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Time-consciousness has long been a focus of research in phenomenology and phenomenological psychology. We advance and extend this tradition of research by focusing on the character of temporal experience under conditions of mania. Symptom scales and diagnostic criteria for mania are peppered with temporally inflected language: increased rate of speech, racing thoughts, flight-of-ideas, hyperactivity. But what is the underlying structure of temporal experience in manic episodes? We tackle this question using a strategically hybrid approach. We recover and reconstruct three hypotheses regarding manic temporality that were advanced and modeled by two pioneers of clinical phenom-enology: Eugène Minkowski (1885-1972) and Ludwig Binswanger (1881-1966). We then test, critique, and refine these hypotheses using heterophenomenological methods in an interview-based study of persons with a history of bipolar and a current diagnosis of acute mania. Our conclusions support a central hypothesis due to Minkowski and Binswanger, namely, that disturbance in the formal structure of temporal experience is a core feature of mania. We argue that a suitably refined variant of Binswanger's model of disturbance in manic protention helps to explain a striking pattern of impaired insight and impaired reasoning in manic episodes.
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Philosophical Psychology
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Manic temporality
Wayne Martin, Tania Gergel & Gareth S. Owen
To cite this article: Wayne Martin, Tania Gergel & Gareth S. Owen (2018): Manic temporality,
Philosophical Psychology, DOI: 10.1080/09515089.2018.1502873
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Published online: 08 Aug 2018.
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Manic temporality
Wayne Martin
, Tania Gergel
and Gareth S. Owen
School of Philosophy and Art History, University of Essex, Essex, UK;
Institute of Psychiatry,
Psychology, and Neuroscience, Kings College London, London, UK
Time-consciousness has long been a focus of research in
phenomenology and phenomenological psychology. We
advance and extend this tradition of research by focusing
on the character of temporal experience under conditions of
mania. Symptom scales and diagnostic criteria for mania are
peppered with temporally inected language: increased rate
of speech, racing thoughts, ight-of-ideas, hyperactivity. But
what is the underlying structure of temporal experience in
manic episodes? We tackle this question using a strategi-
cally hybrid approach. We recover and reconstruct three
hypotheses regarding manic temporality that were
advanced and modeled by two pioneers of clinical phenom-
enology: Eugène Minkowski (18851972) and Ludwig
Binswanger (18811966). We then test, critique, and rene
these hypotheses using heterophenomenological methods
in an interview-based study of persons with a history of
bipolar and a current diagnosis of acute mania. Our conclu-
sions support a central hypothesis due to Minkowski and
Binswanger, namely, that disturbance in the formal structure
of temporal experience is a core feature of mania. We argue
that a suitably rened variant of Binswangers model of
disturbance in manic protention helps to explain a striking
pattern of impaired insight and impaired reasoning in manic
Received 20 October 2017
Accepted 22 March 2018
Bipolar; Edmund Husserl;
Eugène Minkowski; Ludwig
phenomenology; protention;
Symptom scales and diagnostic criteria for mania are peppered with tempo-
rally inected language: increased rate of speech, racing thoughts, ight-of-
ideas, hyperactivity. Moreover, a growing body of research lends support to
the hypothesis that mania involves some kind of disturbance in the character
of temporal experience. One study found that, in comparison to healthy
controls, persons in acute manic episodes reported an accelerated ow of
timeand overestimated duration in a variety of duration-judgement tasks
(Bschor et al., 2004). A second study found that persons with mania tend to
remember time intervals as having been shorter than they actually were
CONTACT Wayne Martin School of Philosophy and Art History, University of
Essex, Wivenhoe Park, Colchester, Essex CO4 3SQ, UK
© 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecom, which permits unrestricted use, distribution, and reproduction in any medium, provided the original
work is properly cited.
(Mahlberg, Kienast, Bschor, & Adli, 2008). These recent ndings support
earlier controlled studies which reported on accelerated subjective time
experience in mania (Mezey & Knight, 1965;Tysk,1984). Drawing on a
review of existing literature, Bschor and colleagues sought to clarify the extant
experimental vocabulary in this area ofresearch, dening time experienceas
the subjective experience [of] how fast or slow time is passingand dening
time senseto include all aspect of experiencing time ow and judging time
spans(Bschor et al., 2004, pp. 222223, emphasis added).
In what follows, we seek to build upon these recent research ndings by
exhibiting a distinctive feature of temporal experience in mania. In order
to do so, we turn to the tradition of clinical phenomenology. Drawing on
insights from that tradition, we bring into focus an aspect of temporal
experience in mania that has not been thematized in recent empirical
research and which is distinct from the experience of passing time, time
ow, or judgement of duration.
Temporal experience has been one of the enduring concerns of the phe-
nomenological movement since its inception, and some of its most important
research results have emerged in this area. But while the celebrated investiga-
tions of Bergson, Husserl, and Heidegger regarding temporal experience have
been extensively discussed and debated (see, e.g. Blattner, 1999;Guerlac,2006;
Kortooms, 2002;Miller,1984), what has attracted less attention are the
ndings of a group of pioneering clinicians who sought to use the phenom-
enological investigation of time-consciousness to develop a better under-
standing of the structure of temporal experience in their patients. In what
follows our aim is to recover and extend this tradition of clinical phenomen-
ological investigation of temporal experience, with particular attention to the
experience of acute mania. In doing so, we adopt a strategically hybrid
approach, rst reconstructing the accounts of manic temporality proposed
by leading twentieth century clinical phenomenologists, then testing their
theories against empirical evidence drawn from a clinical study.
We proceed as follows. We begin by identifying three key hypotheses
regarding manic temporality that were rst formulated by Minkowski
(Section 1). We then reconstruct and assess two phenomenological models
for those hypotheses developed by Binswanger (Sections 24). In the nal
sections of the article (Sections 5 and 6), we test and rene Minkowskis
hypotheses and Binswangers models using heterophenomenological data
from an interview-based study of temporal experience in the acutely manic
phase of what is clinically described as bipolar disorderor bipolar I.Our
conclusions (Section 7) support a central hypothesis due to Minkowski and
Binswanger, namely, that disturbance in the formal structure of temporal
experience is a core feature of mania. We argue that a suitably rened variant
of Binswangers model of disturbance in manic protention helps to explain a
striking pattern of impaired insight and impaired reasoning in manic
episodes. Our results bring into focus a structure of Husserlian protention
that has not been generally recognized, which is displayed most vividly
under conditions of pathology, and which suggests a deep connection
among temporality, inductive reasoning, and self-knowledge.
1. Minkowskis three hypotheses
As an initial benchmark in surveying the tradition of clinical phenomen-
ology, we turn to a seminal case study reported by Minkowski in 1923. The
case does not itself involve mania, but it matters for our purposes none-
theless because it records rather vividly the initial framing of a cluster of
insights about temporality and mood disorder whose validity we propose
to assess. Minkowski recounts an extraordinary episode during which he
served as the personal physician to a 66-year-old man suering from a
severe form of depression. The man was besieged by feelings of guilt, and
lived in continual anxiety both about his own imminent torture and
execution and the execution of members of his family. His persistent and
distressing delusions included the conviction that all the waste and refuse
of the world was to be pumped into his stomach.
Minkowskis relationship to this patient was unusual. His duties as
personal physician were so arranged that he lived with the man continu-
ously, day and night, for a period of 2 months, apparently in quite intimate
It was during this extended close interaction and observation
that Minkowski hit upon what would become his principal hypothesis. His
training had taught him to probe the mans condition by rst examining
the specic content of the delusional experiences, and then endeavoring to
trace them back to specic disorders of perception or judgement.
But over
the course of their shared residence, Minkowski came to a dierent con-
clusion. Where,he asked, is the discordance between [the patients]
psyche and [my] own?(Minkowski, 1923, p. 131). His answer: the
patients most fundamental disorder was neither perceptual nor judgmen-
tal but temporal. And the most important dierence between doctor and
patient pertained not to the content of the patients delusions but to the
form of his temporal experience.
Intriguingly, one clue that led Minkowski to this hypothesis concerned a
distinctive impairment of his patients reasoning abilities: each day, in a state
of considerable anxiety and fear, the man would insist that his execution
would take place that night. Minkowski reports on his own reaction:
[At rst] I consoled myself with the thought that, come the morning, he would see that
all his fears had been in vain. However, the same scene was repeated the next day and
the next, until after three or four days I had given up hope, whereas his attitude had
not budged one iota. What had happened?. . .. I, as a normal human being, had rapidly
drawn from the observed facts my conclusions about the future. He, on the other
hand, had let the same facts go by him, totally unable to draw any prot from them for
relating himself to the same future. I now knew that he would continue to go on, day
after day, swearing that he was to be tortured to death that night, and so he did, giving
no thought to the present or the past. (Minkowski, 1923, p. 132)
Already with this one case report we encounter a number of the themes
that will concern us in what follows. Minkowskispatientsuers from a
condition in which his thought processes and aective life fail to track
the realities of his situation. That condition itself involves the collapse of
a fundamental component of ordinary human reasoning what
Minkowski calls the tendency to generalize,or what we might call
inductive reasoning. And all this, Minkowski boldly proposes, is rooted
in a profound disorder in his general attitude toward the future.
