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Meditation, psychedelics, and other similar practices or induction methods that can modulate conscious experience, are becoming increasingly popular in clinical and non-clinical settings. The phenomenology associated with such practices or modalities is vast. Many similar effects and experiences are also reported to occur spontaneously. We argue that this experiential range is still not fully described or understood in the contemporary literature, and that there is an ethical mandate to research it more extensively, starting with comprehensive documentation and definition. We review 50 recent clinical or scientific publications to assess the range of phenomena, experiences, effects, after-effects, and impacts associated with a broad variety of psychoactive compounds, meditative practices, and other modalities or events. This results in a large inventory synthesizing the reports of over 30,000 individual subjects. We then critically discuss various terms and concepts that have been used in recent literature to designate all or parts of the range this inventory covers. We make the case that specialized terminologies are needed to ground the nascent research field that is forming around this experiential domain. As a step in this direction, we propose the notion of "emergence" and some of its derivatives, such as "emergent phenomenology," as possibly foundational candidates.
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BACKGROUND: Developmental trauma increases psychosis risk and is associated with poor prognosis. It has been proposed that psychosis in survivors of developmental trauma gives rise to a distinct 'traumatogenic' phenotype. AIMS: Given the implications for personalised treatment, we sought to explore the traumatogenic psychosis phenotype hypothesis in a systematic review and meta-analysis of studies comparing psychotic presentations between adults with and without developmental trauma histories. METHOD: We registered the systematic review on PROSPERO (CRD42019131245) and systematically searched EMBASE, Medline and PsycINFO. The outcomes of interests were quantitative and qualitative comparisons in psychotic symptom expression (positive, negative, cognitive) and other domains of psychopathology, including affect regulation, sleep, depression and anxiety, between adults with and without experience of developmental trauma. RESULTS: Of 34 studies included (N = 13 150), 11 were meta-analysed (n = 2842). A significant relationship was found between developmental trauma and increased symptom severity for positive (Hedge's g = 0.27; 95% CI 0.10-0.44; P = 0.002), but not negative symptoms (Hedge's g = 0.13; 95% CI -0.04 to 0.30; P = 0.14). Developmental trauma was associated with greater neurocognitive, specifically executive, deficits, as well as poorer affect, dissociation and social cognition. Furthermore, psychotic symptom content thematically related to traumatic memories in survivors of developmental trauma. CONCLUSIONS: Our findings that developmental trauma is associated with more severe positive and affective symptoms, and qualitative differences in symptom expression, support the notion that there may be a traumatogenic psychosis phenotype. However, underdiagnosis of post-traumatic stress disorder may also explain some of these findings. More research is needed to explore this further.
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WHAT IS KNOWN ON THE SUBJECT?: The COVID-19 pandemic has brought new sources of stress and challenges for people dealing with obsessive compulsive disorder (OCD). WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The study uncovered the unique experiences of Jordanian patients with OCD during the COVID-19 pandemic, revealing three main themes: Navigating Constraints: The Dual Pathways of Social Engagement and Avoidance, estranging family attachments and shifting OCD landscapes. Family dynamics played a significant role, with some families unintentionally exacerbating OCD symptoms through excessive accommodation, while others openly expressed irritation, both contributing to worsened symptoms. The research unveiled a notable deficiency in the availability of professional mental health support for individuals with OCD throughout the pandemic. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Accessible and culturally appropriate e-mental health interventions can bridge the gap in mental health support, especially during crises like the pandemic. It is crucial to involve family members in the treatment process to address family dynamics that may either support or hinder recovery among patients with OCD. ABSTRACT: INTRODUCTION: Pandemics, like COVID-19, can significantly harm the mental well-being and overall quality of life for individuals and their families. Those with pre-existing mental conditions, especially obsessive compulsive disorder (OCD), are more vulnerable to negative psychosocial effects since the fear of being infected or transmitting infection to others are some of the main characteristics of the illness. There is a need for a nuanced understanding of the personal, social and cultural experiences of people with OCD within their specific psychosocial context. AIM: To explore how Jordanian patients with OCD experienced their illness during COVID-19. METHOD: A descriptive phenomenological design using semi-structured interviews with a purposive sample of 12 patients diagnosed with OCD and experiencing different types of OCD symptoms. Data were analysed thematically, and reported based on the critical appraisal skills programme (CASP) checklist for qualitative studies. RESULTS: Three main themes emerged: (1) Navigating Constraints: The Dual Pathways of Social Engagement and Avoidance (seeking solace through social interaction and embracing quarantine as an opportunity for social avoidance); (2) Estranging family attachments (enforcing proximity and struggling with intimacy); and (3) Shifting OCD landscapes (transforming existing obsessions and escaping to new compulsions). The interviews documented a complete lack of references to receiving professional mental health support throughout the pandemic. DISCUSSION: This study aligns with previous research indicating a surge in OCD severity during the pandemic, fuelled by distressing news and heightened hygiene measures. Notably, it underscores the strain on familial relationships, with some cases showing protective effects but many demonstrating worsening symptoms due to excessive family accommodation. The absence of professional mental health support during the pandemic raises questions about the quality and accessibility of mental health services in Jordan. IMPLICATIONS FOR PRACTICE: The findings underscore the need for continued mental health support and intervention, particularly during times of heightened stress and isolation. Integrating e-mental health resources and cultural adaptation can play a vital role in providing accessible and effective support for individuals with OCD, including those in the Jordanian Arab culture. As we navigate future challenges, it is crucial to prioritize the well-being of individuals with OCD and ensure they have access to appropriate and tailored mental health services.
