Psychiatric barbarism

Stephan Oliveira, a Brazilian psychiatrist, provides a rich phenomenological account for psychiatry in his book Barbarism and the human: Phenomenology, meaning of life and psychiatric practice, based especially on the work of Michel Henry and Jean-Luc Marion. These new French phenomenologists question the primacy of Husserlian intentionality and see the origin of human phenomena as more based on affectivity than their appearance in consciousness.

As I wrote in my article:-

The phenomenology of subjectivity and existence has implications for the nature of consciousness. The study of a person’s lived experience in the world shows that subjective experience and con­sciousness cannot be naturalised as physical pro­cesses. Our primary experience actually puts us in the world as embodied beings. It is what creates the foundation for scientific knowledge. An integrated personalistic concept of human beings is fundamental to any scientific understanding of the brain.

I’m not sure whether it matters how radical the phenomenological reduction is in its implications for psychiatric epistemology. I have emphasised in this blog the anti-cognitivist phenomenology of Thomas Fuchs (see eg. previous post) and the enactive psychiatry of Sanneke de Haan (see eg. another previous post). Both critique psychiatry from anti-positivist and anti-reductionist positions, as does Stephan, using the new French phenomenology. The experiential, subjective dimension of psychopathology needs to be recognised and accepted. Psychiatry should be understood as relational medicine.

What I like about Stephan's perspective is how he exploits the idea of 'barbarism' from Michel Henry. Doing so may create a more direct challenge to biomedical psychiatry than merely saying psychiatry needs to move to a more relational practice. The tendency to disregard subjectivity/affectivity by focusing on brain pathology can lead to patients feeling their experiences are being ignored. Treating people as objects is symbolic violence, and actual psychiatric practice, both in its history and currently, has shown its barbarity by its defiance of life.