Fostering dialogue: a phenomenological approach to bridging the gap between the "voice of medicine" and the "voice of the lifeworld"

This article adopts Husserl's transcendental phenomenology to explore the complex relationship between patients and physicians. It delves into the coexistence of two distinct voices in the realm of medicine and health: the "voice of medicine" and the "voice of life-world." Divided into three sections, the article emphasizes the importance of shifting from a scientific-medical attitude to a more personalistic approach in physician-patient interactions. This shift aims to prevent depersonalization and desubjectification. Additionally, it highlights the equal and irreducible nature of patients while acknowledging the vital role physicians hold in the realm of illness. The article stresses the need for a balanced and equitable relationship between both parties, rooted in the shared life-world. Moreover, empathy is underscored as a crucial element in fostering meaningful dialogue, wherein understanding diverse perspectives and attitudes towards illness is paramount. The article argues that differences between patients and physicians are necessary for empathy, while shared similarities form its foundation. Ultimately, a harmonious relationship facilitates empathy and enables the constitution of a new sense of life for both patients and physicians.

Facing the Unknown: An Inductive Analysis of the Lived Experience of Medical Residents during the COVID-19 Pandemic

INTRODUCTION

The COVID-19 pandemic had significant repercussions for the everyday life and public health of society. Healthcare professionals were particularly vulnerable. Here, we interviewed medical residents about their lived experiences during the pandemic to offer a phenomenological analysis. To this end, we discuss their pandemic experiences considering Jaspers' "limit situation" concept - that is, a radical shift from their everyday experiences, to one causing them to question the basis of their very existence.

METHODS

We interviewed 33 medical residents from psychiatry and other specialties from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) who either (a) worked directly with COVID-19 patients or (b) provided psychiatric care to other healthcare professionals. Semi-structured interviews were developed using the Inductive Process to Analyze the Structure of lived Experience (IPSE).

RESULTS

The descriptions of the lived experiences of medical residents during the pandemic were organized into four content themes: (a) existential defense, (b) limit situations during the COVID-19 pandemic, (c) changes in lived experience, and (d) new world meanings through lived experience.

CONCLUSION

During the COVID-19 pandemic, medical residents experienced what can be thought of as a "limit situation," as they encountered the healthcare delivery challenges coupled with the social isolation imposed by the COVID-19 pandemic. These challenges included fear of infection and potential death, uncertainty about the future, and the emotional overload caused by the sharp increase in patient deaths. That said, after facing such a limit situation, residents reported feeling strengthened by this experience. This is consistent with the notion that when confronted with limit situations, we draw on our resources to overcome adversity and, in turn, reap existential gains. Health care providers might use these experiences to energize their own professional approach.

"You would think she would hug me": Micropractices of Care Between First-Generation College Students and Their Parents During Covid-19

The Covid-19 pandemic has greatly disrupted the education of first-generation college students (first-gens)-those whose parents did not complete a college degree. With campuses closed, activities canceled, and support services curtailed, many first-gens have increasingly relied on their parents for mental, emotional, and logistical support. At the same time, their parents face compounding stresses and challenges stemming from the prolonged effects of the Covid pandemic. We examined the role that relational dynamics between first-gens and their parents played in how they weathered the first 2 years of the Covid pandemic together. We draw upon journals submitted by self-identified first-gens and parents of first-gens to the Pandemic Journaling Project between October 2021 and May 2022 as part of a pilot study of first-gen family experiences of Covid-19, along with a series of interviews conducted with three student-parent dyads. We argue that what we term the micropractices of care-the "little things," like a kind word, small gift, or car ride, that were regularly exchanged between parents and students-played a key role in mental wellness and educational persistence. We find that when there is synchrony between practices offered by one dyad member and their reception by the other, mental wellbeing is preserved. When there is asynchrony, mental health is destabilized. These findings reflect the strategies on which first-gen families have creatively relied to maintain shared mental wellness and student success during a time of crisis. We show how everyday mental wellness is forged in the intersubjective space between two people engaged in achieving shared life goals.

Maternal perception of infant's intersubjectivity: a questionnaire

INTRODUCTION

Intersubjectivity is a fundamental dimension of the mother-infant relationship.

OBJECTIVE

Design of a questionnaire to assess maternal perception of the infant's intersubjectivity.

DESIGN

After running a focus group with mothers of infants within their first year of life, items related to maternal perception of the infant's intersubjectivity were generated. These items were applied to a sample of 125 mothers and the results were submitted to principal components analysis.

RESULTS

Principal components analysis (forced extraction to 3 factors, KMO = .752, Bartlett = 976.202, p = .000; explained variance = 42.12%) identified 22 items grouped in three factors: a) F1, 'Interactive Competence' (α = .817); b) F2, 'Emotional States' (α = .749), and c) F3, 'Initiative' (α = .647). Positive and significant correlations were observed among all MPIIQ factors (p ≤ .01). Maternal perception of infant's intersubjectivity varied according to the number of gestational weeks at birth (T = -1.15, p ≤ .05) and according to the infant´s age (F = 7.834, p ≤ .001). Mothers of preterm infants reported lower perception of infant's intersubjectivity whereas mothers of older infants reported higher perception of infant's intersubjectivity.

CONCLUSION

The Maternal Perception of Infant's Intersubjectivity Questionnaire (MPIIQ) seems to be a sensitive instrument, able to discriminate different levels of maternal perception about the infant's intersubjective competences.

Reframing Anorexia Nervosa: A Phenomenological Exploration of the Self-Other Relationship with Husserl's Intersubjective Theory

This paper explores the overlooked contributions of Husserl's Phenomenology of intersubjectivity in understanding anorexia nervosa. It highlights the intricate relationship between the self and others, emphasizing their mutual constitution while acknowledging inherent differences. The distorted body image approach often overlooks this perspective, leading to psychopathological issues in individuals with anorexia nervosa. By integrating subjective experience and external observation, a more balanced and equal intersubjective relationship can be established. Utilizing this philosophical framework allows for a deeper understanding of the disorder's dynamics and sheds new light on the subjective experiences of individuals with anorexia nervosa in relation to others.

Metacognitive Reflection and Insight Therapy (MERIT) Delivered Virtually During the COVID-19 Pandemic: An Illustration of Two Cases

Alternative platform offerings for psychotherapy have become a necessity in the age of the novel coronavirus (COVID-19) pandemic. The current study describes the virtual adaptation of Metacognitive Reflection and Insight Therapy (MERIT) for people with psychosis. MERIT is a recovery-oriented psychotherapy that has shown promise in increasing metacognition and allowing individuals to make meaning of their psychiatric challenges and direct their own recovery efforts. MERIT delivery requires the assumption that metacognitive reflection is an intersubjective act where individuals make meaning with others instead of in isolation. As such, considering the current COVID-19 pandemic, research is needed to understand how intersubjectivity and the therapeutic alliance may differ in a virtual environment rather than in-person. The present study addresses this question by illustrating two case examples of MERIT's adaptation to a virtual delivery telehealth format. Moreover, this study expands on Lysaker and colleagues' (2020) investigation of virtual adaptations of MERIT by exploring how MERIT is adapted in a virtual environment, how intersubjectivity changes in a virtual environment, and, what opportunities virtual platforms allow for metacognitive reflection. Overall, we found that MERIT can be successfully delivered in a virtual telehealth platform. We discuss opportunities and considerations for MERIT and other psychotherapy virtual delivery.

