Anthony Vincent Fernandez

This dissertation is a contribution to the contemporary field of phenomenological psychopathology, or the phenomenological study of psychiatric disorders. The work proceeds with two major aims. The first is to show how a phenomenological approach can clarify and illuminate the nature of psychopathology—specifically those conditions typically labeled as major depressive disorder and bipolar disorder. The second is to show how engaging with psychopathological conditions can challenge and undermine many phenomenological presuppositions, especially phenomenology’s status as a transcendental philosophy and its corresponding anti-naturalistic outlook. In the opening chapter, I articulate the three layers of the subject matter of phenomenological research—what I refer to as “existentials,” “modes,” and “prejudices.” As I argue, while each layer contributes to what we might call the “structure” of human existence, they do not do so in the same way, or to the same degree. Because phenomenological psychopathology—and applied phenomenology in general—aims to characterize how the structure of human existence can change and alter, it is paramount that these layers be adequately delineated and defined before investigating these changes. In chapters two through five, I conduct hermeneutic and phenomenological investigations of psychopathological phenomena typically labeled as major depressive disorder or bipolar disorder. These investigations address the affective aspects of depression and mania, and the embodied aspects of depression. In addition to clearly articulating the nature of these phenomena, I show how certain psychopathological conditions involve changes in the deepest or most fundamental layer of human existence—what I refer to as existentials. As I argue, many of the classical phenomenologists (including Husserl and Heidegger) believed that these structural features were necessary, unchanging, and universal. However, this presupposition is challenged through the examination of psychopathological and neuropathological conditions, undermining the status of phenomenology as a transcendental philosophy. While this challenge to classical phenomenology is only sketched in the early chapters, in chapters six and seven I develop it in more detail in order to achieve two distinct ends. In chapter six I argue that psychopathology and neuropathology not only challenge phenomenology’s status as a transcendental philosophy, but also supply a key to developing a phenomenological naturalism (which I contrast with a naturalized phenomenology). Phenomenological naturalism, as I articulate it, is a position in which phenomenology is not subsumed by the metaphysical and methodological framework of the natural sciences, but nonetheless maintains the capacity to investigate how the natural world stands independent of human subjectivity (and how events in the natural world can bring about changes in the most fundamental structures of human existence). In the seventh chapter I argue that a phenomenology in which existentials are contingent and variable rather than necessary and unchanging allows phenomenologists to contribute to new dimensional approaches to psychiatric classification. Rather than begin from distinct categories of disorder, these approaches begin from distinct core features of human existence. These features, referred to as either dimensions or constructs, can vary in degree and are studied in both normal and pathological forms.

Social scientists often rely on philosophy as a source of theory. Among others, phenomenology has played an especially significant role in the social sciences. However, despite the now century-long history of phenomenological theory in the social sciences, there has been remarkably little in the way of explicit or systematic reflection on what, exactly, social scientists are doing when they use phenomenology as theory or to theorize. In this article, we identify a largely unarticulated use of phenomenology, which stands between what we might call “grand theory” on the one hand and the “application of theory” on the other. Between these two poles, we find social scientists developing new theory intended to conceptualize a particular class of phenomena or domain of inquiry. We call this use “theorizing with phenomenology.” After identifying and unpacking some examples, we systematize its distinctive features and present it as an alternative mode of empirically anchored theorizing.

Current evidence suggests that the efficacy of psychedelic therapy depends, in part, on the character of psychedelic experiences themselves. One pronounced aspect of psychedelic experiences is alterations to the experience of time, including reports of timelessness or transcending time. However, how we should interpret such reports remains unclear, and this lack of clarity has philosophical and clinical implications. For instance, “true” timelessness may be considered antithetical to having any experience at all, and descriptions of experiences involving “timelessness” are known to be diverse and of varying clinical significance. In this article, we utilize a phenomenological approach to the study of temporality to highlight ambiguities in current constructs used to assess psychedelic experiences. In doing so, we advance some preliminary phenomenological accounts of psychedelic therapy’s mechanisms of action, such as psychedelic temporality acting as a kind of counterpoint for depressive temporality. We conclude by outlining how a dedicated phenomenological research program can provide a nuanced map of psychedelic temporality, guiding future research in a manner that addresses both philosophical and clinical ambiguities.

