BACKGROUND:The schizoidism-syntony dyad offers a good start for a comprehensive view of psychopathology. Rooted in schizophrenia and manic-depressive illness in Kretschmer's characterology, these concepts gained prominence, under Bleuler and Minkowski, as expressions of personal relational patterns to the environment. SUMMARY:It seems insightful, therefore, to compare the concepts to the organism-environment relationship in autopoiesis and 4E cognition, anticipated in Plessner's biological phenomenology. This paper outlines schizoidism and syntony, which have positive features but become psychoses in their extremes. The paper then briefly approaches the organism-environment coupling in autopoiesis and 4E cognition before finally discussing schizoidism and syntony within this framework. KEY MESSAGES:Schizoidism-syntony is akin to decentered-centered (Plessner) and to Körper-Leib, and is also correlated with other dyads. Schizoidism and syntony may share profound commonalities with 4E cognition and, especially considering the enactive approach, with the autopoietic notion of sense-making. This work supports those psychopathologists who have identified a fluid relationship between symptom complexes and the normal psyche. It aligns with the relevance of interdisciplinary enlightenment in the cognitive sciences, particularly highlighting psychopathology.
INTRODUCTION:Network analysis shifts psychopathology research from latent variables to symptom interactions. While mainly cognitive-behavioral, its convergence with psychodynamic theories remains underexplored. This review maps empirical studies combining psychodynamic constructs and network models. METHODS:Following JBI and PRISMA-ScR guidelines, databases (2008-2025) were searched for studies linking both approaches. RESULTS:Fifteen studies (N = 13,771 participants) identified three recurrent psychodynamic domains: personality organization, mentalization, and attachment; as central or bridge nodes within networks (mostly graphical Gaussian models). CONCLUSIONS:This tri-axial architecture supports the central role of psychodynamic concepts within psychopathology. Network analysis appears promising for operationalizing selected psychodynamic constructs and for examining their position within broader psychopathological systems, although its capacity to capture psychodynamic processes remains limited in cross-sectional designs.
BACKGROUND:Personality and personality disorders (PDs) are closely related constructs, but the nature of their relationship remains uncertain. Dimensional models suggest PDs are extreme manifestations of personality traits. We investigated the etiological links between broad personality factors and dimensional PD factors using quantitative analyses of common and unique genetic and environmental etiological factors affecting both normative and deviant personality, emphasizing methods to minimize measurement bias. METHODS:Seven national twin cohorts participated (N = 2,353 twins from 1,188 families), assessing personality traits with questionnaires across three adolescent waves and personality disorder traits via age-19 clinical interviews. Exploratory factor analyses of personality traits and the three-cluster ABC factors of PDs simplified the factor structure of the measures. Biometric twin analyses with Cholesky modeling identified genetic and environmental links among factors. RESULTS:factor analysis of Personality traits yielded Non-resilient, Disinhibited, and Disaffected factors. PDs fit an Emotional/Erratic, Anxious/Fearful, and Odd/Eccentric factor structure. Phenotypic correlations varied, but the Disinhibited factor had minimal relations to specific PD factors. Crucially, approximately one-third of the genetic variance was shared between personality and PDs. However, the majority of genetic variance and all non-shared environmental variance were trait specific suggesting predominantly distinct etiological pathways. CONCLUSION:The significant genetic overlap supports the continuum model, results bolstered by using broad factors and method triangulation. However, unique genetic and environmental influences point to distinct etiological pathways differentiating personality and PDs. These findings endorse the continuum model yet highlight the need for further research to grasp the complex relationships between personality and PDs.