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There is a lack of research on gender diverse people's experiences with endometriosis. We explored the experience of 11 transgender and non-binary people with endometriosis using phenomenology. We collected data through multiple interviews and diaries and constructed two themes using hermeneutic analysis: (1) Unhomelikeness of Living with Endometriosis and being Gender Diverse, and (2) Towards a Homelikeness of Living with Endometriosis as a Gender Diverse Individual, which we discussed in relation to Svenaeus Phenomenology of Medicine. Unhomelikeness is an experience of disconnection with our bodies and being-in-the-world as a result of living with a chronic disease. We show how gender diverse people with endometriosis may have additional layers of unhomelikeness due to further diagnostic delays, endometriosis symptoms that may trigger gender dysphoria and experiences with treatment that are not inclusive of their gender identity. We advocate for additional support and awareness for gender diverse people with endometriosis.
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BACKGROUND: Young adults living with kidney failure make decisions to select a kidney replacement therapy choice in partnership with healthcare professionals. However, little is known about how they experience kidney replacement therapy treatment decision-making and the impact this has on their well-being. OBJECTIVES: To explore young adults living with kidney failure experiences of treatment decision-making. The treatment decision-making investigated is about the choice of dialysis and/or kidney transplant options. DESIGN: A qualitative interpretive hermeneutic phenomenology study. PARTICIPANTS: Purposeful sampling was used to recruit young adults with kidney failure from social media, electronic media such as local kidney group websites and word of mouth. Semistructured interviews were conducted with (n = 18) participants aged 18-30 years. APPROACH: Inductive analysis of the data were performed using Braun and Clarke's thematic analysis framework. FINDINGS: The five themes generated were (1) awareness and anticipation of future kidney replacement therapy decision; (2) health information and education; (3) engaging in decision-making, support and choices; (4) implementation of kidney replacement therapy and transitioning into the new normal life and (5) the impact of decision-making and choice on well-being. CONCLUSIONS: Decision-making significantly affected young adults' psychosocial and mental well-being. Young adults had unmet informational and decisional needs and struggled to cope due to lack of support. A four-talk model, with an implement talk phase added to the existing three-talk (team talk, option talk, decision talk) shared decision-making model, would promote a focus on the implementation of choice and support the transitioning from previous life to long-term dependence on treatment.
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Does self-control express or suppress our true selves? This article reviews the emerging body of literature on the effect of self-control on authentic self-expression from the actors' (self-signaling) and the observers' (other-signaling) perspective. While actors can experience self-control as either expression or suppression of the self, individual differences in decision-making or personal values can predict when self-control is more likely to be experienced in one way or the other. Self-control also signals to observers both positive (e.g., competent, trustworthy, powerful) and negative (e.g., inauthentic, robotic, less warm) identities, with specific inferences depending on the context (e.g., work vs. fun). Overall, the relationship between self-control and self-expression is more nuanced than earlier research suggested, and several open questions await further investigation.
