Phenomena Journal - International Journal of Psychopathology, Neuroscience and Psychotherapy

Time is everywhere and nowhere

Giuseppe Errico — Fri, 01 Mar 2024 00:00:00 +0000

The following analyses on inner time, in the psychological-psychiatric field, includes the addresses, research and studies of the main authors, mainly psychiatrists, philosophers, psychotherapists, who have analyzed lived time, hypertime and chronodesis. The author's clinical reflections on the relationship 'lived time/dark suffering' are collected. Thus, the difficult theme running through the present research is the analysis of the temporal constitution in patients in states of psychic suffering, the failure at the psychic level of a healthy understanding of temporal phenomena (temporal distortions). The focus is thus on the epistemological fulcrums, factors and filters related to the constructions, distortions and alterations of temporal experiences during a state of psychic suffering. The author's work in the field of the treatment of temporality focuses on fundamental themes: dark suffering/consciousness in the experience of time, hypertime (the 'tyranny of the present' in our historical horizon), and chronodesis in patients (the link to temporal horizons). This research, the subject of a series of analyses by the writer, is often underestimated by clinicians for therapeutic purposes. In the psychological-psychiatric field, the analysis of many psychic disorders focuses mainly on unconscious or relational processes and, almost never, on a deep understanding of the patient's lived time. To clinicians, the understanding of lived time mistakenly appears to be of little use and of little methodological rigour. However, the reference to the temporal paradigm opens up new perspectives for therapeutic research that may enable us to gain ground on the cure.

The Working on the emotion of anger in panic disorder: a phenomenological-existential and Gestalt psychotherapy approach

Fri, 01 Mar 2024 00:00:00 +0000

Panic disorder is currently one of the most widespread anxiety disorders in Western countries. The authors, psychologists and Gestalt psychotherapists, have observed in their psychotherapeutic settings some recurring tendencies in people who report panic attack symptoms. In the narratives of the latter there is often a failure to assume clear and defined positions within one's emotional, relational and professional life. In addition to being a manifestation of anxiety and fear, the authors hypothesize that in panic disorder there is existential and relational distress connected to inadequate anger management. The frequently reported experience concerns the inability to refuse to do something you don't want and the consequent sense of frustration and anxiety. According to a vision of Gestalt therapy, a person feels anger when he does not get what he wants, or when he finds himself in a territorial conflict. From here derive the different actions relating to the manifestation of anger itself. This article illustrates a proposal for an intervention study on the expression of the experience of anger connected to panic attacks. From a phenomenological-descriptive perspective, the authors will collect the lived experience of anger connected to panic disorder through a semi-structured interview. The information collected will be useful to outline the elements of a descriptive psychopathology of anger connected to panic disorder in a Gestalt perspective.

The phenomenal field: the origin of the self and the world

Gianni Francesetti — Thu, 07 Mar 2024 00:00:00 +0000

From the broad debate on the definition of the field in Gestalt psychotherapy, many questions emerge that often reflect diverse conceptions present since the cultural and scientific background from which this model was born. Beyond the differences, all attempt to move beyond a conception of the human being as an isolated and isolable individual. Among the many cruxes of this discourse, I believe that a central question for discriminating the definition we use - implicitly or explicitly - is this: is the field different for each subject, or is it a common dimension for those in a given situation?

This question cannot find an answer unless we first specify what we mean by "field." My argument is that there is a definition of the field for which the field is individual (organism-environment field) and another definition for which the field is a common dimension (phenomenal field). Obviously, each allows us to grasp some aspects that the other leaves in shadow. And I consider the two conceptualizations as an expression of the insoluble tension and oscillation between an individualistic perspective and a pre-personal one.

In the atmosphere of incredible cultural ferment in Germany in the 1920s, the drive to go beyond an individualistic conceptualization of the human being involved many movements and modes of exploration: in philosophy, psychology, sociology, politics, and psychoanalysis. A glowing crucible rich in possibilities and nuances, an emerging state in which attempts to move beyond a mechanistic and reductionistic view of the world and human being moved in sometimes contradictory ways. Gestalt psychotherapy has deep roots in this environment, developing its therapeutic potentials and bringing with it some theoretical ambiguities. One of these concerns precisely the conceptualization of the field: indeed, there were circulating conceptualizations of the field as predominantly individual attribute, as well as as a totality that involves everyone and constitutes the very root of life.

