Benefits and Challenges of the Phenomenological Approach to the Psychiatrist's Subjective Experience: Impassivity, Neutrality, and Embodied Awareness in the Clinical Encounter

2019 ◽  
Vol 26 (4) ◽  
pp. E-83-E-96
Author(s):  
Svetlana Sholokhova
2021 ◽  
Vol 16 (2) ◽  
pp. 116
Author(s):  
Ida Bagus Putu Supriadi

This research was designed qualitatively descriptively because the field phenomenon that wanted to be expressed was in the form of subjective experience and knowledge of the informants, then analyzed to obtain intersubjective conclusions. Aims to identify and interpret field data based on the view of transcendental communication. Postpositivistic paradigm with a phenomenological approach to communication. The material object of the procession is ngereh for the monks in Bali, while the formal object is the application of the concept of transcendental communication. The use of qualitative design means that this research emphasizes more on reality with interactive, plural dimensions, and the existence of an exchange of social experiences that can be interpreted individually. Hinduism (Bali) is a tantrayana religion. All activities of practicing tattwa and morals are in the form of religious events, which use the traditional ritual. One of the religious events, which contain the practice of divinity is the use of statues/pretima in the form of a temple bhatara which is worshiped in temples in Bali and several temples outside Bali. Before becoming a priest, a newly created pretime/barong/rangda, a purification ritual (sacralization) must be carried out to get the panugrahan as a priest's tapakan. This chilling procession for the bhatara's tread is the object of this research, and four important things have been found. First, at each stage of the ritual a transcendental communication event occurs. Second, the transcendental communication component in the context of the ngereh procession at the bhatara's footprint in Bali includes the procession actors (pengereh) and supernatural/supernatural powers (who act as communicators and communicants alternately). Mantras or sehe that are spoken and mudras that are made mystically (act as messages), as a means of upakara as a yantra or communication medium. Third, the context of transcendental communication that can be identified for the tapakan bhatara is: the context of communication when the mangala/stakeholder/sangging performs the prayascita ceremony. when  the mangala/stakeholder/sangging performed the ngatep and mintonin ceremonies, and when the mangala/stakeholders/sangging performed the pasupati and ngereh ceremonies. The four effects of transcendental communication include cognitive experience/knowledge, affective experience/knowledge, and behavioral experience/knowledge


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S258-S258
Author(s):  
Iona Johnson

Abstract Stroke is a common health concern in the U.S. with 795,000 new strokes each year. Women dominate these numbers, with 55,000 more strokes per year than men, yet they are underrepresented in stroke research. Some research indicates that women have worse physiological and psychosocial outcomes after stroke than men, yet little is known about how they experience recovery. This study used a qualitative phenomenological approach to address the question: “What is the experience of stroke recovery for community dwelling women age 60 or older?” The participants were 10 women, ages 60 – 78, with times post-stroke ranging from 4 months to 15 years. They participated in 2 semi-structured interviews, with auto-photography used to enhance sharing of information. Between the two interviews, they were provided with a digital camera and asked to take pictures that helped to explain their lives before and after stroke. During the 2nd interview, participants described their pictures, and answered additional questions about their recovery. Interviews were transcribed verbatim, and the narratives were coded and analyzed thematically to describe how this sample of individuals experienced stroke recovery. Four overarching themes emerged from the data: 1) the stroke event, 2) a new chapter, 3) meaning and process of recovery, and 4) self-identity. In general, narratives revealed that recovery is described as a complex, individualized, and subjective experience that extends beyond overt physical abilities. Participants in this study experienced changes in self-identity and described a “new normal” after stroke. Implications and recommendations for rehabilitation, research, and policy are discussed.


2020 ◽  
Vol 53 (5-6) ◽  
pp. 282-290
Author(s):  
Laura Fonzi ◽  
Angelo Picardi ◽  
Valentina Monaco ◽  
Matteo Buonarroti ◽  
Elisabeth Prevete ◽  
...  