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Abnormal experiences of time (ATEs) are an established object of research in phenomenological psychopathology. Objective: The purpose of this study was the first validation of the Transdiagnostic Assessment of Temporal Experience (TATE), a structured phenomenological interview concerning ATEs in individuals with diverse mental health conditions, and its adaptation for the Polish language. Methods: The research employed a mixed-method approach and consisted of several phases including (1) consensual translation; (2) construct and content validation by an expert panel; (3) direct feedback from patients with lived experiences of alcohol addiction, borderline personality, autism, and clinical depression; (4) an auditorium questionnaire with 98 respondents without mental health issues, who were both interviewed and gave qualitative feedback; and (5) a final expert panel and approval. Results: Following multiple stages of modification, the final TATE demonstrates strong internal consistency and validity (Cronbach's α = 0.9), with strong correlations between the frequency, intensity, and impairment of various forms of ATEs as well as their rare occurrence among healthy participants. Conclusions: TATE represents a multidimensional and structured quantitative phenomenological approach to temporal experience for psychiatry and clinical psychology. This article presents the validated version of TATE for Polish alongside updated administration guidelines. It is now the state-of-the-art TATE that may be further adapted to other languages, including English.
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Background Clinical role transition is known to pose a challenge to doctors in training. The intensive care unit (ICU) is noted to be a demanding workplace environment, although relatively little is known about the experience of doctors as they transition to intensive care medicine (ICM) at the postgraduate level. Thus, this study aimed to explore the experience of registrar-grade doctors undergoing this transition and to examine the interplay between personal and professional life at this time. Methodology This qualitative study was guided by transcendental phenomenology and multiple and multidimensional transitions theory (MMT). Data were collected via 11 semi-structured interviews and analysed using a six-step analysis. Peer debriefing and a reflexive diary were used. Results The experience of doctors undergoing the transition to ICM was found to be influenced by the clinical environment of the ICU, a demanding and potentially stressful workplace, and one in which collegial support was valued. The previous experience of the individual undergoing the transition was relevant, and the impact of this transition on their professional development and identity was notable. Consistent with MMT, the interplay between personal and professional life was significant, as participants outlined the impact of anxiety before a shift, the emotional and cognitive burden of a shift, and the effect of this transition on their personal relationships. Conclusions This study observes the ICU to be an extremely challenging workplace environment, with a notable influence on the personal lives of those working therein. Nevertheless, ICM offers invaluable opportunities for learning and both personal and professional growth.
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BACKGROUND: Subjective experience is central to the nature of mental illness, yet it has not played a central role in most empirical approaches to psychopathology. While phenomenological perspectives in psychiatry have seen a recent resurgence, there remains a need for more detailed models of psychopathological processes based on explicit phenomenological and enactive foundations. SUMMARY: We present a framework derived from the Nested States Model (NSM) through which such phenomenologically-grounded models might be constructed. The NSM describes the dynamic structure of subjective experience as a system of nested states that reciprocally influence one another across hierarchical layers. Here, we show how the NSM provides a scheme for characterizing patterns of experience that comprise various psychopathological processes. We demonstrate the utility of this scheme both for clinical practice and for building our knowledge of psychopathological processes more broadly. KEY MESSAGES: The NSM can advance three aims that we see as critical for the lasting integration of phenomenological approaches to psychopathology within psychiatry. First, we show that the NSM provides a means for constructing clinical formulations and treatment considerations that center squarely on an individual's subjective experiences. Second, the NSM supplies a framework for organizing findings from clinical-phenomenological research that can guide the construction of broader phenomenologically-grounded models of psychopathological processes. Lastly, the NSM aligns our perspective on subjective experience with emerging perspectives on brain dynamics, helping to bridge phenomenological work with ongoing neurophysiological research.
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In quantum foundations, there is growing interest in the program of reconstructing the quantum formalism from clear physical principles. These reconstructions are formulated in an operational framework, deriving the formalism from information-theoretic principles. It has been recognized that this project is in tension with standard ψ-ontic interpretations. This paper presupposes that the quantum reconstruction program (QRP) (i) is a worthwhile project and (ii) puts pressure on ψ-ontic interpretations. Where does this leave us? Prima facie, it seems that ψ-epistemic interpretations perfectly fit the spirit of information-based reconstructions. However, ψ-epistemic interpretations, understood as saying that the wave functions represents one's knowledge about a physical system, recently have been challenged on technical and conceptual grounds. More importantly, for some researchers working on reconstructions, the lesson of successful reconstructions is that the wave function does not represent objective facts about the world. Since knowledge is a factive concept, this speaks against epistemic interpretations. In this paper, I discuss whether ψ-doxastic interpretations constitute a reasonable alternative. My thesis is that if we want to engage QRP with ψ-doxastic interpretations, then we should aim at a reconstruction that is spelled out in non-factive experiential terms.