Autistic patterns of language use, including echolalia, gestalt language processing, and formulaic repetition, have been theorized largely within behavioral and developmental frameworks. Such accounts have documented the functional range of these phenomena in valuable detail, yet their experiential structure has received little attention. This paper develops a phenomenological account of autistic language and temporality. We argue that echolalia and gestalt language are best understood not as deficient approximations of normative speech but as expressions of a distinctly structured temporal consciousness. Drawing on Husserl's analysis of inner time-consciousness and Merleau-Ponty's account of bodily intentionality, we propose that autistic temporal experience may be marked by a heightened density of the present moment, a configuration in which retention and protention are differently weighted and in which the instant attains a relative closure that canonical phenomenological accounts do not anticipate. Gestalt language, read in this light, appears less as a failure of analytic decomposition than as a mode of meaning-making that preserves semantic wholes rooted in bodily-affective memory. The argument carries implications for both phenomenological theory and clinical practice: it questions the assumption of a universal temporal substrate underlying language acquisition, and it motivates a clinical reorientation from suppressing echolalia toward interpreting it.
Introduction: In the past 2 decades, phenomenological interviews have been used in psychopathological research, mostly in schizophrenia, demonstrating how psychopathology and psychiatry can benefit from phenomenology. For autism spectrum condition, there was no such an interview, which is why we designed the Examination of Autistic Intersubjective Experience (EAIE). Methods: In the present study, we conducted the EAIE with 20 autistic and 20 non-autistic individuals. Results: Our results showed considerable differences between the two study groups in the total score and in each domain. For the total EAIE scores, we found good internal consistency, but this was insufficient for the individual domains, with two exceptions. Interrater reliability was almost 0.9, while intrarater reliability was 0.6 after repeating the interview almost 2 years later. Conclusion: We demonstrated the viability of utilizing the EAIE to assess, quantify, and investigate subjective anomalies in the experience of intersubjectivity among autistic individuals. Due to the low internal consistency, we recommend focusing predominantly on the total scores if EAIE is intended for quantitative assessment of deviations in social interaction rather than for qualitative evaluation.
INTRODUCTION:Rage attacks (RA) are prevalent in patients with Tourette syndrome (TS) and affect their quality of life severely. Due to TS's relationship with attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD), a genetic reason or an increased level of irritability from early in life could be hypothesized. This longitudinal study aimed to examine the correlation between tic severity and comorbidities and RA at baseline and 6 years later. We hypothesize that a higher symptom load of TS and comorbidities results in more RA. METHODS:We examined 314 patients with TS (age 5-19) at baseline and re-examined 227 patients 6 years later together with a matched control group using various instruments to assess the severity of tics, ADHD, OCD, and the presence of RA. RESULTS:Patients experienced more RA than control subjects at both time points. Patients with RA at baseline had more compulsions and higher ADHD scores at baseline than patients without RA, but this difference was not seen at follow-up. Patients with RA at follow-up had higher ADHD scores at baseline. Tic severity was worse in patients with RA at both time points but was lower in the group who had developed RA at T2. CONCLUSION:Patients with TS had significantly more RA than control subjects. The severity of compulsions and ADHD correlated with the presence of RA, and higher ADHD scores early in life correlated with the presence of RA in adolescence. This suggests that it is important to screen for the presence of RA in patients with TS - especially in patients who also have comorbid ADHD and/or OCD.
Background: An involuntary hospitalization (IH) for treatment purpose is initiated when a person refuses admission while clinicians consider them severely mentally ill and in urgent need of treatment to improve their condition. Qualitative studies of IH patients show that patients later describe mixed experiences and consequences of IH. No study has examined in-depth with views from different perspectives what the disagreement on need of care consists of. Aim: This study wants to explore convergences and divergences in perspectives within triads of patients with non-affective psychosis involuntarily hospitalized for treatment purpose, their relatives, and professionals involved in the same IH focusing on the period prior to IH, experiences of hospitalization, and the outcome of IH. Method: Qualitative interviews were conducted when the patients were in a stabilized phase. The description of each patient’s condition in the chart was discussed with the patient in question. Interviews were thematically analyzed, and the three different perspectives were triangulated. Results: We found divergences within triads on the need for and outcome of IH, the notion of illness, and the expectations of the hospital treatment. Most patients did not feel ill or in need of treatment. Most professionals and relatives deemed IH necessary, but many relatives were dissatisfied with the outcome. All participants emphasized the hospital’s lack of capacity. Conclusion: This triangulation study on IH highlights the complexity of this intervention, revealing a fundamental divergence between the perspectives of patients, experiencing their psychotic condition as meaningful, the hospital system responding primarily with a medical perspective, and the relatives desiring a more personalized approach.