Right brain-to-right brain psychotherapy: recent scientific and clinical advances

This article overviews my recent acceptance of a Lifetime Achievement Award from Sapienza University of Rome, in which I discussed three decades of my work on the right brain in development, psychopathogenesis, and psychotherapy. In the following, I offer current brain laterality and hemispheric asymmetry research indicating that right brain emotional and relational processes operate beneath conscious awareness not only in early human development, but over the lifespan. I discuss recent interdisciplinary studies on the central role of ultrarapid right brain-to-right brain intersubjective communications of face, voice, and gesture and the implicit regulation of emotion in nonverbal attachment dynamics. Special emphasis is on the fundamental psychobiological process of interpersonal synchrony, and on the evolutionary mechanism of attachment, the interactive regulation of biological synchrony within and between organisms. I then present some clinical applications, suggesting that effective therapeutic work with "primitive" nonverbal emotional attachment dynamics focuses not on conscious verbal insight but on the formation of an unconscious emotion-communicating and regulating bond within the therapeutic relationship. Lastly, I review recent hyperscanning research of the patient's and therapist's brains during a face-to-face, emotionally focused psychotherapy session that supports the right brain-to-right brain communication model. I end suggesting that the right brain is dominant in both short-term symptom-reducing and long-term growth-promoting deep psychotherapy.

The Human Spectrum: A Phenomenological Enquiry within Neurodiversity

INTRODUCTION

Autism has typically been characterized by its external manifestations rather than experienced phenomenology, with consequent impacts on both research and practice. There have recently been increasing calls for more phenomenological enquiry in autism, but little actual work reported.

METHOD

A shared participatory phenomenological self-investigation was conducted, by the four authors, of lived experience across the autistic/non-autistic divide. The sample size was chosen as necessary for the feasibility and acceptability to participants of such work in this context. Roles of "researcher" and "interviewee" were purposefully alternated between participants to establish trust and reciprocity. Initial phenomenological reduction or bracketing was applied to the description and recording of each participant's intimate lived experience in a number of key domains across social relationships, the physical environment, development, and in adult life. These experiences were shared within dialogue to open them to investigation and questioning from the others, with alternating interviewer and respondent roles. A third step synthesized these shared observations across individuals into themes of continuity and difference.

RESULTS

A number of emergent themes, such as the need for trust and reliability, and the impact of context on regulation of emotion, sociability, and empathy, showed striking commonalities between all participants. Other themes, such as primary sensory experience and social joining, pointed up more clear differences between autism and non-autism in development and the adult world. Themes of interest-focus and attention were marked by both commonalities and difference.

CONCLUSIONS

This shared phenomenological method was taken as a first step within a new area of active investigation in autistic phenomenology. It proved successful in eliciting detailed information on self-experience. The results suggested hypotheses for a new understanding of autism within the wider "human" spectrum of experience; for instance, the common basic need for trust and social connection but striking differences in sensory experience. It suggested that some characteristics long thought intrinsic to autism, such as social mis-perception and reduced empathy, may be alternatively understood as state-dependent outcomes contingent on specific contexts and interactions. Implications are suggested for testing in further research, developmental theory, and intervention practice.

First-Episode Psychosis and Centrality in the Work of Psychiatrist Henri Grivois: A Dialog with Phenomenological Psychopathology

The article traces the hypotheses of the contemporary French psychiatrist Henri Grivois, concerning what he calls nascent psychosis. In a perspective close to descriptive phenomenology, Grivois tries to identify the alteration of subjective experience specific to the first moments of a psychosis. He thus describes the experiences of concernment and centrality as consisting in a disruption of the tacit mechanisms of mimesis and interindividual attunement. Using the common points between Grivois's aim and that of the phenomenological approach, the article puts these two conceptions of first-episode psychosis into dialog, questioning in particular the prereflexive register of experience. The notion of centrality questions the conditions of the constitution of intersubjectivity: it places the question of the bodily and gestural incarnation that founds the relationship to the other at the center of our understanding of psychosis. Grivois's hypotheses and the phenomenology of psychoses together contribute to the questioning of the therapeutic methods employed in the early stages of treatment. Centrality, in particular, questions the limits of verbal descriptions of psychotic experiences and invites us to think about methods that are based more on the anchoring and bodily attunement of the patient and the therapist.

Social Distancing and Social Biosensing: Intersubjectivity from Afar

The shelter-in-place orders across the U.S. in response to the COVID-19 pandemic forced many relationships once sustained by in-person interaction into remote states through computer-mediated communication (CMC). Work, school, holidays, social engagements, and everyday conversations formerly experienced through rich and contextual in-person interactions instead have taken place on messaging, voice, and video chatting platforms that diminish or altogether lack many social cues and other qualities critical to social interaction. The difficulties feeling connected to one another observed during this period have stressed the need for novel forms of communication that enable deeper interactions. Social biosensing, the interpersonal sharing of physiological information, has shown promise facilitating social connection at a distance. In the present research we document the experiences of nine pairs of friends (N = 18) who navigated living through a shelter-in-place order, reporting on their experiences sharing their electrodermal activity (EDA) in response to short videos. Participants described the artificial and unnatural nature of communicating using typical forms of CMC and a range of interpretations of EDA as both emotional response and as representative of personal characteristics. We implemented a phased approach to study the temporal nature of forming an understanding of unfamiliar yet intimate data like EDA. Our results indicate typologies of meaning-making processes: "stablers", "broadeners", and "puzzlers". We also interpreted our findings through the lens of intersubjectivity, analyzing how analogical apperception and dialogical interaction both play a role in participants' meaning-making about their own and their partner's biosensory information. We conclude with implications from this work pertinent to intersubjectivity theorists, social biosensing researchers, and CMC system designers and developers.

Narrative as co-regulation: A review of embodied narrative in infant development

We review evidence of non-verbal, embodied narratives in human infancy to better understand their form and function as generators of common experience, regulation, and learning. We examine their development prior to the onset of language, with a view to improve understanding of narrative as regular motifs or schemas of early experience in both solitary and social engagement. Embodied narratives are composed of regular patterns of interest, arousal, affect, and intention that yield a characteristic four-part structure of (i) introduction, (ii) development, (iii) climax, and (iv) resolution. Made with others these form co-created shared acts of meaning, and are parsed in time with discreet beginnings and endings that allow a regular pattern to frame and give predictive understanding for prospective regulation (especially important within social contexts) that safely returns to baseline again. This characteristic pattern, co-created between infant and adult from the beginning of life, allows the infant to contribute to, and learn, the patterns of its culture. We conclude with a view on commonalities and differences of co-created narrative in non-human primates, and discuss implications of disruption to narrative co-creation for developmental psychopathology.

Enhancing patient-centred communication across barriers: The case of intersubjectivity management in medical interpreting

OBJECTIVE

This study introduces the concept of intersubjectivity management in medical interpreting and identifies relevant interactional strategies employed by the interpreter, also explores their effectiveness in facilitating positive clinician-patient communication.