Psychedelic-assisted therapy (PAT) is an emerging intervention in psychiatry, for which there is preliminary evidence for effectiveness in eating disorders (EDs). The subjective psychedelic experience is considered an important driver of positive outcomes following PAT; however, conventional study design approaches often overlook many of the nuances inherent to the experience. Consequently, considerable information is lost between the first-person account and its scientific interpretation and documentation. Phenomenology—a philosophical and empirical approach to studying lived experience—offers tools to assess and understand the experiential mechanisms of PAT. This commentary advances the case for a phenomenological approach to PAT research in EDs, focusing on key domains of experience that underlie both ED psychopathology and psychedelic experiences, including embodiment, intersubjectivity, affectivity, temporality, spatiality and selfhood. We define and outline these phenomenological domains of EDs and psychedelic experiences and critically examine current measurement approaches. Following, we provide specific research recommendations, including phenomenologically grounded qualitative research and microphenomenology (i.e., the assessment of short-lived, pre-conscious experiences), to more fully capture psychedelic experiences and determine their significance for ED outcomes. The application of phenomenology to the PAT study design may contribute to a better understanding of how individuals experience PAT and generate testable hypotheses to advance psychedelic interventions.

Despite Martin Heidegger's famous analysis of Angst [anxiety] in Being and Time, contemporary phenomenologists have had surprisingly little to say about everyday experiences of anxiety—whether healthy or pathological. But Martin Vestergaard Kristiansen's recent work shows how phenomenology can provide a wealth of insight into the complexities and nuances of anxiety (Kristiansen, 2023a, 2023b). Moreover, his work demonstrates the central importance—perhaps even necessity—of conducting these studies empirically. The novelty of his insight is not found in armchair speculation or even critical reflection on existing texts. The novelty comes from the qualitative data generated by his phenomenologically grounded... Read More.

Illness and injury are often accompanied by experiences of bodily objectification. Medical treatments intended to restore the structure or function of the body may amplify these experiences of objectification by recasting the patient’s body as a biomedical object—something to be examined, measured, and manipulated. In this article, we contribute to the phenomenology of embodiment in illness and medicine by reexamining the results of a qualitative study of the experiences of nurses and patients isolated in an intensive care unit during the first wave of COVID-19. Drawing upon the phenomenological concept of embodiment—as developed in the work of Edmund Husserl, Maurice Merleau-Ponty, Jean-Paul Sartre, and Emmanuel Levinas—we reconsider how bodily objectification manifests in complex clinical encounters. We show that, in these settings, objectification is not simply the unilateral act of a clinician objectifying a patient. Rather, both clinicians and patients reported a variety of objectifying experiences influenced by their interactions, the immediate context of the intensive care milieu, and the broader atmosphere of a global pandemic. In light of these findings, we argue that bodily objectification in illness and medicine can often be more complicated than typically presented in the phenomenological literature.