Jean-Luc Marion notes that one of the characteristic and constitutive traits of our culture is the removal of genesis, that is, how the self and the world come into being, take shape. They are given and not problematized. Marion emphasizes that what is given is donated and problematizes: given as, when, where, by whom? In order to use the concept of the individual as the center of the world, as Western modernity has done, it is necessary to 'forget' its origin, as if there has always been a separate, independent, even self-sufficient subject. Center of the world and measure of all things. Already posing the question is therefore somehow subversive.

If the self is an emergent phenomenon that in the making of experience differs from a world, to explore its genesis we need a theory of experience. Gestalt psychotherapy elaborates this theory starting from Gestalt psychology and American Pragmatism, another profound influence for the birth of this approach. In particular, it was Paul Goodman, a librarian at the University of Chicago, who brought the concepts of William James, John Dewey, and George Herbert Mead into the foundation of Gestalt psychotherapy. This is not the place to delve into the complexity of this theory of experience, and we refer to the founding text for a thorough description [3] and to subsequent texts [4; 5; 6; 7; 8; 9] for the clinical and psychopathological implications of this process. It is enough to remember here that experience is a process that arises from an undifferentiated background and in which a boundary of contact gradually emerges that separates and unites a self and a world. From this original dimension, subjects and objects emerge: "Neither the object, nor the subject are placed" [10].

Here we are grappling with a phenomenon that is difficult to describe and easily neglected: as Bernhard Waldenfels writes, only apparently paradoxically, "we originate from elsewhere, in a place where we have never been and will never be." We emerge from a background in which we are not yet constituted as distinct subjects in a distinct world. We are here in the auroral chiaroscuro of experience. Object and subject are nominal precipitates - they have become 'things' - as a result of a historical transformation of their linguistic connotation: until the Middle Ages they were considered a process in which a sub-jectum was thrown here and an ob-jectum was thrown there [12]. This origin is the place of the vague and the confused, of the undifferentiated, of the chiaroscuro, of the indefinite [13]: a place that Descartes discarded indicating a method of inquiry based on clear and distinct ideas and that positivist science then swept away, producing as an effect the disenchantment of the world where everything is mechanically knowable and transparent [14]. There is therefore a dimension "neither subjective nor objective" [15], a dimension "prior to the subject and the world" [16], mostly neglected in modernity. Indeed, this removal is constitutive of the very birth of modernity.

Merleau-Ponty calls this emerging dimension the "phenomenal field" [10]: this is the undifferentiated field - before the poles of the subject and the world are defined - from which phenomena emerge. It is the threshold of the world and the self. In this field (just as in Maxwell and Faraday's electromagnetic field and in Einstein's conceptualized gravitational field) there are forces that condition the emergence of phenomena. These are the intrinsic tensions of the field - the intentionality of the field. Intentionality can be understood as a force that belongs to individuals, but this is not the meaning we refer to here. We refer to the anonymous intentionality that precedes individuals, as conceptualized by Merleau-Ponty: "We are only a place of passage" [10]. As Martin Heidegger argues: "In the heart of consciousness there is always a depersonalization." They are anonymous (that is, not yet mine or yours) and they are functional (that is, they produce effects) [10].

Experience therefore arises from the undifferentiated, a place where the poles of the subject and the world have not yet been defined. Infant research [17], neuroscience [18], phenomenology, and phenomenological psychopathology [19; 20] also agree on this.

Attempting a definition as clear and operational as possible, I define this phenomenal field as the horizon of probability of emergence of phenomena in the current situation. This definition allows us to explore field theory in the light of complex systems theory, see Sarasso et al. [25, in press]. Phenomena (or we can also say figure-ground processes) emerge depending on the forces that make them more or less probable or improbable. These forces bend the horizon, deform it, and open or close possibilities. For example, at a party among friends, it is more likely that jokes and laughter, moments of joy, and feelings of lightness will emerge, during which time will tend to pass quickly. In a funeral wake, on the other hand, it is more likely that feelings of heaviness, slowing down or rarefaction of time, gloominess, and stillness will emerge. In black holes, the force that bends the event horizon is gravity; in the phenomenal field, it is the intentions at play that bend it. In the therapeutic encounter, these forces - embodied intentions - move both the patient and the therapist, who are functions of them. In this paradigm - where the self is not a structure but a process that emerges in the situation - the forces of the phenomenal field are in motion before the subjects are differentiated and defined. Therefore, we can say that the therapist and the patient emerge, "are made," within the situation and are moved by the forces of the field. The phenomenal field is pathos: it is undergone and not chosen [11; 21]. The phenomenal field is not "a thing," it is not reifiable: it is a horizon and it changes - more or less - at every moment.