METHODS

We used conversation analysis (CA) to analyse 27 video recordings of interpreter-mediated dental visits, participants involve English-speaking dentists, Cantonese as the first language (L1) patients and bilingual dental surgery assistants (DSA) who also play the role of ad hoc interpreters.

RESULTS

The DSA-as-interpreter manages intersubjectivity for the dentist and patient through interactional strategies, such as reformulating action types, redesigning contents and information capacity, summarising and concentrating turns, constantly monitoring the situation and eliciting spoken or unspoken expressions that are medically relevant from both sides to validate them. The strategies effectively enabled and enhanced the mutual understanding and interpersonal alignment between the dentist and patient. More importantly, the DSA constantly orients to patient-centred communication.

CONCLUSION

Although not professionally trained for interpreting, the DSA-as-interpreters demonstrated discursive strategies. The strategies evidently facilitated positive dentist-patient communication and relationships.

PRACTICE IMPLICATIONS

The conceptualisation and significant strategies demonstrated by the DSA-as-interpreters could potentially inform the solution of enhancing multilingual health communication in clinical staff training.

The Concept of Synchronization in the Process of Separation-Individuation Between a Parent and an Adolescent

Objectives

Humans experience the process of separating-individuating themselves from an object via the conflict between dependence and independence within the self. The separation-individuation theory focuses on the psychological process of individualizing oneself. Although adolescents' individuation from their parents is based on intrapsychic events, there is an increasing need for an intersubjective understanding of it. We applied intersubjectivity to adolescents and parents to interpret and find solutions for problems arising during their individuation process.

Methods

This study retrospectively reviewed a case of a son and his father treated by the author. From the study subject, contents that represent adolescents and parents' interaction and separation in the individualization process were extracted and analyzed, and their experiences shared in this process were reconstructed from the therapist's perspective.

Results

From the case involving an adolescent boy with conduct problems and his interactions with his father, the authors observed the phenomenon of intersubjectivity and proposed the concept of "synchronized individuation" between adolescents and parents. As adolescents rapidly grow and change, they experience various dynamic interactions with their parents. Through learning to tolerate the conflicts and ambivalent tension inherent in this individuation process, adolescents and their parents develop their new identity.

Conclusion

"Synchronized individuation" should be understood as complementary to, rather than exclusive from, the existing concept of the separation and individuation. It offers a new paradigm with which to understand adolescent-parent conflicts in the process of separation- individuation.

Concept of Synchronized Individuation Based on the Characters in a Movie and a Fairy Tale

Objectives

Among adolescent development tasks, being independent of parents is an essential process for emotional and physical separation. There are many conflicts of separation and individuation between parents and adolescents; however, most clinicians explore the process of separation and individuation only from adolescents' perspective. Whether simultaneously or sequentially, separation-individuation occurs between adolescents and parents, respectively. The authors have already introduced the theory of synchronized individuation in a clinical case to explain the concept of this intersubjective phenomena. This study also attempts to prove the synchronized individuation theory through the interaction of characters in a movie and a fairy tale.

Methods

The authors present the basis for the theory of synchronized individuation of adolescence through the growing process of Mason Junior, the main character of the movie "Boyhood," and from the process of the separation of a hen, Sprout, and an orphaned duckling in "The hen who dreamed she could fly."

Results

Synchronized individuation was developed and observed from Mason, the son's perspective in "Boyhood," and Sprout, the mother's subjective perspective in the story of the hen.

Conclusion

Increasing conflict and mutual impact in the relationship between adolescents and parents, ambivalent feelings for separation, selective identification of each other, mutual respect through mutual recognition, and role changes in relationship position were confirmed. Sons and mothers were individualized with synchronization.

"We know what they're struggling with": student peer mentors' embodied perceptions of teaching in a health professional education mentorship program

This paper reports on a study of student peer mentorship in the context of nursing education in a higher education program in Canada. The study used an embodied hermeneutic phenomenological methodology to investigate student peer mentors' perceptions of teaching during peer mentorship. The data were collected over one calendar year (2019) and involved analysis of 10 participants' interview data and their 'body maps,' produced in response to guided questions. Through the data analysis a core theme of 'commitment to mentee growth' was identified, along with seven interrelated themes: sharing responsibility for learning, moderating stress, mediating power relations, navigating unknown processes, valuing creative approaches, offering generous acceptance, and facilitating confidence. Student peer mentorship has the potential to contribute to health professions education in a number of unique ways including through embodied attunement, trusting intersubjective relations, and dialogic education. This study is innovative in its purposeful design and aim to investigate both cognitive and embodied perceptions of student peer mentors. The findings point to the promise of student peer mentorship for advancing health sciences education. Implications for peer mentorship program development in health professions education are discussed.

Person-Centered Psychiatry as Dialogical Psychiatry: The Significance of the Therapeutic Stance

In this article, we present holistic and person-centered perspectives in psychiatry, with the aim of better understanding what a focus on personhood might really mean and what clinical implications it might have. We first introduce classical and philosophical concepts of personhood, in order to then outline person-centered approaches in psychiatry, which mainly focus on the person of the patient. We then argue that, for it to really be person-centered, psychiatry must necessarily also focus on the person of professionals. We thus explore the notion of stance, as the expression of the therapist's personhood. By unpacking the effects that a professional's stance can have on patients, we finally turn to a consideration of the interpersonal sphere. More specifically, we propose clinical considerations on a therapeutic stance that strives to support and to help the person of the patient unfold. Such a stance must - we argue - necessarily be a dialogical one. Drawing on these considerations, we thus claim that a truly person-centered approach in psychiatry must necessarily and automatically be interperson-centered and dialogical. In the concluding remarks, we finally discuss broader societal implications and outline future research perspectives.

Doctored Images: Enacting "Pain-Work" in John Berger and Jean Mohr's A Fortunate Man (1967)

This essay argues that Berger and Mohr's A Fortunate Man (1967) - comprising social observation and photographs of the rural practitioner, Dr. Sassall and his patients - enacts an embodied, intersubjective empathy called "pain-work." The book enacts "pain-work" through two strategies. Firstly, by conflating three ways of seeing - Berger's observation, Mohr's photography, and Sassall's medical gaze - it shows that the clinical encounter embodies objective vision through intersubjective pain. Secondly, it employs the concepts of recognition and witnessing to show how the subjectivity of the physician is distributed in his community. Thus, Berger and Mohr witness Sassall's witnessing of his patients; even as Sassall and his patients are constituted intersubjectively, so too are Berger, Mohr, and Sassall.

Developing intersubjectivity and teamwork skills through learning circles on clinical placement: A mixed methods study

AIM

To determine the efficacy of learning circles on developing intersubjectivity and teamwork skills and determine barriers to and facilitators of, learning circles as a learning tool.

BACKGROUND

Teamwork skills are vital for safe, effective nursing care and are dependent on individual team members' shared understandings or intersubjectivity. Work-based learning circles offer a potential pedagogic strategy to promote teamwork.

METHODS

In work-based learning circles conducted in 2018, students drew a concept map based on a clinical case and discussed an element of it with the group. Using a convergent parallel mixed methods design, a cross-sectional survey of students using a student clinical experience questionnaire and a qualitative descriptive approach for interviews with clinical facilitators was conducted.

