Three Dangers: Phenomenological Reflections on the Psychotherapy of Psychosis

Abstract

Background/Aims: This paper offers a hermeneutic-phenomenological perspective on three dangers relevant to the psychotherapy of an underserved and often poorly understood population: persons with schizophrenia and other psychotic conditions. Methods: The discussion offered relies on analyses offered by Heidegger (on the “forgetting of the ontological difference”), Husserl (on the nature and importance of intersubjectivity), and Levinas (on appreciating the “infinitude” of human experience, versus adopting a “totalizing” attitude). Results: The three dangers are: (1) that of neglecting the ontological horizon or overall framework dimension of altered experience in favor of a preoccupation with more obvious, content elements of experience (e.g., by focusing overly much on specific delusional beliefs and their apparent falsehood, rather than on how delusions may be experienced and how literally they may, or may not, be taken); (2) the danger of overemphasizing the relevance and need for direct interpersonal interaction at the expense of appreciating issues concerning the implicit, intersubjective sense of sharing (or not sharing) perspectives with other persons; and finally (3) the error of being overconfident of one’s ability to grasp the patient’s subjectivity. Conclusion: The paper explores how phenomenology’s general perspective may offer a helpful alternative or supplement to some widespread attitudes and practices.