Psychopathology, Atmospheres, and Clinical Transformations: Towards a Field-Based Clinical Practice

Abstract

The concept of atmosphere in psychopathology has been used sporadically and by only a few, albeit authoritative, authors, although such contributions, largely neglected by debate in psychiatry and psychotherapy, today are particularly interesting because they point to and support a conception of psychopathology that goes beyond a symptomatic and individualistic understanding of human suffering. The dominant paradigm in clinical psychotherapy and psychiatry today makes use of third-person descriptive diagnosis, and clinical work aims at changing the way the patient (dys)functions. Such an approach is far from satisfactory and has not proven to be successful in addressing the problems it promised to resolve. In this chapter I attempt to describe how the concept of “atmosphere” can help open up a different understanding of psychopathology, diagnosis, and clinical practice. It can help also to steer us towards an aesthetic diagnosis that goes beyond the diagnosis of symptoms and towards a field-based clinical practice, which goes beyond the individual or bi-personal. It is a paradigm shift that will lead us onto a new epistemological ground, one that is different from the individualistic perspective, where clinical work focuses on the suffering individual to effect change, but also from the bi-personal paradigm, which sees the relationship co-created by two individuals who come together and jointly produce change. This new horizon posits the relationship before the related, where subjects and the world emerge incessantly from an undifferentiated ground in which they are not yet defined.