RESULTS

Overall, 128 Bachelor of Nursing students (88.9% response) completed the survey and five facilitators (50%) attended group interviews. Students agreed that core teamwork skills were developed during their placement and clinical facilitators reported (1) student engagement in the learning circle processes; (2) learning much about students' abilities; and (3) developing subtle teaching skills to enhance discussion. Sharing experiences from different wards and clinical experiences was a platform for developing intersubjectivity.

CONCLUSIONS

To promote intra-professional teamwork skills, conducting learning circles with students from different disciplines may further enhance intersubjectivity and is an area for further research.

Do you hear what I hear? Perceived narrative constitutes a semantic dimension for music

Music has attracted longstanding debate surrounding its capacity to communicate without words, but little empirical work has addressed the topic. Here, 534 participants in the US and a remote region of China participated in two experiments using a novel paradigm to investigate narrative perceptions as a semantic dimension of music. Participants listened to wordless musical excerpts and determined which of two presented stories was the correct match. Correct matches were stories previously imagined by individuals from the US or China in response to each of the excerpts, while foils were correct matches to one of the other tested excerpts. Results revealed that listeners from Arkansas and Michigan had no difficulty matching the music with stories generated by Arkansas listeners. Wordless music, then, far from an abstract stimulus, seems to engender shared, concrete narrative perceptions in listeners. These perceptions are stable and robust for within-culture participants, even at geographically distinct locales (e.g. Arkansas and Michigan). This finding refutes the notion that music is an asemantic medium. In contrast, participants in both the US and China had more difficulty determining correct story-music matches for stories generated by participants from another culture, suggesting that a sufficiently shared pool of experiences must exist for strong intersubjectivity to arise.

Face-to-face configuration in Japanese macaques functions as a platform to establish mutual engagement in social play

A face-to-face configuration and eye-to-eye contact are considered a basis for intersubjectivity, as they create a situation in which interactants are mutually attentive. Studies in humans have shown that the face-to-face configuration establishes active engagement by interactants in subsequent interactions, but it is not clear whether a similar function exists in non-human animals. Using data from a group of Japanese macaques (Macaca fuscata), this study compared dyadic play fighting sessions preceded and not preceded by a face-to-face configuration. During play fighting, players compete to gain an advantage over their playmates by attacking them unilaterally (i.e., attacking them without being attacked or pinning them to the ground). Defining the inter-player asymmetry of active engagement in play in terms of the difference in the duration of each individual's advantage over the other, we found that asymmetry was lower in play bouts with a face-to-face beginning than in play bouts without one. Additionally, in play bouts not preceded by a face-to-face configuration, individuals who faced their partner at the onset of play unilaterally attacked their partner for a significantly longer duration than did those who did not face their partner at the onset of play. Conversely, in play bouts preceded by a face-to-face configuration, there was no difference in the duration of unilateral attacks. Overall, our results indicated that the face-to-face configuration in Japanese macaques functions as a platform to establish mutual engagement by interactors and enhances symmetry within play interaction.

We, ourselves and us: Tensions of identity, intersubjectivity and positionality stemming from the people and dancefloors project

Grounded in intersubjective participatory action research, the people and dancefloors project has sought to produce a space for the co-creation of knowledge about dancefloors and drug taking, building a platform for developing insights from the positionality of current drug users. Through film, it provides hermeneutic insight while legitimising their voices. In this paper, we share some reflections as researchers/users/activists arising from our involvement in the project. To begin with, we reflect on the motivations for the project, and the epistemic suppositions that animated it. This is followed by conversational style interviews where we re-evaluate our position in light of the project, with a particular focus on the tensions that drug use introduces between professional, personal and political domains in our lives. These reflections are useful to people who use drugs and hold privilege by nature of their social and cultural position. While questioning the silencing of personal experiences in relation to drug use, we also react to some of the traditional tendencies of academia, including institutionalised individualism, which isolates researchers and discourages them from finding political collectivity, and the subjectivist/objectivist dichotomy, which supports a tendency to objectify research participants while removing the self from the equation. Despite the challenges that arise from disentangling our multiple experiences and identities, our intersubjective dialogue inspires deeper learning about ourselves and each other, encouraging us towards a more openly political stance.

Meaning-Making Activity in the Emotional Experience of Borderline Personalities

This article describes the mereological constitution of contents in the intentional acts of people affected by borderline personality disorder (BPD) or emotionally unstable personality disorder (EUPD) in order to shed light on the origin of the emotional instability characterizing this disorder. The article will first discuss the emotional cycle of people affected by this disorder; second, it will focus on the mereological aspect of the meaning-making<A51_FootRef>1</A51_FootRef> experience in the intentional act; third, it will show how this meaning-making experience usually interacts with axiological<A51_FootRef>2</A51_FootRef> qualities that affect the continuity of their sense of reality. From the investigation, it emerges that the mereological constitution of contents occurs in a way that is disruptive of the continuity of BPD/EUPDs' interaffective lifeworld as it generates intersubjective disturbances on the axiological, logical, and ontological levels. On this basis, as a concluding suggestion, the paper will propose an alternative way to approach the problem, soothe the disturbance, and encourage integration.

The Bracketing of Presence: Dematerialization and Disembodiment in Times of Pandemic and of Social Distancing Biopolitics

The purpose of this paper is to help us understand how and why the COVID pandemic, and its associated biopolitics of social distancing, may have affected our relationships with our own bodies and other persons, thus helping to accelerate what might be termed a bracketing of presence that was already well underway in our modern and contemporary social practices. We focus on 3 historical vectors, all rooted in specific technologies, that have profound implications at the levels of our social imaginary and prereflective ways of being: architecture, social media, and medicine. Architecture has progressively eliminated "porosity" between spaces by establishing clear borders between public and private spaces (also within the private ones), thereby contributing to our drive for social distancing. Social media have provided apparatuses that replace intercorporeal encounters with disembodied, virtual interactions mediated by images. Visual experiences that are more embodied, participatory, and "immersed" are replaced by passive forms of "seeing": the other becomes an image for me, and I for the other. The object of medicine has also recently dematerialized with the advent of the new "optical" and "digital" machines of modern medicine, which can operate remotely thanks to an increasingly powerful interface reliant on computational power and the resources of artificial intelligence, thereby dispensing with body-to-body interactions. We offer these reflections as routes to a better understanding of changes that have occurred and are occurring on the planes of both culture and individual psychological existence.

The Clinician's Subjective Experience during the Interaction with Adolescent Psychiatric Patients: Validity and Reliability of the Assessment of Clinician's Subjective Experience

INTRODUCTION

The last decade has witnessed a resurgence of interest in the clinician's subjectivity and its role in the diagnostic assessment. Integrating the criteriological, third-person approach to patient evaluation and psychiatric diagnosis with other approaches that take into account the patient's subjective and intersubjective experience may bear particular importance in the assessment of very young patients. The ACSE (Assessment of Clinician's Subjective Experience) instrument may provide a practical way to probe the intersubjective field of the clinical examination; however, its reliability and validity in child and adolescent psychiatrists seeing very young patients is still to be determined.

METHODS

Thirty-three clinicians and 278 first-contact patients aged 12-17 years participated in this study. The clinicians completed the ACSE instrument and the Brief Psychiatric Rating Scale after seeing the patient, and the Profile of Mood State (POMS) just before seeing the patient and immediately after. The ACSE was completed again for 45 patients over a short (1-4 days) retest interval.

