What Is It like to Be a Person with Schizophrenia in the Social World? A First-Person Perspective Study on Schizophrenic Dissociality – Part 2: Methodological Issues and Empirical Findings

Stanghellini, Giovanni; Ballerini, Massimo

doi:10.1159/000322638

Cited by 53 publications

(30 citation statements)

References 73 publications

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“…Rather, we propose that the specific therapeutic format outlined here can be fruitfully complemented by other therapeutic approaches: the use of fluctuating self-disorders as an early warning sign might add to the effectiveness of relapse prevention while trait-like self-disorders could better be approached by strategies that focus on the individual assignment of higher-order meaning [38,39]. All of these theoretical implications and therapeutic applications require further research, both phenomenological and empirical.…”

Section: Discussionmentioning

confidence: 99%

From Theory to Clinical Practice: A Phenomenologically Inspired Intervention for Patients with Schizophrenia

Nischk¹,

Dölker

Rusch³

et al. 2015

Psychopathology

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Background: Phenomenological conceptualizations of schizophrenia regard the fundamental transformation of self-experience as the central feature of the schizophrenic state of mind. Recently, self-disorders as subtle, trait-like, merely subjective alterations of self-experience have received vast empirical attention. However, the question of how to address self-disorders psychotherapeutically has remained neglected. Methods: From phenomenologically inspired analyses of self-disorders we derive a therapeutic intervention that focuses on the following: (1) verbalizing diffuse changes in self-experiences and (2) conceptualizing these self-experiences in terms of aggravating and relieving factors in order to stimulate coping and derive targeted therapeutic interventions. Results: The clinical implementation is illustrated by two case studies. The feasibility of our approach is preliminarily supported by an exploratory study. Conclusions: This intervention seems promising in assisting patients to develop an embodied and enacted understanding of self-disorders.

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Section: Discussionmentioning

confidence: 99%

From Theory to Clinical Practice: A Phenomenologically Inspired Intervention for Patients with Schizophrenia

Nischk¹,

Dölker

Rusch³

et al. 2015

Psychopathology

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“…• “When I was a child, I used to watch others to see what was the moment to be happy or to be sad.” [39]…”

Section: Domains and Descriptions Of Items And Subtypesmentioning

confidence: 99%

EAWE: Examination of Anomalous World Experience

et al. 2017

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The “EAWE: Examination of Anomalous World Experience” is a detailed semi-structured interview format whose aim is to elicit description and discussion of a person's experience of various aspects of their lived world. The instrument is grounded in the tradition of phenomenological psychopathology and aims to explore, in a qualitatively rich manner, six key dimensions of subjectivity - namely, a person's experience of: (1) Space and objects, (2) Time and events, (3) Other persons, (4) Language (whether spoken or written), (5) Atmosphere (overall sense of reality, familiarity, vitality, meaning, or relevance), and (6) Existential orientation (values, attitudes, and worldviews). The EAWE is based on and primarily directed toward experiences thought to be common in, and sometimes distinctive of, schizophrenia spectrum conditions. It can, however, also be used to investigate anomalies of world experience in other populations. After a theoretical and methodological introduction, the EAWE lists 75 specific items, often with subtypes, in its six domains, together with illustrative quotations from patients. The EAWE appears in a special issue of Psychopathology that also contains an orienting preface (where the difficulty as well as necessity of studying subjective life is acknowledged) and a brief reliability report. Also included are six ancillary or background articles, which survey phenomenologically oriented theory, research, and clinical lore relevant to the six experiential domains.

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“…They may engage in a sort of empirical study into others' transactions meant to discover an explicit algorithm to make sense of others' behavior. This algorithmic conceptualization of social life can be defined as an observational or ethological attitude aimed at providing an explicit personal method or algorithm for taking part in social transactions [6,7,33] (EAWE 3.3, Alienated/intellectual strategies for understanding others). This alienated strategy can be considered to be secondary cognitive forms of compensation that are adopted largely in response to disordered emotional attunement.…”

Section: What Is Dissociality?mentioning

confidence: 99%

“…Whereas clinical phenomenology focuses on the subjective/personal dimension of this disturbance, general psychiatry concentrates on more general and putatively “objective” dimensions of psychopathological syndromes. There are three main limitations to the concept of “social dysfunction” as standardly defined by conventional psychiatry: (1) it endorses a strictly behavioral-functionalist perspective in which deficits in social behavior are emphasized; (2) these deficits are mainly defined and assessed in quantitative reduction of performance; and (3) it encompasses too many heterogeneous domains of life, e.g., everyday functioning, social contacts, education, occupation, and consequences of stigmatization [6,7]. The main shortcoming of most studies on social dysfunction in schizophrenia reflects these limitations, since they do not give sufficient consideration to the personal level of experience in real-world functioning.…”

Section: Introductionmentioning

confidence: 99%

Other Persons: On the Phenomenology of Interpersonal Experience in Schizophrenia (Ancillary Article to EAWE Domain 3)

2017

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In this paper, we discuss the philosophical and psychopathological background of Domain 3, Other persons, of the Examination of Anomalous World Experiences (EAWE). The EAWE interview aims to describe the manifold phenomena of the schizophrenic lifeworld in all of their concrete and distinctive features, thus complementing a more abstract, symptom-focused approach. Domain 3, Other persons, focuses specifically on subjectively experienced interpersonal disturbances that may be especially common in schizophrenia. The aim of this domain, as with the rest of the EAWE, is to provide clinicians and researchers with a systematic orientation toward, or knowledge of, patients' experiences, so that the experiential universe of schizophrenia can be clarified in terms of the particular feel, meaning, and value it has for the patient. To help provide a context for EAWE Domain 3, Other persons, we propose a definition of “intersubjectivity” (IS) and “dissociality.” The former is the ability to understand other persons, that is, the basis of our capacity to experience people and social situations as meaningful. IS relies both on perceptive- intuitive as well as cognitive-computational resources. Dissociality addresses the core psychopathological nucleus characterizing the quality of abnormal IS in persons with schizophrenia and covers several dimensions, including disturbances of both perceptive-intuitive and cognitive-computational capacities. The most typical perceptive-intuitive abnormality is hypoattunement, that is, the lack of interpersonal resonance and difficulties in grasping or immediately understanding others' mental states. The most characteristic cognitive-computational anomaly is social hyperreflexivity, especially an algorithmic conception of sociality (an observational/ethological attitude aimed to develop an explicit, often rule-based personal method for participating in social transactions). Other anomalous interpersonal experiences, such as emotional and behavioral responses to others, are also discussed in relation to this core of dissociality.

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What Is It like to Be a Person with Schizophrenia in the Social World? A First-Person Perspective Study on Schizophrenic Dissociality – Part 2: Methodological Issues and Empirical Findings

Cited by 53 publications

References 73 publications

From Theory to Clinical Practice: A Phenomenologically Inspired Intervention for Patients with Schizophrenia

From Theory to Clinical Practice: A Phenomenologically Inspired Intervention for Patients with Schizophrenia

EAWE: Examination of Anomalous World Experience

Other Persons: On the Phenomenology of Interpersonal Experience in Schizophrenia (Ancillary Article to EAWE Domain 3)

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