherapeutic, suggest that we should not try to ‘fix’ indeterminacy.

To close the analysis, I consider how indeterminacy in one’s experience of oneself can be embraced in our autobiographical narratives, and how this might be said to be therapeutic. I introduce autobiographical narrative to the discussion for two reasons. Firstly, Merleau-Ponty suggests that the desire for total manifestation makes us think of ourselves, and others, in terms of story. Secondly, influential discussions of autobiographical narrative in the context of mental health have focussed on its capacity to provide structure and coherence, e.g. by linking events in their temporal, causational order, to one’s experience. What has been neglected in these discussions is the potentially therapeutic effects of embracing indeterminacy in autobiographical narrative. For example, acknowledging that the perennial indeterminacy that characterises our experience calls into question our proposed authority on ourselves, and so too the absolute truth of our autobiographical narratives. I offer some suggestions of how acknowledging these ideas can be thought of as being therapeutic, i.e. ameliorating or protecting against negative affect.

GRZEGORZ KOPACZ, M.D.

Studies: 1984. Medical University of Lublin. Work: 1984-2015 Department and Psychiatry Clinic in Lublin. Medical University of Lublin. 1984-1999 Department of Psychiatry, 1999 – 2000. Organizer and Head of the Youth Department, 2000 to 2014 Director of the Department of Treatment of Neurotic Disorders, Anorexia, Bulimia, 1995 – 2008 Family Therapy Center, 1996 – 2000. Consultant of Nursing Homes
Lectures and Exercises. Universities: the Catholic University of Lublin in Lublin, UMCS, Faculty of Fine Arts – University of Rzeszów (anatomy), University of Life Sciences in Lublin (hippotherapy), WSEI in Lublin,
PhD thesis 1994. “Assessment of positive and negative symptomatology in paranoid schizophrenia.”
Polish National Prize Kaczyńskiego 1994, numerous didactic and scientific rector awards.
1995 assistant professor, 1998-99 Scholarship (Kortenberg (University of Leven) Belgium). Member of the Faculty Board of the Medical University in Lublin, Polish Psychiatric Association.
In the past, the Society of Polish-American Psyciatrists, the Society of Polish-German Psychiatrists, and the European Society for Transactional Analysis. Organization of Conferences – nationwide LSN (2006 Chairman of the Organizing Committee of the XII LSN), 44 Congress of PTP 2014, member of the editorial board of ‚Studies on Schizophrenia’. Author of over 40 scientific publications in domestic and foreign journals and papers, several reviews – national magazines – psychiatry, psychology, philosophy. Languages - English, Russian. Interests: Philosophy, Art (he is the author of drawing and painting exhibitions), classical music.

Lecture title: The importance of pre-phenomenology in the process of expertise in psychiatry and anthropology.

Clinical classifications in psychiatry should be a reflection of competent clinical expertise. The currently used analysis based on clinical and experimental knowledge and classical logic is insufficient for optimal clinical evaluation, description of phenomenological processes, and mechanisms of psychic phenomena and their disorders. The purpose of the presentation will be to make people aware of the possibility of a rational description and knowledge of the pre-phenomenological sphere that determines the shape of observable phenomena, which is possible and may come from neurophysiological, neuroanatomical, clinical, philosophical analyzes of mental functioning that bring us closer to descriptions of quantum mechanics and theoretical physics. This is in line with Roger Penrose’s suggestions that the brain may be the „only real quantum computer” existing in our world. According to the proposed hypothesis, full psychiatric expertise should include pre-phenomenological space combined with phenomenological space, which are in a similar relationship as particle physics to Newtonian physics. Based on the available knowledge and many years of therapeutic experience, the author refers to the phenomena of awareness, intuition in the context of their hypothetical therapeutic

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.

Poster title: Ethical aspects of animal research in psychiatry

Rationale

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.

Resolving controversies

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.

Lecture title: Classical metaphysics and contemporary psychiatry

Rationale

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.

Aim

The aim of this study is to present the application of metaphysics based on the works of the Lublin Philosophical School in modern psychiatry.

Results

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.)

Conclusions

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.

Dr Jan Kutnik

JP II Catholic Univerity of Lublin / »Artes Liberales« Academy

I graduated in history (Maria Curie-Sklodowska University, 2007, M.A. thesis on 19th century Russian anarchism), philosophy (MCSU, 2009, M.A. thesis on Thomas Carlyle’s and Frederick Nietzsche’s historiosphy) and psychology (The John Paul II Catholic University of Lublin, 2014, M.S. thesis on the concept of authenticity in existential theory). I received a Ph.D. degree in philosophy for a dissertation on “Sobornost and Dialogism: The I-Other Relationship as the Essential Aspect of Subjectivity” (MCSU, 2013). At present, I am enrolled in the final year of the doctoral program in psychology at the Catholic University of Lublin. My project is an analysis of structurally related existential factors which are activated by representations of boundary situations. I am also a member of the board of the “Well of Memory” Association, a non-government organization dedicated to the preservation of Jewish cultural heritage in the Lublin region and commemoration of the Holocaust.