RESULTS

All ACSE scales showed high internal consistency and moderate to high temporal stability. Also, they displayed meaningful correlations with the changes in conceptually related POMS scales during the clinical examination.

DISCUSSION

The findings corroborate and extend previous work on adult patients and suggest that the ACSE provides a valid and reliable measure of the clinician's subjective experience in adolescent psychiatric practice, too. The instrument may prove to be useful to help identify patients in the early stages of psychosis, in whom subtle alterations of being with others may be the only detectable sign. Future studies are needed to determine the feasibility and usefulness of integrating the ACSE within current approaches to the evaluation of at-risk mental states.

The role of eye contact in young children's judgments of others' visibility: A comparison of preschoolers with and without autism spectrum disorder

Typically-developing (TD) children under age 5 often deny that they can see a person whose eyes are covered (e.g., Moll & Khalulyan, 2017). This has been interpreted as a manifestation of their preference for reciprocal interactions. We investigated how 3- to 4-year-old children with autism spectrum disorder (ASD, n = 12) respond in this situation. Because a lack of interpersonal connectedness and reciprocal communication are core features of this disorder, we predicted that young children with ASD will not make mutual regard a condition for seeing another person and therefore acknowledge being able to see her. Against this prediction, children with ASD gave the same negative answers as a group of TD (n = 36) age-mates. Various interpretations are discussed, including the possibility that some children with ASD are capable of relating to others as second persons.

Creativity and Fiction: Interpretative Horizons on the Emergence of the New in the Relationship Between Individual and Culture

This article aims to establish, in the light of Semiotic-Cultural Constructivism in Psychology, a contribution to the research of creative processes through a reflection on the emergence of the new in the relationship between self-other-world. It is intended to advance in the classic approaches to creativity, by focusing on the unusual and ambiguous, affective-singularizing and, simultaneously, everyday-cultural face of the perspective of the possible and the new in the course of human action. In this way, the article focuses on fiction as a psychic reality that participates in the intersubjective field inherent to creative dynamics, as well as addresses affectivity in the Boeschian grammar from the place of the ambivalence and the dynamics between myths and fantasms in the forms of meaning construction in the face of disturbing experiences and uncertainty about the future. As an interpretive exercise, this text discusses a comic strip by a pair of elementary school students about a character who studies in a school where nothing was prohibited. The discussion of the data seeks to broaden the reading about the ways of fictionalizing the lived experience, pervasive to the everyday plot of the self, and its relationship with creativity in the future of human action.

Principles of early intervention

The great majority of children with neurodevelopmental challenges do not get specific intervention until after their second birthday. This worsens their outcomes, because a great part of the entire neuroplastic window for learning is misspent. There is emerging evidence that the impact on outcomes of early goal-directed training involving the parents in infants with neurodevelopmental disabilities is significantly superior to the results achieved in older children and adults, especially if intervention commences in the first months of life. This chapter outlines the common elements of neurodevelopment and early intervention. It includes an outline of some of the primary early intervention practices and the scientific evidence driving them.

Inching Toward a Unified Metatheory for Psychology

Zagaria et al. (2020) have aptly suggested that as a discipline, psychology is a giant with feet of clay. Drawing on the content of introductory textbooks, the authors show that there is little coherence and consensus about the meaning of key psychological terms - including such terms as psychology, mind, behavior. Drawing on evidence marking psychology is a "soft" science, the authors suggest that psychology can profit by adopting the "hard" foundation of evolutionary psychology as its metatheory. While Zagaria et al.'s characterization of psychology's fractious foundation has deep merit, their desire to erect a psychological metatheory on evolutionary psychology is unlikely to solve the problem they so aptly identify. At the least, I suggest a unified metatheory must: (a) establish a shared psychological lexicon; (b) elaborate a methodology that coordinates first-, second- and third-person modes of inquiry, and (c) develop a process model that describes psychological functioning at the biological, psychological and socio-cultural levels of analysis. To illustrate, I describe how contemporary relational and systems frameworks provide a framework that can move us in these directions.

Ultrasociality and Intersubjectivity

Multidisciplinary studies of evolution are pointing toward an intersubjective understanding of human cognition, belief, and behavior. Contrary to classical views of reason and knowledge, human mental capacity should not be thought of as an individually based tool for independent judgment and logical problem-solving. Instead, key aspects of learning and cognition were likely shaped to facilitate our species' greatest relative advantage from the standpoint of natural selection: large-scale collaboration. Much of what appears to be faulty reasoning or inaccurate belief when viewed at the level of individuals makes more sense when considered in terms of intersubjectivity and group-level processes. Yet, distributed cognition also has shortcomings. Among these is, paradoxically, the propensity toward individualistic understandings of human thinking and behavior. Moreover, our intersubjective thought processes tend to be biased in favor of our in-groups and maintaining existing systems. Taken together, these premises correspond with some of the theoretical underpinnings of community research and social action. Yet, they challenge or complicate others. Further consideration of humans' intersubjective cognition and learning may yield improved results in a variety of practices, including education and efforts to catalyze social and systemic changes.

Collaborative Competence during preschooler's Peer Interactions: Considering Multiple Levels of Context within Classrooms

The present study introduced an interaction based, contextually contingent method for the study of social competence among preschoolers from low income families of color. Contrary to prevailing methods that assess social competence among individual children, this study used the interacting group as the unit of analysis. The constructs of intersubjectivity and collaborative complexity were adapted for an observational measure of 277 naturally occurring episodes of children's free play. The results of a multi-level analysis demonstrated a significant impact of the flexibility of the play environment and the characteristics of the peer group on the social complexity of children's peer interactions during play. To explain the study's findings a theory of how children's collaborative competence emerges according to the features of the physical and social context is proposed. More specifically, there is a bi-directional relationship between the flexibility of space and materials in the immediate play environment and children's focus on either interpersonal dynamics or collective goals of shared activity during peer play interactions. Implications for both empirical study and theorization of children's collaborative competence is discussed. More specifically, the need for measures that consider the interactive nature of social development, include non-verbal indicators of collaborative competence and consider environmental influences on children's peer interactions is highlighted. Including consideration of collaborative competence as framed by shared activity and collective goals during peer interactions in an understanding of social competence, rather than an exclusive focus on individual development of social skills is proposed.

Trauma and intersubjectivity: the phenomenology of empathy in PTSD

With my research, I wish to contribute to the discussion of post-traumatic psychopathologies from a phenomenological perspective. The main question I pursue is to what extent PTSD can be understood as an intersubjective psychopathology and which implications this view might have. In this paper, I argue that the mode of perception allowing for intersubjective experience is vulnerable to disruptions through traumatic events. I begin with a short elaboration on what intersubjectivity entails before proceeding to illustrate how it can be impaired. Then, I focus on the concept of empathy as a mode of perception: I propose that due to a disruption of the ability to empathize an individual suffering from PTSD may cease to experience the other as another subject that offers possibilities for interaction. The traumatized individual is thus unable to establish meaningful connections with others. I offer some implications this view might entail for thinking about trauma treatment.

