An Unavoidable Mind-Set Reversal: Consciousness in Vision Science.

In recent decades, the debate on consciousness has been conditioned by the idea of bottom-up emergence, which has influenced scientific research and raised a few obstacles to any attempt to bridge the explanatory gap. The analysis and explanation of vision conducted according to the accredited methodologies of scientific research in terms of physical stimuli, objectivity, methods, and explanation has encountered the resistance of subjective experience. Moreover, original Gestalt research into vision has generally been merged with cognitive neuroscience. Experimental phenomenology, building on the legacy of Gestalt psychology, has obtained new results in the fields of amodal contours and color stratifications, light perception, figurality, space, so-called perceptual illusions, and subjective space and time. Notwithstanding the outcomes and the impulse given to neuroscientific analyses, the research carried out around these phenomena has never directly confronted the issue of what it means to be conscious or, in other words, the nature of consciousness as self-referentiality. Research has tended to focus on the percept. Therefore, explaining the non-detachability of parts in subjective experience risks becoming a sort of impossible achievement, similar to that of Baron Munchausen, who succeeds in escaping unharmed from this quicksand by pulling himself out by his hair. This paper addresses how to analyze seeing as an undivided whole by discussing several basic dimensions of phenomenal consciousness on an experimental basis and suggesting an alternative way of escaping this quicksand. This mind-set reversal also sheds light on the organization and dependence relationships between phenomenology, psychophysics, and neuroscience.

Las fases iniciales de la psicosis. ¿Se han olvidado de Klaus Conrad? / The early phases of psychosis. Has Klaus Conrad been forgotten?

Las primeras fases de la psicosis han sido objeto de atención psicopatológica, con especial empuje a partir de las aportaciones de Jaspers y su escuela. Tradicionalmente, se sabe que la evaluación de estas fases requiere de una exploración clínica atenta y cuidadosa. Sin embargo, a principios de este siglo una corriente de entusiasmo biomédico llevó al convencimiento de que era posible identificar a las personas en riesgo de psicosis mediante biomarcadores. De esta forma se podrían aplicar medidas preventivas para evitar su progresión. Los programas de fases iniciales o de primeros episodios se extendieron profusamente. Los promotores de estos programas hicieron tabla rasa del saber psicopatológico previo y buscaron en un espacio natural donde no encontraron nada. Las claves para entender la psicosis están en la vivencia, no en los biomarcadores. Klaus Conrad hizo aportaciones indispensables para identificar y describir los fenómenos vivenciales que aparecen en las primeras etapas de la psicosis. A pesar del tiempo transcurrido desde entonces y de los hallazgos neurocientíficos, conservan vigencia y actualidad. (AU)

The first phases of psychosis have been the object of psychopathological attention, with special emphasis from the contributions of Jaspers and his school on. It is traditionally known that the evaluation of these phases requires an attentive and careful clinical examination. However, at the beginning of this century a current of biomedical enthusiasm led to the conviction that it was possible to identify people at risk of psychosis by means of biomarkers. In this way, preventive measures could be applied in order to avoid progression. Early-stage or first-episode programs spread widely. The promoters of these programs made a clean slate of previous psychopathological knowledge and searched in a natural space in which they found nothing. The keys to understanding psychosis are in the experience, not in biomarkers. Klaus Conrad made essential contributions to identify and describe the experiential phenomena that appear in the early stages of psychosis. Despite the time that has passed and neuroscientific contributions, they remain valid and up-to-date. (AU)

A case report and first-person account of an individual at risk for psychosis who improved during the COVID-19 pandemic.

Background: The COVID-19 pandemic is expected to increase stress and mental health symptoms. We present the case of a young man at risk for psychosis who has paradoxically shown symptomatic and functional improvement as a result of circumstances produced by COVID-19. These changes were unexpected given the client's persistent mental health struggles in the year leading up to the COVID-19 outbreak in the United States and the expectation of an exacerbation of psychotic-like symptoms. Methods: This report is based on clinical assessments and the client's first-person account during the height of the pandemic when stay at home orders were in place. Results: During the pandemic, the client demonstrated increased agency by taking on more responsibility at home and obtaining part-time employment. He showed improvement in his mood and relationships with others, had less symptom-related distress, and significantly reduced his cannabis use. The client interpreted these improvements in terms of changing his mindset toward more adaptive thoughts and engaging in healthy coping skills such as praying, reading, and healthy eating. Conclusions: This case highlights the importance of fostering agency in clients during a time of crisis and ensuring that clinicians be aware of potential biases about mental health symptom exacerbation.

"Being a team of five strong women we had to make an impression:" The College Math Academy as an intervention into mathematics education.