Philosophy of dialogue and psychology of dialogue (Dialogical Self Theory ): dialogue or two monologues?

(part of the panel: Dialogue and dialogicality in theory and practice – psychology, psychiatry and the philosophy of dialogue)

Undoubtedly the category of dialogue plays an important descriptive and defining role in two basic human sciences: philosophy and psychology. In both these fields of science, „dialogue” became especially important in the 20thcentury, as part of the philosophy of dialogue (Rosenzweig, Buber, Levinas) and the Dialogical Self Theory (Hermans). I will present and analyze the relationship of these two dialogisms, asking whether they are complementary theories or whether it is impossible to talk about one dialogical concept of man on their basis. These questions seem to be particularly interesting, because both concepts use different methodology specific to their fields. Both also originated from the analysis of completely different aspects of dialogue. Philosophers referred to varied qualities of interpersonal relationships, emphasizing the subject’s creative significance and value of dialogical contact. In turn, Hermans focused on more subtle, internal dialogue activity (which is one of the most interesting characteristics used to describe personality and its development). Historically, both ways of thinking have developed independently from each other. The Dialogical Self Theory occurred much later than the philosophy of dialogue, and Hermans initially used Bachtin’s thought (not related to the thought of the 20thcentury philosophy of dialogue). Both the philosophy of dialogue and the Dialogical Self Theory have nowadays established themselves theoretically and are part of the landscape of both philosophy and psychology in general as a permanent landmark. Hence, one can legitimately ask: Are they, therefore, only two separate scientific „monologues” or is there any space for dialogue (coherent discourse) for these two visions of the self / subject? This issue is also an excellent exemplification of the problem of how the relationship and the mutual influence between psychology and philosophy – today.

Dr. ESTEBAN LASO

Universidad de Guadalajara

Esteban Laso holds a PhD. in social psychology and is a psychotherapist. Universidad de Guadalajara, México. His academic interests are emotions and philosophy of mind.

How emotions configure our prereflective experience of the world

The aim of this presentation is to bring to reflection how our emotional states could articulate the experience that we have of the world and also our interpersonal relations in a prereflective way (Grunderfahrungen.)
We would also like to sketch how our emotional states influence empathy in an intercorporal based experience, we want to put to discussion concepts like, among others, lived body, emotional resonance, mentalization.

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.

Bibliography: https://scholar.google.fr/citations?user=fkvwYLoAAAAJ&hl=fr

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.

Mira Marcinów, PhD

Polish Academy of Sciences

Psychologist, Philosopher, Assistant Professor (Adiunkt) in the Institute of Philosophy and Sociology in Polish Academy of Sciences. Recent books: ‘The History of Polish Madness. Volume 1. The Study of Melancholy’ (2018) and ‘The Unhealed Wound of Narcissus. Psychoanalysis in Poland before 1939’ (2018) (with B. Dobroczyński).

Lecture title: The Specific History of Hysteria in Poland

In this talk I present my recent introductory research results of the history of hysteria in Poland with emphasis on 19th century, when we had on Polish lands so called ‘epidemic hysteria’. I investigate polish psychiatric texts about the etiology of hysteria related to female sexuality and methods of its ‘treatment’ such as: female genital mutilation. I trace the theories and prototypes of polish hysteria from the 19th century to the present and question the assumption that hysterical person must be women. Finally, I expect that defining for example borderline personality disorder as contemporary hysteria, show how the diagnosis of hysteria was negotiated. The project to trace the history of hysteria in Poland is part of my larger research project devoted to writing trilogy: ‘The History of Polish Madness’. The first volume on the history of melancholy in Poland has already been published (Marcinów, 2018) and gained interest also among non-specialists. My talk will be the first presentation of partial research on volume two devoted to the history of hysteria in Poland (in preparation).

M. Marcinów, Historia polskiego szaleństwa. Tom I. Słońce wśród czarnego nieba. Studium melancholii”, Gdańsk 2018.

Dr Ivan Nenchev

Universitätsmedizin Berlin, Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus

Ivan Nenchev is currently employed as a Resident Physician and an Assistant Professor at the psychiatric hospital St Hedwig Berlin, where he is involved in various research projects. His research specializes on the intersection of medicine and humanities, with themes such as language and the use of emojis in schizophrenia, as well as psychoanalytic interpretations of ancient mythology. Moreover, Ivan conducts a creative writing group with schizophrenic patients, and he is a member of the psychoanalytic association Lacanian Orientation Berlin. He studied Medicine in Sofia and Berlin, and received a doctorate in Medicine from the Charité University Medicine Berlin with a monograph on The Sense of Agency: Results of an Electrophysical Experiment.