Enactive social cognition: Diachronic constitution & coupled anticipation

This paper targets the constitutive basis of social cognition. It begins by describing the traditional and still dominant cognitivist view. Cognitivism assumes internalism about the realisers of social cognition; thus, the embodied and embedded elements of intersubjective engagement are ruled out from playing anything but a basic causal role in an account of social cognition. It then goes on to advance and clarify an alternative to the cognitivist view; namely, an enactive account of social cognition. It does so first by articulating a diachronic constitutive account for how embodied engagement can play a constitutive role in social cognition. It then proceeds to consider an objection; the causal-constitutive fallacy (Adams & Aizawa, 2001, 2008; Block, 2005) against enactive social cognition. The paper proceeds to deflate this objection by establishing that the distinction between constitution and causation is not co-extensive with the distinction between internal constitutive elements and external causal elements. It is then shown that there is a different reason for thinking that an enactive account of social cognition is problematic. We call this objection the 'poverty of the interactional stimulus argument'. This objection turns on the role and characteristics of anticipation in enactive social cognition. It argues that anticipatory processes are mediated by an internally realised model or tacit theory (Carruthers, 2015; Seth, 2015). The final part of this paper dissolves this objection by arguing that it is possible to cast anticipatory processes as orchestrated as well as maintained by sensorimotor couplings between individuals in face-to-face interaction.

Social Life in the Schizophrenia Spectrum: A Phenomenological Study of Five Patients

BACKGROUND

Social difficulties are a hallmark of schizophrenia spectrum conditions, yet their background and exact nature remain contested. Previous pivotal studies on chronically ill patients have suggested that a position of "positive withdrawal" is associated with a decreased tendency to rehospitalization. This concept designates an essentially withdrawn but not negatively experienced position balanced by elements relating the individual to the social world.

OBJECTIVES

To explore a less ill subgroup of schizophrenia spectrum patients' ways of navigating the social world and examine potential links to anomalous self-experiences by applying key insights from phenomenology and anthropology.

METHOD

The present study was part of a 5-year follow-up on a group of first-admission schizophrenia spectrum patients. From this sample of 48 patients, 5 were selected for qualitative evaluation following the principles of thematic analysis.

RESULTS

A "positively withdrawn" position characterizes a wider group of patients than originally reported. Further, we identified a preference for partaking in social activities in particular circumstances with clearly circumscribed goals or social roles and rules. This alleviated social discomfort and helped patients stay embedded in a social milieu. All patients experienced high levels of self-disorders.

CONCLUSIONS

We suggest that certain aspects of social impairment may, in fact, reflect meaningful compensatory mechanisms, and argue that this conceptualization of social difficulties is relevant to various psychotherapeutic interventions.

Projective identification and "telepathic dreams"

Based on the pioneering works by Freud and other authors with regard to telepathic dreams, and specifically those related to Klein's projective identification and latterly developed by Bion and Grinberg, the author reviews some concepts associated with the theory of intersubjectivity. An example of a telepathic dream that emerged within an analytic process is integrated with these concepts in order to propose several hypotheses about their genesis. The main hypothesis is that projective identification and counter-identification, in their normal and abnormal forms, are the oneiric basis of communication. One member of the analytic pair transmits unconsciously to the other the contents of his real life, and the other one dreams about it; this way the dominant emotions and phantasies are made conscious. An emotionally intense climate, especially with abandonment phantasies, is required to achieve this type of communication. These dreams, infrequent in analysis, underscore intersubjective creativity, the "analytic third" described by Ogden. The author mentions some concepts based on neuroscience and quantum physics as possible explanations for the biological basis of unconscious communication.

Objectivity applied to embodied subjects in health care and social security medicine: definition of a comprehensive concept of cognitive objectivity and criteria for its application

BACKGROUND

The article defines a comprehensive concept of cognitive objectivity (CCCO) applied to embodied subjects in health care. The aims of this study were: (1) to specify some necessary conditions for the definition of a CCCO that will allow objective descriptions and assessments in health care, (2) to formulate criteria for application of such a CCCO, and (3) to investigate the usefulness of the criteria in work disability assessments in medical certificates from health care provided for social security purposes.

METHODS

The study design was based on a philosophical conceptual analysis of objectivity and subjectivity, the phenomenological notions 'embodied subject', 'life-world', 'phenomenological object' and 'empathy', and an interpretation of certificates as texts. The study material consisted of 18 disability assessments from a total collection of 86 medical certificates provided for social security purposes, written in a Norwegian hospital-based mental health clinic.

RESULTS

Four necessary conditions identified for defining a CCCO were: (A) acknowledging the patient's social context and life-world, (B) perceiving patients as cognitive objects providing a variety of meaningful data (clinical, psychometric, and behavioural data - i.e. activities and actions, meaningful expressions and self-reflection), (C) interpreting data in context, and (D) using general epistemological principles. The criteria corresponding to these conditions were: (a) describing the patient's social context and recognizing the patient's perspective, (b) taking into consideration a variety of quantitative and qualitative data drawn from the clinician's perceptions of the patient as embodied subject, (c) being aware of the need to interpret the data in context, and (d) applying epistemological principles (professional expertise, dialogical intersubjectivity, impartiality, accuracy and correctness). Genuine communication is presupposed. These criteria were tested in the work disability assessments of medical certificates. The criteria were useful for understanding both how objectivity fails during work disability assessments and how it can be improved in the writing of certificates.

CONCLUSION

The article specifies four necessary conditions for the definition of a CCCO in health care and social security medicine and the corresponding criteria for its application. Analysis of the objectivity of work disability assessments in medical certificates for social security confirmed the usefulness of the criteria.

On the Concept of Praecox Feeling

Despite the development and widespread diffusion of modern nosographic systems, the diagnosis of schizophrenia continues to raise several epistemological issues. To address these issues, a number of researchers are currently pursuing the possibility of an integration between reliable, objective approaches and the intersubjective perspective in the clinical encounter. In the present article, we discuss Rümke's popular concept of praecox feeling, as introduced in 1941 and re-elaborated over the following 20 years. Our aim was to thoroughly analyze the author's original formulation and to identify the connections between his thinking and certain psychopathological developments, epistemological issues, and research perspectives on schizophrenia. The praecox feeling is presented by Rümke as a sensitive diagnostic tool for schizophrenia that is rooted in the peculiar subjective experience of the clinician when encountering a schizophrenic patient. This experience seems to be characterized by two essential dimensions: a subjective one, which reflects the failure of a clinician's empathic effort due to a fundamental alteration of the intersubjective space, a phenomenon related to schizophrenic autism, and a gestaltic, objective one, which is grounded in the clinician's implicit typifying process as a consequence of collecting recurrent clinical observations over the course of his/her professional experience. According to Rümke, the diagnostic use of the praecox feeling should be limited to the acute phases of the schizophrenic process, as the clinician's experience of an intersubjective struggle is attenuated in interactions with older, chronic patients. The multifaceted nature of Rümke's proposal seems to have contributed to some theoretical critiques and to inconclusive results from empirical investigations, leading to a progressive devaluation of the scientific and diagnostic validity of praecox feeling. The present analysis of the original concept suggests that a renewed research interest in the role of the clinician's subjective experience with regard to the schizophrenic patient could be helpful.