INTRODUCTION:Various governments around the world implemented stay-at-home orders, colloquially known as lockdowns, in response to the COVID-19 pandemic. Existing research suggests that these lockdowns had significant impacts upon the lived experiences of temporality of many people, with widespread reports of anomalous experiences of temporal passage and difficulties with judgements of temporal duration. METHODS:We conducted a phenomenologically framed online survey of 830 people in the state of Victoria, Australia, focused on temporal experiences of the state's COVID-19 pandemic lockdowns in 2020 and 2021. This survey used an adjusted version of the Transdiagnostic Assessment of Temporal Experience (TATE) scale to get clearer about the frequency of the temporal anomalies and disruptions of these lockdowns. RESULTS:Our survey results confirm much of the existing research regarding the widespread prevalence of anomalous temporal experiences. In particular, we found that around half of our participants reported slowness, feeling out of sync (with others and the world), and persistent worry about the future during the lockdowns, with these reported disruptions falling sharply after restrictions ended in late 2021. CONCLUSION:By juxtaposing these survey results with existing work in the phenomenology of depression, we contend that many people experienced depressive-like temporal experiences under lockdown. We also outline the need for further phenomenologically informed research of this kind, which conjoins both qualitative and quantitative methods.
Introduction: Evidence suggests that childhood maltreatment is associated with adult psychopathology, including borderline personality disorder (BPD). Mentalizing and attachment styles (anxiety and avoidance) are implicated in psychopathology development and maintenance of psychopathology, and may serve as treatment targets. Methods: This study investigated (1) associations between childhood maltreatment (severity and multiplicity) and adult psychopathology (psychological distress and BPD symptoms), and (2) indirect effects of mentalizing, anxious attachment style, and avoidant attachment style. Using structural equation modeling and network analysis, we tested these relationships in a cross-sectional sample of 340 participants. Results: Results supported a dose-response relationship between maltreatment and adult psychopathology, with both severity and multiplicity significantly associated with increased psychological distress. Mentalizing exhibited a partial indirect effect in this association, as lower mentalizing was related to higher levels of psychopathology. Attachment anxiety demonstrated an indirect effect across the maltreatment-psychopathology relationship, whereas attachment avoidance was not found to be a meaningful indirect pathway. Notably, mentalizing difficulties emerged as the strongest indirect pathway across all models, highlighting mentalizing interventions as promising transdiagnostic approaches for mitigating the psychological impacts of childhood trauma. Exploratory network analysis broadly converged with these findings, showing that mentalizing and attachment anxiety were uniquely associated with psychopathology after controlling for all other variables in the network, whereas attachment avoidance occupied a peripheral position. Conclusion: Overall, these results enhance understanding of mechanisms linking early adversity to adult psychopathology, emphasizing the importance of interventions addressing transdiagnostic risk factors such as mentalizing difficulties and heightened attachment anxiety.