Linguistic and Philosophical Problems with Psychiatric Metaphor Comprehension Tests

(together with Benjamin Wilck)

Our paper exposes inconsistencies in recent psychiatric literature on figurative speech comprehension, focusing on metaphor comprehension. Both psychiatric diagnostics and research employ figurative speech comprehension tests to determine the test person’s ability to understand figurative speech. The inability to understand figurative speech, which commonly counts as a symptom of schizophrenia, is called “concretism”. We argue that the psychiatric metaphor comprehension tests used in psychiatry to determine metaphor miscomprehension are committed to linguistically and philosophically contestable background assumptions. Especially paraphrase tests imply a sharp distinction between literal and metaphorical meaning and, in particular, the view that metaphor comprehension consists in the ability to paraphrase metaphors. Moreover, they presuppose that healthy people effortlessly and intuitively understand metaphors, which implies that failing paraphrase tests indicates mental disorder. Against this we argue that while metaphor miscomprehension might well indicate mental disorder, failing paraphrase tests does not demonstrate metaphor miscomprehension, after all. By identifying linguistic and philosophical difficulties with the underlying understanding of ‚metaphor’ in the reviewed psychiatric literature (altogether 295 studies), we suggest to revise the testing procedures currently in use. The main claims of our paper are the following:

i. The psychiatric tests for concretism currently in use fail by relying on linguistically contestable background assumptions.

ii. Many of the psychiatric metaphor (or, more generally, figurative speech) comprehension tests currently in use are even inconsistent with their own linguistic background assumptions.

iii. Especially the psychiatric metaphor paraphrase tests, which constitute the dominant variant of psychiatric figurative speech comprehension tests, fail to show what they are supposed to show. That is to say, psychiatric metaphor paraphrase tests are not sufficient to detect concretism in the proband.

iv. Insofar as the correlation between schizophrenia and concretism is established on the basis of metaphor paraphrase testing procedures, the commonly held view that concretism is a symptom of schizophrenia is not justified (even though it might well be true).

v. There is a philosophical way to save psychiatric metaphor paraphrase tests from being abandoned.

By appealing to contemporary philosophical research on metaphor, we suggest a modified psychiatric metaphor paraphrase test for concretism, which does not fall victim to the same linguistically contestable background assumptions as the standard paraphrase tests. Besides providing a showcase for the application of philosophy of language in clinical research and diagnostics, the present research project contributes to a better understanding of the linguistic features of schizophrenic patients.

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)

(part of the panel: Intersubjective phenomena in the Clinical Setting. Approaches by E. Minkowski, H.C. Rümke and contemporary studies)

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.

Paul, L. A. (2014). Transformative experience. Oxford, UK: Oxford University Press.Saks, E. R., & Golshan, S. (2012). Informed consent to psychoanalysis: the law, the theory, and the data. Oxford, UK: Oxford University Press.

MARTA PLACHY B.A., M.A.

University of Warsaw

B.A. in Philosophy (University of Warsaw), M.A. in English and American Studies (University of Gdańsk), currently working on M.A. thesis in philosophy devoted to the idea of communication in Karl Jaspers’ thought.

Lecture title: Karl Jaspers: embracing solitude

Reflection on solitude as part of the human condition dates back to the origins of philosophical study of human nature. Plato, who has been called the first poet of solitude, defines solitude as a necessary condition for thinking, described as an inner dialogue. Solitude (most frequently understood as being alone without feeling lonely), loneliness (associated with the feeling of alienation) and many other types of solitary conditions or experience (such as aloneness, solitary confinement or isolation) have been addressed for centuries by theologians, philosophers, social thinkers, writers and artists.
As the British sociologist Frank Furedi points out, it was not until the 21st century that loneliness became an issue for health professionals, rapidly acquiring the status of an epidemic. While a considerable group of experts higlight the negative impact of loneliness on our health or sense of well-being, to a degree that it can even lead to psychiatric disorders, other health professionals warn that medicalising loneliness might prove harmful, as the problem should be dealt with in a holistic rather than single-handed manner. According to Frank Furedi: „Instead of medicalising loneliness and calling it an epidemic, we need to find better ways of engaging with ourselves.” The aim of this study is to present the idea of solitude from the perspective of Karl Jaspers’ thought – as part of „a necessary and infinitely dialectial movement” between „the pleasure in individuality, and thus the impulse towards solitude, and the suffering of individuality, and thus the impulse away from solitude.” The experience of solitude, in Jaspers’ view, is a fundamental step on our path from self-being to Existenz, finding fulfilment in existential communication: „self-being means loneliness, but a loneliness in which I am not yet myself; for loneliness is the sensed readiness in possible Existenz – which becomes real Existenz only in communication.”

Marek Pokropski, PhD

University of Warsaw

I work as assistant professor at the Institute of Philosophy of the University of Warsaw. My current research interests focus on phenomenology, cognitive sciences, philosophy of mind, and philosophy of science.

Title of lecture: Explanatory models in psychiatry. A case of schizophrenia

(together with Krystyna Bielecka)

In the paper, we focus on explanatory models for schizophrenia. First, we argue that models proposed by rationalistic psychology (Campbell 2002), phenomenology (Sass 2014), as well as neurobiology (Andreasen 1999) cannot themselves deliver a complete explanation of the mental malady. All of these approaches share similar fault of ignoring one or more essential levels of the malady. Second, we argue for integrative and multilevel approach to explanation of schizophrenia. Integrative approach would integrate essential levels, on which factors for schizophrenia occur, including levels such as biological (including evolutionary), psychological, phenomenological, and social. Third, as a candidate for integrative framework we consider a model called mechanistic property cluster (MPC) (Kendler, Zachar, Craver 2011). Accordingly, a mental malady is a cluster of interrelated causes, properties and symptoms produced by underlying causal mechanisms. Importantly, mechanisms are thought to be multilevel, moreover, no single mechanism can explain the complex cluster of a malady. MPC approach is a compromise between reductive approaches, it seeks for causal explanation but also tries to capture the multiplicity and heterogeneity of symptoms.