Minkowski hazards several descriptions of the underlying disturbance
in the patients lived experience of time: That time which we normally
integrate into a progressive whole was here split into isolated frag-
ments;[the] carry-over from past and present into the future was
completely lacking in him;[he] was completely lacking . . . [a] propul-
sion toward the future;the future was blockedor shut o
(Minkowski, 1923, pp. 132138).
The mature statement of Minkowskis view is found in his major study
of 1933: Lived Time. In a brief but important passage, Minkowski applies
his hypothesis to mania.
In my estimation, the structural analysis of the person in a state of manic excitement
will have to be undertaken in this direction, and this all the more so because it allows
us to view manic excitement from the same point of view as melancholia, namely, as
a disorder relevant to unfolding in time, or if you wish, as a manifestation of a mental
subduction in time. (Minkowski, 1933, p. 296, emphasis added)
Minkowskis hypothesis is that mania has its roots in the temporal struc-
tures of human experience, and specically in an impairment in the way
that time unfolds”–that is, the way in which temporal experience is
articulated into a past, present, and future. Borrowing a term from
Mignard (1924), he describes the underlying disorder as a subduction
in time that is, as a modication to an inferior level.
As to the specic
form that subduction takes in mania, Minkowski proposes the following
A person in a state of manic excitement lives only in the now, and his contact with
the environment is restricted to the now; he has no present any more, since in
general he no longer experiences unfolding in time.(Minkowski, 1933, p. 294,
emphasis added, translation altered)
Following Husserl, Minkowski distinguishes between a temporally and
hermeneutically thin now and a thick, expansive, and hermeneutically
rich present. He argues that when a persons lived future is lost or distorted
under conditions of mania, the result is a subductionin temporal
experience. In Minkowskis Bergsonian terms: There is no longer any
lived duration [durée]; the manic individual becomes the plaything of the
now, always variable, changing from one instant to the next; he lives in
the grip of the now, in which he exists and out of which he is incapable of
creating a present(Minkowski, 1933, pp. 294296).
We need nally to take note of one further claim advanced in
Minkowskis brief remarks about mania. Notice that in the passages just
cited, Minkowski claims not only that mania involves living only in the
now,but also a resulting restriction in his contact with the environment
[son contact avec lambiance].In elaborating this idea, Minkowski writes
of the particular shrinking [rétrécissement] which the manic persons vital
contact with reality undergoes, which, without completely annihilating it,
renders this contact particularly supercial(p. 295).
Minkowski himself never provided a detailed development of these
proposals, and many of his formulations are suggestive without being
precise. But he nonetheless framed a trio of hypotheses of considerable
importance for subsequent research. To summarize: (1) Disturbance in the
formal structure of temporal experience is a core feature of mania. (2)
Persons in states of mania live only in the now,no longer experiencing
the usual unfolding of time into a complex present, past, and future. (3)
Disturbance in the temporal structure of experience limits contact with
realityfor the person undergoing a manic episode.
2. Binswangersrst model
Minkowski described his three hypotheses about mania as mere sugges-
tions(Minkowski, 1933, p. 294). But his core hypotheses were later
developed by his Swiss contemporary and friend, Ludwig Binswanger,
who credited Minkowski as being the rst to introduce phenomenology
into psychiatry for practical purposes(Binswanger, 1946, p. 231). Unlike
Minkowski, who wrote about manic experience only in passing,
Binswanger devoted two books to the topic; they were separated from
each other by nearly 30 years. He also approached the topic with some-
thing that Minkowski seems to have lacked: detailed knowledge of the
phenomenological research on temporal experience undertaken by Husserl
and Heidegger.
Indeed, we can usefully treat Binswangers work in this
area as an attempt to provide a model for Minkowskis hypotheses, using
resources drawn directly from Husserl and Heidegger.
In the end,
Binswanger provided not one but two such models one drawing pri-
marily on Heidegger and one drawing mainly on Husserl. In this section,
we examine the rst model, returning to the second model in Section 4.
BinswangersÜber Ideenucht (1933)
was published as a book in the
same year as MinkowskisLived Time. Its focus was the so-called ight-of-
ideasthat has long been one of the presentations most closely associated
with mania. Theoretically, it was profoundly shaped by HeideggersBeing
and Time, which had been published in 1927 (and which received only a
footnote mention in Minkowskis study). The broad strategy of
Binswangers book was to use certain core concepts and strategies from
Being and Time in order to describe and articulate manic experience. For
our purposes, three ideas are central: the claim that there is a distinctive,
world-disclosive mood [Stimmung] associated with manic episodes, the
claim that this mood has its own distinctive temporal structure, and the
thesis that the temporal disturbance at work in mania can be understood as
a narrowing or shrivelingin the way in which temporality temporalizes
itself.We consider each of these points in turn.
Binswangers point of entry for this early investigation was the phenom-
enon of manic optimism. He distinguishes two broad forms of optimism,
which he refers to as primaryand secondaryoptimism. The dening
feature of secondary optimism is its dependence on some belief or positing
of one kind of another. One of Binswangers examples is Odysseus, whose
optimism about getting home to Ithaca derives from his explicit belief that
Athena will protect him in fulllment of her promises. Panglossian optimism
rests on positing that this is the best of all possible worlds. From these various
forms of secondary optimism, Binswanger distinguishes primary optimism as
aStimmung”–as a mood or attunement. Unlike that of Odysseus or
Pangloss, it does not rest on any conviction, posit or belief. He coins the
term Stimmungsoptimismus(optimism-as-mood) to distinguish it (p. 57).
Applying Heideggerian principles, Binswanger holds that the manic mood
of primary optimism is both world-disclosiveand temporally structured.
According to Heidegger, to be in a particular mood is to nd oneself in a
world with a distinctive texture.
Accordingly, Binswangers analysis of manic
experience begins by trying to articulate the texture of the world of manic
optimism. The terms in which he does so are often metaphorical. The manic
world is all-rosy,cloudless, bright, and wide-open(p. 58). Even at this rst
stage of the phenomenological articulation, temporal features enter in. This is
hardly surprising, insofar as optimism would seem to be an essentially
temporal phenomenon, implicating a sense for a future with a distinctive
valence. The manic individual, Binswanger observes, always plans, hopes or
expects something pleasing,and has the sense of an unlimited horizon of
time. Even death, if it is considered at all, is encountered as a gateway to a
further existence (p. 58). So the manic world is temporally innite.
The next stage of Binswangers investigation again follows a
Heideggerian path. Having described these features of the manic mood
and its world, he sets out to identify the underlying structures of temporal
experience associated with it (pp. 153162). The description he oers is
closely modeled on a largely neglected section of Being and Time, in which
Heidegger describes the distinctive temporal rhythm of what he calls
The curious individual whom Heidegger describes is charac-
terized by a supercial, highly distractible, enthusiastic attraction to what-
ever proximately presents itself. Adapting a comment from Rilke,
Binswanger describes the tempoof manic curiosity as involving a form
of leaping [springen], tumbling [taumeln], and sliding [gleiten] from one
thing to another. Following Heidegger, he emphasizes the crucial conse-
quence. Mania brings with it what Heidegger calls Aufenthaltlosigkeit: the
manic individual never lingers or tarriesin a situation but is ever and
always leaping oto something new.
Binswanger is particularly struck by
Heideggers description of a condition of the curious individual as being at
once überall und nirgends”–everywhere and nowhere. So for Binswanger,
mania is eectively assimilated to an extreme case of what Heidegger calls
The nal stage in Binswangers early analysis is also an attempt to follow
Heideggerian principles. For Heidegger, the fundamental structures of our
existence have their deepest source in the distinctive ways in which, in his
notorious jargon, temporality temporalizes itself.The primitive or ori-
ginalstructure of temporal experience becomes articulated or unfolded
into the familiar, orderly, sequential structures of past, present, and future.
Binswangers thesis is that the core phenomenon at work in mania is a
disturbance in this temporal articulation. In mania, Binswanger claims,
the structure of temporalizing is shrivelled [geschrumpft] and narrowed to
mere enpresenting [Gegenwärtigen](p. 162).
Even with this much of Binswangers story in view, it should already be
clear that and how Binswangers position in 1933 provides a Heideggerian
model for Minkowskis hypotheses.
Minkowskisrst hypothesis was that
disturbance in the formal structure of experience is a core feature of mania;
Binswanger tries to specify just what that disturbance is. Minkowski
claimed that the manic individual lives in the grip of the now;
Binswanger traces this back to a fundamental narrowing or shriveling
(p. 162) in the unfolding of temporal experience. Minkowski claims that
one result of these temporal disturbances is a loss of vital contact with
reality; Binswanger describes manic Aufenthaltlosigkeit [restlessness],
which he identies as the most extreme counter-phenomenon
[äußerste Gegenphänomenen] to what Heidegger calls the Augenblick
the experience in which we are able to grasp a situation for what it is
and respond to it resolutely (p. 159).
Binswangers early model of manic temporality is fascinating, not least
as a vivid trace of the impact of Being and Time upon an early adopter
from the world of clinical psychiatry. But it is not without its diculties.
Two in particular merit comment at this stage. First, although Binswanger
relies heavily on Heideggers theory (and jargon!) in elaborating his model,
it is not clear that the resulting position makes sense in Heideggerian
terms. Specically, it is not clear to what extent the shrivelingor nar-
rowingof manic temporality is consistent with Heideggers theory of
temporal experience. Here, alas, Binswanger does not say as much as one
might hope to specify exactly what the shrivelingand narrowing
consists in. But if it is understood to mean that there could be a form of
meaningful presence without an experience of past or future, then this
would seem to be at odds with some of Heideggers most fundamental
doctrines: his thesis about the existential priority of the future, and most
importantly, his thesis about the original unity of the three temporal
ecstases. For Heidegger, in short, the experience of a meaningful present
is fundamentally dependent on an experience of a richer temporal struc-
ture that includes futurity.
