Psychiatric Diagnosis and Classification - ResearchGate

156 PSYCHIATRIC DIAGNOSIS AND CLASSIFICATION
fundamental feature of conscious experience is its intrinsically non-spatial
nature. Consciousness is not a physical object but a dimension of phenomenality.
Consciousness does not consist of separable, substantial ``thing-like'')
components, exerting a mechanical±efficient causality on each other. Rather,
the phenomenological concept of consciousness implies a meaningful network
of interdependent moments i.e. non-independent parts), a network
founded on intertwining, motivation and mutual implication [42], encompassing
and framed by an intersubjective matrix. These views have important
implications for psychopathological taxonomic endeavor.
First, examination of single cases, as already pointed out by Jaspers, is
very important. Reports from few patients, able to describe their experiences
in detail, may be more informative of the nature of the disorder than
big N studies performed in a crude, simplified way. Subjective experience
or first-person perspective, by its very nature, cannot be averaged, except at
the cost of heavy informational loss. In other words, in-depth study of
anomalous experience should serve as a complement to strictly empirical
designs. But even the latter may be dramatically improved, if the psychopathological
examinations are phenomenologically informed.
Second, a psychiatrist, in his diagnostic efforts, is always engaged in what
is called a ``typification'' process [43, 44]. At the most elementary level,
typification simply implies ``seeing as'', the fact that we always perceive
the world perspectivally, i.e. we always see objects, situations and events as
certain types of objects, situations and events e.g. when we see a bus driving
away from a bus-stop and a man running in the same direction, we will tend
to perceive the man as trying to catch a bus that he had missed) [45]. The
most frequent type of typification is the pre-reflective and automatic one,
linked to the corporeal awareness, and this holds for the diagnostic encounter
as well. We sense the patients as withdrawn, hostile, sympathetic, eccentric,
etc., and such typifications depend on our knowledge and experience,
and will be perhaps modified upon further interactions with the patient. But
we can also engage in reflective attitudes in order to make our typifications
more explicit.
The notion of typicality or of a prototype is crucial here: it is a notion
important in all cognitive research [46±48]. Prototypes are central exemplars
of a category in question: e.g. a sparrow is more typical of the category
``birds'' than is a penguin, which cannot fly and does not seem to have
wings. Most cognitive and epistemic categories are founded upon a ``family
resemblance'', a network of criss-crossing analogies between the individual
members of a category [29], with very characteristic cases occupying central
position, and less typical cases forming a continuum towards the border of
the category, where the latter eventually blends into other, neighboring
categories. Prototype can be empirically established by examining the cooccurrence
of its various features; this happens tacitly in the formation of a