Christopher Poppe

Institute for Biomedical Ethics, University of Basel, Switzerland

Christopher Poppe is a PhD Candidate at the Institute for Biomedical Ethics (IBMB) at the University of Basel, Switzerland. He holds a Master in Clinical Psychology and Psychotherapy (MSc, 2016) from the University of Kassel, Germany, and subsequently studied philosophy at Humboldt University of Berlin and the University of York, UK. In the long run, he looks to finish his philosophical education with a Master’s degree in philosophy from the University of Hagen, Germany.

Title of lecture: Stepwise informed consent to psychoanalysis: the challenge from transformative experience

Psychotherapists have a legal and moral duty to obtain informed consent from their patients before the start of therapy. For informed consent to be valid, the patient needs to weigh the consequences of different treatment choices. In some forms of psychotherapy this is more difficult than in others. In the case of psychoanalysis, personal consequences (i.e. so called unwanted effects of psychotherapy, for example divorce) are often unknown and, more importantly, cannot be reasonably weighed up before the start of psychoanalysis. Hence, it can be argued that psychoanalysis constitutes a transformative experience in the sense of L.A. Paul (2014). Undergoing psychoanalysis is both personally and epistemically transformative. On the one hand, personal transformation is facilitated through insight in psychoanalysis. On the other hand, psychoanalysis is epistemically transformative because only by experiencing psychoanalysis we get to know its therapeutic methods (i.e. interpretation, transference, etc.). This is the reason for training analyses. It is unclear how to choose for or against undergoing psychoanalysis. In rational choice theory, each of the outcomes of psychoanalysis (i.e. divorce) would have an expected utility for the person. If the expected utility is unintelligible to the patient beforehand because of the transformative nature of psychoanalysis, this complicates informed consent. In light of this, some authors have recommended to adopt a stepwise approach to informed consent, where informed consent is repeatedly obtained throughout the process of psychoanalysis. If for example the psychoanalyst makes a first transference interpretation during the process, then “the analyst could say something more about how transference works” (Saks & Golshan, 2012, p. 87).
However, I hold that this stepwise informed consent does not constitute a valid form of informed consent due to the irreversibility of the psychoanalytic experience, which renders the patient’s choice null and void. L.A. Paul’s (2014) solution of choosing transformative experiences as a revelation will be discussed.

Dr Mateusz K. Potoniec

Faculty of Polish Studies – Jagiellonian University

Literary anthropologist in spe, currently studying at the Jagiellonian University Faculty of Polish Studies in Cracow. His research is focused on two main areas: medical humanities and nonfictional narratives – especially literary reportage. Currently he combines both disciplines by co-leading a pioneering Polish programme in narrative medicine.

Lecture title: Trans* identities, authorial responsibility and boundaries of (literary) reportage in Jacek Hugo-Bader’s “Underground Life of Ewa H.”

For the last 30 years reportage (and literary journalism in general) have undergone the process of becoming arguably the most commonly read, widely discussed and influential literary genre in Poland. The most resonant of the post-1989 literary discussions touched somehow questions of authorial responsibility, formal boundaries, and truth in (literary) reportage, yet surprisingly scarce and asymmetrical is the scholarly reflection on the subject. In this presentation I would like to investigate the ways in which literary journalism should become the area of interest in the fields of medical (and health) humanities theory and practice. The discussion of Jacek Hugo-Bader’s (in)famous article “Underground Life of Ewa H.” (“Podziemne życie Ewy H.”) will serve as my pretext and starting point. I will try to present the way in which trans* person, her body and identity, is presented in the text, how the unusual and radical narrative form (re)creates and unjustly (de)constructs them. Following theoretical considerations of the poetics of postmodern reportage and canons of journalistic ethics I will show how the author, through the text itself, forgoes the responsibility for the story and his protagonist. I will rise to the concept of ethical criticism showing how this pathography disguised as autopathography made its influence on the heroine herself. Finally, I will try to consider if (and how) such text of radical, questionable, but undoubtedly impressive formal aspects could be put to good use in narrative medicine training.

SAHANIKA RATNAYAKE

University of Cambridge

I’m a PhD candidate at the University of Cambridge, my project concerns the history and philosophy of Cognitive Behaviour Therapy

Normative Judgements and Cognitive Behavioural Therapy

Normative judgements play a number of significant roles in human psychology. Judgements such as „I really shouldn’t have done that”, „One ought to donate money to charity” or „I must manage my time better” may encompass a number of roles ranging from: evaluations of past behaviour; motivating, explaining or guiding future action; expressing an individual’s obligations and so on. Given the centrality of these judgements in human psychology, it should be of little surprise that they come to be scrutinised by psychotherapy. I consider the way in which one of the two main contemporary schools of psychotherapy, Cognitive Behavioural Therapy (CBT), approaches normative judgements and considers the effect of this approach on the normativity of these judgements. To use the terminology I develop in my paper: CBT reframes the thoughts that express normative judgments and in doing so defuses their normativity.

