Content and Psychology

The theoretical underpinnings and practical worth of content-based, intentional, or "folk" psychology have been challenged by three distinct groups of philosophical critics in the past 15 years or so. The first group, comprised by Hilary Putnam, Tyler Burge, and other advocates of "wide" or "externalist" theories of meaning, claims that traditional psychologists have been mistaken in assuming that our beliefs, desires, and other content-laden states supervene on or inhere in our individual minds or brains. The other two groups are both "eliminative materialists," who charge that the intentional approach is inadequate and that it can or will be replaced by a completely non-interpretive discipline: either neuropsychology, in the view of Patricia and Paul Churchland, or a strictly syntactic computational psychology, according to Stephen Stich. ;This dissertation defends "notional world" or narrow intentional psychology against these charges, primarily on the strength of its practical merits, in contrast to the limitations and adverse effects of the proposed alternatives. Psychology is at least partly an applied science with a mandate to help understand and treat concrete psychological problems such as Post Traumatic Stress Disorder and depression, I argue, so any theorist who proposes to reconfigure or phase out existing approaches must be prepared to take over these duties with at least equal facility. However, whereas various "narrow" schools of psychotherapy such as Cognitive Therapy are fairly successful in this regard and show every indication of continuing to be needed for the foreseeable future, the Syntactic Theory seems to show very poor promise of being able to help relieve the distress of people with psychological disturbances, while a purely neurobiological approach is inappropriate in many cases, and tends to cause a variety of untoward and dangerous side-effects. As for the "wide" theorists with their emphasis upon the social and environmental contributions to meaning: they must acknowledge that a good deal of content is in the head; and, more importantly, by focusing on the role of the "experts" in a society's language-game, they miss the whole point of a psychological attribution, which is to understand an individual's reasons--however idiosyncratic--for acting as he or she does

An Experimental Approach to the Evaluation of Spatial Structure in the Paintings of Schizophrenics and Alcoholics: The Scots and the Alaskan Eskimos

An extensive review of related literature offers an opportunity to examine work which has describe the schizophrenic personality disorganisation as a process of disintegration, involving a fundamental change in relationships with reality. There is a disintegration of the selfboundary, making it difficult for the schizophrenic individual to differentiate between himself and the outer world. This disintegration process is not always apparent because the schizophrenic abandons verbal communication. He still needs to communicate, however, and often replaces verbal communication with the nonverbal graphic form of expression. Billig (1970) suggested a relationship between the stages of the schizophrenic's ego disintegration and specific changes in the graphic representation of space. These characteristic changes in spatial structure could, according to Billig (1970), be detected universally in the spontaneous paintings produced by schizophrenics. The primary purpose of this research, designed to experimentally investigate Billig's (1970) spatial structure theory and compare the results with his findings, was to develop a nonverbal diagnostic tool to be used with schizophrenic patients. Perceptual size and distance constancy tests were included in the experimental procedure to provide a new source of information about the relationship between disturbances of the ego boundary, body image, the self, the perceptual constancies, and space perception as described by Weckowicz and Sommer (1960). Consequently, the experimental procedure included tests of size and distance constancy as well as two painting tasks (free-choice and suggested subject). To isolate the effects of culture and to explore the possible similarity between two clinical groups that share symptoms, such as thought disorder, six groups were tested, comprising schizophrenics, alcoholics, and controls (individuals with no psychiatric history) from both Eskimo and Scottish cultures. The primary hypothesis, which stated that there is a significant positive correlation between the amount of error made on a size constancy task and the ratings representing the disintegration of spatial structures in paintings, was not supported by the experimental data, although some of the secondary hypotheses were supported. For example, there was a significant difference between the spatial structure ratings of the Scottish schizophrenics and Eskimo schizophrenics. In spite of the fact that the spatial structures characteristic of the schizophrenic patient (Billig, 1970) were detected in the paintings of the Eskimo schizophrenics, there was a significant difference between the ratings for the Scottish and Eskimo schizophrenic groups. The paintings produced by the Eskimo alcoholic subjects received the highest percentage of the rating that represented the spatial structure characteristic of the most extreme stage of schizophrenic deterioration. Therefore, the universal application of Billig's (1970) theory was not supported by the results of this study. The research perspective emphasised the need for methodological detail and design associated with psychiatric art evaluation. It was submitted that the spatial structure rating scale, the nonverbal diagnostic tool, developed for this study would be most efficient if applied to one patient's paintings throughout the course of his treatment. Various explanations for the findings are discussed as well as numerous methodological proposals and directions for future research

