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      Close, yet so far away: a phenomenology of the praecox feeling in the diagnosis of schizophrenia as intercorporeal alienness

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          Abstract

          Debates concerning the reliability and validity of operationalized criteria and diagnostic tools have surrounded the issue of schizophrenia diagnosis and clinical decision-making related to the disorder. The notion of the praecox feeling (PF) has played a prominent role in the discussions as an example of the possibility of a rapid and potentially valid diagnosis based solely on “intuition” or a peculiar emotional experience or impression arising in a physician during an interaction with a patient with schizophrenia. In this paper, we argue that PF is enabled by the (phenomenologically understood) intercorporeal dimension of the clinical encounter. Intercorporeality in this sense denotes intertwinement between embodied expressions that may lead to feelings of connection but also, as in the case of PF, of disconnection and strangeness—the experience of alienness. Following Waldenfels, alienness ranges from the average social encounter to more extreme and peculiar forms—such as PF. To prove our point, we analyze the metaphors used by physicians in various cultural contexts (the United States, the United Kingdom, and Poland) to express the apparently ineffable experience of the PF. We focus on two dominant metaphors of distance: the first expressing spatial distance by referring to an “object in-between” the physician and the patient and the second expressing mental distance by referring to the “other-worldliness” of the patient. We interpret the object in-between metaphors as reflecting the sense of separateness and the other-worldliness metaphors as reflecting the sense of strangeness, with both meanings unified in the notion of “close remoteness.” Such unsettling but speculation-provoking feeling of close remoteness may be rendered by the concept of “the eerie” (Mark Fisher). We conclude that metaphor and phenomenological analysis facilitate an understanding of the experiential profile of PF in the clinical encounter, outlining relevant clinical implications.

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          Describing one’s subjective experience in the second person: An interview method for the science of consciousness

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            Enactive intersubjectivity: Participatory sense-making and mutual incorporation

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              Towards a second-person neuropsychiatry.

              Psychiatric disorders can affect our ability to successfully and enjoyably interact with others. Conversely, having difficulties in social relations is known to increase the risk of developing a psychiatric disorder. In this article, the assumption that psychiatric disorders can be construed as disorders of social interaction is reviewed from a clinical point of view. Furthermore, it is argued that a psychiatrically motivated focus on the dynamics of social interaction may help to provide new perspectives for the field of social neuroscience. Such progress may be crucial to realize social neuroscience's translational potential and to advance the transdiagnostic investigation of the neurobiology of psychiatric disorders.
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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2759883Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/432998Role: Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/2808668Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/2813045Role: Role: Role:
                URI : https://loop.frontiersin.org/people/144661Role: Role:
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                02 October 2024
                2024
                : 15
                : 1445615
                Affiliations
                [1] 1 Phenomenological Psychopathology and Psychotherapy, Psychiatric Clinic, University of Heidelberg , Heidelberg, Germany
                [2] 2 Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences , Poznań, Poland
                [3] 3 Institute of Philosophy, Marie Curie-Sklodowska University , Lublin, Poland
                [4] 4 IDEAS NCBR (National Centre for Research and Development) , Warsaw, Poland
                [5] 5 Department of Psychiatry and Humanities in Medicine, Texas A&M Health Science Center, College , Station, TX, United States
                Author notes

                Edited by: Kerrin Artemis Jacobs, University of Witten/Herdecke, Germany

                Reviewed by: Leonhard Schilbach, Ludwig Maximilian University of Munich, Germany

                Rasmus Johnsen, Copenhagen Business School, Denmark

                *Correspondence: Marcin Moskalewicz, moskalewicz@ 123456gmail.com
                Article
                10.3389/fpsyt.2024.1445615
                11479871
                39415890
                406da200-0d6d-4ed7-b056-497b992d2da7
                Copyright © 2024 Vial, Moskalewicz, Szuła, Schwartz and Fuchs

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 07 June 2024
                : 03 September 2024
                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 123, Pages: 13, Words: 8738
                Funding
                Funded by: Universität Heidelberg , doi 10.13039/501100001661;
                Funded by: Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu , doi 10.13039/501100010438;
                The authors declare that financial support was received for the research, authorship, and publication of this article. IV was supported by the Konrad Adenauer Stiftung; TF was supported by the German Research Foundation (DFG) for the project “Dynamics of Oikeiosis. Familiarity and Trust as Basic Elements of an Intersubjective Anthropology and Their Significance for Psychopathology” (project number: 513696000); MM was supported by the Alexander von Humboldt Foundation and MM’s and AS’ research on phenomenology was funded by the Polish National Science Centre (Project No. 2021/42/E/HS1/00106). For the publication fee we acknowledge financial support by Deutsche Forschungsgemeinschaft within the funding program “Open Access Publikationskosten” as well as by Heidelberg University and Poznan University of Medical Sciences.
                Categories
                Psychiatry
                Conceptual Analysis
                Custom metadata
                Psychopathology

                Clinical Psychology & Psychiatry
                praecox feeling,phenomenological psychopathology,alienness,metaphor,clinical decision-making,diagnostic techniques and procedures,embodiment,intercorporeality

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