BACKGROUND:Contemporary psychiatry has advanced by decomposing behavior into discrete constructs, improving reliability but fragmenting conceptual foundations. Excessive comorbidity, blurred diagnostic boundaries, and the reification of operational criteria have created a gap between empirical data and the understanding of mental life as a coherent, lived whole - the modern paradox of "more data, less coherence." SUMMARY:We revisit Karl Jaspers' notion of the whole of psychic life (Ganze des Seelenlebens) as a foundational reference. After clarifying Jaspers' methodological framework - emphasizing the complementary roles of phenomenological description, understanding (Verstehen), and causal explanation (Erklären) - we propose an "upframing" of his concept through 5 guiding principles: relationality, historicity, subjectivity, intentionality, and indeterminacy. These principles translate classical phenomenology into a conceptual framework that can be operationalized in contemporary psychiatry, statistics, and neuroscience. We also develop practical tools to isolate patterns of experience without treating them as autonomous entities, allowing reductionism to function as a local methodological tool rather than a global explanatory framework. Finally, we discuss implications for diagnostic systems, transdiagnostic research, and emerging technologies. KEY MESSAGES:Re-centering inquiry on the whole of psychic life restores context to clinical practice and integrates subjective experience with biological data. The 5 proposed principles offer a structured, operationalizable approach to Jaspers' legacy. This framework provides a coherent point of reference for psychiatric education, research design, and the interpretation of neurobiological findings without losing the human core of the discipline.
INTRODUCTION:The Praecox Feeling refers to clinicians' immediate sense of disturbed interpersonal contact when encountering individuals with schizophrenia. Although considered subjective, this experience persists in clinical practice through the PANSS Poor rapport item, used as an indirect operational proxy. The behavioral substrates underlying this judgment remain insufficiently specified. We examined whether objectively quantified gestural behavior during first contact relates to clinician-rated Poor rapport and whether interaction partners adapt their nonverbal behavior accordingly. METHODS:Naïve interaction partners (IP) engaged in two first-contact interactions, one with an individual with schizophrenia (ISZ) and one with a matched control (MAT), in an ecological setting. Gestural expansiveness was quantified using automatic motion tracking. Poor rapport was assessed independently during a subsequent standardized PANSS interview conducted by a trained psychiatrist not involved in the interaction. RESULTS:Within the schizophrenia group, reduced gestural expansiveness during first contact was associated with higher clinician-rated Poor rapport. No significant group difference in gestural expansiveness was observed between ISZ and MAT. However, interaction partners showed reduced gestural expansiveness when interacting with ISZ. CONCLUSIONS:Ecologically measured gesture kinematics were associated with independently assessed clinician-rated interpersonal disturbance. These findings suggest that Praecox Feeling may reflect clinicians' sensitivity to subtle, measurable alterations in embodied interpersonal dynamics that generalize across interactional settings. Disturbed social contact appears to emerge within a dyadic system rather than from individual behavior alone. Objective movement markers may contribute to operationalizing early interpersonal disturbance and may contribute to refining the phenomenological construct of Praecox Feeling.
INTRODUCTION:Decreased sound tolerance (DST) is a common, yet understudied, sensory experience among individuals with autism. Beyond neurobiological or behavioral explanations, DST can be understood phenomenologically as a distinct mode of auditory being-in-the-world. This study examined how adults with autism experience, interpret, and inhabit their auditory world in situations where sound becomes overwhelming or invasive. METHODS:Eight adults with autism were recruited through social media and participated in in-depth semi-structured interviews focused on their experiences with DST. Participants had a prior clinical diagnosis of autism established by a neurologist or psychiatrist (in some cases supported by ADOS-2), which was subsequently verified by the research team according to DSM-5 criteria. The interview guide was designed to collect information about perception, informed by Karl Jaspers' clinical phenomenology and Maurice Merleau-Ponty's philosophy of perception as sensitizing frameworks. Data were analyzed using Amedeo Giorgi's method, which includes holistic reading, delineation of meaning units, transformation into phenomenological-psychological language, and eidetic synthesis. RESULTS:Participants described DST as an embodied and relational shift in how sound was encountered. Certain sounds are experienced as intense, intrusive, or difficult to accommodate, affecting bodily attunement and ongoing activities. The phenomenon fluctuated with emotional state, fatigue, and contextual predictability and was often accompanied by physical exhaustion and a need to recalibrate through rest or withdrawal. Alongside these challenges, participants also reported moments of heightened clarity and attunement, revealing a distinctive way of perceiving and engaging with the auditory world. CONCLUSION:DST in individuals with autism might be understood as a modification in the structure of embodied perception and auditory attunement, beyond a mere sensory alteration. From a phenomenological perspective, DST reflects a particular relational configuration with the auditory world that shapes embodiment, affectivity, and intersubjectivity. These findings contribute to the emerging phenomenological psychopathology of autism by describing how auditory experience can participate in the formation of lived presence and being with others.
