RESUMO
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.
RESUMO
Due to growing skepticism about the current psychiatric model, psychopathology has once again aroused interest in the psychiatric field. This article intends to examine the current perspectives of the phenomenological approach of psychopathology in the context of psychiatry. To this end, we will situate phenomenology along the historical course of psychopathology, presenting the particularities of its understanding of the psychiatric object, and finally, we will defend, in general terms, the affinity of the phenomenological approach with the aspirations and practical needs of the field of psychiatry.
Dado o crescente ceticismo em relação ao modelo psiquiátrico dominante atual, a psicopatologia voltou a despertar interesse como ciência. O presente artigo pretende examinar as perspectivas atuais da psicopatologia fenomenológica no cenário da psiquiatria. Para tal, situaremos sua posição no curso histórico da disciplina psicopatologia, apresentaremos as particularidades de seu entendimento de objeto psiquiátrico e, por fim, defenderemos, em linhas gerais, a afinidade da abordagem fenomenológica com as aspirações e as necessidades de natureza prática do campo da psiquiatria.
En raison du scepticisme croissant à l´égard du modèle psychiatrique dominant actuel, l´interêt pour la psychopathologie comme science est en train de ressurgir. L’article qui suit examine les perspectives contemporaines de la psychopathologie phénoménologique dans le domaine de la psychiatrie. Pour ce faire, les auteurs situent la psychopathologie phénoménologique dans l´histoire de la discipline de la psychopathologie, présentent les particularités de sa façon de comprendre l´objet psychiatrique et pour conclure, soutiennent la pertinence de l´approche phénoménologique en ce qui concerne les aspirations et les exigences pratiques du domaine de la psychiatrie.
Teniendo en cuenta el creciente escepticismo relacionado al modelo psiquiátrico dominante en la actualidad, la psicopatología volvió a despertar interés como ciencia. El presente artículo examina las perspectivas contemporáneas de la psicopatología fenomenológica en el campo psiquiátrico. Para la realización de esta tarea, los autores la ubicarán en el curso histórico de la disciplina psicopatológica, presentarán las particularidades de la comprensión de su objeto psiquiátrico y, finalmente, defenderán la pertinencia del aporte fenomenológico a las aspiraciones y necesidades prácticas de la psiquiatría.
Angesichts des wachsenden Skeptizismus in Bezug auf das aktuelle dominante psychiatrische Modell, steigt das Interesse an die Psychopathologie als Wissenschaft erneut an. Der vorliegende Artikel untersucht die aktuellen Perspektiven der phänomenologischen Psychopathologie im Bezug zur zeitgenössischen Psychiatrie. Zu diesem Zweck analysieren wir ihre Situation im historischen Verlauf der Psychopathologie als Disziplin, erläutern wie sie das psychiatrische Objekt definiert und beschreiben abschliessend in generellen Zügen, wie weit die phänomenologische Vorgehensweise den praktischen Bestrebungen und Bedürfnissen der Psychiatrie entgegenkommt.
