La Hora de la Fenomenología en la Esquizofrenia

Abstract

Este trabajo expone las aportaciones de la fenomenología en el entendimiento de la esquizofrenia. Se empieza por mostrar que la fenomenología viene a recuperar la tradición psicopatológica, perdida a partir del éxito del DSM-III, así como del establecimiento de la neurobiología como corriente dominante. Sus aportaciones se exponen conforme a tres apartados, relativos a la concepción, evaluación y tratamiento. La evaluación, trata de poner de relieve las experiencias de primera persona que caracterizan el comienzo de la esquizofrenia, para el caso, la antedicha alteración de la ipseidad. A este respecto, se indagan cinco dimensiones: la autoconciencia e implicación en el mundo, la corporalidad, la corriente de conciencia, la delimitación y permeabilidad del yo y la reorientación existencial. Se indican las posibilidades que la fenomenología abre para el tratamiento psicológico. Se señalan la actitud fenomenológica como apertura psicoterapéutica y la importancia de la hermenéutica y de la narrativa. Así mismo, se tratan de ver en la perspectiva fenomenológica las terapias con base en mindfulness y aceptación y compromiso.

Alternate abstract:

This study describes the contributions that phenomenology can make to our understanding of schizophrenia. It begins by showing that phenomenology is recovering the psychopathological tradition lost after the success of the DSM-III and the establishment of neurobiology as the dominant approach. Its contributions are described in three parts: its conceptualization, evaluation and treatment of schizophrenia. Concerning its conceptualization, phenomenology conceives of schizophrenia as an ipseity disorder, characterized by an intensified awareness of things which are normally implicit or pre-reflexive, by a diminished sense of oneself as the subject of experience and action, and by alteration of perceptive articulation with the world. The main evaluation method is the semi-structured interview, which is aimed at underlining the first-person experiences which characterize the beginning of schizophrenian (namely, the abovementioned alteration of ipseity). Five dimensions of this alteration are investigated, self-awareness and involvement in the world, bodiliness, stream of consciousness, delimitation and permeability of the self and existential reorientation. The possibilities offered by phenomenology for psychological treatment are discussed. Approaching psychotherapy from a phenomenological point of view and the importance of the hermeneutics and narrative are also signaled. Furthermore, therapies based on mindfulness and acceptance and commitment are seen from the perspective of phenomenology.