Borderline We-Space? The Phenomenology of the Background of Safety in Borderline Personality Disorder

Borderline personality disorder (BPD) is a severe psychiatric condition characterized by instability in identity, relationships, and affect. Individuals, with BPD typically lack a coherent sense of self, are highly sensitive to interpersonal stressors, experience intense fluctuations in mood, and frequently engage in impulsive and self-destructive behaviors. Although both empirical research and development of effective psychotherapy have evidently progressed over the past years, many aspects regarding the structure of experience and the life-world typical for persons with BPD are not yet fully understood. Somewhat surprisingly, phenomenological psychopathology has only recently started to pay more attention to the disorder. A comprehensive elaboration of the phenomenology of BPD is therefore still lacking. This article aimed to contribute to such a phenomenological understanding by focusing on what we think is an essential aspect that has yet not been sufficiently addressed: the background of safety. To clarify what this means, we depart from Sandler’s [<i>Int J Psychoan</i>. 1960;41:352–6] psychoanalytic concept and elaborate on it phenomenologically. This leads us to argue that the development of a background of safety requires a particular embodied presence of others, which, in turn, contributes to the constitution of a safe we-space, a shared and familiar environment providing a matrix for the experience of a stable world. However, even when established, the background of safety remains in need of a continuous reconfirmation through corresponding experiences within a sufficiently reliable and controllable environment. The background of safety is vulnerable and open to (interpersonal) disruptions like trauma or neglect. In BPD, we suggest 3 aspects regarding the phenomenology of the background of the safety need to be considered: first, typically, patients with BPD did not develop a robust background of safety in infancy; second, weakening of the background of safety gives rise to symptoms and dynamics typical for BPD; third, these symptoms and dynamics further undermine the possible development of a background of safety in adult life and thus gravitate toward a petrification of the borderline condition, a “stable instability.” To conclude, we examine whether this concept should be understood as a <i>trouble générateur</i> and, last, consider its clinical implications.

Do delusions have and give meaning?

Delusions are often portrayed as paradigmatic instances of incomprehensibility and meaninglessness. Here we investigate the relationship between delusions and meaning from a philosophical perspective, integrating arguments and evidence from cognitive psychology and phenomenological psychopathology. We review some of the empirical and philosophical literature relevant to two claims about delusions and meaning: (1) delusions are meaningful, despite being described as irrational and implausible beliefs; (2) some delusions can also enhance the sense that one’s life is meaningful, supporting agency and creativity in some circumstances. Delusions are not incomprehensible representations of reality. Rather, they can help make sense of one’s unusual experiences and in some circumstances even support one’s endeavours, albeit temporarily and imperfectly. Acknowledging that delusions have meaning and can also give meaning to people’s lives has implications for our understanding of psychotic symptoms and for addressing the stigma associated with psychiatric conditions.

Schizophrenia, Temporality, and Affection

Temporal experience and its radical alteration in schizophrenia have been one of the central objects of investigation in phenomenological psychopathology. Various phenomenologically oriented researchers have argued that the change in the mode of temporal experience present in schizophrenia can foreground its psychotic symptoms of delusion. This paper aims to further the development of such a phenomenological investigation by highlighting a much-neglected aspect of schizophrenic temporal experience, i.e., its non-emotional affective characteristic. In this paper, it denotes the type of an experience wherein an afflicted individual experiences a pervasive pull or attraction coming from the past, present, and future. By employing Husserl’s account of affection, I argue that such an affectively prominent temporal experience is not yet another abnormality that happens to be present in schizophrenia. Instead, it is indicative of the core disturbance that underpins the schizophrenic temporal mode of experience. I identify such a disturbance as ‘affective modification dysfunction’ and employ it as a core concept with which I synthesize and organise heterogeneous components of schizophrenic temporal experience in their conceptual unity. For the sake of clear description, I organise those components into the following categories: 1.) Time Stop 2.) Ante-festum 3.) Déjà vu/vécu and 4.) Time Fragmentation. I conclude by demonstrating how approaching schizophrenic temporal experience from its affective dimension can further help us better understand its pre-psychotic phase known to precipitate schizophrenic primary delusion, i.e., delusional mood.