Whilst this technique of reframing and defusion might be useful in some ways, I argue that it is inappropriate to use with certain normative judgements. Normative judgements concern many areas of normativity and not all of these fall comfortably under the province of psychotherapy. Given that many individuals seek psychotherapy with the hopes of gaining insight into what they should do, normative judgements concerning practical reasoning, that is, deliberation concerning what means to adopt in order to reach some desired end, seems to fall under the purview of psychotherapy. However, normative judgements can also concern morality. I suggest that, given the background professional considerations of psychotherapy, it is inappropriate to defuse moral judgements.

Dr Justyna Rynkiewicz

Maria Curie-Skłodowska University

I’m a doctor of Philosophy (Maria Curie-Sklodowska University, 2018) with a master’s degree in Psychology (MCSU 2013). Currently I’m employed at the Maria Curie-Sklodowska University as senior lecturer at Faculty of Philosophy and Sociology and also in „Towarzystwo Nowa Kuźnia”, a non-government organisation with a goal in preventing of social pathology, including addiction prevention, where I carry out the role of Head of the unit and a psychologist. I’m also a coordinator of four editions of Przyjazny Uniwersytet (Friendly University) project, which helps people during or after a psychological crisis to adapt and properly function in the academic community. My interests are focused mainly around the problem of man as a subject in his relations with other people and the environment; philosophy and psychology of quality of life.

Lecture title: Is there anything left to say? – philosophy of dialogue and psychotherapy do panelu Dialogue and dialogicality in theory and practice – psychology, psychiatry and the philosophy of dialogue

(part of the panel: Dialogue and dialogicality in theory and practice – psychology, psychiatry and the philosophy of dialogue)

Ferdinand Ebner is one of the most important philosophers of dialogue who presents a philosophical view on mental disorders. Ebner perceives insanity as a result of collapsing of “I”. If someone face no counterbalance to his mental processes, he will be mastered by them. The only way to prevent this kind of mental state is to develop an authentic communication with another person, who can oppose the imperialism of one’s egoistic end egocentric self.

Ebner’s point of view on the origin of mental disorders is based on the statement that a constitutive feature of human is being in relations with others, and the quality of these relations determines the way of human existence.

In this context I will try to answer a question: if experts in mental health can still learn from Ebner’s, Martin Buber’s and Emanuel Levinas’s theories. I will discuss those elements of philosophy of dialogue that are already present in some of psychotherapeutic and psychiatric approaches. I will also raise the issues of the thoughts of Ebner, Buber and Levinas that seem to be forgotten.

On the one hand, experts in mental health are usually convinced that quality of the relationships between patient/client and the helper is crucial to the treatment process . On the other hand, they seem to be unaware of the reasons why it is so important, namely, ontological and anthropological analyses provided by philosophers of dialogue.

In my opinion these ways of thinking about the human being could be a basis for a genuinely open attitude to patients, and help professionals to overcome the temptation to see clients throughout their disorders.

Marcin Rządeczka

Maria Curie-Skłodowska University

Lecture title: Evolutionary explanation of Autism Spectrum Disorder and Schizophrenia Spectrum Disorder in the light of the life history theory

Undoubtedly, both ASD (Autism Spectrum Disorder) and SSD (Schizophrenia
Spectrum Disorder) can be classified as extremely complex objects of scientific inquiry,
which is not only a result of their multi-level causal hierarchy, mostly consisting of dozens of
intrinsic and extrinsic factors, but also some very intricate criteria of diagnosis. It is nearly
impossible to apply typological thinking to them, due to the fact that they form wide spectra
of manifestations defeating any attempt to classify them as a discrete entity with a well-
defined set of constituent symptoms. For the abovementioned reasons, until recently, the
science of psychopathology lacked any serious candidate for a unifying theoretical framework
able to offer, at least, some draft explanation of the ASD and SSD ultimate causes.
Indubitably, understanding mental disorders in terms of their proximate (i.e.
mechanistic, neurobiological) causes is of great importance for both science and practice of
medicine but offers no valuable answer to questions regarding the emergence of a certain
disorder in a population. To answer such a question one must delve deeply into the
evolutionary biology and reframe the research perspective. Unsurprisingly, both populational
and phylogenetical approach shed new light on the origin of mental disorders, describing
them as unavoidable failures of complex systems.
The fruitful union of computational biology and evolutionary psychopathology aims to
use computational modelling for the sake of creating the unified large-scale picture of mental
disorders. According to the null-hypothesis, any sufficiently complex process influenced by,
at least, several genetic and environmental factors, each of which in a highly variable manner,
will be manifested as a broad spectrum of phenotypes, described roughly by the bell-shaped
curve. In other words, this model predicts that abnormal cognition and behaviour occurs in
any population of organisms by default. Low-frequency abnormalities are the natural result of
the high variability of a functional phenotype. Both ASD and SSD fall into this category.
However, judging from the evolutionary perspective there is a strong link between the
ASD and SSD due to the fact that both spectra of disorders are closely correlated with
radically different models of parental investment and life-history strategies. Hyper-
mechanistic cognition presented in patients with ASD correlates with delayed reproduction,
the smaller number of offspring and their relatively higher quality whereas hyper-mentalistic
patients with less severe cases of SSD usually demonstrate earlier sexual maturation, the
higher rate of risk-taking and lower parental investment.
1) Giudice, M., (2018), Evolutionary Psychopathology. A Unified Approach.
2) Érdi, P., Bhattacharya, B., Cochran, A. (2017), Computational Neurology and Psychiatry.
3) Wallace, R. (2017), Computational Psychiatry. A Systems Biology Approach to the
Epigenetics of Mental Disorders.
4) Shackelford, T.K., Zeigler-Hill, V., (2017), The Evolution of Psychopathology.
5) Brune, M., (2016), Textbook of Evolutionary Psychiatry and Psychosomatic Medicine. The
Origins of Psychopathology.

