Giovanni Stanghellini

• MD, Dr. Phil. h.c.
• Professor (Full) at University of Florence

This is the first bottom‐up review of the lived experience of postpartum depression and psychosis in women. The study has been co‐designed, co‐conducted and co‐written by experts by experience and academics, drawing on first‐person accounts within and outside the medical field. The material initially identified was shared with all participants in a...

Background: Cannibalism is a practice based on the assimilation of the enemy, characterized by different ritual phases. The cultural anthropologist Francesco Remotti provides insight into this practice, stating that the Tupinamba tribes - an ethnic group living along the Eastern Atlantic coast of Brazil - use it to demonstrate their superiority ov...

Background. Borderline Personality Disorder (BPD) is a prevalent psychopathological condition, affecting 0.7–2.7% of the general population. Given the known link between identity formation and the temporal, metacognitive, and narrative processes that contribute to its coherence, the aim of the present systematic review is to synthesize the current...

Introduction: Prominent eating disorders (EDs) theories identify a critical relationship between body and self. One of the ways to study this relationship is through autobiographical memories (AMs). The present review aimed to evaluate the studies that investigated AM in patients with EDs. Methods: A search of PubMed, ScienceDirect, and Scopus data...

The present commentary raises some concerns about the risk of iatrogenic harm arising out of the diagnosis of functional neurologic and somatic disorders. These concerns are supported by evidence from the history of hysteria and findings from contemporary brain imaging. We discuss their implications for practice.

Abnormal experiences of time (ATEs) are an established object of research in phenomenological psychopathology. Objective: The purpose of this study was the first validation of the Transdiagnostic Assessment of Temporal Experience (TATE), a structured phenomenological interview concerning ATEs in individuals with diverse mental health conditions, an...

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...

The diagnosis of hysteria, despite being fundamental in the birth of psychiatry, has currently been removed from nosography. This choice speaks of the renunciation by contemporary nosography of understanding psychopathological conditions as structural entities, with internal coherence and meaningfulness - which on the contrary should be reconsidere...

Considered by many the foremost German language literary critic of the first half of the 20th century, Walter Benjamin remains a star in our contemporary constellation of cultural criticism. His broad range of reference coupled with his dazzling linguistic versatility and radical understanding of technological transformation and its relation to soc...

Introduction: Abnormal self-experiences are a common feature of major depression despite their absence from current diagnostic manuals. Current diagnostic criteria leave us with an impoverished conception of depressive disorders, and they fail to exploit the diverse experiential alterations that might be useful for understanding and diagnosing pat...

We provide here the first bottom‐up review of the lived experience of mental disorders in adolescents co‐designed, co‐conducted and co‐written by experts by experience and academics. We screened first‐person accounts within and outside the medical field, and discussed them in collaborative workshops involving numerous experts by experience – repres...

Background Psychotic‐like anomalous self‐experiences (ASEs) are core and early features of schizophrenia spectrum disorders, which have been recently also postulated to underlie embodiment disturbance in feeding and eating disorders (FEDs). The present study was aimed at investigating the interplay between ASEs and specific psychopathology in FED....

A comprehensive handbook covering current, controversial, and debated topics in psychiatric practice, aligned to the EPA Scientific Sections. All chapters been written by international experts active within their respective fields and they follow a structured template, covering updates relevant to clinical practice and research, current challenges,...

Background Phenomenological research has enriched the scientific and clinical understanding of Eating Disorders (ED), describing the significant role played by disorders of embodiment in shaping the lived experience of patients with ED. According to the phenomenological perspective, disorders of embodiment in ED are associated with feelings of alie...

L'approche historique, kraepelinienne et catégorielle du diagnostic et de la classification ne parvient pas à décrire la complexité de l'état neurodéveloppemental de nombreuses personnes qui accèdent quotidiennement aux services de santé mentale et rend les frontières entre les troubles psychiatriques peu claires surtout en cas de comorbidités, sou...

