The phenomenon of delusion can be conceptualized as radical alienness, which resists the understandable/incomprehensible duality, as emphasized in Manuel Reyes’s and Manuel Ugalde-Duarte’s lecture.
In the lecture held on 9th September in the Grand Hall of the Institute of Social Sciences (via Zoom and in front of a live audience), Manuel Reyes and Manuel Ugalde-Duarte from the University of Chile argued that delusion, a central phenomenon in schizophrenia spectrum disorders, poses several conceptual challenges that have profound clinical implications. One of these revolves around the meaning that delusions would have. In psychopathology, with a third-person approach, the possibility of the meaning of delusions has been rejected as a mechanical effect of brain dysfunction. In response, during the last decades, several psychopathological perspectives have emerged, deeply influenced by phenomenology, which attempts to rethink and reconstruct the modalities of meaning that delusions imply, as well as clinical and methodological approaches that privilege first-person accounts and lived experience. One methodological tool developed in response to these critical reflections is the notion of radical empathy or second-order empathy.
It has been suggested that these proposals would provide an alternative to the hermeneutic injustice to which patients with such experiences would be exposed. Although these efforts seem valuable, they struggle with several problems that limit the possibility of forms of other meanings than understanding or interpretation. First, these approaches are based on the assumption that the construction of meaning is successful and adequate when the clinician can translate the patient’s experiences into something relatively transparent, transferable, and understandable. Second, the existing difference in the way of experiencing and communicating between patient and clinician implies a defective difference on the part of the patient that the clinician, endowed with the appropriate hermeneutic resources, could delimit and overcome by achieving a full understanding of what the patient experiences.
This lecture was the eighth in the 2024 series of seminars on “Philosophy and Psychiatry” organized by the Center for Philosophy at the Institute of Social Sciences.