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.

Joost Schreuder

University of Groningen

Lecture title: The Social Construction of Mental Disorders out of Real Symptom-Networks

At least since Thomas S. Szasz (1960) proclaimed mental illness to be a myth, there has been a lively debate between realists and social constructionists about mental disorder. Realists claim that mental disorders are mind-independent entities, in the sense that these disorders exist outside of our representations of them, and that we can obtain knowledge about these entities. Social constructionists, on the other hand, claim that mental disorders are not mind-independent entities; instead, their existence depends on the society we live in.

I argue that these two views can be reconciled by using a recently developed model of mental disorder: symptom-networks (Borsboom & Cramer, 2013). Symptom-networks conceptualize mental disorders as clusters of symptoms (patterns of behavior, cognition or affect) that are strongly associated with each other. These clusters arise both due to symptoms causing each other and due to other causal mechanisms, such as genetics or adverse life events, affecting these symptoms. This conceptualization fits the complex etiology of mental disorders.

On the realist side, I argue that symptom-networks are mind-independent entities: regardless of what we think about mental disorders, whether symptoms are strongly associated with each other due to causal mechanisms is a matter of fact. Moreover, we can obtain knowledge about symptom-networks by conducting studies on the factors that give rise to clusters of symptoms. To the extent that we have evidence that there are causal mechanisms that give rise to a particular cluster of symptoms, we are justified in believing that that cluster constitutes a real symptom-network.

While symptom-networks are real, I argue that the distinction between those symptom-networks that constitute mental disorders and those that do not is socially constructed in two ways: society (1) defines and (2) partially shapes pathology. To defend point (1), I argue that neither the concept of dysfunction nor the presence of undesirable properties can give us an objective distinction between pathology and non-pathology. How we make the distinction will instead be up to us, based on the consequences of a given symptom-network and whether we deem psychological or psychiatric intervention appropriate for that network. However, I argue that the consequences of a symptom-network are also partially socially constructed (point (2)), since those consequences depend on whether a society can and will accommodate the symptoms of that network.

This conceptualization of mental disorder addresses both the concerns of realists and social constructionists. On the realist side, it avoids relativism about mental disorders, since they must be constituted by a particular kind of mind-independent entity: symptom-networks. Moreover, it is possible to obtain knowledge about these entities. However, on the social constructionist side, my account does not conceal the societal forces that define and shape pathology.

Szasz, T. S. (1960). The myth of mental illness. American Psychologist, 15(2), 113-118.

Borsboom, D., & Cramer, A. O. J. (2013). Network analysis: An integrative approach to the structure of psychopathology. Annual Review of Clinical Psychology, 9, 91-121.

JORDAN SIBEONI

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.

JOANNA SMOLENSKI

City University of New York, Graduate Center

Joanna Smolenski, M.Phil., M.A., is a Ph.D. candidate in Philosophy at the City University of New York (CUNY) Graduate Center, focusing on applied ethics (especially bioethics), moral psychology, and social and political philosophy. She is particularly interested in questions at the intersection of ethics and emerging technologies, with a focus on informed consent.

In addition to her doctoral work, Ms. Smolenski is an Ethics Fellow at the Icahn School of Medicine at Mount Sinai (ISMMS) and a CUNY Baccalaureate for Unique and Individualized Studies (CUNY BA) Advising Fellow at the City University of New York. She
also teaches undergraduate students in the philosophy department at NYU, and has taught widely throughout the CUNY system. Until recently, she served as the Managing Editor for the Journal of Critical Care, the official journal of the World Federation of Societies of Intensive and Critical Care Medicine and the Society for Complex Acute Illness.

Prior to her work at CUNY, Ms. Smolenski pursued graduate studies in Bioethics at NYU’s Center for Bioethics and was a John Jay Scholar in Philosophy and Political Science at Columbia University, where she graduated magna cum laude with honors in Philosophy.