Background: Phenomenological literature has recently given much attention to the concept of atmosphere, which is the pre-individual affective tonality of the intersubjective space. The importance of atmospheres in psychopathology has been described for various disorders, but little is known about the interaction with hysteria. The aim of the prese...

The COVID-19 pandemic has caused global stress. However, people reacted differently, some with various forms of distress. Although vulnerable groups were more likely to suffer in this situation, heterogeneity was also reported at this level. We revised the concept of vulnerability in medicine and mental health using schizophrenic symptoms as paradi...

This co-written paper discusses strategies for dealing with schizophrenia. For Helene Cæcilie, an expert by experience, dance has served as an artistic outlet for schizophrenia, allowing her to work and exist in the world. Through the act of automatic writing while in psychosis, Helene Cæcilie has transformed the bewildering world of her mind into...

This paper highlights the limitations of narrative logic in mental health care, and in particular of “narrative vigilance”—the tendency to watch over experience via narrativisation, and to tether the concrete particulars of experience to the hypothetical structure of a narrative signification. Narrative logic is grounded in hypotaxis—the syntactic...

This paper argues that a dialectical synthesis of phenomenology’s traditional twin roles in psychiatry (one science-centered, the other individual-centered) is needed to support the recovery-oriented practice that is at the heart of contemporary person-centered mental health care. The paper is in two main sections. Section I illustrates the differe...

This handbook is currently in development, with individual articles publishing online in advance of print publication. At this time, we cannot add information about unpublished articles in this handbook, however the table of contents will continue to grow as additional articles pass through the review process and are added to the site. Please note...

We provide here the first bottom‐up review of the lived experience of depression, co‐written by experts by experience and academics. First‐person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of depression, family members and carers, represen...

Since its discovery in 1943, LSD has been used by artists, scientists, and intellectuals, amongst others, to stimulate their creative insights. Federico Fellini, one of the most important film directors in the XX century, used LSD when it was still legal under the guidance of his psychoanalyst during a phase of personal and creative crisis. This ar...

Dis-sociality (DS) reflects the impairment of social experience in people with schizophrenia; it encompasses both negative features (disorder of attunement, inability to grasp the meaning of social contexts, the vanishing of social shared knowledge) and positive features (a peculiar set of values, ruminations not oriented to reality), reflecting th...

The concept of hysteria, although apparently surpassed by contemporary nosographic classifications, continues to be talked about. Following Charbonneau’s attempt to de-feminize and de-sexualize hysteria, clinical phenomenology can offer a perspective which, freed from stigma and prejudices through the suspension of judgement, allows us to understan...

What is commonly referred to as “depression” indicates a heterogeneous complex disorder that includes distinct psychopathological forms. A more accurate classification can be achieved by assessing the individual experiences of depression and tracing back each of these forms to the specific vulnerable structure from which they emerge. Each of these...

This paper sheds light on some aspects of what contemporary clinical theory calls “borderline” condition providing a description of a key figure of late-modern culture that I will call Homo dissipans (from Latin dissipatio , - onis = scattering, dispersion). Homo dissipans is the opposite of Homo œconomicus , the form that “narcissism” takes on in...

There is increasing recognition of the importance of the humanities and arts in medical and psychiatric training. We explore the poetry of Charles Baudelaire (1821–1867) and its evocations of depression through themes of mood, time and self-consciousness and discuss their relation to images of ‘spleen’, the ‘snuffling clock’ and the ‘sinister mirro...

This paper, aligned with contemporary thinking in terms of patient-centered care and co-creation of patient care, highlights the limitations of the reductionist approaches to psychiatry, offering an alternative, “emergent” perspective and approach. Assuming that psychopathological phenomena are essentially relational, what kind of epistemological f...

Traditional psychopathological approaches to modelling the evolution of mental disorders, such as schizophrenia, often rest on the assumption that symptoms are the passive expression of an underlying disease process. In contrast, phenomenological approaches have highlighted the role that the person, as a meaning-making agent undergoing basic anomal...