Conceptualization and treatment of schizophrenia in Lacanian psychoanalysis: towards a clinic of the sinthome

Schizophrenia is rarely referred to in Lacan’s scholarship, and even more rarely in the socalled later Lacan. Yet the French psychoanalyst’s teaching on knotting and the theory of the sinthome of the 1970s can be utilized for the theoretical and clinical approach to this psychotic type. The gradual emphasis on the real in Lacan’s teaching can act as a guide both for its conceptualization and for the treatment supported by those clinicians who see schizophrenic subjects. My investigation of the conceptual history of schizophrenia led to the conclusion that despite psychiatric scholars having noted from early on an aspect that pertains to the real – schizophrenic discourse – this was disregarded, having been deemed one of the condition’s numerous morbid outcomes. In the same way, early psychoanalysts emphasized the aspect of subjectivity that Lacan calls the imaginary in the treatment of schizophrenia, trying, thus, to address it via a mechanism typical of the other major psychotic type, paranoia. This approach does not seem consonant with Freud’s reading of the two types, although he never elaborated upon their differentiation beyond the early 1910s. In fact, although the suggested Lacanian approach to schizophrenia derives from the last decade of Lacan’s teaching, it has roots in Freud’s view of psychosis of the mid-1910s and early 1920s. I have attempted to create a paradigm for the impact of those findings in examining the case of the late-19th-century Greek poet, writer and scholar Georgios Vizyenos. I argue that Vizyenos was characterized by a schizophrenic’s relation to the body, language, and the social bond. In his life and work, examined in detail, we see how the cause, triggering, and temporary treatment of his psychosis are linked to a concept with a direct relation to the real: ‘child’. Testimonies from Vizyenos’ childhood show his resistance to semblance, which had specific effects upon his body. It is, then, demonstrated how in late adolescence and mature life the subject renamed himself and acquired a sense of his body thanks to a ‘modified’ narcissism that did not resemble the coordinates of the paranoiac’s ego. This construction is approached through the later Lacan’s theories of the sinthome and the escabeau. Finally, it is shown how that invention was temporary, with Vizyenos being unable, in the end, to avoid the return of jouissance to the subject’s body. The theoretical and clinical implications of the study of Vizyenos’ case are discussed in relation to the contemporary Lacanian approach to schizophrenia. It is suggested that the singular character of the subject’s relation to the real could lead us to cross schizophrenia with a bar, schizophrenia, as Lacan did for the signifier ‘woman’ in his later teaching. Thus, the sinthomatic approach, which emphasizes the subject’s relation to the real rather than the universal subscription to Oedipus, does not seem unsuitable for the treatment of subjects who are schizophrenic. This is argued at greater length by comparing it with psychoanalytic orientations that place more emphasis on the use of the imaginary or the symbolic

The lived experience of psychosis: a bottom-up review co-written by experts by experience and academics

: Psychosis is the most ineffable experience of mental disorder. We provide here the first co-written bottom-up review of the lived experience of psychosis, whereby experts by experience primarily selected the subjective themes, that were subsequently enriched by phenomenologically-informed perspectives. First-person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of psychosis as well as family members and carers, representing a global network of organizations. The material was complemented by semantic analyses and shared across all collaborators in a cloud-based system. The early phases of psychosis (i.e., premorbid and prodromal stages) were found to be characterized by core existential themes including loss of common sense, perplexity and lack of immersion in the world with compromised vital contact with reality, heightened salience and a feeling that something important is about to happen, perturbation of the sense of self, and need to hide the tumultuous inner experiences. The first episode stage was found to be denoted by some transitory relief associated with the onset of delusions, intense self-referentiality and permeated self-world boundaries, tumultuous internal noise, and dissolution of the sense of self with social withdrawal. Core lived experiences of the later stages (i.e., relapsing and chronic) involved grieving personal losses, feeling split, and struggling to accept the constant inner chaos, the new self, the diagnosis and an uncertain future. The experience of receiving psychiatric treatments, such as inpatient and outpatient care, social interventions, psychological treatments and medications, included both positive and negative aspects, and was determined by the hope of achieving recovery, understood as an enduring journey of reconstructing the sense of personhood and re-establishing the lost bonds with others towards meaningful goals. These findings can inform clinical practice, research and education. Psychosis is one of the most painful and upsetting existential experiences, so dizzyingly alien to our usual patterns of life and so unspeakably enigmatic and human