A phenomenologically grounded empirical approach to experiences of adolescent depression

Extant literature suggests a correlation between the thematic core of an adolescent’s personal account of depression and the trajectory of her personality development. This possible correlation has not been explored in a way that includes detailed qualitative analyses of reported experiences of adolescent depression. By discussing a single case design, this contribution illustrates and justifies an interpretative procedure that has been implemented to assist such an exploration. The paper focuses on the suitability of this approach for the investigation of all-encompassing alterations of the experiential field in psychopathological conditions. I argue that this suitability is grounded in a phenomenological understanding of the explicative task in terms of a disclosure of the intentional constitution of the life-world of adolescent depression. The discussion begins with a contextualization of the single case design within a multilayered and methodologically mixed study. Against this background, I illustrate the steps of a ‘systematic of interpretation’ aimed at exposing meaning horizons. Touching on issues concerning the empirical validity of the approach, these meaning horizons are construed as objectively plausible frames of intelligibility of a subjectively particular form of experience. Drawing on a characterization of transcendental arguments, I discuss the relationship between the illustrated procedure and the investigational attitude that, according to Husserl, defines phenomenology as a properly philosophical endeavor. In this context, I eventually characterize the illustrated procedure as a crossover approach to human experiential life aligned with the tradition of phenomenological psychopathology.

A values-based phenomenology for substance use disorder: a new approach for clinical decision-making

Phenomenological psychopathology has been defined as a human science that is concerned with the object on which clinical psychology and psychiatry act. How psychopathological experiences are understood is an important factor determining decision-making in clinical care. An accurate understanding of psychopathology is fundamental to the effectiveness of mental health treatments. This is even more important in a field such as substance use disorders in which social and cultural values influence both diagnosis and decision-making. In this article, we offer a contribution to clinical decision-making in substance use disorders by suggesting the association of Phenomenological Psychopathology and Values-Based Practice, constituting a Values-based Phenomenology We present a fictitious clinical case (to preserve confidentiality), illustrating a three-step practical application of Values-based Phenomenology. We conclude that although still a nascent discipline, Values-based Phenomenology offers a promising approach to reducing the gap between services and patients’ needs in clinical decision-making, and thus to improving clinical care in substance use disorders.

HUSSERL AND DIMENSIONS OF TEMPORALITY: A FRAMEWORK FOR THE ANALYSIS OF TEMPORAL EXPERIENCE

Temporality is one of the key components of our experience, but the experience of time is hardly one and the same for all of us throughout our lives. The experience of time in its entirety is not solid and simple. It is a fluid and complex phenomenon consisting of a multitude of dimensions. In medical phenomenology and phenomenological psychopathology there are ample cases of different temporal experiences analysed in the context of the illness experience. However, only a few attempts have been made to propose a conceptual framework that could not only be used to conduct a concrete analysis in a more systematic manner, but also provide a solid and comprehensive theoretical basis. The aim of this article is to draw on the rich distinctions found in Husserl’s phenomenology to outline a framework of different temporal dimensions for the analysis of temporal experience. The framework could provide conceptual tools to analyse temporal experiences in any field of study that deals with the human experience, including medical phenomenology and phenomenological psychopathology. The resulting analysis would be not only clearer, more comprehensive and precise, but also more systematic and conceptually consistent. The framework consists of fourteen dimensions of temporal experience ordered in seven binary distinctions: (1) change and structure, (2) immanence and transcendence, (3) ownness and intersubjectivity, (4) passivity and activity, (5) receptivity and spontaneity, (6) presentation and representation, (7) unthematized temporality and thematized temporality.

Exploration of Everydayness in Schizophrenia: A Phenomenological Approach

This article explores everydayness as a specific form of experience of the world and its alterations in schizophrenia. In the field of phenomenological psychopathology, the transformations of subjective experience in schizophrenia have been the subject of a great deal of work, but the relationship between these alterations of subjective experience and the experience of the everyday remains largely unexplored. A phenomenological point of view leads us to explore everydayness as a constitutive framework of experience, one that may be impeded in schizophrenia. The question of the everyday allows us to bridge the gap between the descriptions of subjective experience proposed by phenomenological psychopathology and what is at stake in therapeutic treatment. It seems to us that the work of constructing an individual narrative of the everyday may be a useful psychotherapeutic approach for helping patients rebuild the framework of everydayness.

Schizophrenia in the World: Arguments for a Contextual Phenomenology of Psychopathology

Traditionally, phenomenological theories of schizophrenia have emphasized disturbances in self-experience, with relatively little acknowledgement of the surrounding world. However, epidemiological research consistently demonstrates a strong relationship between traumatic and stressful life events and the development of schizophrenia, suggesting that encounters in the world are highly relevant for many people diagnosed with this disorder. This paper reviews foundational texts in phenomenology and phenomenological psychopathology on the nature of subjectivity and its disturbances, finding support for broadening contemporary phenomenological models of schizophrenia to incorporate world events and their subjective meaning as essential aspects of this disorder. This contextual approach to phenomenology emphasizes the relationship between self and world, one that is especially unstable, unclear, and untrustworthy in schizophrenia. Both epidemiological and phenomenological research can benefit from this approach: in epidemiology, researchers might consider the ways that various risk factors are experienced by persons vulnerable to schizophrenia, while phenomenologists are encouraged to inquire about the environmental and social context in which altered experiences occur and incorporate these considerations into their explanatory models.