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Traditional theories of motor learning emphasize the automaticity of skillful actions. However, recent research has emphasized the role of pre-reflective self-consciousness accompanying skillful action execution. In the present paper, we present the course-of-experience framework as a means of studying elite athletes' pre-reflective self-consciousness in the unfolding activity of performance optimization. We carried out a synthetic presentation of the ontological and epistemological foundation of this framework. Then we illustrated the methodology by an in-depth analysis of two elite windsurfers' courses of experience. The analysis of global and local characteristics of the riders' courses of experience reveal (a) the meaningful activities accompanying the experience of ongoing performance optimization; (b) the multidimensionality of attentional foci and the normativity of performance self-assessment; and (c) a micro-scale phenomenological description of continuous improvement. These results highlight the fruitfulness of the course-of-experience framework to describe the experience of being absorbed in an activity of performance optimization.
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Background: It is not rare that intensive care unit (ICU) patients report unusual subjective experiences, ranging from a feeling of harmony with the environment to complex phenomena such as near-death experience (NDE). This 1-year follow-up study investigates the characteristics and potential global impact of the NDE memories recalled by ICU survivors. Method: We prospectively enrolled 126 adult survivors of a prolonged (>7days) ICU stay (all etiologies), including 19 (15 %) who reported a NDE as identified by the Greyson NDE scale. The NDE group underwent a semi-structured interview one month later evaluating their memory characteristics and the associated life-threatening situation. One year after inclusion, all patients (regardless of whether they recalled an NDE) were contacted for a follow-up Greyson NDE scale assessment and questions about their ICU experience and opinions on death since discharge. Results: The Greyson NDE scale revealed that the most frequently reported features were altered time perception, heightened senses and life review, and the Greyson total scores did not evolve over time. NDE memories persisted, with a consequent number of phenomenological characteristics (e.g., visual details, emotions). One year post-ICU, two patients (18 %) of the NDE group and 12 (24 %) of the non-NDE group were less afraid of death. Conclusions: Results emphasize the clinical importance of interviewing all ICU patients to explore any memory after an ICU stay.
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BACKGROUND: Emergency personnel are the first line of emergency response systems to respond to emergencies; in essence, they are usually exposed to a wide range of physical and psychological problems. Accordingly, the current study aimed to clarify the lived experiences of paramedics when exposed to Patients' Deaths during their missions in 2023. METHODS: This study was carried out using a qualitative approach and interpretative phenomenology from January 9, 2022, to September 21, 2023. The research was performed in Fars, Alborz, and Isfahan provinces in Iran. Data were gathered using semi-structured interviews with 17 male emergency personnel (both from the emergency medical service and Red Crescent). The obtained data were analyzed utilizing Smith's approach to clarify the lived experiences of emergency responders when facing deaths in various incidents in Iran. RESULTS: Seventeen emergency personnel with the age range of 24-60 (average = 39) years and with a history of confronting patients' deaths during their services were interviewed. Their lived experiences of being exposed to patients' deaths during the emergency response in Iran were classified into three main themes: psychological and emotional status, personality, disposition, and behavior status, and mental and physical status. Sub-themes such as psychological and emotional problems, mental and physical problems, and sub-subthemes such as anxiety, stress, decreased appetite, irritability, insomnia, forgetfulness, and fatigue were also noted within the main themes. CONCLUSION: While emergency personnel work diligently to save the lives of patients, the current study demonstrated that they were susceptible to multiple psychological, emotional, and physical problems, which potentially affect their lives outside of the workplace and make them more vulnerable to related physiological and psychological diseases. It is recommended that policymakers and clinical educators make ways to prevent these problems and provide emergency personnel with physical, psychological, and emotional support.
