Jasper Feyaerts

Interactions between obsessional symptoms and interpersonal dynamics: An empirical single case study

Both classical and contemporary psychoanalytic theories stress the importance of interpersonal dynamics in treating neurotic symptoms. Associations between the symptomatic and interpersonal level were formally represented in the symptom specificity hypothesis (Blatt, 1974, 2004), which linked obsessional symptoms to an autonomous interpersonal stance. Findings from cross-sectional group studies on symptom specificity, however, do not converge, possibly indicating that the complexity of associations is underestimated. This article presents a theory-building case study specifically aiming at refinement of the classical symptom specificity hypothesis by quantitatively and qualitatively describing the longitudinal clinical interplay between obsessional symptoms and interpersonal dynamics throughout a psychodynamic psychotherapy. Interpersonal functioning was assessed by means of the core conflictual relationship theme method (Luborsky & Crits-Cristoph, 1998). Findings affirm a close association between symptoms and interpersonal dynamics. However, obsessional symptoms proved to be determined by profound ambivalences—manifesting both within and between relationships—between dependent and autonomous interpersonal behavior. Psychodynamic interventions focusing on interpersonal conflicts were associated with symptomatic alterations. Conceptual and methodological considerations, limitations and future research indications are discussed.

How to return to subjectivity: Natorp, Husserl, and Lacan on the limits of reflection

This article discusses the recent call within contemporary phenomenology to return to subjectivity in response to certain limitations of naturalistic explanations of the mind. The meaning and feasibility of this call is elaborated by connecting it to a classical issue within the phenomenological tradition concerning the possibility of investigating the first-person perspective through reflection. We will discuss how this methodological question is respectively treated and reconfigured in the works of Natorp, Husserl, and Lacan. Finally, we will lay out some possible consequences of such a cross-reading for the conception of subjectivity and the concomitant effort to account for this dimension of first-person experience in response and in addition to its omission within the standard third-person perspective of psychological research.

Metaphor in psychosis: on the possible convergence of Lacanian theory and neuro-scientific research

Starting from the theories of leading psychiatrists, like Kraepelin and de Clérambault, the French psychoanalyst Jacques Lacan (1901–1981) formulated an original theory of psychosis, focusing on the subject and on the structuring role of language. In particular, he postulated that language makes up the experience of subjectivity and that psychosis is marked by the absence of a crucial metaphorization process. Interestingly, in contemporary psychiatry there is growing empirical evidence that schizophrenia is characterized by abnormal interpretation of verbal and non-verbal information, with a great difficulty to put such information in the appropriate context. Neuro-scientific contributions have investigated this difficulty suggesting the possibility of interpreting schizophrenia as a semiotic disorder which makes the patients incapable of understanding the figurative meaning of the metaphoric speech, probably due to a dysfunction of certain right hemisphere areas, such as the right temporoparietal junction and the right superior/middle temporal gyrus. In this paper we first review the Lacanian theory of psychosis and neuro-scientific research in the field of symbolization and metaphoric speech. Next, we discuss possible convergences between both approaches, exploring how they might join and inspire one another. Clinical and neurophysiological research implications are discussed.

Interactions between Obsessional Symptoms and Interpersonal Ambivalences in Psychodynamic Therapy: An Empirical Case Study

The classical symptom specificity hypothesis (Blatt, 1974) particularly associates obsessional symptoms to interpersonal behavior directed at autonomy and separation from others. Cross-sectional group research, however, has yielded inconsistent findings on this predicted association, and a previous empirical case study (Cornelis et al., in press; see Chapter 2) documented obsessional pathology to be rooted in profound ambivalences between autonomous and dependent interpersonal dynamics. Therefore, in the present empirical case study, concrete operationalizations of the classical symptom specificity hypothesis are contrasted to alternative hypotheses based on the observed complexities in Chapter 2. Dynamic associations between obsessional symptoms and interpersonal functioning is further explored, aiming at further contribution to theory building (i.e., through suggestions for potential hypothesis-refinement; Stiles, 2009). Similar to the first empirical case study (Chapter 1), Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of supportive-expressive psychodynamic therapy. In line with findings from Chapter 1, findings reveal close associations between obsessions and interpersonal dynamics, and therapist interventions focusing on interpersonal conflicts are documented as related to interpersonal and symptomatic alterations. Observations predominantly accord to the ambivalence-hypothesis rather than to the classical symptom specificity hypothesis. Yet, meaningful differences are observed in concrete manifestations of interpersonal ambivalences within significant relationships. Findings are again discussed in light of conceptual and methodological considerations; and limitations and future research indications are addressed.

Content Matters, a Qualitative Analysis of Verbal Hallucinations

Auditory verbal hallucinations have traditionally especially been researched from a form-based approach, with content getting much less attention. In this article, we argue for the importance of looking at content to get a fuller understanding of the hallucinatory experience. Guided by Lacanian psychoanalysis, we conducted a thematic and a narrative analysis on interviews with 10 schizophrenic patients about their hallucinations. We discerned five themes in the data, which were based on Lacanian theory and had to do with existential questions: parenthood and authority, sexuality and relationships, gender identity, life in the light of death, and what does the other want? Furthermore, we added a theme for unclassified content. Narratively, we found that participants constructed a story of four steps about their hallucinatory experiences. These steps were disturbing events in the past posing an existential question, triggering event, period of confusion, and hearing voices that allude to existential themes. Participants succeed in different degrees in integrating their hallucinatory experiences in their own life history. These stories can be situated on a continuum by making use of three prototypical narrating styles: the meta-delusional, delusional, and chaotic narrative type. Overall, our analysis shows that hallucinations can both be thematically and narratively organized, by making use of a theoretical framework like Lacanian psychoanalysis. Our research demonstrates that hallucinatory contents are not random but are about existential issues imbedded in a life narrative. Future research would benefit of integrating content and form-based approaches.

The Logic of Appearance: Dennett, Phenomenology and Psychoanalysis

In the present essay, we aim to develop and contrast three different positions toward Sellars’ distinction between the manifest and scientific images of man: Dennett’s philosophical reconstruction of neurocognitive science, contemporary phenomenology and psychoanalysis. We will suggest that these respective traditions and the substantial differences between them can be understood in terms of a ‘logic of appearance.’ Related to this are differing ideas about the rights and limits of the first-person perspective, the relation between conscious experience and belief, and the issue of naturalization. In the final part, we will try to specify, on the basis of a detailed reading of the disagreement between Dennett and phenomenology, in what way psychoanalytic theory could respond to these different issues.

Expression and the unconscious

In the present essay, we aim to develop an expressivist reading of the phenomenon of first-person authority and the adverbial meaning of unconsciousness. In the first part, Wittgensteins grammatical remarks on the asymmetry between the first -and third-persons in psychological self-ascriptions are developed as an alternative to detectivist explanations according to which first-person authority is to be regarded as a matter of epistemic accomplishment. In the second part, this expressivist account will be used to propose a non-epistemic analysis of the meaning of unconsciousness and to offer a critical discussion of both Freuds and Lacans respective readings of the unconscious. Regarding the latter, we will reject the idea that the concept of the unconscious (i) necessitates the introduction of a (Cartesian) “subject of the unconscious” and (ii) could be deduced from the paradoxes of first-personal reference.