The phenomenal field acts here and now, and just like a gravitational field, I can grasp it by sensing its effects. The gravitational field here and now is common; the effects on each of us are different. Conceptualizing the field as an organism-environment field helps us not to abstract the organism from its environment but maintains an individual centrality; conceptualizing the field as a phenomenal field helps us to highlight the forces to which we are all subjected in a given situation. The phenomenal field (horizon of probability) therefore results from the set of forces acting in the situation; these give it its limits and transformative potentials. They are the dynamic forces activated in a given situation. It is important to remember that the phenomenal field is in turn influenced by the emergences that develop; for this reason, it is a constantly changing process. Again, we can use the gravitational field as an example: bodies subjected to the influence of the gravitational field also influence the field itself, in proportion to their mass. In the clinical encounter, patient and therapist are therefore subjected to the forces of the field and at the same time influence them, in a process of circular complexity not reducible to simple cause-effect schematizations.

One way to grasp the phenomenal field is to pay attention to the atmosphere of the situation. An atmosphere is the affective quality that permeates a space. It is a concept that we have explored starting from its interesting characteristic of resisting and challenging Cartesian dichotomies: an atmosphere is neither solely in the environment nor solely in the subject, it is neither solely subjective nor solely objective, neither solely agentive nor solely suffered. Let's leave aside the broad and lively debate on the theme of atmospheres in clinical practice and instead take up a quote from Kurt Lewin:

"To adequately characterize the psychological field, specific elements must be taken into consideration, such as particular objectives, stimuli, needs, relationships, as well as more general characteristics of the field such as atmosphere (for example, friendly, tense, or hostile atmosphere) or the amount of freedom. These characteristics of the field as a whole are as important in psychology as, for example, the field of gravity for explaining events in classical physics. Psychological atmospheres are empirical realities and are scientifically describable facts" [23, author's translation, emphasis in the original].

The gravitational field is not just a metaphor for the phenomenal field: it is one of the forces that act in the phenomenal fields from which we emerge and that curve the probabilities of the emergence of phenomena. Just imagine if the field were to change as in a spacecraft: other experiential phenomena - sensory and motor - would emerge. The fact that it is a common field does not negate that it has different effects for each individual: the effects of the gravitational field are different for each of us, just use a scale to measure them. Yet we are all subject to the same force. In turn, we influence the field itself, imperceptibly for gravity, potentially significantly for other types of acting forces. In a depressive field present in a given situation, we are all subject to depressive forces - that is, forces that pull us down - and we may experience slowed time, or conversely, manic reactivity or binge eating or alcohol abuse, or countless other possibilities. But the forces of the depressive phenomenal field influence all those who find themselves in the situation.

The method of Conscious Creative Embodied Aesthetic Experience®: from a bio-psycho-social perspective