<b><i>Introduction:</i></b> The clinical encounter is still at the core of the psychiatric evaluation. Since the diagnostic process remains basically clinical in nature, several authors have addressed the complexity of the clinical reasoning process and highlighted the role played by intersubjective phenomena and clinician’s feelings. Some recent studies have supported the view of a significant link between the clinician’s subjective experience during the assessment and the diagnosis made. In a globalized world, this issue requires a careful reflection, since cultural differences may affect the intersubjective atmosphere of the encounter, which may indirectly influence the clinician’s thinking. <b><i>Methods:</i></b> We used a previously validated instrument, named <i>Assessment of Clinician’s Subjective Experience</i> (ACSE), to compare the clinician’s subjective experience during the evaluation of Italian patients with the subjective experience of the same clinician during the assessment of foreign patients. The 2 patient groups (<i>n</i> = 42 each) were individually matched for known potential confounders (age, sex, categorical diagnosis, and clinical severity). <b><i>Results:</i></b> We found no significant differences in mean scores on all ACSE dimensions (tension, difficulty in attune­ment, engagement, disconfirmation, and impotence), which suggests that cultural diversity did not substantially affect the clinician’s subjective experience. However, the lack of information about the native country and linguistic proficiency of about a quarter of foreign patients may have limited the possibility to detect subtle or specific differences, especially with regard to the clinician’s empathic attunement. <b><i>Conclusions:</i></b> Although further investigation is needed, our preliminary findings may have significant implications for the reflection upon the clinician’s empathic experience as well as pragmatic consequences for the act of psychiatric diagnosis in the cross-cultural encounter.


2020 ◽  
Vol 26 (2) ◽  
pp. 167-175
Author(s):  
So young Lee ◽  
Jung A Kim

Purpose: The purpose of this study was to explore the subjective experience of moral distress among nurses working in long-term care hospitals.Methods: A phenomenological approach was used for the study. Data were collected from May to July, 2019 using open-ended questions during in-depth interviews. Participants were nurses working in long-term care hospitals and had reported experiences of moral distress. Nine nurses participated in this study.Results: Three themes emerged from the analysis using Colaizzi’s method: (1) confusion and distress about the meaning of care, (2) a feeling of helplessness caused by connivance, (3) enduring in the organization.Conclusion: Sufficient labor supply, environmental improvements, programs for improving interpersonal skills, education and counseling on end-of-life care, and recognition improvement about long-term care hospitals are suggested to reduce the moral distress of long-term care hospital nurses.


2008 ◽  
Vol 57 (4) ◽  
Author(s):  
Andrea Virdis

Il presente contributo si offre come un’indagine intorno alle diverse teorie sul fondamento ontologico della pratica medica, secondo due specifiche prospettive che derivano da un approccio teleologico e fenomenologico. L’approccio teleologico muove da un modo aristotelico-tomista di intendere la medicina come un atto diretto ad un fine: questa prospettiva è radicata nell’assunto che esiste un bene inerente alla medicina, tale da definirne il fine proprio. La medicina viene considerata come un’attività intrinsecamente etica, nella quale tecnica e comportamento sono entrambi ordinati in relazione ad un bene onnicomprensivo: il fine naturalmente dato della salute. L’approccio fenomenologico (nella sua corrente realista) mostra come la medicina manifesti la sua essenza nell’incontro clinico tra un paziente (che si ammala e necessita aiuto) ed un medico (che possiede una data abilità di cura e può aiutarlo). Nel contesto della vulnerabilità di quel particolare paziente, l’incontro clinico è il “momento” in cui la medicina e il suo fine di cura sono posti in essere. Entrambe le prospettive rivelano che ciò che la medicina è dipende da quello che è il suo fine, vale a dire, che la conoscenza della natura della medicina non è il punto di partenza dell’etica medica, ma il suo risultato: occorre conoscere il fine della medicina (ovvero, il bene intrinseco ad essa), per sapere precisamente ciò che la medicina è. Inoltre, entrambi gli approcci sembrano supportare la possibilità di affermare l’esistenza di una moralità interna della medicina, fondamentale per determinare i doveri, le virtù e le obbligazione del medico in accordo con la natura stessa della medicina. ---------- The aim of this paper is to inquire into the different theories about the ontological foundation of medical practice, according to two specific perspectives that come from teleological and phenomenological approaches. Teleological approach starts from an Aristotelian-Thomist way to intend medicine as an end-oriented act: this view is rooted in the assumption that a good inherent to medicine exists and defines the proper ends of medicine itself. Medicine is considered as an inherently ethical activity, in which technique and conduct are both ordered in relation to an all-encompassing good: the naturally given end of health. Phenomenological approach (in its realistic current) points out how medicine manifests its essential being in the clinical encounter between a patient (that got sick and needs help) and a doctor (that has the skill and can help him). In the context of the vulnerability of that particular patient, the clinical encounter is the “moment” in which medicine and its healing end are put in being. Both perspectives reveal that what medicine is, depends on what its end is, that is to say, that the knowledge of the nature of medicine is not the starting point of medical ethics, but its result: we must know the end of medicine (i. e., the good inherent to), to know what medicine exactly is. Moreover, they demonstrate the existence of an internal morality of medicine which is fundamental to determine duties, virtues and obligation of the physician in accordance with the nature of medicine itself.