This paper, a first-person account, describes a community psychology-aligned intervention into a precalculus mathematics class at an Hispanic Serving Research Institution. The intervention was designed because the standard precalculus mathematics class had a high failure rate, especially for Latinx students, which was serving as a barrier for declaration of a Science, Technology, Engineering, or Mathematics major. The high failure rate indicates a structural problem that requires a structural intervention. The paper is coauthored with the teaching team, undergraduates who had taken the course, a graduate student who evaluated the class, and a community psychologist. We describe the ways that the new course, the College Math Academy, transformed the social environment through capacity building, providing access to valued resources for historically marginalized groups, facilitating opportunities to critique dominant power structures, prioritizing perspectives and experiences of people of color, and promoting understanding of how various social forces shape culture and values. The course also decentered white educational norms via adapting decoloniality and liberatory practices. In turn, each person describes their experience of the course. We draw on the first-person accounts to show how they illustrate a transformative, decolonial, and liberatory social environment. We end with implications for how community psychologists can work in their universities to support structural change.

A story of recovery from the dangers of drug use and psychosis.

WHAT IS KNOWN ON THE SUBJECT?: The effectiveness of Clozapine for some people suffering from schizophrenia. The use of street drugs as self-medication and a coping mechanism. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The difficulties of treating someone with addiction problems and psychotic symptoms. Allowing them time in hospital only once they are off the drugs. Once I was in the recovery ward, I knew I wouldn't go back to drug use. Describing my own experience of drug use and suicidal thinking as an expression of frustration at not being able to make the changes I needed and wanted. To then finally make that change and to embrace a better life, when things started to move forward I made a commitment to do all I could to stay well. I knew what I wanted. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This story describes a lack of action from the mental health services. The psychosis was considered to be caused by the drug use and nothing could be done until the drug use had stopped. I believe more could have been done to provide a safe space for rehabilitation and eventually recovery. The recovery ward that I was admitted to give me 16 months to turn my life around, services like these can be a lifesaver. Hospitals can be so quick to discharge patients that they end up coming straight back, and I was given the time and support I needed to make big changes. ABSTRACT: Introduction This is a story of a very difficult time in my life. A time when I got stuck into heavy drug use and a time when I was begging the mental health services for help. The suicide attempts show that I was unable to see a life for myself, but it includes the recovery, the commitment I made to myself to live a good life. I think it shows both the desperation of suffering with schizophrenia but also some optimism that people who suffer can find a meaningful occupation. Aim The aim is to offer hope, but also highlight some of the fears. There is more to be done to offer help and hope to those struggling with mental health and drug problems. Maybe with the correct care, people can be treated for both addiction and psychosis. I had to quit the drugs myself and only when I tried to kill myself did I receive any help. The drugs made me feel good about myself and the people around me, but living without them is a much better life. Narrative I wanted to give the first person account of being drawn into drug use and then wanting to quit. Many people feel a desire to quit but never get the will power or the help. I realised the drugs weren't giving me the high I wanted and decided to remove myself from the group and leave town. More people can be helped to believe in a life without drugs. Discussion and implications for practice Addiction is something that may never have a solution, but for many people with mental health problems it offers a way out of suffering. I actually felt much better about myself and life with the use of drugs. It gave me some control over my psychosis and lifted my mood, but in my story I had to realise myself I could do better without. More can be done to support people away from drugs and into work, I replaced the drugs with work and it has been a huge achievement. People need to know there is better for them.

First-Person Accounts of Change Among Young Adults Enrolled in Coordinated Specialty Care for First-Episode Psychosis.

OBJECTIVE: This study investigated how clients of a coordinated specialty care (CSC) program for first-episode psychosis perceived how they changed while attending the program, what the most important changes were, and what mechanisms they believed helped bring about these changes. METHODS: Study participants were 121 individuals (71 men and 50 women) from 35 CSC programs across 22 U.S. states. Responses to the primary questions of interest were procured through a semistructured interview. Data on the length of time in the CSC program were also obtained. The authors used systematic content analyses to analyze these qualitative data. RESULTS: Participants reported a greater number of changes the longer they had received CSC services. Half of the participants reported improved psychiatric symptoms, and this change was the most important for almost one-third (31%; N=32) of the sample. In addition, 39% (N=45) of participants also reported improved social and interpersonal skills, changes in their attitude to and perspective on life, and more treatment engagement. Participants most frequently endorsed therapy as the mechanism underlying their improvement. CONCLUSIONS: Standardized outcome measures allow systematic assessment of clinical and functional status, but they do not provide a nuanced understanding of the underlying mechanisms or the areas of improvement most important to individual clients. The findings reinforce the value of mixed methods in both research and quality improvement efforts as well as for greater integration of patient-selected outcome measures.