In lieu of an abstract, here is a brief excerpt of the content:Priming and Narrative Habits in the Phenomenological InterviewReflections on a Study of Tourette SyndromeThe author reports no conflicts of interest.In "Dimensions, Not Types: On the Phenomenology of Premonitory Urges in Tourette Syndrome," Lisa Curtis-Wendlandt and Jack Reynolds provide new insights into some of the experiences characteristic of Tourette syndrome (TS). Their study is an excellent example of applied phenomenology (Burch, 2021), combining philosophy and qualitative research methods to illuminate experiences that have often been mischaracterized in the existing literature. In their study, they focus on what is commonly referred to as a "premonitory urge" (PU): the "anticipatory urge that is often thought to precede the onset of the motor and phonic tics that are part of Tourette Syndrome" (Curtis-Wendlandt & Reynolds, 2024, p. 26). They ask not only whether PU is a necessary feature of TS, but also whether the very concept of PU accurately portrays the experiences and behaviors that it's intended to refer to. They point out that existing scales used to assess PU, for example, seem to implicitly narrow the relevant experiences by assuming that they are a) always negative and b) always internal, or inwardly focused (Curtis-Wendlandt & Reynolds, 2024, 26). Curtis-Wendlandt and Reynolds question these in-built assumptions about PU, suggesting that they may provide an overly narrow depiction that misses the genuine diversity of experiences that precede the onset of a motor or phonic tic.To explore these phenomena in more detail, they conducted a study intended to elicit fresh descriptions of these experiences. They interviewed 12 teenagers with a diagnosis of TS about their experiences of ticcing and tic suppression. Using the micro-phenomenological method (Petitmengin, 2006), they asked participants to reflect on a specific tic or tic suppression event and to recall the event in detail. Throughout the interview, [End Page 43] they asked open-ended questions about sensory, cognitive, or affective experiences surrounding the event. Through these interviews, they were able to generate rich descriptions of these experiences and investigate how these descriptions differed from standard accounts in the existing literature.Curtis-Wendlandt and Reynolds provide a detailed account of how they designed their phenomenological study, both philosophically and empirically. However, there is an important aspect of their method that they discuss only in a cursory or implicit way, which is what I want to focus on here. Throughout their study, they were concerned that participants might simply parrot back well-worn medicalized characterizations of PU. Such characterizations risk simplifying or even occluding key aspects of the participants' experiences that might be difficult to reflect upon or describe. However, despite stressing the importance of eliciting fresh descriptions, Curtis-Wendlandt and Reynolds provide only glimpses of how the interviews actually unfolded and what kinds of techniques they used to elicit these descriptions.In my experience, it is quite common to hear phenomenological psychologists and psychiatrists express concern that people may simply repeat common psychiatric or medicalized characterizations of their condition, rather than genuinely reflect upon and describe their first-person experiences. The philosophical assumption is that we all fall back on culturally sedimented language and terminology when describing our experiences. Someone who has spent extended periods of time interacting with psychiatrists and other healthcare professionals, for example, is likely to have picked up common ways of describing their condition—ways that may have helped them receive a diagnosis or obtain treatment. There is nothing inherently wrong with falling into these culturally sedimented characterizations. They facilitate everyday communication through a shared language and terminology. But phenomenologists are often concerned that this kind of culturally sedimented language covers over or obscures the phenomenon or experience they are trying to investigate. For example, if a psychiatrist has often described their patient's depressed mood as "sadness," then that patient may be likely to self-describe their mood as sadness in an interview setting. It might, in fact, be the case that their mood is best described as sadness. But it could also be the case that their mood would be more accurately described as, for instance, a sense of emptiness or feeling deep despair. The challenge is therefore to know whether someone's self-description is...

In this chapter, we explain how Karl Jaspers’ concept of empathy can be expanded by drawing upon the tradition of philosophical phenomenology. In the first section, we offer an account of Jaspers' concepts of empathy and incomprehensibility as he develops them in General Psychopathology and “The Phenomenological Approach in Psychopathology.” In the second section, we survey the recent literature on overcoming Jaspers' notion of incomprehensibility and expanding his concept of empathy. In the third section, we outline the levels of investigation at which phenomenological inquiries into psychopathology may proceed. These levels of human existence are, in descending order of depth, (1) phenomenal experiences, (2) interpretive frameworks, (3) modes of existence, and (4) existentials. In the fourth and final section, we argue that to fully empathically comprehend patients with schizophrenia and other mental disorders, the possibility of alterations at all four levels of existence must be acknowledged.

This chapter provides an overview of how existential phenomenology has influenced qualitative research methods across a range of disciplines across the social, health, educational, and psychological sciences. It focuses specifically on how the concepts of “existential structures,” or “existentials”—such as selfhood, temporality, spatiality, affectivity, and embodiment—have been used in qualitative research. After providing a brief introduction to what qualitative research is and why philosophers should be interested in it, the chapter provides clear, straightforward examples of how qualitative researchers have used existentials to analyze qualitative data and design qualitative studies. The chapter is intended to introduce philosophers to existential approaches to phenomenological qualitative research, with the aim of facilitating interdisciplinary dialogue and collaboration.

The proper relationship between phenomenology and naturalism has reemerged as a pressing issue following interdisciplinary developments in the cognitive sciences. Most solutions opt for a naturalized phenomenology, rather than a phenomenological naturalism. This article takes up the latter approach, confronting the implications of Merleau-Ponty's reformulation of Husserl's paradox of subjectivity. I argue that Merleau-Ponty's formulation—which I term “the paradox of madness”—reveals a deep, ontological contingency in what Husserl took to be necessary transcendental structures of consciousness and world, revealing that these transcendental structures are in fact embedded in and contaminated by the very world they constitute and disclose.

