Examination of self patterns: framing an alternative phenomenological interview for use in mental health research and clinical practice.

Mental disorders are increasingly understood as involving complex alterations of self that emerge from dynamical interactions of constituent elements, including cognitive, bodily, affective, social, narrative, cultural and normative aspects and processes. An account of self that supports this view is the pattern theory of self (PTS). The PTS is a non-reductive account of the self, consistent with both embodied-enactive cognition and phenomenological psychopathology; it foregrounds the multi-dimensionality of subjects, stressing situated embodiment and intersubjective processes in the formation of the self-pattern. Indications in the literature already demonstrate the viability of the PTS for formulating an alternative methodology to better understand the lived experience of those suffering mental disorders and to guide mental health research more generally. This article develops a flexible methodological framework that front-loads the self-pattern into a minimally structured phenomenological interview. We call this framework 'Examination of Self Patterns' (ESP). The ESP is unconstrained by internalist or externalist assumptions about mind and is flexibly guided by person-specific interpretations rather than pre-determined diagnostic categories. We suggest this approach is advantageous for tackling the inherent complexity of mental health, the clinical protocols and the requirements of research.

Ontology and Politics: Interdependence and Radical Contingency in Merleau-Ponty's Political Interworld.

This paper takes as its point of departure Merleau-Ponty's assertion: "everything will have to begin again, in politics as well as in philosophy". In pursuing his later work, Merleau-Ponty signalled the need for a reconfiguration of his philosophical vision, so it was no longer caught in Cartesianism and the philosophy of consciousness. This required a turn towards ontology through which he consolidated two key ideas: firstly, a pervasive interdependence articulated in his reversibility thesis and the ontology of 'flesh'; secondly, a radical contingency at the heart of existence. This paper interrogates the political implications of these ideas, and specifically regarding humanism and human progress. Relatedly, I address the question - how might recognitions of ontological interdependence and radical contingency support a flourishing democracy? Merleau-Ponty's early political work concerned the issues of his day - Nazism, Marxism and the status of humanism - and did not engage extensively with these emerging onto-political concerns. Nonetheless, there are indicative reflections in the writings and interviews; the political implications of his ontological interrogations become more thematic in the later works. There is no rupture between the earlier and later works regarding his philosophical vision, although he later distanced himself from Marxism with revelations of the gulags under Stalin and the Korean War. The overarching claim of this paper - we need to rethink politics from the ground up beginning with ontology; ontology is political and the political is intrinsically ontologically informed. Getting the ontology 'right' is a matter of discovery and not theory choice.

The Declaration of Interdependence! Feminism, Grounding and Enactivism.

This paper explores the issue whether feminism needs a metaphysical grounding, and if so, what form that might take to effectively take account of and support the socio-political demands of feminism; addressing these demands I further propose will also contribute to the resolution of other social concerns. Social constructionism is regularly invoked by feminists and other political activists who argue that social injustices are justified and sustained through hidden structures which oppress some while privileging others. Some feminists (Haslanger and Sveinsdóttir, Feminist metaphysics. In E. N. Zalta (Ed.), Stanford encyclopedia of philosophy. Stanford: Stanford University, 2011) argue that the constructs appealed to in social constructivism are real but not metaphysically fundamental because they are contingent. And this is exactly the crux of the problem-is it possible to sustain an engaged feminist socio-political critique for which contingency is central (i.e., that things could be otherwise) and at the same time retain some kind of metaphysical grounding. Without metaphysical grounding it has been argued, the feminist project may be rendered nonsubstantive (Sider, Substantivity in feminist metaphysics. Philosophical Studies, 174(2017), 2467-2478, 2017). There has been much debate around this issue and Sider (as an exemplar of the points under contention) nuances the claims expressed in his earlier writings (Sider, Writing the book of the world. Oxford: Clarendon Press, 2011) and later presents a more qualified account (Sider, Substantivity in feminist metaphysics. Philosophical Studies, 174(2017), 2467-2478, 2017). Nonetheless, I propose the critiques and defences offered by the various parties continue to depend on certain erroneous assumptions and frameworks that are challengeable. I argue that fundamentality as presented in many of these current accounts, which are underpinned by the explicit or implicit ontologies of monism and dualism and argued for in purely rationalist terms which conceive of subjects as primarily reason-responding agents, reveal basic irresolvable problems. I propose that addressing these concerns will be possible through an enactivist account which, following phenomenology, advances an ontology of interdependence and reconceives the subject as first and foremost an organism immersed in a meaningful world as opposed to a primarily reason-responding agent. Enactivism is thus, I will argue, able to legitimize feminist socio-political critiques by offering a non-reductive grounding in which not only are contingency and fundamentality reconciled, but in which fundamentality is in fact defined by radical contingency. My paper proceeds in dialogue with feminists generally addressing this 'metaphysical turn' in feminism and specifically with Sally Haslanger and Mari Mikkola.

Towards a Phenomenology of Self-Patterns in Psychopathological Diagnosis and Therapy.

Categorization-based diagnosis, which endeavors to be consistent with the third-person, objective measures of science, is not always adequate with respect to problems concerning diagnostic accuracy, demarcation problems when there are comorbidities, well-documented problems of symptom amplification, and complications of stigmatization and looping effects. While psychiatric categories have proved useful and convenient for clinicians in identifying a recognizable constellation of symptoms typical for a particular disorder for the purposes of communication and eligibility for treatment regimes, the reification of these categories has without doubt had negative consequences for the patient and also for the general understanding of psychiatric disorders. We argue that a complementary, integrated framework that focuses on descriptive symptom-based classifications (drawing on phenomenological interview methods and narrative) combined with a more comprehensive conception of the human subject (found in the pattern theory of self), can not only offer a solution to some of the vexed issues of psychiatric diagnosis but also support more efficacious therapeutic interventions.

Dynamical Relations in the Self-Pattern.

The notion of a self-pattern, as developed in the pattern theory of self (Gallagher, 2013), which holds that the self is best explained in terms of the kind of reality that pertains to a dynamical pattern, acknowledges the importance of neural dynamics, but also expands the account of self to extra-neural (embodied and enactive) dynamics. The pattern theory of self, however, has been criticized for failing to explicate the dynamical relations among elements of the self-pattern (e.g., Kyselo, 2014; Beni, 2016; de Haan et al., 2017); as such, it seems to be nothing more than a mere list of elements. We'll argue that the dynamics of a self-pattern are reflected in three significant and interrelated ways that allow for investigation. First, a self-pattern is reflectively reiterated in its narrative component. Second, studies of psychiatric or neurological disorders can help us understand the precise nature of the dynamical relations in a self-pattern, and how they can fail. Third, referencing predictive processing accounts, neuroscience can also help to explicate the dynamical relations that constitute the self-pattern.