Dramatherapy Performance and Schizophrenia

This research project examines the impact of therapeutic performance-making within Dramatherapy practice for clients with schizophrenia. "Dramatherapy Performance", a specific model of therapeutic work which is defined and presented here, consists of the clients' construction of a performance through a therapeutic process and its presentation to an invited audience of their Significant Others. The context of existing evaluation methods in Dramatherapy concerns either the development of the clients' abilities within a group process, such as role-playing or dramatic involvement, or the change of the clients' symptoms after a groupwork as measured by existing psychometric scales. However, no specific method of evaluation of performance-making to be used within clinical practice has been constructed yet. For this reason a new instrument for evaluating this model of work was formulated, namely the "Dramatherapy Performance Evaluation", which derives from a combination of psychiatric and theatre semiotics. This instrument is inspired by Aristotle's "Poetics", used for the first time for assessment in Dramatherapy and analyses the structural elements of a performance in relation to the clients' schizophrenic psychopathology. Furthermore, this project examines the effect of a "Dramatherapy Performance" on the clients' overall psychopathology, and their relationship to self and others. A clinical trial conducted in a Day Hospital for young adult clients with schizophrenia allowed a qualitative evaluation of the therapeutic process as well as quantitative measurements of the clients' symptom change. The outcomes of this project suggest that "Dramatherapy Performance" has a significant effect on the clients' dramatic involvement within the group process, on the decrease of their overall "negative symptomatology", on increasing their "competence and efficacy" and on changing their perceived support from their significant others. The "Dramatherapy Performance Evaluation" showed the importance of the performance's unifying cathartic structure as well as demonstrating how non-verbal therapeutic processes reinforce the impact of verbal processes. It also distinguished the usefulness of collective techniques- such as participation in a chorus- for the less functional clients as opposed to character work for the more functional clients. This research confirms the value of "Dramatherapy Performance" as a treatment for specific schizophrenic symptoms, in addition to medication, and provides Dramatherapy practice with a new and useful instrument for the evaluation of both the therapeutic process and the progress of clients with schizophrenia

The paradoxical self: awareness, solipsism and first-rank symptoms in schizophrenia

Schizophrenia as a pathology of self-awareness has attracted much attention from philosophical theorists and empirical scientists alike. I view schizophrenia as a basic self-disturbance leading to a lifeworld of solipsism adopted by the sufferer and explain how this adoption takes place, which then manifests in ways such as first-rank psychotic symptoms. I then discuss the relationships between these symptoms, not as isolated mental events, but as end-products of a loss of agency and ownership, and argue that symptoms like thought insertion and other ego-boundary disorders are by nature a multitude of paradoxes created by a fragmented awareness. I argue that such fragmentation does not always require or lead to a delusional elaboration as the definitive feature of its phenomenology, and present reasons for the role of the first-person pronoun as a mere metaphor used to represent the patient’s bizarre experiences where sensory perception and thinking processes converge. Further, I discuss the initial benefits of adopting a solipsistic stance and how despite being a maladaptive strategy, it nevertheless acts as a protective barrier for the integrity of one’s self. Lastly, I offer some suggestions for clinical practice, emphasizing the importance of understanding the patient’s suffering in any therapeutic alliance

Descandalizing Laing: R.D. Laing as a social theorist

The scandal surrounding R.D. Laing’s work concerns both his life and his theories. Given that there is sufficient biographical material on Laing already in existence, this thesis focuses upon his theoretical contributions. No substantial review and critique of the criticism of Laing is currently in existence. The main objectives of this thesis are to evaluate the critiques of Laing, and to examine these in the light of his contributions to social theory. The critiques of Laing fall into three main categories: conservative critiques by psychiatrists, feminist critiques, and left-wing criticism. The methodological problems involved in the production of a critique are highlighted within each category of criticism. Some of the critiques of Laing constitute little other than criticism of the critic’s own misreading and misinterpretation of his work, which omit the lack of textual evidence to support the critic’s claims. The lines of development of key concepts within Laing’s work, and his intentions for his projects, may be ignored. Laing’s feminist critics view his work as prejudiced against women