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Pesquisa Qualitativa , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Irã (Geográfico) , Pessoal Técnico de Saúde/psicologia , Entrevistas como Assunto , Auxiliares de Emergência/psicologia , Adulto Jovem , ParamédicoRESUMO
In competitive sports, momentum encompasses positive or negative changes in cognition, physiology, emotions, and behavior caused by sudden or a series of continuous events. Momentum occurring during basketball games leads to significant performance variation regarding positive net points differences for a specific team within a certain period. This study designed a quantitative framework based on two performative dimensions (time constraints and point differentials) to accurately identify momentum in basketball games, and explored the role of momentum in games. We identified 2,083 momentum occurrences in 372 professional elite basketball games. The number of momentum occurrences for winning teams is significantly higher than for losing teams (1.78 ± 0.47 Difference Value, p < 0.001); the correlation between momentum and game outcomes decreased as each quarter progressed. To distinguish the influence of contextual variables on momentum, we divided games into five types based on the team quality differences between the team and the opponent team. The decision tree model shows that first-quarter momentum is critical in games where weaker teams defeat stronger teams. This study provides insights for basketball coaches to formulate game strategies. More importantly, the momentum conceptual framework can help researchers identify and capture momentum, offering inspiration and reference for subsequent research.
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Increasing evidence shows that survivors of sexual violence frequently experience relationship difficulties following their victimization. Little is known regarding how couples which formed post-assault cope with the impact of the prior assault. Hence, the aim of the current study was to gain insight into post-assault formed couples' experiences in coping with the impact of sexual violence. To this end, an interview study was conducted with five female survivors and their male partners who began their romantic relationship post-assault. A dyadic phenomenological interview analysis revealed that sexual victimization is a dyadic stressor but is not always considered as such by the couple. In addition, disclosure is described as a potential bonding experience. Flexibility and creativity from both partners are required as they adapt to the post-assault impact. In addition, meaningful communication and considering the perspective of one's partner seemed to be key to dyadically cope successfully. The current study also identified challenges couples had to manage, including caregiver burden and role confusion. Results suggest that interventions supporting couples in their continuous efforts toward mutual understanding can foster trust and growth.
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Illness and injury are often accompanied by experiences of bodily objectification. Medical treatments intended to restore the structure or function of the body may amplify these experiences of objectification by recasting the patient's body as a biomedical object-something to be examined, measured, and manipulated. In this article, we contribute to the phenomenology of embodiment in illness and medicine by reexamining the results of a qualitative study of the experiences of nurses and patients isolated in an intensive care unit during the first wave of COVID-19. Drawing upon the phenomenological concept of embodiment-as developed in the work of Edmund Husserl, Maurice Merleau-Ponty, Jean-Paul Sartre, and Emmanuel Levinas-we reconsider how bodily objectification manifests in complex clinical encounters. We show that, in these settings, objectification is not simply the unilateral act of a clinician objectifying a patient. Rather, both clinicians and patients reported a variety of objectifying experiences influenced by their interactions, the immediate context of the intensive care milieu, and the broader atmosphere of a global pandemic. In light of these findings, we argue that bodily objectification in illness and medicine can often be more complicated than typically presented in the phenomenological literature.
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[This corrects the article DOI: 10.3389/fpsyg.2024.1354719.].
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In recent decades, the debate on consciousness has been conditioned by the idea of bottom-up emergence, which has influenced scientific research and raised a few obstacles to any attempt to bridge the explanatory gap. The analysis and explanation of vision conducted according to the accredited methodologies of scientific research in terms of physical stimuli, objectivity, methods, and explanation has encountered the resistance of subjective experience. Moreover, original Gestalt research into vision has generally been merged with cognitive neuroscience. Experimental phenomenology, building on the legacy of Gestalt psychology, has obtained new results in the fields of amodal contours and color stratifications, light perception, figurality, space, so-called perceptual illusions, and subjective space and time. Notwithstanding the outcomes and the impulse given to neuroscientific analyses, the research carried out around these phenomena has never directly confronted the issue of what it means to be conscious or, in other words, the nature of consciousness as self-referentiality. Research has tended to focus on the percept. Therefore, explaining the non-detachability of parts in subjective experience risks becoming a sort of impossible achievement, similar to that of Baron Munchausen, who succeeds in escaping unharmed from this quicksand by pulling himself out by his hair. This paper addresses how to analyze seeing as an undivided whole by discussing several basic dimensions of phenomenal consciousness on an experimental basis and suggesting an alternative way of escaping this quicksand. This mind-set reversal also sheds light on the organization and dependence relationships between phenomenology, psychophysics, and neuroscience.