Chapter

Subjectivity, Intersubjectivity, and Psychological Functioning

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Abstract

Person-centered psychiatry (PCP) has to consider both the intrasubjective and the intersubjective aspects of clinical situations whenever a person suffers from psychopathological disorders. These considerations are required not only when these disorders are due to failure in the developmental process but also when they result from any other determinant because, they contribute to the person’s quality of life and healing process. To understand and assess psychopathology one should take into account three psychological dimensions: phenomenological, structural, and metaphoric (symbolic), which involve as well the patient’s environment and family. Person-centered psychiatry (PCP) should not be reduced to individualization of care or to respect for patients’ rights, as it aspires to something more: the recognition of the individual subjectivity of the whole person of the patient beyond what characterizes his or her illness or the status of a patient. Subjectivity and intersubjectivity are bricks of the therapeutic relationship, i.e., interactive construction professionals should build with the patient and for him or her, involving all those who are contributing to their health care and health status. Teamwork and peer supervision are crucial to enhance and sustain this interactive process.

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... Such psychological parameters of professional activity as purposefulness, activity, personal mediation, creativity characterize the level of development of professional consciousness of the specialist. Thus, any professional sphere fits into the consciousness of the individual, making it professional, specifying his professional affiliation to social life (Botbol and Lecic-Tosevski, 2016). ...
... Psychosemantic approach is based on the methodical principle of studying personality through the study of "partiality" of her consciousness. Botbol and Lecic-Tosevski (2016) draw attention to the fact that the human consciousness is polyphonic in the sense of the presence of plurality "I" and dialogue. For a person in the professional consciousness, the position of the generalized other can largely be identified: "colleagues"," administrator", the image of the" ideal "and the image of the ideal "I". ...
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The authors show that the study of social professional subjectivity of the individual indicates that one of the most important effects is that the person as an object of social action in one form or another becomes the subject of these actions because of their own professional activity. In the article it is shown that social determination of individual-mental development of professional subjectivity of the personality and its activity are inherent. The transformation of the person from the object to the subject is carried out only based on activities in which certain social functions of the specialist are realized. The given facts confirm the principle of interconnection of consciousness and activity developed in the national philosophy, the unity of which is formed in certain social conditions. Implementation of this principle to the study of professional subjectivity of the individual means that the main components and personal qualities should be studied in close connection with its activities. © 2018 International Strategic Management Association. All Rights Reserved.
Chapter
Subjective experience is central to person-centered psychiatry for ethical, conceptual, and pragmatic reasons. Experience is central to what is of greatest concern to patients and drives help-seeking, coping, and treatment response. In the case of psychiatric disorders, alterations of experience may be crucial signs and symptoms of illness, indicating the nature of the problem and providing targets for intervention. In this chapter, we consider some of what is known about the nature of the processes of embodiment, interpretation, and enactment that contribute to subjectivity. We discuss phenomenological, cognitive-interpretive, and sociocultural approaches to illness experience. Both the experience and expression of health and illness depend on bodily, psychological, and interpersonal processes of perception, attention, interpretation, coping, and communication. We outline an approach to clinical assessment that gives explicit attention to patients’ experience and values through understanding the meanings of symptoms and suffering in social and cultural context.
Article
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To review the conceptual bases of Person-centred Integrative Diagnosis (PID) as a component and contributor to person-centred psychiatry and medicine and to outline its design and development. An analysis was conducted of the historical roots of person-centred psychiatry and medicine, tracing them back to ancient Eastern and Western civilizations, to the vicissitudes of modern medicine, to recent clinical and conceptual developments, and to emerging efforts to reprioritize medicine from disease to patient to person in collaboration with the World Medical Association, the World Health Organization, the World Organization of Family Doctors, the World Federation for Mental Health, and numerous other global health entities, and with the coordinating support of the International Network for Person-centered Medicine. One of the prominent endeavours within the broad paradigmatic health development outlined above is the design of PID. This diagnostic model articulates science and humanism to obtain a diagnosis of the person (of the totality of the person's health, both ill and positive aspects), by the person (with clinicians extending themselves as full human beings), for the person (assisting the fulfillment of the person's health aspirations and life project), and with the person (in respectful and empowering relationship with the person who consults). This broader and deeper notion of diagnosis goes beyond the more restricted concepts of nosological and differential diagnoses. The proposed PID model is defined by 3 keys: broad informational domains, covering both ill health and positive health along 3 levels: health status, experience of health, and contributors to health; pluralistic descriptive procedures (categories, dimensions and narratives); and evaluative partnerships among clinicians, patients, and families. An unfolding research program is focused on the construction of a practical guide and its evaluation, followed by efforts to facilitate clinical implementation and training. PID is aimed at appraising overall health through pluralistic descriptions and evaluative partnerships, and leading through a research program to more effective, integrative, and person-centred health care.
Chapter
Grounded on the idea that medicine should focus on the patient in the totality of his person and not only on his or her disease, person-centred medicine (PCM) proposes conceptual principles and practical means to reach this goal. This chapter will present these principles and one of the main tools elaborated to implement them: the methodological role of empathy as a way to include the subjectivity of the participants (the patient, their family or their caregivers, and the health professionals—medical and nonmedical) in the medical encounter. Additionally, we refer to relationships of PCM with the PCA.
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