BACKGROUND:An important feature of contemporary phenomenological psychopathology is the development of explanatory accounts, constructed at the level of first-person experience, for why certain phenomena appear in a psychiatric condition. Termed phenomenological explanation, this approach to explanation is intended to uniquely contribute to diagnostic classification and etiology. Despite its promise for psychiatry, there has yet to be sustained dialogue on the question of how phenomenological explanations can be developed, evaluated, and refined. This paper begins this project. SUMMARY:We first explicitly articulate the philosophical commitments of phenomenological psychopathology. Focusing on the self-disorder model, we show how phenomenological psychopathology operates according to these commitments in proposing explanatory accounts that are in service of two disciplinary aims: typification (i.e., diagnostic classification) and pathogenetic insight (explaining how core symptoms of a condition emerge). We then turn our attention to the three research paradigms typically employed in phenomenological psychopathology: the clinical case study, quantitative methods, and qualitative methods. Here, we demonstrate how each paradigm has strengths and limitations in adhering to the commitments and aims of phenomenological psychopathology. KEY MESSAGE:The practice of phenomenological explanation is best understood as an integrative process in which awareness of the strengths and limitations of distinct research paradigms shapes study design, the interpretation of results, and decisions about future empirical projects.
INTRODUCTION:There is a growing need to translate insights from phenomenological psychopathology into psychotherapeutic practice. Phenomenology offers a deeper understanding of the lived experience of psychosis, and this understanding can render psychotherapy more individualized, empathically attuned, and recovery oriented by attending to experiential dimensions that conventional, symptom-focused approaches may overlook. In this study, we report qualitative findings of patients' lived experiences of group visual art therapy, which we conceptualize as structured phenomenological art therapy. This approach was informed by insights from phenomenological psychopathology and designed specifically for psychiatric patients with schizophrenia spectrum disorders. This approach can be considered nested within arts-based phenomenological research. METHODS:The structured phenomenological art therapy was offered to 15 patients with schizophrenia spectrum disorders. The intervention involved twelve structured sessions. The course of therapy was systematically documented, and each patient's experiences were examined through a combination of direct observation, in-depth interviews, and solicited diaries. The study adopted a qualitative research design, structured as a multiple or plural case study. RESULTS:The results indicate that visual art can serve as a therapeutic medium, facilitating self-exploration, and contribute to the construction of narrative identity. Engaging in artistic expression helped patients articulate their emotions, gain new perspectives, and cultivate a sense of hope. The therapeutic process also fostered interpersonal communication and shaped patients' perceptions and experiences of others. CONCLUSION:During the structured phenomenological art therapy, several patients identified key personal challenges amenable to change, a core objective of psychotherapy, demonstrating the intervention's potential for patients with schizophrenia spectrum disorders.