Purpose Anorexia nervosa (AN) is characterized by a diminished capacity in perceiving the physiological correlates of interoceptive sensations, namely bodily self-consciousness. Given the neural division of self-processing into interoceptive-, exteroceptive- and mental-self, we hypothesize neural deficits in the interoceptive-processing regions in...

The psychopathological analysis of hysteria is a victim of narrow conceptualizations. Among these is the inscription of hysteria in the feminine sphere, about body and sexuality, which incentivized conceptual reductionism. Hysteria has been mainly considered a gendered pathology, almost exclusively female, and it has been associated with cultural a...

This paper describes the form that narcissism takes in contemporary society in the light of Homo œconomicus – a concept developed by philosopher Foucault to describe a key figure of late modernity: the entrepreneur of himself whose core values are utility (every action must be directed towards production) and optimization (what costs more than it p...

Psychosis is the most ineffable experience of mental disorder. We provide here the first co‐written bottom‐up review of the lived experience of psychosis, whereby experts by experience primarily selected the subjective themes, that were subsequently enriched by phenomenologically‐informed perspectives. First‐person accounts within and outside the m...

The term “psychopathology” is employed in a number of different ways. In the present chapter, it is used with specific reference to defining, understanding, and categorizing symptoms of mental suffering, as reported by people with intellectual disability (ID) and/or autism spectrum disorder (ASD) and observed through their behavior. After a descrip...

This contribution aims to highlight the theoretical and epistemological premises of the co‐writing experience, a practice where a clinician and a patient are mutually engaged in jointly or collaboratively writing a narrative related to the patient’s experience. Unlike a typical set of therapeutic techniques, co‐writing is based on sharing perspecti...

Cognitive, psychodynamic, and phenomenological scholars converged their attention on abnormal bodily phenomena as the core psychopathological feature of eating disorders (EDs). While cognitive approaches focus their attention on a need for “objective” (i.e., observable, measurable) variables (including behaviours and distorted cognitions), the phen...

Understanding other persons is not merely a kind of accurate knowledge about the other, a concept that grasps the states of mind motivating the other’s behaviors and expressions. Rather, it is a complex phenomenon that mingles the voluntary with the involuntary, conative with nonconative postures, cognitive with pathic forms of cogito, nature with...

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 (TATE), a structured interview that can be used by researchers and clinicians without a comprehensive phenomenological background to explore abnormal...

Purpose Recent studies demonstrated that the embodiment disorder represents a core feature of eating disorders (EDs). The aim of this study was to evaluate the role of its variation as a possible mediator of the efficacy of enhanced cognitive behavioural therapy (CBT-E) on classic ED symptomatology, including body uneasiness. Methods 73 patients w...

Objective: The aim of the study was to provide a qualitative analysis of anomalous bodily experiences (ABEs) of persons affected by feeding and eating disorders (FEDs). In particular, this study aimed to refine the description of bodily experiences in persons with FEDs so as to improve their treatment. Sampling and methods: This is a naturalisti...

Background: Depressive disorders, despite being classified as mood or affective disorders, are known to include disturbances in the experience of body, space, time, and intersubjectivity. However, current diagnostic manuals largely ignore these aspects of depressive experience. In this article, we use phenomenological accounts of embodiment as a t...

The purpose of this paper is to help us understand how and why the COVID pandemic, and its associated biopolitics of social distancing, may have affected our relationships with our own bodies and other persons, thus helping to accelerate what might be termed a bracketing of presence that was already well underway in our modern and contemporary soci...

Social dysfunctions (SD) are frequently observed in subjects with schizophrenia. Some of these dysfunctions are also observed in other neuropsychiatric disorders such as autism spectrum disorders (ASD), major depression, bipolar disorder, or Alzheimer disease. Recently, a characterization of a specific type of SD in schizophrenia has been proposed,...