A second diculty is more internal to Binswangers own commitments
a potential tension between his starting point and his nal position. Here
we have to recall that Binswangers point of entry for the phenomenology
of manic experience was manic optimism. Optimism itself would seem to
be an intrinsically temporal mood; it is constituted in part by an orienta-
tion toward good things to come. Moreover, as we noted, Binswanger
himself provides an articulation of some of the distinctive temporal struc-
ture of the world disclosed by Stimmungsoptimismus [optimism-as-mood]
including the sense of temporal openness toward an unbounded future.
So there is at least a prima facie problem in accommodating all this with
the ultimate conclusion about a form of temporality that is shriveledor
narrowed to mere presence.
Neither of these problems are necessarily insuperable. But in order to
resolve them we would need something that Binswangers 1933 book does
not provide: a more detailed analysis of the specic structure of the
experienced present that predominates in mania. Thirty years later,
Binswanger attempted to provide exactly that. But this time he saw the
need to supplement his Heideggerian strategies with resources drawn from
Husserls theory of time-consciousness.
3. A very brief comment on protention and retention
Before considering Binswangers second model of manic temporality, we
need to revisit Husserls core concepts of retention and protention.
Husserls landmark 1905 lectures on what he called internal time-con-
sciousnessarticulated a distinction between an instantaneous nowand
what, following William Stern, he refers to as Präsenzzeit the lived
presentor presence time.
In unpacking the phenomenological
structure of the experienced present, Husserl identied the twin phenom-
ena of retentionand protention.Retention and protention are tempo-
rally inected forms of intentional experience. But Husserl insists that their
intentional structure diers from that of the more familiar phenomena of
remembering and expecting.
In the standard case of memory, as Husserl understands it, we recol-
lector recapitulatea past event or episode. In doing so the event or
episode comes to mind.That is, it becomes present once again whether
because we intentionally bring it to mind, or because it happens to spring
to mind.Husserl introduces a key piece of technical terminology to refer
to this phenomenon of becoming present”–Vergegenwärtigung. The term
dees any easy translation; we resort to James Churchills neologism
presentication(Husserl, 1964, p. 36n). The key point, as applied to
the past, is that what Husserl calls secondary memory (recollection)
involves presentication of some sort: what is past is made presentfor
conscious attention. Retention is dierent. In retention, we neither recol-
lect nor recapitulate the past event, and we do not experience the past
content as present once again. In Husserls provocative shorthand: I
directly perceive the past (Husserl, 1950, vol. X, pp. 39, 79).
Husserl exhibits the phenomena he has in mind with reference to his
example of the melody. If someone plays a simple tune with one hand on a
piano, but then abruptly stops midway through, we experience a retention
of the note that has just played, experiencing it not as present but as past.
At the same time we have a protentive experience, in a characteristic
modality of partly determinate indeterminacy, of the as-yet-still-future
note to follow. Crucially, we do not hear all of this in the same mode; if
we did then we would hear either a chord or a cacophony. Husserl argues
that these retentive and protentive experiences are the primal manifesta-
tion of time in our experience, that they are essentially non-presentify-
ing,and that they are both distinct from and conditions upon the more
familiar temporal experiences of reproductive memory and expectation.
The foregoing summary is a fairly standard synopsis of Husserls posi-
tion, even if commentators dier on particular details or points of empha-
sis. But at this point, we reach an important fork in the road. Husserls
reliance on the musical example has led many readers and commentators
to assume that retention and protention pertain narrowly and specically
to the experience of the only-just-past and the about-to-occur. Zahavi, for
example, characterizes a protention as a more or less indenite intention
of the phase of the object about to occur(Zahavi, 2003, p. 83, emphasis
added). The assumption that retention and protention extend only to the
temporally proximate is both reected in and reinforced by the history of
(mis)translating HusserlsPräsenzzeit[presence-time, lived presence] as
the specious present”–a term which has been used in psychology
specically in connection with the experience of concurrence.
It is not
entirely clear whether Husserl himself intended to restrict the use of
retentionand protentionto the temporally proximate. But whatever
Husserls own position on the matter of denition, it will be crucial for our
purposes to distinguish two discrete commitments of his substantive
theory. The rst is the identication of retention and protention as sui
generis non-presentifyingintentional acts directed at past or future
stimuli, events, or phases of temporally extended objects. The second is
the particular application of these concepts in the interpretation of the
experience of the just-now-passedand the just-about-to-occur.In
seeking to understand and develop Binswangers later theory of manic
temporality, we will need to disentangle the two commitments.
4. Binswangers second model
With this distinction in hand, we can now turn to Binswangers second
model, which he develops in his 1960 book Melancholia and Mania.
book takes the form of a series of studies intended to provide a unied
theory of the two phases of what we would now call bipolar I, and which
Binswanger describes as the manic-depressive antinomic(p. 113). The two
central concepts for our purposes are, rst, the idea of the construction of
the present[Aufbau der Gegenwart], and, second, the idea of Husserlian
protention and retention as maßgebenden intentionalen Fädenroughly:
normative intentional threads. We address these two concepts in turn. The
rst concept, the Aufbau of the present,is a natural development of
insights shared by Husserl, Heidegger, and Minkowski. If the now is tem-
porally simple while the lived present is temporally complex, then we need
an account of the temporal constitution of the present the way that it is
built upor constructed.
In providing an account of that Aufbau
[construction], Binswanger describes protention and retention as the
intentional threadsout of which the temporal fabricis woven (p. 96).
It should be clear that we are once again here in the domain of
metaphor. Binswanger thinks of lived time as a kind of temporal fabric
or weave[Gewebes] which makes it possible for temporal objects to
appear and indeed mediates our whole relationship to our environment.
Protention and retention are then understood to be the major threads (the
warp and the weft, so to speak) out of which that fabric is woven.
Crucially, Binswanger describes these threads as maß-gebenden that is,
as establishing the measureor as norm-giving.
The substantive thesis
is then that temporal experience is built-upor constructed in part from a
set of protentions and retentions against which experience is measured or
assessed. In aective disorders, Binswanger claims, this weaving upof the
present becomes distorted.
This is a tantalizing proposal, and one that points toward the possibility of
lling the lacuna we found in his earlier model. If we could provide a
perspicuous account of this temporal Aufbau [construction, structure] and
its disturbances, we would be on our way to an articulation of the phenom-
enological substructure of temporal experience in mania. That is the good
news. The bad news is that the promise is never properly fullled. One
persistent problem is that Binswangers writings on this topic never break
free from these rst metaphorical formulations. Binswanger oers a number
of suggestive elaborations of his governing metaphor of the fabric,
weave,and threads,but the metaphor itself is never fully cashed.
The more serious problem for present purposes is that Binswanger
operates with a number of competing deployments of the metaphor;
these dierent versions themselves pull in rather dierent directions and
are not obviously consistent. His most frequent elaboration (and the
ocial story) is that in conditions of manic excitation the weave of the
temporal fabric undergoes a kind of loosening[Auockerung] (p. 96).
Note that if we take this metaphor seriously, we would have to say that the
normative intentional threads of protention and retention remain; they are
just not woven together as tightly as in other congurations of experience.
One result might be that certain kinds of extended temporal objects simply
cannot be experienced; they slip through the gapsin the weave of our
temporal fabric, which lacks the degree of continuity needed to capture
them. But in other passages, Binswanger claims that in mania the temporal
threads are torn up [zerreißen] into fragments,(p. 95) retreat
[Zurücktreten] or indeed disappear [altogether(p. 115). On this applica-
tion of the metaphor, the collapse of temporal experience would be more
thoroughgoing. If the threads disappear then surely the fabric goes with it.
But alongside these rst two deployments of his metaphor, Binswanger on
one occasion makes use of a third. Interestingly, the third deployment is the
one that is most tightly connected to one of Binswangers case studies, The
Case of Olga Blum. As is often the case with Binswangers case studies, he
sketches the basic facts of the case and then intensely focuses on an illumi-
nating moment from one particular episode. With Olga Blum, the episode
involves reading Goethe. At one point during her stay at his sanatorium,
Binswanger gives Olga a copy of Faust and invites her to read it. When later
asked for her reaction, her response is: I am lucky that Goethe lived before
me; otherwise I would have had to write it! (p. 99).
In reecting upon this response, the feature that Binswanger nds most
signicant is not so much Olga Blums relief at not having to write Faust
herself, but rather the characteristic form of manic optimism reected in
her condence that she could indeed write it herself if she had needed to.
Binswanger elaborates on this optimism in terms of its protentive
The protentive moment emerges from the whole sentence in which Olga Blum
(both) expressed her relief that the prior existence of Goethe relieved her of the
eort of having to write a Faust like his, while at the same time harboring no doubt
that she would succeed at such a task. This is the protention that hangs in the air,
since all retentive moments are missing, on which she would be able to build (p. 101,
emphasis added).
Notice here a third deployment of Binswangers governing metaphor.