2020 ◽  
Vol LII (1) ◽  
pp. 68-71
Author(s):  
Natalya V. Kropocheva ◽  
Anna A. Lebedeva

The problem of understanding of patients in modern psychiatry is discussed. Nowadays patients subjective experience is almost entirely excluded from psychiatric manuals that brings risk of ignoring holistic patients experience. This experience can be shared by psychiatrist only in context of mutual trust. The latter as an approach to communication requires certain theoretical background which differs from the current one in modern psychiatry. The phenomenological approach is seen as promising for evolution of psychiatry because this approach was made in the 20th century to descript pathological and everyday experience. We reveal importance of patients subjective experience to diagnostics and description of mental illnesses according to current literature in the field. We also suggest original research of need for understanding in Russian psychiatry professionals.


KRITIS ◽  
2021 ◽  
Vol 30 (1) ◽  
pp. 35-51
Author(s):  
Defri Harianto Natan ◽  
Wahyuni Kristinawati

Flourishing is a subjective experience when positive emotion, engagement, positive relationships, meaning and accomplishment combine effectively (Seligman, 2011). Previous research found that engagement is not related to artistic activity (D'raven & Pasha-Zaidi, 2016), even though painting is an artistic experience with a sense of emotion, happiness, etc. (Winarno & Aryanto, 2016). The Association of Mouth and Foot Painting Artists (AMFPA) is an international association of painters with physical disabilities in which painters do not have hands and therefore rely on their mouths or feet when painting. This study aims to describe the flourishing of painters with physical disabilities who [the] are members of AMFPA. The method used in this research is a qualitative method with a phenomenological approach to capture the phenomena experienced by the participants as closely as possible (Smith, 2009). Interviews by telephone (conducted during the Covid-19 pandemic situation) and limited observation were carried out on 3 participants (male, aged 41-54 years) during March - November 2020, only once. Each interview session lasts 90-120 minutes by telephone. The validity of the data was tested using data triangulation, namely interviewing the significant other (Bachri, 2010), such as spouse, siblings and co-workers of the participants. The results of this study indicate that one of the elements of flourishing, namely engagement, is also experienced by painters with physical disabilities. Other findings show that the different backgrounds and experiences of each painter can have an impact on their flourishing experiences.


2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Stephanie Bogue Kerr ◽  
Marguerite Soulière ◽  
Lorraine Bell

The present article presents the findings of a phenomenological study, which sought to explore the subjective experience of kidney transplantation amongst young people who lived the transition from pediatric to adult care.  This study was conducted using a qualitative phenomenological approach, involving semi-directed interviews with five people, three of whom received their kidney transplants as children, the other two as young adults. An in-depth analysis of their narratives revealed the paradoxical nature of the kidney transplant experience for these individuals; existing between self and other, sickness and health, and at times, between life and death. The liminal nature of transplantation was found to be an important quality of the experience, thus leading to an analysis of the experience in relation to the theoretical concepts of liminality and rites of passage. This analysis culminates in the introduction of the term transliminal-self, to encompass the complexity of the experience. Finally, the article concludes with a discussion regarding the relevance of the subjective experience for the practice of medical and allied health professionals who work with transplant recipients. 


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