Building on a view of Feeding and Eating Disorders (FEDs) as passions, this chapter illustrates through personal testimony and materials from publicly accessible (Pro-Ana) websites the nature of anorexia as a kind of religion. The explicit values of this ‘religion’ are shown to have their origins in a cultural value we call ‘ocularcentrism’. Some o...

The main aim of our article is to discuss the importance of recognition in the psychotherapeutic process. To achieve recognition, patient and clinician should be able to build a space where the patient can find an “ecological niche” in which he can find an “adaptive equilibrium” between the burdensome demands of his psychopathological condition and...

This open access book offers essential information on values-based practice (VBP): the clinical skills involved, teamwork and person-centered care, links between values and evidence, and the importance of partnerships in shared decision-making. Different cultures have different values; for example, partnership in decision-making looks very differen...

Purpose Recent studies hypothesized that sexual dysfunctions represent not just complications of eating disorders (EDs), rather they should be attributed to the core psychopathology of these disorders. Therefore, disorders of the embodiment and insecure attachment may play a role in maintaining an abnormal sexual functioning, given their known rela...

The chapter I have co-authored is about clinical experiences in mental health where spirituality played a significant role, based on experiences from New Zealand. The book is now Open Access. The link is: https://link.springer.com/book/10.1007%2F978-3-030-47852-0

Building on the optical-coenaesthetic disproportion model of so-called eating disorders, this paper provides a framework for the psychotherapy of people affected by these conditions. This model characterizes “eating disorders” as disorders of embodiment and identity, where a sense of unfamiliarity with one’s own flesh, experienced as shifting and i...

This paper explores the potential threats of digital phenotyping and the ways it may redesign our body experience and conceptualization. We argue that technology in digital medicine, and in psychiatry in particular, is not merely an extrinsic device to achieve improvements in knowledge, diagnosis, and treatment of diseases; rather, it intrinsically...

This is an explorative study on values of 25 patients affected by borderline personality disorder interviewed in a clinical setting (phenomenological-dynamic psychotherapy) and re-classified following Consensual Qualitative Research. We identified three main categories of values: recognition (the importance for attention, acknowledgment, commendati...

The available treatments of Eating Disorders (EDs) mirror an excessive focus on symptoms to be eliminated rather than on the acknowledgment of what is relevant from the patient’s perspective. This Editorial offers a critical review of the limitations of the DSM-5-oriented approaches, as well as of their extreme consequences, namely ocularcentrism,...

Background: Patients with schizophrenia display experiential anomalies in their feelings and cognitions arising in the domain of their lived body. These abnormal bodily phenomena (ABP) are not part of diagnostic criteria for schizophrenia. One of the reasons is the difficulty to assess specific ABP for schizophrenia spectrum disorders. The present...

Schizophrenia patients frequently display an array of abnormal bodily phenomena (ABPs). There is literature to suggest that the presence of ABPs may be representative of a fundamental disruption of the embodied and prereflexive state of selfhood and hence be relevant for the development of schizophrenia spectrum disorders. ABPs have been considered...

Questo capitolo presenta alcuni tra i principali autori internazionali che si muovono nell’ambito della psicopatologia fenomenologica contemporanea. In particolare viene presentato il contributo di Alfred Kraus, Otto Doerr-Zegers, Louis Sass, Josef Parnas e Thomas Fuchs.

Recensione pubblicata in "Psicologia Fenomenologica": https://www.psicologiafenomenologica.it/articolo/smarrimenti-della-carne-figure-del-corpo/

Abnormal space experience (ASE) is a common feature of schizophrenia, despite its absence from current diagnostic manuals. Phenomenological psychopathologists have investigated this experiential disturbance, but these studies were typically based on anecdotal evidence from limited clinical interactions. To better understand the nature of ASE in sch...

