Theory & Psychology

Karl Jaspers’ assertion of the un-understandability of schizophrenic psychosis, which rests on a division between what is psychologically understandable and what must be explained via natural causation, has faced numerous challenges from within phenomenological psychopathology. But despite significant developments in the phenomenology of schizophrenia, I suggest that this dichotomy, between psychological understandability and naturalistic explanation, is still present in some phenomenological research on schizophrenia today, even in work that explicitly critiques the limitations of empathic understanding and the purported incomprehensibility of schizophrenic delusions. Other theories of subjectivity, particularly those in the Lacanian tradition, offer one way to recognize the impossibility of understanding without turning to naturalistic explanation. These theories may encourage us to better integrate other key insights in phenomenology, most clearly articulated in the work of Merleau-Ponty, that look beyond “conscious” awareness—those that allow for a renewed appreciation of the un-understandable in schizophrenia, and indeed in all human experience.

In this paper, I elucidate how lived space is transformed in social anxiety disorder. The cognitive–behavioral framework that dominates the field conceptualizes the disorder as an intrapsychic dysfunction and sidelines concrete experience. The omnipresent sense of threat as it expresses itself “out there” in the patient’s experiential world thus remains unexplored. Looking to first-person descriptions of social anxiety, I argue that the felt presence of the Other constantly threatens the patient’s sense of autonomy and ownership of the places they inhabit. They experience others violating the boundaries of their intimate spaces and banishing them from public spaces. These experiences point to an altered mode of inhabiting space I term intersubjective overdetermination. The patient is condemned to live in the space of the Other. I compare this conceptualization to the commonplace cognitive–behavioral account. I end by discussing the treatment implications of this account of socially anxious lived space.

South Africa cannot ignore the far-reaching influence of its colonial and apartheid history on the psychological functioning of its people. Psychotherapy as a fundamental psychological intervention approach cannot ignore its evolving history as the architect of the social psyche and of an individual’s psychological functioning. With regards to psychodynamic psychotherapy, the literature has lamented this therapeutic approach’s lack of consideration of the impact of the colonial and apartheid historical trauma on the prevailing sociocultural and mental health challenges. The crux of this article is to address this epistemological lacuna, by arguing for the integration of psychodynamic theory with cultural-historical activity theory (CHAT) for application in therapeutic processes. The article further posits that this integration needs to be introduced in training programmes for student psychotherapists who, as in the case of South Africa, are themselves the descendants of the generation that was exposed to historical trauma of colonialism and apartheid and are living with latent transgenerational trauma. To create a suitable foundation for the integration of psychodynamic theory and CHAT in psychotherapeutic practice, there is a need to apply critical pedagogical strategies in the training programmes of psychotherapists. Thus, this article further highlights the possibilities of employing critical pedagogical principles that incorporate ontological reflection, pedagogic discomfort, troubled knowledges, mutual vulnerability, strategic empathy, and compassion.

Clinical psychology is characterized by persistent disagreement about fundamental aspects of the discipline ranging from what mental disorders are to what constitutes effective treatment. Attempts to address the problem of epistemic disagreement have been frequently based on establishing the correct answer by fiat without identifying and addressing the sources of the disagreement. We argue that this strategy has not worked very well and the result is frequently ongoing and intractable disagreement, with each side in an argument convinced they are correct. In this paper, we outline an epistemic disagreement procedural model intended to assist researchers and clinicians in the field of clinical psychology to identify, explore, and develop inquiry strategies that capitalize on situations where competing knowledge claims are made. The result is a flexible conceptual framework committed to a defensible epistemic pluralism, fallibilism, and contextualism, across the various research tasks constituting the field of clinical psychology.

There is no direct way for researchers to test theories. One reason is that theories contain nonobservational terms that refer to unobservable entities. Consequently, researchers add auxiliary assumptions to aid in traversing the distance between theories and empirical hypotheses. The results may confirm the empirical hypothesis, an empirical victory, or the results may disconfirm the empirical hypothesis, an empirical defeat. Either way, it is not clear whether to make an attribution to the theory, the auxiliary assumptions, or both. The present goal is to review techniques researchers have employed, or could employ, that aid in assessing the weight of the evidence with respect to crediting or blaming theories or auxiliary assumptions for empirical victories or defeats.

This article introduces the project Return to Reality: What Does the World Ask of Us? This project evolved from a concern that frameworks in mental health operate with knowledge as their primary mode in such a way that reality is lost from sight. This is not primarily an epistemological problem, but an ethical and existential one: ethical because a knowledge-mediated relation to the real can make us blind to the ethical imperatives found in encounters with reality; existential because to be a subject is to respond to what is real. The works of Gert Biesta are a key inspiration. We use Levinas’s, Lingis’s, and Arendt’s ideas to elaborate these concerns. A return to reality is needed; a shift from knowledge-based to reality-sensitive approaches. We relate these ideas to the Open Dialogue approach, with the key imperative of responding to the presence of those present, and to Reflecting team practices, which Tom Andersen describes as being guided by people’s bodily responses.