What he ascribes to Olga Blum in this passage is not a loosely woven
temporal fabric, or a form of experience in which the protentional and
retentional threads are zerreißen. For Olga Blum a distinctive form of
manic protention is indeed at work, but it hangs in the air,without
being interwoven with the correlate retentions.
5. Six patterns
We turn now to the second strand of our strategically hybrid approach.
While the proposals developed by Minkowski and Binswanger are rich and
suggestive, and while they were grounded in extensive clinical experience,
they also suer from intrinsic limitations. As we have seen, their positions
are often articulated in metaphors that are dicult to cash, and they suer
from ambiguities and prima facie inconsistencies that are dicult to
resolve. Binswangers second model is in many ways the most developed
theory from this tradition, and was the fruit of many decades of clinical
experience and phenomenological research. But even here, we encounter
multiple deployments of key metaphors without the evidence that would
allow us to choose among them. In order to overcome these limitations,
and in order to assess the models we have documented, we introduce
empirical evidence from our interview-based study of manic temporality.
Our presentation of ndings here is of necessity selective; for present
purposes we focus on those that have direct bearing on Minkowskis
hypotheses and Binswangers models.
We begin with a few words about the design of the study. The partici-
pants were 12 individuals selected for histories of bipolar disorder, being
acutely manic at the point of the interviews, and being eective commu-
nicators of their manic experience. The study received research ethics
approval and the rules of the Mental Capacity Act (2005) were followed.
We employed the technique of second-person phenomenologyon
which we have reported in earlier work (Owen, Freyenhagen, Hotopf, &
Martin, 2015; Owen, Freyenhagen, & Martin, 2018; Owen, Freyenhagen,
Martin, & David, 2017). We approached the research participants as
collaborators, and as informants as to the character of their own manic
experience. In a series of approximately 1-hour, semi-structured inter-
views, participants were invited both to report on their ongoing
experiences at the time of the interview and to reect on earlier experi-
ences of manic episodes, as well as the possibility of future ones. The
interviews were conducted by an experienced clinical psychiatrist (GO)
and were organized around a series of open questions, with opportunities
for follow-up and discussion between interviewer and participant.
In keeping with Dennetts proposals for heterophenomenology
(Dennett, 1992), we treated participant reports as primary data to be
interpreted; we did not assume that they were always reliable informants.
The interviews were recorded, transcribed, and subsequently codedusing
iterative tagging (Charmaz, 2006), undertaken collaboratively by the three
co-authors. The recordings, coded transcripts, and contextual information
were then submitted to close interpretative scrutiny. We used the data
from the interviews as evidence from which hypotheses regarding partici-
pant experience could be generated. We then probed these hypotheses
both in subsequent interviews and in further analysis of recordings and
transcripts. We used techniques of grounded theory (Charmaz, 2006; Glaser
& Strauss, 2017) to assist in the construction of higher-order codes and in
the thematization of our data. Excerpts from the clinical interviews cited in
this article are drawn from a large corpus of interview data.
So what did we nd? We identied six patterns in the interview data
that related either directly or indirectly to our core question about tem-
poral experience in mania. Before turning to the patterns, however, it may
be helpful to review a few responses to one of our ice-breaking questions.
We asked participants how they would explain their experience of mania
to someone who had no experience of the condition. Here are three
indicative responses, at least two of which, as it happens, appeal to scenes
from well-known lms.
(1) BP7: Its bright, its very bright. Its as bright as the sun is. . .. The
light is part of me. . .. Im part of the circle of life; Im part of the
energy of life.
(2) BP6: It sounds very weird and stupid but Charlie and the
Chocolate Factory. You know when the elevator smashed through
the roof?. . .. Reach the peak and its . . . through the roof, through
the ceiling. . .. Not nasty. Its like its being free. . .. He looked down
and he could see everything, and everything was his.
(3) BP10: I just love every moment, like you know, the blue of the sky,
the white of the crowds, the green of the trees, you know. . .. Its like
Julie Andrews in the opening of The Sound of Music where shes
spinning her arms around and just singing: The hills are alive. . .
With this by way of background, we turn now to review the six relevant
patterns. First, all participants were able to report on past manic episodes,
and many were able to do so in considerable detail.
(4) BP6: Er. . .. I was with a girl, we was in love and she was great. We
smoked a lot of weed, we drunk a lot of wine, we worked hard. Er. . . so
much so that we rarely cooked, we was out nearly every night having a
meal. A very nice life. But it only lasted like a year, and then maybe we
had one splitoo many, and then. . .. We had our rst sleepless night
and I woke up and I felt sort of weird. I was like sort of up there in the
corner, I looked down and I could see myself sleeping on the bed next
to her. I dont know what happened, and that was it. And then the
next thing I knew, I was naked, walking up the shops for a pint of milk
and a packet of fags. ... I thought it was alright. I thought Oh I can do
what I like, and why not?. . . and the next thing you know I got
arrested for indecent exposure, and the police arrived, and the land-
lord arrived, and then I was in hospital.
Second, participants were able to make reference to concrete future plans.
(5) BP9: Ive just got to make sure I pay my TV license this week.
Third, many participants were able to report in some detail on the
warning signs of an imminent manic episode.
(6) BP2: I always know when Im going to be manic.
Interviewer: You always know?
BP2: Yeah. I always know because I become happier, I become more
inclined to listen to loud music, I tend to buy things, I tend to be
jolly on the whole except when somebody gives me a problem, then I
become very irritable.
Interviewer: So you know? You know what the signs are?
BP2: Ive a got a big insight, and its normal. Im not at the stage
where its the rst time in my life that I had a manic episode. Ive
had manic episodes for 35 years.
Particularly in light of these rst three patterns, a fourth pattern was
particularly striking: all of the participants denied that they were currently
in a manic state, despite being hospitalized with a diagnosis of mania.
(7) BP4: When it comes to bipolar, Im the king of bipolars.
Interviewer: Would you say you were in a manic phase now?
BP4: No.
Interviewer: What phase are you in now, would you say?
BP4: Just in a level phase.
Afth pattern concerned the possibility of future episodes, which the
participants almost all denied.
(8) BP9: I cant even imagine one [future manic episode] . . . Im through
it. Ive not peaked and gone down. Iminadierent arena. This is a
new game now.
(9) Interviewer: So what youre saying is that all the issues about mania,
and managing mania, in the past are. . .
BP4: Fizzling out.
The sixth pattern emerged in response to more open-ended questions
about the future.
(10) Interviewer: When you look to the future, do you see pain and
suering, or do you see possibilities?
BP4: No. I see freedom and liberation. . .
(11) Interviewer: So when you think about the future now, how does the
future seem to you?
BP9: Its great, its golden, its wonderful. Its going to be full of all
the things that I could potentially have, create for myself. . .. I know
that my life will be full of abundance [clicks ngers] if I keep this
synchronistic approach.
(12) Interviewer: Do you have worries about the future, or do you feel
that the futures ...?
BP5: No. I dont fear about the future, the future will take care of itself.
(13) Interviewer: What can you see if you look into the future?
BP6: Palm trees, whitewashed buildings, hot sun. Anywhere, like
that. But not just that, you know. Places where I havent been.
This distinctive attitude toward the future, both highly positive and
yet also largely unspecic, was the single most prevalent temporal theme
in the interviews.
What light do these patterns shed on Minkowskis hypotheses? We
suggest that our data eectively rebut Minkowskis second hypothesis, if
that is understood to mean that persons in conditions of mania live without
awareness of past or future. The participants in our study were severely
manic at the time of these interviews, but they nonetheless reported and
reected in rich detail on their own past, and in both mundane and extra-
ordinary ways on their future. They did not live only in the now.
same evidence casts doubt on Binswangersrst model, at least insofar as its
bottom-line analysis concerned the hypothesis of a shrivelingor narrow-
ingof manic temporal experience to enpresenting.
By contrast, our data lend support to Minkowskisrst hypothesis. The
patterns we identied suggest that there is indeed a distinctive form of temporal
experience at work in mania, and that this temporal structure has important
consequences for example, regarding awareness of illness, practical reasoning,
and awareness of risk. In order to bring this out more fully, letsconsiderthe
following renement (and non-metaphorical specication) of Binswangers
second model. We might call it the Olga Blum variant,since it takes its lead
from Binswangers third deployment of his governing metaphor:
(i) A core feature of acute mania lies in a sui generis form of existential
protention of a future with a uniformly positive valence.
(ii) This form of manic protention extends not only to the next few
seconds (the about-to-occur), but has a global signicance, pro-
jecting a structure for the self-implicating future as a whole.
(iii) Manic protention is in Binswangers distinctive sense maßgebende
[norm-establishing] that is, it establishes a normative standard that
shapes both specic expectations and the interpretation of future
(iv) Because protention is one of the basic constituents of the lived
present, manic protention results in a distinctive form of
Präsenzzeit [presence-time, lived presence] characteristic of mania.
Reverting to Binswangers metaphor, we might say that a sui generis
form of manic protention is the dominant thread in the temporal fabric of
manic optimism.
Second-person phenomenology is of necessity indirect and hermeneutic; it
is rare to nd a denitive proof for a hypothesis. Moreover, there are intrinsic
limits in trying to detect a non-presentifying form of futural experience using
interview techniques that by their nature invite research participants to engage
in explicit, presentifying representations. These limits notwithstanding, we
submit that this Olga Blum variant on Binswangerssecondmodelts with
the data that emerged in our study and this in two senses. First, the Olga
Blum variant ts our data in the modest sense of being consistent with it; as we
have seen, Minkowskis second hypothesis did not fare so well! But more
importantly, the Olga Blum variant ts the data in the sense that it helps
explain important patterns that emerged in the interviews.