Résumé Objectif : cet article présente la version francophone du questionnaire d'inspiration phénoménologique Identity and Eating Disorders (IDEA) (Stanghellini et al., 2012). La littérature d'inspiration phénoménologique met en évidence que les personnes souffrant d'anorexie mentale présentent des perturbations au niveau de l'incarnation et de l'i...

Written in Italian, this chapter investigate lived experience in patients with Eating Disorders, from a phenomenological point of view. The lived body, the other’s gaze, the lived world of these persons are explored to enhance the possibility to grasp the essential structural changes that make meaningful the clinical picture.

Anorexia Nervosa (AN) is characterized by body image distortion. From a phenomenological perspective, body image disturbance has been associated with a more profound disturbance encompassing disorders of the way persons experience their own body. The aim of this study was to disentangle the complex dynamics that connect the experience of one’s own...

This article builds on and extends the ‘optical-coenaesthetic disproportion’ (OCDisp) hypothesis of feeding and eating disorders (FEDs) matching data obtained through clinical research with laboratory evidence from neuroscience and neuropsychological studies. The OCDisp hypothesis, developed through the assessment in clinical setting of bodily expe...

To provide a qualitative analysis of abnormal temporal experiences (ATE) of persons affected by feeding and eating disorders (FED). This is a naturalistic explorative study on a group of 27 patients affected by FED interviewed over a two-year period in a clinical/psychotherapeutic setting. Clinical files were analysed by means of Consensual Qualita...

Since Jaspers' Allgemeine Psychopathologie [1], phenomenology has served as the foundational science for psychopathology, providing a rich framework for the assessment and analysis of subjective experience and its disturbances in mental disorders. The last two decades in particular have seen an international rise and progress of phenomenology in ps...

This paper, endorsing the dialogical perspective in psychotherapy, provides a synopsis of the PHD psychotherapy method, based on the integration of phenomenology, hermeneutics and psychodynamics. The first section covers the background knowledge required for PHD psychotherapy, consolidating and extending three basic concepts: life-world (the origin...

Ce double volume, Psychopathologie phénoménologique : Dépassement et ouverture, est le fruit d’un travail collectif émanant de rencontres internationales tenues à l’Université de Liège du 13 au 15 décembre 2017. La mise au travail d’une phénoménologie clinique, appliquée aux problématiques psychopathologiques (diagnostiques, sémiologiques, méthodol...

Introduction to The Oxford Handbook of Phenomenological Psychopathology.

Reflection on: Madness and Modernism: insanity in the light of modern art, literature, and thought (revised edition) – psychiatry in literature - Volume 213 Issue 5 - Giovanni Stanghellini

Le emozioni e i valori sono considerati le chiavi per la comprensione delle esperienze e delle azioni dei popoli nel mondo in cui abitano. L’intervista clinica tradizionale è spesso criticata perché ignora la narrazione dell’esperienza di un paziente per concentrarsi sui sintomi che possono essere ridotti o controllati. In risposta a tale approccio...

Phenomenological psychopathology is a body of scientific knowledge on which the clinical practice of psychiatry is based since the first decades of the twentieth century, a method to assess the patient's abnormal experiences from their own perspective, and more importantly, a science responsible for delimiting the object of psychiatry. Recently, th...

Metacognition refers to the activities which allow for the availability of a sense of oneself and others in the moment. Research mostly in North America with English-speaking samples has suggested that metacognitive deficits are present in schizophrenia and are closely tied to negative symptoms. Thus, replication is needed in other cultures and gro...

Persons with borderline personality disorder are often described as affected by extreme emotional fluctuations. This article analyses their fundamental emotions: dysphoria and anger, despair, boredom, shame, and guilt. Our focus will be mainly on the two distinct life-world configurations that originate from dysphoria and anger: the dysphoric life-...

Atmospheres in the clinical encounter are intersubjective phenomena experienced by the participants in that situation. In this chapter we will first unveil essential aspects of the ontology and the phenomenology of atmospheres and their role in the process of understanding. We will suggest a specific attitude during the psychiatric interview that a...