Psychopathological dimensions and the clinician's subjective experience

Classical psychopathology highly valued the interaction between clinician and patient, and recent findings have provided preliminary evidence of an association between categorical psychiatric diagnosis and the clinician's subjective experience during the first clinical assessment. To extend these findings, the present study examined the relationship between psychopathological dimensions and clinicians' subjective experiences. The study involved 45 clinicians and 783 patients in several psychiatric inpatient and outpatient units. When they saw a new patient, the clinicians completed the Assessment of Clinician's Subjective Experience questionnaire (ACSE) and the 24-item Brief Psychiatric Rating Scale (BPRS). Scores on five core psychopathological dimensions supported by meta-analytic evidence (Affect, Positive Symptoms, Negative Symptoms, Activation, Disorganization) were derived from the BPRS. Multivariate analysis revealed that each psychopathological dimension was characterized by a distinct pattern of independent associations with certain aspects of Clinician's Subjective Experience, as measured by the ACSE. This study provided preliminary evidence of significant and theoretically consistent relationships between major psychopathological dimensions and the psychiatrist's subjective experience during the first clinical evaluation. Improving the understanding of intersubjective processes may have important implications for theory, practice, research, and training.

A COMPARATIVE LOOK AT INTERSUBJECTIVE AND OBJECT RELATIONAL APPROACHES TO CLINICAL MATERIAL

The Search for a Relational Home: An Intersubjective View of Therapeutic Action. By Chris Jaenicke. London/New York: Routledge, 2015. 100 pp.

[Between psyche and brain : State of the art in psychiatry]

Since its development around 1800 psychiatry has been oscillating between the poles of the sciences and the humanities, being directed towards subjective experience on the one hand and towards the neural substrate on the other hand. Today, this dualism seems to have been overcome by a naturalism, which identifies subjective experience with neural processes, according to Griesinger's frequently quoted statement "mental diseases are brain diseases". The progress achieved by the neurobiological paradigm on the level of a fundamental science is in contrast to the tendency to isolate mental illnesses from the patients' social relationships and to neglect subjectivity and intersubjectivity in their explanation. What should be searched for is therefore an overarching paradigm that is able to establish psychiatry as a relational medicine in an encompassing sense: as a science and practice of biological, psychological and social relationships and their disorders. Within such a paradigm, the brain may be understood and investigated as the central "relational organ" without reductionist constrictions.

Beyond Autism: Introducing the Dialectical Misattunement Hypothesis and a Bayesian Account of Intersubjectivity

Drawing on sociocultural theories and Bayesian accounts of brain function, in this article we construe psychiatric conditions as disorders of social interaction to fully account for their complexity and dynamicity across levels of description and temporal scales. After an introduction of the theoretical underpinnings of our integrative approach, we take autism spectrum conditions (ASC) as a paradigm example and discuss how neurocognitive hypotheses can be translated into a Bayesian formulation, i.e., in terms of predictive processing and active inference. We then argue that consideration of individuals (even within a Bayesian framework) will not be enough for a comprehensive understanding of psychiatric conditions and consequently put forward the dialectical misattunement hypothesis, which views psychopathology not merely as disordered function within single brains but also as a dynamic interpersonal mismatch that encompasses various levels of description. Moving from a mere comparison of groups, i.e., "healthy" persons versus "patients," to a fine-grained analysis of social interactions within dyads and groups of individuals will open new avenues and may allow to avoid an overly neurocentric scope in psychiatric research as well as help to reduce social exclusion.

Ragnar Rommetveit's Approach to Everyday Spoken Dialogue from Within

The following article presents basic concepts and methods of Ragnar Rommetveit's (born 1924) hermeneutic-dialogical approach to everyday spoken dialogue with a focus on both shared consciousness and linguistically mediated meaning. He developed this approach originally in his engagement of mainstream linguistic and psycholinguistic research of the 1960s and 1970s. He criticized this research tradition for its individualistic orientation and its adherence to experimental methodology which did not allow the engagement of interactively established meaning and understanding in everyday spoken dialogue. As a social psychologist influenced by phenomenological philosophy, Rommetveit opted for an alternative conceptualization of such dialogue as a contextualized, partially private world, temporarily co-established by interlocutors on the basis of shared consciousness. He argued that everyday spoken dialogue should be investigated from within, i.e., from the perspectives of the interlocutors and from a psychology of the second person. Hence, he developed his approach with an emphasis on intersubjectivity, perspectivity and perspectival relativity, meaning potential of utterances, and epistemic responsibility of interlocutors. In his methods, he limited himself for the most part to casuistic analyses, i.e., logical analyses of fictitious examples to argue for the plausibility of his approach. After many years of experimental research on language, he pursued his phenomenologically oriented research on dialogue in English-language publications from the late 1980s up to 2003. During that period, he engaged psycholinguistic research on spoken dialogue carried out by Anglo-American colleagues only occasionally. Although his work remained unfinished and open to development, it provides both a challenging alternative and supplement to current Anglo-American research on spoken dialogue and some overlap therewith.

The Special Challenges of Psychotherapy with Persons with Psychosis: Intersubjective Metacognitive Model of Agreement and Shared Meaning

Agreement between client and therapist is an essential part of the therapeutic alliance. While there are general challenges to the creation of agreement and shared meaning in all psychotherapies, there are specific challenges while working with persons with psychosis. These challenges include the different narratives of the client and the therapist with regard to their roles and the description of the condition or problem, as well as possible stigmatic views and theoretical bias. Here we present a metacognitive intersubjective model as a framework for the understanding and resolutions of these challenges. Copyright © 2016 John Wiley & Sons, Ltd.

KEY PRACTITIONER MESSAGE

Goal consensus, agreement and shared meaning are essential for a collaborative process and positive outcome in psychotherapy. Challenges to psychotherapy with persons with psychosis include the different narratives of the client and the therapist with regard to their roles and the description of the condition or problem, as well as possible stigmatic views and theoretical bias. In the intersubjective exchange, the concepts of metacognition and empathy can act as a framework for navigating between the possible challenges and the desired shared meaning and agreement.

Music, empathy and cultural understanding

In the age of the Internet and with the dramatic proliferation of mobile listening technologies, music has unprecedented global distribution and embeddedness in people's lives. It is a source of intense experiences of both the most intimate and solitary, and public and collective, kinds - from an individual with their smartphone and headphones, to large-scale live events and global simulcasts; and it increasingly brings together a huge range of cultures and histories, through developments in world music, sampling, the re-issue of historical recordings, and the explosion of informal and home music-making that circulates via YouTube. For many people, involvement with music can be among the most powerful and potentially transforming experiences in their lives. At the same time, there has been increasing interest in music's communicative and affective capacities, and its potential to act as an agent of social bonding and affiliation. This review critically discusses a considerable body of research and scholarship, across disciplines ranging from the neuroscience and psychology of music to cultural musicology and the sociology and anthropology of music, that provides evidence for music's capacity to promote empathy and social/cultural understanding through powerful affective, cognitive and social factors; and explores ways in which to connect and make sense of this disparate evidence (and counter-evidence). It reports the outcome of an empirical study that tests one aspect of those claims, demonstrating that 'passive' listening to the music of an unfamiliar culture can significantly change the cultural attitudes of listeners with high dispositional empathy; presents a model that brings together the primary components of the music and empathy research into a single framework; and considers both some of the applications, and some of the shortcomings and problems, of understanding music from the perspective of empathy.