Consider rst the patterns regarding participantsawareness of their
own manic condition. As we have seen, participants exhibited detailed
awareness of past mania and knowledge of specic warning signs of
imminent episodes. Yet they denied both current mania and the likelihood
of future episodes. This is an unusual and temporally distinctive form of
what in psychiatry is often described as impaired insight.
But the Olga
Blum variant on Binswangers second model makes sense of it. For on that
hypothesis, manic experience is dominated by a global protention of an
all-goodfuture; future recurrence of illness resists accommodation, since
it conicts with a norm-establishing (maßgebende) protention. What about
present illness? Recall that on Binswangers model, protention plays a
decisive role in the Aufbau [construction] of the experienced present. A
dominant manic protention can thus be expected to yield a form of
experienced presence that cannot easily accommodate the thought that
something is wrong. Since awareness of present illness is ipso facto
acknowledgement that something is wrong, such awareness stubbornly
resists accommodation. Moreover, all participants in our study were keenly
aware that past episodes of mania had resulted in profoundly negative
consequences. An acknowledgement of present illness would bring with it
an expectation of future negative consequences. But this conicts with the
dominant protention.
Notice that none of this interferes with the memory of past manic episodes,
since the core of the hypothesized disturbance concerns a temporally asym-
metrical protention. This variant on Binswangershypothesisinthissensets
the data, explaining a striking and otherwise unexplained temporal asymme-
try in participantsawareness-of-illness. It also helps in making sense both of
the general descriptions oered by participants of their manic condition
(suddenly breaking through to an experience of a brightworld), and of
the distinctive character of their remarks when asked about the future
remarks which were uniformly positive but almost entirely unspecic.
We turn in the nal section to consider the explanatory force of this
variant on Binswangers hypothesis with respect to impairments of inductive
reasoning, together with its bearing on Minkowskis third hypothesis. Before
doing so, however, it is worth taking note of the explanatory advantage that
our hypothesis enjoys over one natural rival. According to this alternative
hypothesis, mania is rst and foremost an aective disorder, and its core
disturbance involves highly elevated aect or mood. On this approach,
manic optimism, with its distinctive attitude about the future, is seen as at
most a derivative phenomenon. Because elevated mood has a pervasive
impact on experience, it is to be expected that a person in a highly elevated
mood will experience everything (including the future) as good.
In assessing the comparative merits of this alternative, we need rst to be
clear that we do not deny that elevated aect is an important feature of
mania. Both Minkowski and Binswanger advance the hypothesis that tem-
poral disturbance is acore feature of mania; we should be open to the
possibility that there are other core features. Moreover, we take one of the
important insights from the phenomenological traditions (both philosophi-
cal and clinical) to be that moods have signicant temporal structure.
Binswangers hypothesis is best understood as a specication of the temporal
structure of the aect at work in manic excitement. With these two clarica-
tions in hand, we come to the crucial point vis-à-vis this alternative explana-
tion: the fact is that the participants in our study did not experience
everything as all-good. They experienced the future as all-good, and this in
turn had a marked eect on their experience of the lived present. But the past
which they recollected was not all good; on the contrary, it included dis-
tinctly negative and painful experiences. A key advantage of Binswangers
hypothesis is that it explains this asymmetry. Appeal to elevated aect alone
(without a supplementary account of its distinctive temporal structure)
leaves the asymmetry unexplained.
6. Manic temporality and existential logic
We turn nally to consider the bearing of this analysis on impairments of
reasoning, and specically on inductive reasoning, in conditions of manic
excitement. There is a classic perspective on inductive reasoning, exempli-
ed by the wartime papers of Rudolph Carnap and Carl Hempel, which
treats induction as a strictly formal, wholly syntactic operation.
merits of that account have been vigorously debated among logicians.
But even on this maximally formal approach, issues about time enter the
logical picture, albeit only time of a very particular sort and playing a
sharply dened role. Carnaps elusive c-function is emblematic:
According to this top-level formula, the degree of credence that Jones
ought to have for hypothesis his a function of h(the hypothesis) and
the evidence available to Jones.
But note the occurrence of ton both
sides of the equation. What is at stake is Jonescredence with respect to h
at time t; the c-function is meant to specify its relationship to the evidence
available to Jones at t. In other words, the rationality of a particular
inductively based belief is always indexed to the evidence available at the
time. At which time? In eect: at the instant when a bet is placed.
It is crucial to remember, however, that inductive reasoning is not only a
matter for formal logic; it is also a phenomenon of lived experience.
Considered in this context, induction has a much richer and more complex
relation to time. We propose to use the term existential logicto refer to
the study of reasoning (including inductive reasoning) as a structure of
experience. The key point to recognize is that existential logic in this sense
is richly temporal. As a phenomenon of lived experience, induction is
about knitting together the lived past with the lived future. And this
holds even if the subject matter of the induction is something long-past.
Why? Because a lived induction is always a way of gathering up evidence
from past experience and using that to project oneself into the future
whether by making some explicit prediction or as a matter of anticipating
what future evidence-gathering will bring. Viewed from this perspective,
we should expect that serious disturbances to the structure of temporal
experience will have consequences for a persons inductive abilities.
With this context in mind, we return to the data. We have already
shown that our variant of Binswangers Olga Blum model helps to make
sense of an otherwise unexplained pattern of impaired insight manifested
by the participants in our study. We are now in a position to see that
something similar holds for the pattern of inductive failure. According to
our hypothesis, the form of temporal disturbance in mania involves an
unspecic but nonetheless dominant protention of global signicance and
unqualied positive valence. For someone whose temporal experience is
characterized by such a disturbance, we should predict that lived induction
will be impaired in specic ways.
Here it is worth pausing to recall Minkowskis patient with whom we
began. Minkowskis patient experienced a future which was absolutely
dominated by the anticipation of imminent torture and execution.
Evidence that conicted with that dominating experience simply failed
to gain traction in inductive proceedings. In mania the disturbance is
inverted. On the hypothesis that we have developed here, temporal
experience in mania is dominated by a distinctive global protention of
unspecied but exclusively good things to come. In the words of one
(14) BP2: Yeah. You feel happy, you feel things are working perfect.
Like all protentions, this distinctive manic protention is determinately
indeterminate. In this case, the key moment of determinacy is that every-
thing will be good; everything will work out. Exactly how things will work
out so well, particularly in light of current behavior that others see as
reckless, is left almost entirely undetermined. And as Binswanger proposed
in the case of Olga Blum, this sui generis form of manic protention hangs
in the air,untethered by retentions that might temper it.
If indeed temporal experience were distorted in this way, what would be
the consequences for lived induction? Where inductive evidence points
toward a conclusion that some particular matter will not be all-good,will
not work out,we can expect that evidence to resist inductive incorpora-
tion, since it conicts with the dominant protention. The result would be
cognitive dissonance in milder states of mania or, in more severe states, the
sense that past experience is irrelevant as a guide to the future. And this is
indeed what the data from our study attests. Recall the words of BP9: This
is a new game now.
What is common between Minkowskis patient and the participants in
our study is, rst, a specic disturbance in temporal unfolding,and
second, an impairment of inductive reasoning. What we can see now is
that the former explains the latter. When inductive evidence conicts with
melancholic pessimism, that evidence cannot be eectively taken up. And
when inductive evidence conicts with manic optimism, pointing toward a
possible negative outcome, that evidence resists incorporation within a
lived induction. One crucial consequence is particularly worth noting:
manic temporality threatens a catastrophic loss of vital contact with the
reality of a world characterized by risk.
Once again, we can gauge the strength of our proposed analysis by
comparing it to a natural rival. We have proposed that a sui generis form of
protention is a core element of mania, and that this temporal disturbance
helps to explain a manifest pattern of failure of inductive reasoning. But
might the order of explanation run in the opposite direction? Could we
posit a failure of inductive reasoning (or perhaps some more general
cognitive failure) as the core feature, and then interpret the disturbance
of protention as a consequence?
In considering this alternative analysis, it
is important to be clear that the data from our study does not suce to
oer clear evidence about causation. Nonetheless, we submit that the data
supports our hypothesis over this natural rival.
The pattern of inductive failure that we identied among participants in
the study manifested itself specically with regard to the likelihood of
future manic episodes and negative future outcomes in light of patterns
reported from past experience. We encountered no evidence of a general
collapse of inductive abilities. The specicity of manifest impairment is left
unexplained if we posit either a general cognitive decit or a global failure
of induction as a core feature of mania. Of course one might in principle
posit a narrow form of inductive failure as fundamental to mania, but to
do so would be problematically ad hoc. A key advantage of our hypothesis
is that it explains the specicity in the manifest pattern of cognitive decit
by appeal to a speciable disturbance in a discrete component of temporal
experience. For as we have seen, our hypothesis predicts just the sort of
inductive impairment that participants manifested: an inability to incor-
porate inductive evidence that conicts with the dominant protention.
7. Limitations and future research
Our ndings are of signicance in psychiatry, law, and philosophy.
Clinically, our results articulate a core feature of the experience of patients
in an acute and understudied phase of illness; they both identify and
explain an unusual pattern of temporally asymmetrical impaired insight.