INTRODUCTION:Transitional age youth (TAY; age 16-25) is a developmental period marked by major biopsychosocial changes and a peak onset of mental disorders. While psychiatric diagnoses rely heavily on distress as a criterion, the concept remains underdefined, particularly for youth who often report subthreshold symptoms. This study aimed to explore how TAY with mental disorders experience and describe their suffering, in order to clarify its phenomenological features and clinical relevance within the context of emerging adulthood. METHODS:We conducted individual semi-structured interviews with 15 TAY receiving psychiatric care at a public hospital in Brussels. Participants were aged 17-25 and came from both inpatient and outpatient settings. Each interview began with a visual tool, during which participants brought visual materials representing their suffering. The interviews were analyzed using thematic analysis. RESULTS:We identified five themes. First, for participants, suffering meant enduring "mental pain," an aversive and inescapable experience, often tied to suicidality. Second, this pain was described as submerging their reality, disrupting their sense of time, world, and self. Third, participants struggled to explain this pain to others and themselves. Fourth, they nonetheless thought it to be abnormal and required professional help, as it signaled the presence of a mental disorder. Lastly, they reported the underlying cause of their mental pain was "having no place in the world," due to patterns of social adversity or an inability to meet social expectations. CONCLUSION:For these TAY, suffering was tied to a damaged social sense of self, fueled by ideals of autonomy and self-improvement that are increasingly hard to achieve. Excessive suffering was often characterized as "depression," and many of their experiences did echo phenomenological accounts of depression. While prior definitions of suffering emphasize causes or outcomes, this study details the experiential core of suffering as mental pain. However, some participants distinguished between pain as an immediate pre-reflective experience and suffering as its reflective aftermath. This supports the view that clinicians must address not only the raw experience but also help patients build meaning from it, bridging symptom relief with narrative understanding.
BACKGROUND:Ketamine has emerged as a promising rapid-acting antidepressant with distinct advantages for the treatment of treatment-resistant depression (TRD). Its therapeutic effects are mediated through multi-target modulation of the glutamatergic system. Unlike conventional antidepressants, ketamine exerts a markedly faster onset of action; however, its long-term safety profile and potential risk of dependence require rigorous evaluation. This scoping review aims to systematically summarize recent advances in research on ketamine's role in depression treatment. SUMMARY:This review synthesizes current evidence regarding ketamine's molecular mechanisms of action, neuroimaging correlates, pharmacological characteristics, and associated ethical considerations. By primarily antagonizing N-methyl-d-aspartate receptors, ketamine rapidly disinhibits the mesolimbic dopamine reward pathway and upregulates brain-derived neurotrophic factor (BDNF) expression via eukaryotic elongation factor 2 kinase (eEF2K) suppression, thereby activating the mammalian target of rapamycin (mTOR) pathway and enhancing synaptic plasticity. Neuroimaging studies further reveal that ketamine induces rapid remodeling of prefrontal-limbic functional connectivity, modulates default mode network activity, and promotes the normalization of cerebral metabolism and structure. Pharmacologically, ketamine exhibits a rapid onset of action and a relatively broad therapeutic window, though notable pharmacodynamic and pharmacokinetic differences exist between its enantiomers and active metabolites, which warrants further investigation. KEY MESSAGES:Ketamine displays rapid onset and high efficacy in the management of TRD; nevertheless, its long-term safety, risk of dependence, and potential cognitive effects necessitate close clinical monitoring. Future research should prioritize the exploration of synergistic treatment regimens and the development of novel ketamine derivatives with improved target specificity and safety profiles to advance the application of precision psychiatry. Collectively, this review provides a foundational reference to guide clinical practice and inform subsequent mechanistic studies on ketamine-based antidepressant therapies.
INTRODUCTION:Epidemiological studies have reported associations between creativity and genetic vulnerability for schizophrenia and other severe mental disorders. Alterations of selfhood have been proposed as a possible link between these phenomena. In this explorative study, we examined disturbances of basic selfhood and imagination, as well as general psychopathology, in a non-clinical sample of professional visual artists. METHODS:Ten visual artists, exhibiting at prestigious galleries, were recruited through professional networks. They underwent a comprehensive interview assessment of psychopathology, including the Present State Examination (PSE), the Examination of Anomalous Self-Experience (EASE), the Examination of Anomalous Fantasy and Imagination (EAFI), and a qualitative interview exploring the creative working process. RESULTS:Four participants described a moderate to high level of self-disorders and/or anomalies of imagination and described an involvement of these experiences in their creative working process. The participants met ICD-10 research criteria for lifetime diagnoses of mood, anxiety, and schizophrenia-spectrum disorders. DISCUSSION:The findings are exploratory and based on a small sample. Drawing on phenomenological considerations, we tentatively suggest that, for some individuals, alterations of the pre-reflective structure of subjectivity may be related to creativity through subtle alienation from fundamental common sense categories, an inclination toward preoccupation with the imaginary, and a spatialized mode of experiencing the inner life.
