Rumination is a repetitive and self-focused style of thinking that reflects how individuals relate to themselves and their experience of time. Drawing on recent studies that combine functional magnetic resonance imaging with self-rated assessment tools, particularly instruments designed to measure patterns of ruminative thought, this paper explores how different styles of rumination relate to the organization of spontaneous brain activity. Rather than interpreting these patterns solely through a neurocognitive lens, I propose a neurophenomenological reading in which brooding reflects a temporal contraction and emotional entrapment, while reflection may preserve a degree of openness and intentionality. Inspired by Francisco Varela's framework, I argue that integrating first-person data with brain imaging findings allows for a richer understanding of how psychological vulnerability is linked with the temporal architecture of the ruminative self.
Background. Somatization is frequently observed among migrants, especially in primary care. One problem is that patients with somatization are often different, the same label including different psychopathological syndrome. Previous phenomenological research has identified five different types of somatization syndromes in immigrants (anxious hypochondriasis, somatization with culture playing a pathogenetic role, somatization with pathoplastic effects of culture, somatization in adjustment reactions to migratory living difficulties, and somatization as post-traumatic reaction). This article adds evidence to previous research with a phenomenological description of a sixth type of somatization in immigrants: delusional hypochondriasis. Methods. The description was based on seven levels: medical examination, description of somatization symptoms, the patients' interpretation of their somatic experience, associated psychopathological phenomena, genetic understanding, clinician's interpretation, and course and treatment. Results. Two cases of delusional hypochondriasis are presented, a man from Africa and a woman from Eastern Europa. The analysis of the cases shows that the understandable basis of the future delusion is the experience of an alarming event that radically changes the trust in the naturalness of the lived bodily experience, as well as the interpersonal trust. It is in this experience of suspension of habitual meanings, with an atmosphere of radical insecurity, that the delusional development starts. The possible role of culture in the way these events are experienced is discussed. Later, progressive jumps of meaning occur, increasing the oddity of the somatic experience, leading to bizarre delusions. The consequences for both psychopathological theory and clinical management are also discussed.
This report is about to present the second version of the Phenomenological Auditory Hallucination Scale (PAHS.2). This is an instrument designed for clinical practice and psychopathological research. Our main aim was to explore hallucinations with a specific attention to qualitative subtle features that often are crucial for the assessment. The scale was designed to assess not only the intrinsic features of hallucinations but also the context in which they are situated (e.g., the state of consciousness, the surrounding atmosphere, the experience of time, etc.). A first version of this scale (PAHS.1) has been discussed at the Roman Circle of Psychopathology, then sent for public consultation (to clinicians and experts by experience). Moreover, the authors administered it to a small sample of patients (with psychosis, PTSD and substance-related hallucinosis) to detect possible difficulties in single items' questions and/or possible answers. In two subsequent meetings, the authors revised the scale and then administered it again to other patients to verify the appropriateness of the changes. In conclusion, in a further meeting, agreement was reached on the final version of the scale (PAHS.2). Future studies may be designed to validate this latest version and evaluate possible further modifications. In the meantime, the PAHS.2 is already available as an interesting phenomenological assessment tool for describing individual cases in qualitative studies.
Dysphoria and impulsivity are states that are described across a range of psychiatric disorders. However, current diagnostic systems like the DSM and ICD, along with traditional psychiatric literature, often overlook the subtle, embodied nuances of these phenomena. The reliance on standardized psychometric scales and efficacy-based guidelines in choosing medication circumvents a more personalized approach within a phenomenological framework that integrates clinical judgment with a deep understanding of patients' embodied experiences. This paper proposes a phenomenologically informed approach in relation to understanding and targeting dysphoria and impulsivity in pharmacological interventions. While one may be inclined to use a specific medication based on label information, the effect on a person's embodied experience can vary significantly. Additionally, the same medication may change the experience of impulsivity or dysphoria in one person in a completely different manner than in another person, which raises the possibility that medications may have their own "phenomenological profiles". Another important aspect is the role of intersubjectivity in the clinician-patient relationship. By modulating the patient's affective responses and facilitating a more balanced sense of self, medication might allow for a deeper, clearer articulation of their lived experience during clinical encounters. Ultimately, I argue for a more nuanced, phenomenologically informed approach to pharmacological intervention. Integrating the patient's lived, embodied experience with an understanding of the subtle effects of medication can enhance clinical judgment and potentially lead to more effective, personalized treatments.
The term 'alien' is often used in public debates regarding migrants, particularly in the United States of America. This term is not in itself negative, as for example in its neutral legal meaning (transfer of ownership), but tends to acquire detrimental meanings over time. For example, this has already happened in the field of psychiatry, where the term 'alienated' to refer to the mentally ill, and that of 'alienation' to refer to his condition, acquired a negative connotation conveying an idea of radical difference. One consequence was, on this basis, the justification of the social separation of patients, locked up in mental asylums. The contribution of phenomenological psychopathology, with its insistence on seeing the patient as alter rather than alienus, has led to notable advances in the humanization of care and in favour of the social integration of patients. Similarly, in current discourse on migrants the term 'alien' has acquired a negative connotation, to underline a radical difference from the natives, implicitly bringing with it the sense of being less human, and therefore less worthy of our empathy, and therefore less holders of human rights. Furthermore, by placing the word 'illegal' next to the word 'alien', the negative public opinion is further strengthened, also transmitting the sense of fear that the term 'illegal' arouses. This article calls on intellectuals and scientists to reject these terms and to raise awareness among the population about their improper use, with the aim of avoiding the dehumanization and stigmatization of people with the least capacity to defend themselves, such as migrants.