Our ndings are legally signicant in identifying a pattern of impaired
reasoning that has direct bearing in applying legal standards of compe-
tenceor decision-making capacity,informing strategies for balancing
the legal imperative to protect vulnerable persons (on the one hand) and
the obligation to support and respect a persons decisions (on the other).
Philosophically, our results suggest a complex interconnection among
structures of temporal experience, self-knowledge, and fundamental opera-
tions of reason.
Our study exhibits limitations that are common in small-scale, qualitative
research. The number of participants made multiple, in-depth interviews
and analysis feasible, but precluded statistical analysis. There was no control
group, although our analysis was informed by experience using a similar
protocol with two populations of persons diagnosed with depression (Owen,
Freyenhagen, Hotopf, & Martin, 2015). The research methodology dictated
selection of participants characterized by high verbal skills, severe illness,
and absence of signicant co-morbidities (e.g. addictions, personality dis-
order); these requirements narrowed the pool of eligibility. And as noted
above, reliance on the clinical interview limited our ability to gather evi-
dence as regard the non-presentifying character of manic protention.
The body of research on temporal experience in mania has been growingin
recent years, but remains small overall, particularly in comparison to the
analogous body of research on depression. Our results contribute to this
growing research corpus in at least three ways. First, we have reconstructed
signicant models of manic temporality from the history of clinical phenom-
enology. Second, we have demonstrated the relevance for mania of a form of
temporal experience (protention) that is distinct both from the experience of
passing time and time ow, and from judgements of duration the phenom-
ena that have been the central focus in recent controlled studies. This in turn
suggests (third) that the standardized vocabulary proposed for research in this
area (Bschor et al., 2004, p. 223) may need to be revisited.
We conclude by noting two research questions that are raised, but not
addressed, by our ndings. As noted at the outset, recent controlled studies
have demonstrated a dierence in the experience of the ow of time between
persons with mania and healthy controls: for persons in manic states, time is
more often experienced as owing quickly. Our study provides evidence of a
distinctive form of protention at work in manic episodes an all-rosy
future is projected. A natural question for further research concerns the
possible connections between the two phenomena. We have not addressed
this question here, but it is a matter that merits both conceptual and
experimental attention. Second, we note that the Olga Blum variant on
Binswangers second model would predict a further asymmetry in inductive
failure during manic episodes. If indeed the distinctive form of protention at
work in mania projects an all-rosyfuture, then we should expect inductive
failure during manic episodes to manifest itself specically with respect to
future negative outcomes. Evidence that inductively warrants a judgement
about a future positive outcome would not resist incorporation to the same
extent. This hypothesis could be tested empirically.
1. One tell-tale detail: at one point Minkowski reects on the patients reaction when I
shaved in front of him(Minkowski, 1923, p. 135).
2. For a reconstruction of this approach to psychopathology, see Berrios (1996).
3. On the use of the form-content distinction in the history of clinical phenomenology,
see Stanghellini and Aragona (2016).
4. For Minkowskissomewhat uneasy appropriation of the term, see Minkowski (1933,
pp. 230231).
5. According to Herbert Spiegelberg, Minkowskisknowledge of Husserl was limited to
the Logical Investigations and the 1929 Paris Lectures, at least part of which he seems
to have attended in person (Spiegelberg, 1972, p. 238). Minkowski seems never to
have engaged seriously with Heideggers writings.
6. There is, admittedly, an element of anachronism in this way of putting it, since
Minkowski published his three hypotheses about mania only after Binswangersrst
model was developed. However, there is also an element of truth in the anachron-
ism, as even Binswangers earlier model is punctuated at key points with references
to Minkowskis work on temporality and mood disorder. Binswanger almost cer-
tainly had knowledge of Minkowskissuggestionsabout mania prior to their
publication in Lived Time.
7. Translations from this text are our own. The material originally appeared in Vols.
2730 of the Schweizer Archive für Neurologie und Psychiatrie.
8. For a discussion of this Heideggerian principle, see Smith (1981,pp. 211235).
9. Heidegger (1927,H346H349). The German term is Neugier literally: greed or lust
for the new.
10. Macquarrie and Robinson translate Aufenthaltlosigkeit with the compound phrase:
never-dwelling-anywhere.Stambaugh translates it as the inability to stay at all.
For present purposes, we shall translate the term as restlessness.
11. For Heideggersdescription of the curious person as überall und nirgends,see
Heidegger (1927, H347).
12. The culminating sentence of Binswangerstemporal analysis carries a footnote
(Binswanger, 1933, p. 162n) that refers back to a number of sources, the rst of
which is Minkowskis 1923 study of his severely depressed patient.
13. Binswanger is here adapting Heidegger (1927,H347). The term Augenblick is a
term-of-art in Being and Time; Macquarrie and Robinson translate it rather freely as
14. A full discussion of these Heideggerian doctrines falls beyond the scope of the present
article. For one relevant piece of textual evidence, see Heidegger (1927, H359H360),
where Heidegger claims that circumspective enpresenting [Gegenwärtigung]...
always belongs to a full ecstatical unity of temporalityand goes on to describe the
present as rooted in the future and in having-been.(translation and emphasis
altered). At H326, he describes the future as releasing from itself the present.
These claims require greater scrutiny than is possible here, but on one reading they
would seem to preclude the possibility of temporal experience that is shriveled to
mere enpresenting.
15. See Husserl (1950, vol. X, p. 21). For Sterns use of Präsenzzeit,see Stern (1897).
On the controversies surrounding the sources of Husserls notion of Präsenzzeit, and
on the history of its (mis)translation, see Gallagher (1998, chap. 3).
16. For the mistranslation, see Husserl (1964), p. 41. The duration of the specious
present has been the subject of considerable debate, but it is generally agreed that
the relevant units are seconds or milliseconds (Pockett, 2003).
17. The extension of the Husserlian concepts of protention and retention to longer
timescales has recently been discussed in Kupke (2009, p. 40).
18. See Binswanger (1960); translations from this text are our own. See also Binswanger
19. The term Aufbau literally means build-up; more colloquially it translates con-
structionor structure.
20. Maßgebend-is another technical term that resists straightforward translation. The
standard dictionary denition is denitiveor authoritative; etymologically the
sense is something like: giving the measure,or establishing the standard.The
corresponding noun, Maßgabemeans stipulation;Maßstabis the ordinary term
for a yardstick or ruler. So perhaps the best translation of maß-gebenendeinto
contemporary philosophical English would be normative.Something is
maßgebende in Binswangers sense insofar as it establishes a standard by which
other experience is assessed, shaping both specic expectations and the interpreta-
tion of other experiences. We leave the term untranslated, but gloss it as norm-
21. Interview questions included: In terms of your spirits and mood right now, how
would you describe it?,”“If you have a sense of how things are now and your future,
how does the future feel?.
22. One might worry here that the interviewer explicitly asked about the participants
future and past and, therefore, may have acted in a suggestive way. By way of
clarication, we would emphasize rst that the questions posed by the interviewer
were designed to be open rather than leading. That they were indeed open questions
is conrmed by the fact that use of a similar interview schedule elicited quite
dierent replies about the future in a related study focusing on persons diagnosed
with severe depression (Owen et al., 2015). Finally, we note that BP9s remark about
plans to renew a television license (see extract 5, above) was made independently of
any interview question about the future, being oered spontaneously at the end of a
nearly 300-word response to a question about the dierences between the partici-
pants experiences inside and outside of hospital. In the course of this wide-ranging
response, BP9 discussed past indebtedness, subsequent struggles to get support to
cope with credit card bills, current solvency and employment, as well as the plan to
pay for the television license. These responses simply cannot be reconciled with the
hypothesis of living only in the now”–whatever the prompt that elicited them.
(We thank an anonymous referee for raising this possibility, and giving us the
opportunity to add this clarication.)
23. The mismatch between our data and Minkowskissecond hypothesis is so striking
that it calls out for an error theory of some sort an explanation of how Minkowski
went so far wrong on this point. We do not oer such an explanation here, but it is
certainly worth reconsidering in this context Minkowskis uneasy reliance on
Mignards notion of subduction,which projects an understanding of mental illness
as some kind of reduced form or lower levelof experience. The power of such
metaphors can be considerable in shaping hypothesis-generation in psychiatry and
phenomenology alike.
24. For analysis of the clinical notion of insight, see Amador and David (2004).
25. See Hempel (1942)and Carnap (1945). For a useful synopsis, see Jerey (1973).
26. We adapt this version of the formula from Jerey (1973, pp. 299300).
27. We are grateful to an anonymous referee for raising this possibility.
28. Support for the research presented here was provided by a grant from the Wellcome
Trust (grant number 097683/Z/11/Z). The authors thank the participants in the
study for making this research possible. Earlier versions of the article were presented
at the American Society for Existential Phenomenology, The Essex Phenomenology
Werkstatt, and the Kings College London Philosophy and Medicine Colloquium.
For helpful comments on earlier drafts, the authors would like to thank these
audiences, and two anonymous referees for this journal.
Disclosure statement
No potential conict of interest was reported by the authors.
This work was supported by the Wellcome Trust [WT 097683/Z/11/Z].
Notes on contributors
Wayne Martin is Professor of Philosophy at the University of Essex and Director of the
Essex Autonomy Project.