INTRODUCTION:Major depressive disorder (MDD) is one of the most frequent psychiatric diseases worldwide. Growing evidence suggests that cortical gyrification measures may present an early risk marker for depression. Medial views of cortical surface reconstructions provide the basis for a simple, expert-rated measure of cortical gyrification. In this study, we examined left anterior cingulate cortex (ACC) gyrification as a potential marker of MDD. We selected this region of interest based on the limbic-cortical dysregulation model of depression and prior research results. METHODS:In a sample of 386 healthy and depressed young adults (147 with MDD), experts rated ACC gyrification using structural MRI reconstructions. Gyrification patterns were compared on clinical (e.g., MDD status), MRI (e.g., automatically derived region-wise curvature and volumetric variables), and psychological outcomes (e.g., personality questionnaire scores). RESULTS:One-third of subjects exhibited two anteroposterior gyri in the left hemisphere, whereas the other subjects exhibited one longitudinal gyrus or longitudinal gyrification was interrupted. Subjects with the fewer-gyri left ACC variant more often experienced MDD at some point in their lifetime (p = 0.048). Moreover, among all subjects with MDD, disorder onset happened earlier in subjects with the fewer gyri variant (d = -0.30), hinting at early developmental contributions to the phenotypic marker. In addition, subjects with fewer longitudinal gyri scored higher on neuroticism (η2 = 0.02), but not on extraversion. Automatically derived measures of gyrification and cortical surface area were largely consistent with the differences observed using the expert rater-based gyrification measure. CONCLUSION:Future studies should investigate left ACC gyrification and, to what extent, it exists in at-risk subjects, further elucidating it with ACC structural and functional connectivity measures.
BACKGROUND:Phenomenological psychopathology has traditionally focused on individual experience, yet contemporary clinical practice increasingly requires understanding of how collective cultural forces shape psychological life. In an era of advanced globalization, stable social aggregates have given way to fluid "cultural flows" that transcend geographical and social boundaries, necessitating new conceptual frameworks for clinical assessment. SUMMARY:This paper proposes a critical expansion of phenomenological psychopathology of the individual to explicitly integrate the collective dimension. In order to accurately describe the scenario of collective life, and its relationship with the psychology and psychopathology of individual existences, we propose two moves: (1) a shift of focus from society (which denotes an organized aggregate of individuals) to culture (a transversal symbolic system, capable of extending beyond the boundaries of the original social group) since in the context of advanced globalization the conception of stable social aggregates has been replaced by models of fluid and changing "cultural flows" and (2) to phenomenologically describe these cultural flows that traverse the contemporary world, we introduce the concept of "cultural existentials" (time, space, body, and others) as a priori conditions of experience derived from the analysis of the fundamental structures of individual lifeworlds, as employed in phenomenology. These cultural existentials are integrated into a dialectical experiential matrix (DEM), designed to overcome the reductionism of both structuralism and subjectivist individualism. The DEM frames the patient's experience as a dynamic interplay between individual freedom (the capacity for self-positioning) and cultural influence. An illustrative application analyzing the convergence between "pornographic culture" and the "homo œconomicus" anthropological type is provided to demonstrate how cultural existentials offer a collective model for specific narcissistic vulnerabilities and dysregulations of alterity, providing a crucial diagnostic device for the clinician. KEY MESSAGES:The DEM provides clinicians with a diagnostic device for understanding how contemporary cultural configurations shape individual psychopathology. By articulating the dialectical relationship between cultural existentials and individual positioning, this framework enables more accurate phenomenological description of patients whose suffering reflects not merely idiosyncratic biography but participation in collective cultural patterns. This approach addresses the limitations of purely individualistic psychopathology while maintaining phenomenological rigor.