Patching the Pathway and Widening the Pipeline: Models for Developing a Diverse Early Childhood Workforce in Chicago.

With the growing appreciation of the importance of early learning experiences for children's healthy development, attention to the cultivation and maintenance of a qualified workforce has steadily increased. Such a workforce must have not just the knowledge and skills related to child development and early learning, but also be linguistically and culturally prepared to meet the needs of an increasingly diverse child and family population. To ensure a highly qualified workforce, programs and policymakers must attend to both the "pipeline" through which new early childhood educators (ECEs) enter the workforce and the "pathways" by which ECEs work toward and obtain the necessary education and credentials for different roles within the field. In line with the aims of this special issue, this paper leverages the first-person account style to describe barriers to and creative solutions for the development of practitioners in low-resourced communities in Chicago, with the goal of informing practice and policy. We describe three prior and ongoing partnership programs between community-based organizations and institutions of higher education, each tailored to support a unique population in the ECE pipeline on the pathway for increased educational attainment and credentialing. Each program is grounded in a specific community of Chicago, a diverse city with a sizable population of children raised in non-English speaking homes. Each program addresses specific needs of the communities they serve, especially around the recruitment, retention, and promotion of bilingual ECEs. Program administrators and community members describe each programs' goals, development, and key components unique to their target population as well as key takeaways. We conclude with an overview of critical components that we identified across these programs in order to create pathways for change within the workforce and the communities they serve.

Sources of Distress in First-Episode Psychosis: A Systematic Review and Qualitative Metasynthesis.

In this study, we aim to increase our understanding of the self-reported sources of distress among people who have experienced first-episode psychosis. Following a systematic literature search, 33 relevant studies containing first-person accounts of first-episode psychosis were identified, which were synthesized using thematic analysis. Two interrelated superordinate themes were identified: intrapersonal distress and interpersonal distress. Participants reported multiple, diverse, and multifaceted sources of distress across both themes. These were substantially different from those routinely recognized and targeted in clinical practice. This review suggests that practitioners who maintain a stance of genuine curiosity about the potential sources of distress for this population will be perceived as more helpful. The findings also highlight the importance of being service user-led when planning and delivering mental health care. Additional clinical and research implications are discussed.

Naturalizing Phenomenology: A Must Have?

Quite a few cognitive scientists are working toward a naturalization of phenomenology. Looking more closely at the relevant literature, however, the 'naturalizing phenomenology' proposals show the presence of different conceptions, assumptions, and formalisms, further differentiated by different philosophical and/or scientific concerns. This paper shows that the original Husserlian stance is deeper, clearer and more advanced than most supposed contemporary improvements. The recent achievements of experimental phenomenology show how to 'naturalize' phenomenology without destroying the guiding assumptions of phenomenology. The requirements grounding the scientific explanation of subjective experience are discussed, such as the nature of the stimuli, their variables, and their manipulation by properly phenomenological methods.

Understanding the Blind Spots of Psychosis: A Wittgensteinian and First-Person Approach.

BACKGROUND: Experiences of psychosis are often assumed to be strange, bizarre, or incomprehensible. The aim of this article is to offer a new step towards a better understanding of how the psychotic process affects a prereflective background. METHODS: We use concepts from the philosophy of Ludwig Wittgenstein to clarify the first-person perspective on psychosis of one of the authors. RESULTS: We describe the early psychotic process as breaking down the "nest of propositions," shaking the scaffolds of our language games. Hereby, the prereflective background that forms our existential orientation in the world is fundamentally altered. We identify different aspects of this process: a dialectic of aha and anti-aha experiences, the experience of groundlessness, and blind spots. Acknowledging and exploring the depth and impact of this process on a person's world may be a first step towards resolving their isolation and suffering. Philosophy can facilitate such an exploration, while interpersonal activation may offer structure and trust in the world, helping the patient to find solid ground in action and interaction. CONCLUSION: This article combines a philosophical approach with a first-person perspective on psychosis to illuminate aspects of psychosis that have not been described or elaborated on before. We argue that psychosis entails an experience of existential groundlessness. Our view has implications for treatment of and recovery from psychosis.

The experience of voice hearing and the role of self-help group: An interpretative phenomenological analysis.

BACKGROUND: Auditory verbal hallucinations (AVHs) played an important role in the psychiatric diagnostics, but in the last few decades the diagnostic-free complex phenomenological understanding of the phenomena of voice hearing became the focus of studies. MATERIALS: Six semi-structured interviews with recovering voice hearers were conducted and analysed using interpretative phenomenological analysis (IPA). DISCUSSION: The self-help group gives significant help in identification and dealing with the voices; therefore, it serves as turning point in the life story of voice hearers. CONCLUSION: Applying self-help group in clinical context contributes to better outcomes in treatment of voice hearers.