Tania Gergel is a Wellcome Trust Senior Postdoctoral Research Fellow at the Institute of
Psychiatry, Psychology and Neuroscience, Kings College London. Although her back-
ground was in ancient philosophy, her research now focuses on mental health, ethics and
Gareth S. Owen is senior lecturer at the Institute of Psychiatry, Psychology &
Neuroscience, Kings College London and consultant psychiatrist at the Maudsley
Hospital, London. His research interests include mental health and justice, decision-
making capacity and psychiatric phenomenology.
Amador, X., & David, A. (Eds.). (2004). Insight and psychosis: Awareness of illness in
schizophrenia and related disorders, 2nd ed.. Oxford: Oxford University Press.
Berrios, G. (1996). The history of mental symptoms: Descriptive psychopathology since the
19th century. Cambridge: Cambridge University Press.
Binswanger, L. (1933). Über Ideenucht [On the ight of ideas]. Zurich: Fuessli.
Binswanger, L. (1946). Über die daseinsanalytische Forschungsrichtung in der Psychiatrie
[The existential-analytic research program in psychiatry]. Schweizer Archive Für
Neurologie Und Psychiatrie,57, 209225.
Binswanger, L. (1960). Melancholie und Manie: Phänomenologische Studien [Melancholy
and mania: Phenomenological studies]. Pfullingen: Neske.
Binswanger, L. (1964). On the manic mode of being-in-the-world. E. Straus (Ed.),
Phenomenology pure and applied. Pittsburgh: Duquesne University Press. 127141.
Reprinted in M. Broome, R. Harland, G. Owen, & A. Stringaris (Eds.), The Maudsley reader
in phenomenological psychiatry (pp. 197203). Cambridge: Cambridge University Press, 2012.
Blattner, W. (1999). Heideggers temporal idealism. Cambridge: Cambridge University
Bschor, T., Ising, M., Bauer, M., Lewitzka, U., Skerstupeit, M., Müller-Oerlinghausen, B., &
Baethge, C. (2004). Time experience and time judgement in major depression, mania
and healthy subjects: A controlled study of 93 subjects. Acta Psychiatrica Scandinavica,
109, 223229.
Carnap, R. (1945). The logic of induction. Philosophy of Science,12(2), 7297.
Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative
analysis. London: Sage Publications.
Dennett, D. (1992). Consciousness explained. Boston: Little, Brown and Co.
Gallagher, S. (1998). The inordinance of time. Evanston, IL: Northwestern University Press.
Glaser, B., & Strauss, A. (2017). Discovery of grounded theory: Strategies for qualitative
research. New York: Routledge.
Guerlac, S. (2006). Thinking in time: An introduction to Henri Bergson. Ithaca: Cornell
University Press.
Heidegger, M. (1927). Sein und Zeit [Being and time]. Tübingen: Niemeyer. Except where
indicated, we follow the Macquarrie and Robinson translation (Being and time,NewYork:
Harper and Row, 1962); page references are given to the usual H pagination of the rst edition.
Hempel, C. (1942). A purely syntactical denition of conrmation. The Journal of Symbolic
Logic,8(4), 122143.
Husserl, E. (1950). Husserliana. The Hague: Martinus Nijho.
Husserl, E. (1964). The phenomenology of internal time-consciousness. (J. Churchill).
Bloomington, Indiana: Indiana University Press.
Jerey, R. (1973). Carnaps inductive logic. Synthese,25(3/4), 299306.
Kortooms, T. (2002). Phenomenology of time: Edmund Husserls analysis of time-conscious-
ness. Dordrecht: Kluwer.
Kupke, C. (2009). Der BegriZeit in der Psychopathologie [The concept of time in psycho-
pathology]. Berlin: Parodos Verlag.
Mahlberg, R., Kienast, T., Bschor, T., & Adli, M. (2008). Evaluation of time memory in
acutely depressed patients, manic patients, and healthy controls using a time reproduc-
tion task. European Psychiatry,23, 430433.
Mezey, A., & Knight, E. (1965). Time sense in hypomanic illness. Archives of General
Psychiatry,12, 184186.
Mignard, M. (1924). La subduction mentale morbide et les théories psychophysiologiques
[Morbid mental subduction and psycho-physiological theories]. LAnnée Psychologique,
Miller, I. (1984). Husserl, perception and temporal awareness. Cambridge, MA: MIT Press.
Minkowski, E. (1923). Étude psychologique et analyse phénoménologique dun cas de
mélancolie schizophrénique, [Psychological study and phenomenological analysis of a
case of schizophrenic melancholia]. Journal De Psychologie Normale Et Pathologique,20,
543558. Citations refer to the pagination of the translation by Bliss, B: Findings in a
Case of Schizophrenic Depression,in May, R., Angel, E. & Ellenberger, H. (Eds.).
Existence: A new dimension in psychiatry and psychology. New York: Simon and
Schuster, 1958, 127138.
Minkowski, E. (1933). Le temps vécu: Etudes phénoménologiques et psychopathologique.
Paris: Delachaux Collection de lEvolution Psychiatrique. Citations refer to the
pagination of the translation by Metzel, N.: Lived time: phenomenological and psycho-
pathological studies. Evanston, Illinois: Northwestern University Press 1970.
Owen, G., Freyenhagen, F., Hotopf, M., & Martin, W. (2015). Temporal inabilities and
decision-making capacity in depression. Phenomenology and the Cognitive Sciences,14
(1), 163182.
Owen, G., Freyenhagen, F., & Martin, W. (2018). Assessing decision-making capacity after brain
injury: A phenomenological approach. Philosophy, Psychiatry and Psychology,25(1), 119.
Owen, G., Freyenhagen, F., Martin, W., & David, A. (2017). Clinical assessment of
decision-making capacity in acquired brain injury with personality change.
Neuropsychological Rehabilitation,27(1), 133148.
Pockett, S. (2003). How long is now? Phenomenology and the specious present.
Phenomenology and the Cognitive Sciences,2,5568.
Smith, Q. (1981). Heideggers theory of moods. The Modern Schoolman,58(4), 211235.
Spiegelberg, H. (1972). Phenomenology in psychology and psychiatry. Evanston, IL:
Northwestern University Press.
Stanghellini, G., & Aragona, M. (2016). Phenomenological psychopathology: Toward a per-
son-centered hermeneutic approach in the clinical encounter. In G. Stanghellini & M.
Aragona (Eds.), An experiential approach to psychopathology (pp. 143). Berlin: Springer.
Stern, W. (1897). Psychische Präsenzzeit [Psychic presence-time]. Zeitschrift Für
Psychologie Und Physiologie Der Sinnesorgane,13, 325349.
Tysk, L. (1984). Time perception and aective disorders. Perceptual and Motor Skills,58,
Zahavi, D. (2003). Husserls phenomenology. Stanford: Stanford University Press.
... Contemporary psychopathologists and philosophers of psychiatry continue to express significant interest in the theme [17][18][19][20][21]. This is a rich literature, but clarity and consistency remain problematic [22,23], and, to our knowledge, the study of temporal experience has not, before our work, been extended to problems in DMC. ...
... The analysis started with close reading of the transcribed texts and, through a process of textual coding, moved toward thematisation. The phenomenological method and analysis is described and illustrated in more detail elsewhere [22,23,26]. Interpretative phenomenological analysis aims to purposefully collect homogeneous samples to address a question about subjectivity or experiential structure. ...
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Background: Within psychiatric practice and policy there is considerable controversy surrounding the nature and assessment of impairments of decision-making capacity (DMC) for treatment in persons diagnosed with affective disorders. We identify the problems of "cognitive bias" and "outcome bias" in assessment of DMC for treatment in affective disorder and aim to help resolve these problems with an analysis of how time is experienced in depression and mania. Sampling and Methods: We conducted purposeful sampling and a qualitative phenomenological analysis of interview data on patients with depression and mania, exploring temporal experience and decision-making regarding treatment. Results: In both severe depression and mania there is a distinctive experience of the future. Two consequences can follow: a loss of evaluative differentiation concerning future outcomes and, relatedly, inductive failure. This temporal inability can compromise an individual's ability to appreciate or "use or weigh" treatment information. Conclusions: The decision-making abilities required for self-determination involve an ability to evaluate alternative future outcomes. Our results show that, within severe depression or mania, anticipation of future outcomes is inflexibly fixed at one end of the value spectrum. We therefore propose a temporal model of decision-making abilities, which could be used to improve assessment of DMC in affective disorder.
... Time experience has repeatedly been proposed as disturbed or altered in mental disorders (Minkowski, 1923;von Gebsattel, 1928;Lewis, 1932;Schilder, 1936;Straus, 1947;Hartocollis, 1975;Fuchs, 2001Fuchs, , 2005Fuchs, , 2007aFuchs, , 2013Wyllie, 2005;Kupke, 2005Kupke, , 2009Zukauskas et al., 2009;Gallagher, 2012;Moskalewicz, 2015;Martin et al., 2018;Vogel et al., 2018aVogel et al., , 2018b, and particularly in schizophrenia (Bouman and Grünbaum, 1929;Minkowski, 1933;Blankenburg, 1971;Vogeley and Kupke, 2006;Fuchs, 2007b;Kupke, 2009;Stanghellini et al., 2015;Moskalewicz, 2018). Meta-analysis of time perception and temporal processing has suggested that patients with schizophrenia may be liable to a higher variability in the function of an internal clock mechanism (Thoenes and Oberfeld, 2017). ...