Lecture title: Epistemic Injustice and Informed Consent in Psychiatry

In medical care, informed consent is taken to be required prior to the distribution of care in order to ensure that patients fully understand the potential risks and benefits of a given medical procedure. However, some patients – for example children – are taken to lack the decisional capacity to provide legitimate consent to care. In such cases, consent is typically given by health care proxies or surrogates, who are designated to look out for the interests of what are considered to be particularly vulnerable populations. In this paper, I will consider another group that is often taken to be incapable of providing legitimate informed consent – populations with psychiatric disorders. How could informed consent operate in psychiatric populations that are particularly vulnerable? Some may suggest that it couldn’t. Many psychiatric conditions can involve acute changes in one’s preferences or reasons for action that it is possible patients would not endorse afterwards. Also, at least some of the reasons offered in psychiatric contexts are not governed by the constitutive ideal of rationality, so are considered to be either bad reasons or fundamentally not reasons at all. Finally, refusal of treatment – if taken by the clinician to be unreasonable – can be grounds for claiming that the patient lacks decisional capacity to consent in the first place. Given such a background, psychiatric patients seem like prima facie bad candidates for providing legitimate informed consent. In this paper, I will consider this question through the lens of standpoint theory. Given that psychiatric patients are members of socially marginalized groups, standpoint theory would suggest that they are socially situated in ways that give them privileged epistemic access to relevant features of their worlds relative to the non-marginalized. Epistemic standpoint enables service users to recognize the ways in which they are systemically excluded and discriminated against, which might not be obvious to those outside their social situation. As such, I will suggest that in at least some cases, denying the ability to consent constitutes an epistemic injustice toward service users.

ANGELOS SOFOCLEOUS

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.

Kiehl, J. (2005) The phenomenological experience of depression, Inter-Regional Society of Jungian Analysts, [Online] http://dust.ess.uci.edu/ppr/ppr_Kie05.pdf

Paskaleva, A. (2011) A phenomenological Assessment of Depression Narratives, Masters thesis, Osnabruck : PICS 2011, vol. 03 [Online], https://pdfs.semanticscholar.org/c431/2368911f4a13eb712c98f38aeac955150eb9.pdf

Ratcliffe, M. (2018). The interpersonal structure of depression. Psychoanalytic Psychotherapy, 32(2), 122-139.

Skodlar, B. (2009). Three different meanings of depression in schizophrenia. A phenomenological perspective. Psychiatria Danubina. 21 Suppl 1. 88-92.

ALIAKSANDR SPITSYN, Master of Rebilitation

State Institute of Management and Social Technologies, Minsk, Belarus

From 1998 to 2006, he practiced and worked in a plant growth and development lab of the Institute of Experimental Botany (biochemistry, plant physiology). From 2009 to 2015 he worked at the Institute of Physiology, National Academy of Sciences (prenosological and rehabilitation physiology), from 2015 to the present day he has been leading research in the field of physiological and psychological anthropology (in connection with addiction.) He is the author of more than 40 scientific publications.

Poster title: Features of thermo-asymmetry in hyperthymically accentuated females

Introduction. To date, the accentuated personality concept by K. Leonhard remains popular among researchers. However, data on the relationship between accentuation and physiological characteristics of practically healthy people is still missing. Aim. This study was conducted to determine the features of temperature asymmetry in young females with hyperthymic accentuation.
Methods. The study was conducted in a female group (n = 31, age 21 ± 3 years). Accentuation was evaluated according to the Smishak test. The temperature of the skin surface was measured in the thumbs. The termo-asymmetry coefficient was calculated in bilaterally symmetric locations (the right point temperature – left point temperature). Results. As a result of a total Smishak test the group was divided into a control group (n = 11) and an observation group (n = 17), three profiles appeared to be inferior. The secondary rating hyperthymic scale in the observation group was 18.88 ± 0.7 versus 9.00 ± 0.9 in the control, while in 4 (24%) there was mild accentuation, it was moderately expressed in 12 (70%), and strongly expressed in 1 (6%). The Pearson correlation between the hyperthymic scale value and thumb pads termo-asymmetry: r = -0,49, significantly at α = 0,05. In this case, the median asymmetry in the observation group was much larger in absolute value (-1,20 ± 0,58 vs. 0,09 ± 0,83 in control).
Conclusions. High thumb termo-asymmetry is more common in hyperthymically accentuated females. It’s one more proof supporting the hypothesis about the relationship between this parameter and the behavior style.

RADOSŁAW STUPAK, MA

Jagiellonian University

I’m a PhD student at the Jagiellonian University, Institute of Psychology (General Psychology Unit, supervisor: dr hab. Bartłomiej Dobroczyński, prof. UJ), and at the Jagiellonian University, Institute of Philosophy (Department of the Philosophy of Culture, supervisor: prof. dr hab. Piotr Mróz). I have also studied at the Radboud University, St. Petersburg State University, Warsaw University and Pontifical University of John Paul II. I’m currently an exchange student at Groningen University.

Lecture title: From mental health industry to humane care. Suggestions for an alternative systemic approach to distress.