In this article, we develop a new approach to integrating philosophical phenomenology with qualitative research. The approach uses phenomenology’s concepts, namely existentials, rather than methods such as the epoché or reductions. We here introduce the approach to both philosophers and qualitative researchers, as we believe that these studies are best conducted through interdisciplinary collaboration. In section 1, we review the debate over phenomenology’s role in qualitative research and argue that qualitative theorists have not taken full advantage of what philosophical phenomenology has to offer, thus motivating the need for new approaches. In section 2, we introduce our alternative approach, which we call Phenomenologically Grounded Qualitative Research (PGQR). Drawing parallels with phenomenology’s applications in the cognitive sciences, we explain how phenomenological grounding can be used to conceptually front-load a qualitative study, establishing an explicit focus on one or more structures of human existence, or of our being in the world. In section 3, we illustrate this approach with an example of a qualitative study carried out by one of the authors: a study of the existential impact of early parental bereavement. In section 4, we clarify the kind of knowledge that phenomenologically grounded studies generate and how it may be integrated with existing approaches.

Psychedelic-Assisted Psychotherapy is being investigated as a treatment for a range of psychiatric illnesses. Current research suggests that the kinds of subjective experiences induced by psychedelic compounds play key roles in producing therapeutic outcomes. To date, most knowledge of therapeutic psychedelic experiences are derived from psychometric assessments with scales such as the Mystical Experience Questionnaire. While these approaches are insightful, more nuanced and detailed descriptions of psychedelic-induced changes to subjective experience are required. Drawing on recent advancements in qualitative methods arising from the interdisciplinary field of phenomenological psychopathology, we propose a systematic and comprehensive investigation into how Psychedelic-Assisted Psychotherapy alters subjective experience. This research program aims to characterise the nature of therapeutic psychedelic experiences by drawing on concepts from philosophical phenomenology. Such characterisations should, moreover, contribute to our understanding of the mechanisms of psychedelic therapy, the role of integration therapy, and related philosophical debates.

Recently, there have been calls to develop a more contextual approach to phenomenological psychopathology—an approach that attends to the socio-cultural as well as personal and biographical factors that shape experiences of mental illness. In this Perspective article, we argue that to develop this contextual approach, phenomenological psychopathology should adopt a new paradigm case. For decades, schizophrenia has served as the paradigmatic example of a condition that can be better understood through phenomenological investigation. And recent calls for a contextual approach continue to use schizophrenia as their primary example. We argue, in contrast, that substance misuse provides a better paradigm case around which to develop a contextually sensitive phenomenological psychopathology. After providing a brief vignette and analysis of a case of substance misuse, we explain why this kind of condition requires considerable sensitivity and attention to context, better motivating the incorporation and development of new contextually sensitive approaches.

In this chapter, I introduce phenomenology and phenomenological psychopathology by clarifying the kind of implicit experiences that phenomenologists are concerned with. In section one, I introduce the phenomenological concept of pre-reflective experience, focusing especially on its relation to the concept of implicit experience. In section two, I introduce the structure of pre-reflective self-consciousness, which has been studied extensively by both classical phenomenologists and contemporary phenomenological psychopathologists. In section three, I show how phenomenological psychopathologists rely on an account of pre-reflective self-consciousness to better understand the experience of schizophrenia and I outline some of the methodological challenges that arise in this field of research. This introduction should facilitate critical engagement and collaboration between phenomenologists and researchers working across a variety of disciplines, including psychology, psychiatry, the cognitive sciences, and analytic philosophy of mind.

Phenomenology has been adapted for use in qualitative health research, where it’s often used as a method for conducting interviews and analyzing interview data. But how can phenomenologists study subjects who cannot accurately reflect upon or report their own experiences, for instance, because of a psychiatric or neurological disorder? For conditions like these, qualitative researchers may gain more insight by conducting observational studies in lieu of, or in conjunction with, interviews. In this article, we introduce a phenomenological approach to conducting this kind of observational research. The approach relies on conceptual grounding to focus a study on specific aspects of the participants’ experiences. Moreover, the approach maintains the openness to novel discoveries that qualitative research requires while also providing a structured framework for data collection and analysis. To illustrate its practical application, we use examples of hemispatial neglect—a neurologic disorder in which patients characteristically lack awareness of their own illness and bodily capacities. However, the approach that we describe can be applied more broadly to the study of complex illness experiences and other experiential alterations.