Dissociation and hallucinations in dyads engaged through interpersonal gazing

Interpersonal gazing in dyads, when the two individuals in the dyad stare at each other in the eyes, is investigated in 20 healthy young individuals at low illumination for 10-min. Results indicate dissociative symptoms, dysmorphic face perceptions, and hallucination-like strange-face apparitions. Dissociative symptoms and face dysmorphia were correlated. Strange-face apparitions were non-correlated with dissociation and dysmorphia. These results indicate that dissociative symptoms and hallucinatory phenomena during interpersonal-gazing under low illumination can involve different processes. Strange-face apparitions may characterize the rebound to "reality" (perceptual reality caused by external stimulus and hallucinatory reality caused by internal input) from a dissociative state induced by sensory deprivation. These phenomena may explain psychodynamic projections of the subject's unconscious meanings into the other's face. The results indicate that interpersonal gazing in dyads can be an effective tool for studying experimentally-induced dissociative symptoms and hallucinatory-like apparitions.

Physical therapy with newborns and infants: applying concepts of phenomenology and synactive theory to guide interventions

Physical therapy involving newborns and young infants is a specialized area of practice reserved for therapists who have advanced training and the competence to help newborns, young infants and their families meet their goals. Beginning at birth, infants apply a significant amount of effort to actively participate in and shape their world. Infants make their intentions and requests for support known through their behaviors during social and physical therapy encounters. The therapeutic encounter viewed from the infant's perspective has received limited attention in the physical therapy literature. The purpose of this article is to discuss concepts related to phenomenology and synactive theory that are relevant to physical therapy with newborns and young infants during the first few months of life after birth.

I wept for four years and when I stopped I was blind

The conversion phenomena of hysteria were the subject of intense study in the late nineteenth and early twentieth centuries, after which work on the subject went into decline. The patients are still with us, however, and I cite an epidemic of hysterical blindness among Cambodian refugees living in the U.S. as a poignant example. Since the advent of brain imaging technology, conversion hysteria has been receiving renewed attention. In this paper, I suggest that examining the ideas about hysteria from the past, especially those of Charcot and Janet are fertile areas of study, including the illness and its relation to hypnosis, shock, suggestion, and dissociation theory. I also address the role of the imaginary and the imagination in the illness and critique the implicit dualist model used in most brain imaging studies that distorts the integration of psyche and soma. I summon Merleau-Ponty's body-subject, infant research on intersubjectivity, and Vittorio Gallese's "embodied simulation" as possible windows onto the problem of hysterical conversion, and finally I suggest that along with imaging studies, more dynamic narrative strategies should be used if we hope to understand the metamorphoses, mimesis, and powerful emotions that all play a part in this mysterious disease.

[Intersubjectivity: Between Explanation and Understanding]

The discussion on explanation and understanding has led to a division in the sciences, based on what is considered to be inherent to each of the domains. The task of the natural sciences would be the explanation, while that of the social sciences would be understanding or interpretation.There is a line of work that currently seeks to overcome the methodological dualism and to propose more interdisciplinary studies, such as the studies on emergence of the mental in the framework of intersubjective relationships. In particular, the concept of intersubjectivity defended by the phenomenology as an embodied practice, is being supported by the results of investigations carried out on the basis of the cognitive neuroscience and developmental psychology. Authors from different roots, such as J. Bruner and S. Gallagher propose considering these types of interdisciplinary collaboration as a possible way to integrate the traditions of the explanation and understanding. The purpose of this paper is to analyze to what extent this collaboration between phenomenology and sciences, particularly on the subject of understanding others and their relevance for the understanding of certain psychopathologies, has allowed to close the gap that had opened in the nineteenth century between these traditions.

Early intersubjective skills and the understanding of intentionality in young children with Down syndrome

This study examined the relationship between early intersubjective skills (joint attention and affect sharing) and the development of the understanding of intentionality in 16 young children with Down syndrome (DS) and 16 developmentally matched children with other developmental disabilities (DD). The study of intentionality focuses on how children come to understand the goal-directed actions of others and is an important precursor to the development of more complex social cognitive skills, such as theory of mind. Joint attention and affect sharing were examined using the Early Social Communication Scales (Mundy, Sigman, & Kasari, 1990; Seibert, Hogan, & Mundy, 1982). Meltzoff's (1995) behavioral reenactment paradigm was used to examine the understanding of intentionality. For children with DS, higher rates of affect sharing were associated with poorer intention reading abilities. This pattern was not observed in children with other DD. These results suggest that the intersubjective strengths associated with DS may not support the development of intentionality-interpretation skills. Future research is needed to explore if children with DS have the joint attention behaviors needed to be intentional.

[Mental issues of clinical research interviews in an intercultural context]

INTRODUCTION

The interview is an intersubjective meeting in which the stakes are complex. This frequently used method in social and human sciences research brings to the foreground various mental processes. Despite its clear distinction from the therapeutic interview, due to its purpose and the origin of the request, the research interview generates for both the participant and the researcher unconscious phenomena and contributes to the epistemological reflection inherent to the clinical approach.

AIM OF THE PAPER

The aim of this article is to demonstrate that the mental processes mobilized in the participants and in the researcher, who belong to the same culture of origin during the research interview, may be analyzed in four dimensions: intrapsychique, intersubjective, projective and group.

METHODS

So as to illustrate the various mental processes that are engaged, a research conducted in clinical intercultural psychology regarding the adaptive processes and the identity strategies of Korean mothers living in France or in Quebec is used. In order to offer maximum freedom of expression to the participants, the interviews were conducted in Korean, and then translated into French. The intrapsychic dimension is illustrated by an example from the interview with a 44-year-old Korean woman met in Paris. Following the Rogerian theory (1952, 1961), we understand that the participant comes to a coherent reorganization of her own conception throughout the interview, allowing her to speak and to think about her autobiography. From the interaction between two subjectivities, the thought and the discourse are involved in the co-construction of meaning. The understanding of the intersubjective dimension is supported by the theory of Winnicott (1971), developed for the transitional space. Like the mother-child relationship in the game device, the mental permeability available to the researcher is supposed to guarantee the development of the interviewee's confidence. The example of the interview conducted with another 39-year-old Korean woman living in Paris illustrates this intersubjective dimension. The analysis of the relationship between the researcher and his object of research will argue the projective dimension. In the quoted research, the researcher is facing a situation in which the participant's problems remind him of his own questionings. The work of analysis, with hindsight and in the after fact, on the position of the researcher and his subjective implication, is necessary to avoid the possible risk of subjectivation. The group dimension has several levels: institutional, national, international or even worldwide. Thus, the intercultural aspect is particularly highlighted in an attempt to present the complexity of the process.

DISCUSSION

The idea of the interculturality awareness at several levels was highlighted in particular by taking the institutional transference/counter-transference movement into consideration. The transfer mezo level revealed itself as one of the analyzers of the group dimension, such as the motivation for accepting the participation in our investigation. In other words, it requires understanding both the relationship conducted by each individual with the institution, and that conducted by two subjects met within the institution. In the current world marked by globalization, "the geohistory of the clinical encounter" (Derivois, 2010) becomes an interesting tool to understand the complexity of the encounter issues arising from the clinical consultation.