If we took global statistics about the prevalence of mental health disorders and disabilities as indicators of the effectiveness of our mental health care systems and models of treatment, the conclusion would be obvious: they are failing. They are not only failing us as researchers and clinicians, but more importantly they are failing our patients and clients. The biopsychosocial model (which actually seems to be a “bio-bio-bio model”, according to the American Psychiatric Association former president) needs a radical overhaul. This model is characteristic mainly of Western or Global North countries, however there are ongoing efforts and calls to export it globally. Here, I would like to tentatively propose a few principles around which an alternative humanistic mental health care system could be organized and a rough outline of such a system. I will focus on mood and psychotic disorders while arguing for it, but there is no reason to think that such a system could not be useful with regards to other diagnostic categories. I will also propose some solutions for research practice, regarding research methodology, important research questions and last but not least diagnostic systems. I will focus on arguing for specific solutions instead of proving that the current model is not working. This proposition is in many ways a synthesis of already existing theoretical and practical approaches.

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.

Benjamin Wilck M.A.

Humboldt University Berlin, Department of Philosophy, Research . Training Group Philosophy, Science and the Sciences

Benjamin Wilck is completing a PhD in Philosophy in the Research Training Group Philosophy, Science and the Sciences at Humboldt University Berlin. In his doctoral dissertation, he critically examines the philosophical commitments and background assumptions of Euclidean geometry and number theory. His research interests are rooted in the philosophy and history of science, as well as in ancient philosophy. Currently, Benjamin is also involved in various research projects concerning the intersection of psychiatry, linguistics, and philosophy at the Charité University Medicine Berlin. Benjamin studied Philosophy, Cultural Studies and Aesthetics in Berlin, Paris, and Princeton. Throughout his academic training, he received a number of grants and awards, the latest being scholarships from the German Research Foundation and Humboldt University Berlin.

Lecture title: Linguistic and Philosophical Problems with Psychiatric Metaphor Comprehension Tests

Together with Ivan Nenchew

i. The psychiatric tests for concretism currently in use fail by relying on linguistically contestable background assumptions.

ii. Many of the psychiatric metaphor (or, more generally, figurative speech) comprehension tests currently in use are even inconsistent with their own linguistic background assumptions.

v. There is a philosophical way to save psychiatric metaphor paraphrase tests from being abandoned.

MACIEJ WODZIŃSKI

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

Universitary Psychiatric Clinic, University of Chile

Together with:

Agnieszka Brejwo

Department of Philosophy, University of Warsaw

Felipe Crocco

Universitary Psychiatric Clinic, University of Chile,

Marcin Moskalewicz

Poznan University of Medical Sciences, University of Oxford

MAURO PALLAGROSI, PhD

Sapienza University of Rome

Raffaele Vanacore

Medical Doctor, resident in Psychiatry at the University „L. Vanvitelli”, Napoli

Intersubjectivity has been a most relevant issue concerning the study of psychopathology, emphasizing the problems and questions of the dynamics of subjective experience through focusing on the situation of an 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 have an introduction followed by three presentations.

The introduction, by Felipe Crocco and Jonathan Véliz Uribe, will address the contribution of Eugène Minkowski on this subject, highlighting this author’s view on intuition and linking it with the idea of intersubjectivity, in order to put forth epistemological, ontological and psychopathological questions in the clinical setting.

The first presentation, with Agnieszka Brejwo, Tudi Goze, and Marcin Moskalewicz, reviews the concept of the Praecox Feeling (PF) in the diagnosis of schizophrenia. It presents the results of a survey regarding PF among clinicians in France and Poland demonstrating its prevalence in clinical decision making. It also discusses its validity, reliability, and phenomenological rationale in contemporary clinical decision-making dominated by operationalized diagnosis.

The second presentation by Mauro Pallagrosi, exhibits how psychiatric patients share a specific impairment in the structure of intersubjectivity, also presenting disturbances of other a priori structures in ways that are specific to particular diagnostic entities. Under this scope he shows that the intersubjective dimension of consciousness might represent a key domain to explore in clinical settings, as it may prove to be valuable for diagnostic purposes. He then discusses the theoretical background, the development and the structure of the Assessment of Clinician’s Subjective Experience (ACSE), a psychometric instrument which explores this domain; focusing the discussion on the intersubjective phenomena occurring during the clinical encounter with psychotic patients.

The last presentation, exposes the proposals of Raffaele Vanacore regarding phenomenologically oriented examinations (EASE, EAWE and ACSE). He argues for their usefulness as a methodology for early detection of schizophrenic prodromal stages. Basic pre-psychotic anomalies and the clinician’s incapacity to implicitly share an intersubjective space with the patient are taken into account in order to investigate the core Gestalt of schizophrenia spectrum disorders. In light of the above, Raffaele proposes that the development of an interactive psychotherapeutic field could play a crucial role in ameliorating the prognosis of these prodromal phases; and, moreover, argues that the constitution of a shared intersubjective space is the foundation for the recovery of basal anomalies and of possible further interventions (pharmacological, familiar or social).

Panel title: Psychoanalysis and expertise – a difficult relationship

Chair of panel: Mira Marcinów, PhD

Polish Academy of Sciences

Together with:

Grzegorz Michalik

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.

Antoni Grzybowski

Jagiellonian University

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?