Currently, anomalous lived temporality is not included in the main diagnostic criteria or standard symptom checklists. In this article, we present the Transdiagnostic Assessment of Temporal Experience, a structured interview that can be used by researchers and clinicians without a comprehensive phenomenological background to explore abnormal time experiences in persons with abnormal mental conditions regardless of their diagnosis. When extensive data gathered by this scale are available, it will be possible to delineate well-defined anomalous lived temporality profiles for each psychopathological disorder. This instrument may also prove useful for clinicians by providing a more refined assessment of relevant psychopathological symptoms and an in-depth understanding of the patient’s abnormal behaviour as related to specific types of time experience. In the first part of the article, we provide a brief overview of the phenomenological concept of temporality, including pre-phenomenal and phenomenal time, synthesis, conation and synchronization, and of abnormal time experiences in persons affected by psychopathological conditions. In the following part, we describe the basic structure of the interview that comprises seven categories corresponding to the abnormal features of lived temporality: anomalies of synchrony, of time structure, of implicit time flow, of explicit time flow, and anomalous experiences of the past, the present and the future. The paper also includes a section on administration and scoring of the TATE scale, the complete interview and a Likert table for quantifying the frequency, intensity and interference with daily life of the phenomena explored.

Today, many philosophers write on topics of contemporary interest, such as emerging technologies, scientific advancements, or major political events. However, many of these reflections, while philosophically valuable, fail to contribute to those who may benefit the most from them. In this article, we discuss our own experience of engaging with nursing researchers and practicing nurses. By drawing on the field of philosophical phenomenology, we intervene in a longstanding debate over the meaning of “empathy” in nursing, which has important implications for nursing research, training, and practice. However, our intention is not only to introduce and discuss this philosophical intervention. Rather, we present this intervention as a model for how philosophers might successfully engage with the field of nursing, and perhaps with other fields as well, with the aim of effecting positive change in research or practice. The article proceeds in five parts. First, we introduce the problem of conceptual clarity in nursing and explain why many nursing concepts are still in need of refinement. Second, we discuss the origins of the concept of empathy in nursing and outline the challenges associated with borrowing theory from other fields. Third, we explain how nurses tend to conceptualize empathy today, drawing upon the psychological distinction between cognitive and emotional empathy. Fourth, we discuss our intervention in this debate and explain how we attempt to resolve existing conceptual confusions by developing the concept of empathy from the ground up. Fifth, we conclude by briefly reflecting upon some of the challenges of interdisciplinary engagement and providing some recommendations based upon our own experience.

Aims and Objectives. This article uses the concept of embodiment to demonstrate a conceptual approach to applied phenomenology. Background. Traditionally, qualitative researchers and healthcare professionals have been taught phenomenological methods, such as the epoché, reduction, or bracketing. These methods are typically construed as a way of avoiding biases so that one may attend to the phenomena in an open and unprejudiced way. However, it has also been argued that qualitative researchers and healthcare professionals can benefit from phenomenology’s well-articulated theoretical framework, which consists of core concepts, such as selfhood, empathy, temporality, spatiality, affectivity, and embodiment. Design. This is a discursive article that demonstrates a conceptual approach to applied phenomenology. Method. To outline and explain this approach to applied phenomenology, the Discussion section walks the reader through four stages of phenomenology, which progress incrementally from the most theoretical to the most practical. Discussion. Part one introduces the philosophical concept of embodiment, which can be applied broadly to any human subject. Part two shows how philosophically trained phenomenologists use the concept of embodiment to describe general features of illness and disability. Part three illustrates how the phenomenological concept of embodiment can inform empirical qualitative studies and reflects on the challenges of integrating philosophy and qualitative research. Part four turns to phenomenology’s application in clinical practice and outlines a workshop model that guides clinicians through the process of using phenomenological concepts to better understand patient experience. Conclusion and Relevance to Clinical Practice. A conceptual approach to applied phenomenology provides a valuable alternative to traditional methodological approaches. Phenomenological concepts provide a foundation for better understanding patient experience in both qualitative health research and clinical practice, and therefore provide resources for enhancing patient care.