Missing links in phenomenological clinical neuroscience: why we still are not there yet

Aaron L Mishara
Current Opinion in Psychiatry 2007, 20 (6): 559-69

PURPOSE OF REVIEW: The phenomenology or systematic study of the patient's subjective experience in neuropsychiatric disorders is widely recognized as important. The methods used, the type of 'knowledge' obtained and the relationship of these observations to standard methods of clinical neuroscience, however, remain ill-defined and highly controversial.

RECENT FINDINGS: Advances in the phenomenology of consciousness, self, body-experience, time-perception and intersubjectivity of neuropsychiatric disorders have been made. This review examines two differing approaches to the phenomenological psychiatry-neuroscience interface: the neo-phenomenological approach claims that some of its key concepts (e.g. the hyperreflexivity/ipseity model, prereflective self-awareness) are able to constrain neuroscience; the existential-phenomenological approach counters that phenomenology's role is not to constrain neuroscience but to provide hypotheses for further experimental study. This review compares these two approaches and assesses the current success of their respective claims.

SUMMARY: By integrating work of largely untranslated authors, such as Binswanger, Blankenburg, and von Weizsaecker, neglected or cited out of context in the neo-phenomenological approach, the existential-phenomenological approach provides the 'missing links' between phenomenology and clinical neuroscience in a newly emerging but still fragile balance between disciplines. Optimistic claims about the ability of recently proposed phenomenological concepts (neo-phenomenological approach) to constrain neuroscience are unwarranted.

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