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Disturbances in time experience have been argued to play a significant, if not causative role in the clinical presentation of schizophrenia. Phenomenological considerations suggest a fragmented or dis-articulated time experience causing both primary symptoms such as hallucinations, delusions, and self-disorders, as well as an intersubjective desynchronization. We employed content analysis on material collected from patients diagnosed with schizophrenia using the Time Questionnaire to generate hypotheses on possible disturbances of time experience in schizophrenia. As a key result we find evidence for the distinction between acute psychotic and post-psychotic syndromes. Acute psychosis is predominantly a disturbance of the passage of time, whereas the remission from psychosis is primarily defined by changes in the experience of the explicit structure of time integrating past, present, and future. We discuss our findings with regards to previous insights and observations on time experience and time perception. We suggest our findings hold significance for the diagnostic and therapeutic understanding of schizophrenia as well as for future integrative research on time experience in general.
Nearly all psychiatric diseases involve alterations in subjective, lived experience. The scientific study of the biological basis of mental illness has generally focused on objective measures and observable behaviors, limiting the potential for our understanding of brain mechanisms of disease states and possible treatments. However, applying methods designed principally to interpret objective behavioral measures to the measurement and extrapolation of subjective states presents a number of challenges. In order to help bridge this gap, we draw on the tradition of phenomenology, a philosophical movement concerned with elucidating the structure of lived experience, which emerged in the early 20th century and influenced philosophy of mind, cognitive science, and psychiatry. A number of early phenomenologically-oriented psychiatrists made influential contributions to the field, but this approach retreated to the background as psychiatry moved towards more operationalized disease classifications. Recently, clinical-phenomenological research and viewpoints have re-emerged in the field. We argue that the potential for phenomenological research and methods to generate productive hypotheses about the neurobiological basis of psychiatric diseases has thus far been underappreciated. Using specific examples drawing on the subjective experience of mania and psychosis, we demonstrate that phenomenologically-oriented clinical studies can generate novel and fruitful propositions for neuroscientific investigation. Additionally, we outline a proposal for more rigorously integrating phenomenological investigations of subjective experience with the methods of modern neuroscience research, advocating a cross-species approach with a key role for human subjects research. Collaborative interaction between phenomenology, psychiatry, and neuroscience has the potential to move these fields towards a unified understanding of the biological basis of mental illness.
This chapter is grounded in the ontology of temporality. The focus of the chapter is endogenous temporality and subjective temporality as the lived experience of time. I start with a discussion of the lived experience of time, the ongoing nature of temporality, and possible struggles in restoring and maintaining coherent connections to the past and present in the face of unexpected disruptions in the sensed flow of time. While highlighting the importance of the subjective temporality of our lived experience, I aim to avoid being restricted by the ideas of temporal idealism. Therefore, the chapter includes a brief section on temporal idealism before introducing endogenous temporality as a broader concept applicable beside humans to the world, things, events, and relations. I discuss the agency of time and its connection to becoming. Concerning becoming, a distinction is drawn between the realisation of possibilities and the actualisation of potentialities. The realisation of possibilities is viewed as maintaining our trajectory of movement or form of being, while the actualisation potentialities indicates a qualitative transformation. Both temporality and becoming require a closer look at the present, and pasts and futures, including the notion of the immanence of time. The chapter ends with the temporal structure of agency. Keywords: Lived experience of time, endogenous and subjective temporality, becoming, agency of time, immanence of time, temporal structure of agency
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Psychiatry has witnessed a new wave of approaches to clinical phenotyping and the study of psychopathology, including the National Institute of Mental Health’s Research Domain Criteria, clinical staging, network approaches, the Hierarchical Taxonomy of Psychopathology, and the general psychopathology factor, as well as a revival of interest in phenomenological psychopathology. The question naturally emerges as to what the relationship between these new approaches is – are they mutually exclusive, competing approaches, or can they be integrated in some way and used to enrich each other? In this opinion piece, we propose a possible integration between clinical staging and phenomenological psychopathology. Domains identified in phenomenological psychopathology, such as selfhood, embodiment, affectivity, etc., can be overlaid on clinical stages in order to enrich and deepen the phenotypes captured in clinical staging (‘high resolution’ clinical phenotypes). This approach may be useful both ideographically and nomothetically, in that it could complement diagnosis, enrich clinical formulation, and inform treatment of individual patients, as well as help guide aetiological, prediction, and treatment research. The overlaying of phenomenological domains on clinical stages may require that these domains are reformulated in dimensional rather than categorial terms. This integrative project requires assessment tools, some of which are already available, that are sensitive and thorough enough to pick up on the range of relevant psychopathology. The proposed approach offers opportunities for mutual enrichment: clinical staging may be enriched by introducing greater depth to phenotypes; phenomenological psychopathology may be enriched by introducing stages of severity and disorder progression to phenomenological analysis.
Objectives Speed of thought is a central phenomenon in mood disorders. We aimed to provide an update on the topic ten years after a first narrative review published on racing and crowded thoughts in mood disorders. This update is based on recent publications, including recent works of our group. Methods Narrative review based on publications from the last ten years including publications of our group and a systematic research of references on PubMed. Results The traditional dichotomist view of racing versus crowded thoughts is not refuted but appears to be more complex, as revealed by validation studies of the Racing and Crowded Thoughts Questionnaire. Moreover, this dualistic view can no longer be conceptualized in a simple bijective concordance with the distinction of hypomania versus mixed depression. We also show that racing/crowded thoughts are strongly associated with mixed depression and not with non-mixed depression, that they tend to be more associated in hypomania to irritability than to the typical symptoms of energy and activity increase and that they are clearly distinguishable from ruminations. Yet, although tightly linked to mood disorders, racing/crowded thoughts appear to be associated to anxiety as well as attention deficit/hyperactivity disorder and insomnia. Conclusions Racing and crowded thoughts should be studied in a dimensional perspective as an important facet of mind activity within and beyond the field of mood disorders.
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The assessment of decision-making capacity in patients with acquired brain injury presents a range of clinical and legal challenges. The existing guidance on the conduct of such assessments is often generic; guidance specific to patients with brain injury is sparse and coarse grained. We report on the results of an interview-based study of decision-making capacity in patients suffering from acquired brain injury and organic personality disorder. We identify the clinical and legal challenges associated with the assessment of decision-making capacity in this patient population, review three bodies of relevant research from cognitive neuropsychology and neurophysiology, and draw on phenomenological analysis to identify three distinct abilities that play a role in decision making, but that can be compromised in patients with organic personality disorder. We address the challenge of translating clinical findings into legally attestable results.
Most writing on sociological method has been concerned with how accurate facts can be obtained and how theory can thereby be more rigorously tested. In The Discovery of Grounded Theory, Barney Glaser and Anselm Strauss address the equally Important enterprise of how the discovery of theory from data-systematically obtained and analyzed in social research-can be furthered. The discovery of theory from data-grounded theory-is a major task confronting sociology, for such a theory fits empirical situations, and is understandable to sociologists and laymen alike. Most important, it provides relevant predictions, explanations, interpretations, and applications. In Part I of the book, "Generation Theory by Comparative Analysis," the authors present a strategy whereby sociologists can facilitate the discovery of grounded theory, both substantive and formal. This strategy involves the systematic choice and study of several comparison groups. In Part II, The Flexible Use of Data," the generation of theory from qualitative, especially documentary, and quantitative data Is considered. In Part III, "Implications of Grounded Theory," Glaser and Strauss examine the credibility of grounded theory. The Discovery of Grounded Theory is directed toward improving social scientists' capacity for generating theory that will be relevant to their research. While aimed primarily at sociologists, it will be useful to anyone Interested In studying social phenomena-political, educational, economic, industrial- especially If their studies are based on qualitative data. © 1999 by Barney G. Glaser and Frances Strauss. All rights reserved.
This introduction is an overall outlook of the methods used in phenomenological psychopathology. The several meanings of the term ‘psychopathology’ are differentiated, together with a brief overview of the main ideas in philosophical phenomenology. Then, key methodological concepts in use in phenomenological psychopathology are discussed: form and content, explaining and understanding, static and genetic understanding, epoché and eidos, the existentialia exploring the basic way human beings exist in the world. Finally, the hermeneutic approach in psychopathology is discussed at three levels: the hermeneutics of mental symptoms, the hermeneutic circle in the relationship between symptoms and diagnosis, and the hermeneutics of the deep subjective structure on which the previous levels are grounded.
The grounded theory approach to doing qualitative research in nursing has become very popular in recent years. I confess to never really having understood Glaser and Strauss' original book: The Discovery of Grounded Theory. Since they wrote it, they have fallen out over what grounded theory might be and both produced their own versions of it. I welcomed, then, Kathy Charmaz's excellent and practical guide.
The sense of perplexity is a key feature of delusional mood/ atmosphere which plays an important role in the phenomenology of early psychosis. Here we begin this Chapter by presenting a clinical scenario of the psychosis prodrome and refer to this case study as our basis of discussion. We provide a detailed picture of psychiatric and philosophical literature to investigate in depth the phenomenon of perplexity drawing from theories such as Conrad's stage model of beginning schizophrenia before placing the original case study into context and discuss concepts related to a loss of common sense and delusional elaboration in the pathogenesis of the perplexed feelings experienced by many prodromal individuals. We end the Chapter with clinical implications and offer potential suggestions for improving the assessment, diagnosis and treatment of early psychosis, in particular the importance of recognising the individual's suffering and acknowledge his own reality.