Fri, 01 Mar 2024 00:00:00 +0000

Abstract in inglese: Important contributions to the definition of aesthetics and creativity seize the contemporary paradigm shift, which highlights the inescapable embodied dimension of human intelligence and creativity, drawing inspiration and also important prompts to redefine notions, concepts and theories from it. In order to develop an ethical and aesthetic sensibility, in which body consciousness plays a fundamental role, it seemed essential to start from the epistemological aspects, and then to dwell on "how" it happens and "what" emerges from the relation between art and science. This relation, thanks to the interaction with an artistic product, allowed the collision of two worlds: the one of the artist and the one of the artistic user. From the observation of the quality of this connection, it emerges a poetic and poietic connotation of new links and, therefore, new sensations that are added to the mental construction of the world; this allows us to open to new possibilities to express the creativity of the human mind and to overcome any form of stereotype, judgment and prejudice, to which we are increasingly exposed. Starting from the Archetypes and the latest research in the field of neuroaesthetics, we aim to use in the discipline of psychosomatics and as a pedagogical approach to art a bio-psycho-social method called "Conscious Creative Embodied Aesthetic Experience"®. From a Gestalt perspective, this methodological hypothesis helps understand the mechanisms and processes that underlie the transitions between the individual and the environment, allowing a healthy development of the creative self. This methodological proposal blends bodily techniques with imaginative ones through guided visualization and gestural interpretation of a work of art, to enable the initiation of psycho-body empowerment and the creative management of one's emotional world. The aforementioned method, with its now decade-long testing, has already been used as a Medical Humanities intervention in the Local Health Authority, Rehabilitation Centers, and University Courses. In this pilot study, the effectiveness of the method was monitored by participatory observations led by psychologists, who collected participants' personal post-laboratory experiences; in addition, a self-assessment questionnaire about the quality of nonverbal communication was used: the Diade Rev.3. In order to support the co-creation of the relational experience during the workshops, the personal perceptions of each participant were collected and then archived in an e-book. The goal was to develop a pathway of bodily reappropriation and imitative decoding of the artwork in order to activate the empathic experience through the exploration of the motor aspect, life skills, creativity, coping skills and the improvement of relational skills. Thanks to this experience, it was possible to become aware of deep aspects of one's psychological and existential reality and to initiate a process of solving conflicts and sharing their meaning in order to make culture out of them.

Trauma psychotherapy and blended intervention: a hypothesis of integrated model

Thu, 04 Apr 2024 00:00:00 +0000

The article presented below represents the second work of an in-depth project on the topic of psychotraumatology and the integration of blended intervention in clinical practice. In recent years, the field of mental health, like and more than others, has found itself facing the advent of a collective trauma (the SARS-CoV-2 o COVID-19 pandemic), which has generated the need to delve deeper into how and to what extent traumatic events can impact on personal and collective health and how to intervene in the way that best responds to people's needs. The present work delves into these aspects in a peculiar way, starting from the examination of the origins of the clinical psychotherapeutic interest in trauma, the history of its definition, the most currently significant intervention methodologies, to end with a proposal for integrated intervention of the various clinical models and the blended methodology.

Acceptance and Alliance

Francesco Mercadante, Elena Gigante — Thu, 04 Apr 2024 00:00:00 +0000

A fragment of a psychotherapeutic session is exposed here and explained along the continuum of the therapeutic process and the bond between professional and patient: in particular, the core of the investigation consists of the analysis of the functional concepts of acceptance and alliance, an analysis aimed at re-examining of methods, relations and objectives. The originality of the work, in fact, is revealed in the analysis of the language system within which the figures of speech take shape. Repetitions and their semantic function, ambiguity and vagueness as elements of the approximation of meaning and other phenomena of communicative intention are indicators of the interaction between the organism and the environment of which the authors take care, in an attempt to illustrate a different path of self-realization, in which discomfort can appear in the forms of awareness.

Work and Organizational Psychology in Healthcare Systems

Fri, 01 Mar 2024 00:00:00 +0000

Since the beginning of the pandemic, healthcare personnel have faced serious difficulties and continuous emergencies, highlighting the increasing need for psychological support for those dealing with such challenges. In a mental health prevention perspective for those who should provide 'health,' it would be desirable to develop a healthcare policy that includes the structured integration of work and organizational psychology inhealthcare contexts. Aligned with the objectives of the "New guarantee system for monitoring healthcare" (DM 12 March 2019 published in the Official Gazette on 14 June 2019, operational from 1 January 2020), which, in collective prevention, describes the well-being of organizational and workplace indicators that deliver health, we aim to analyze the needs and challenges in this regard. This study proposes an initial review of the literature on the current presence/absence of structured interventions in work and organizational psychology in healthcare systems to analyze the actual policies of healthcare facilities, considering that realizing such presence is not simple. It would open the door to questions about effective healthcare planning, the recruitment and allocation of human resources, and management leadership; inefficiency that is proven to be a co-cause of organizational distress, operator burnout, and malpractice. With the long-term goal of proactively developing a specific line of activity, distinct from clinical psychology, in healthcare settings, we express an innovative position useful to operators and healthcare companies. They could benefit from a specific role and function that guides, with its presence and function, the culture and consciousness of the organization towards the correct management of human resources and systematically provides the necessary psychological support to operators in order to deliver well-being and not distress to users.