Tuesday 28 October 2014

PERFECT Launch (4): Anticipating Interdisciplinarity

This post is by Michael Larkin, co-investigator for project PERFECT.

Michael Larkin
I’m a psychologist, and I’m based in the clinical psychology training team at the University of Birmingham. I have a particular interest in phenomenological approaches to psychology, and most of my research involves asking phenomenological questions about various forms of anomalous or distressing experience (how do people make sense of these experiences?), or about the responses of various psychosocial and healthcare services to those experiences (what is it like to receive these interventions?). I’m particularly interested in the relational and cultural context of the answers to both of these questions, and this makes an interesting bridge to the work of PERFECT.

From a psychological perspective, PERFECT is interesting because it invites us to see ‘delusions’ (strange beliefs, disproportionate commitments, or ‘factually-erroneous cognitions’) as having some functional value – some epistemic benefits, and perhaps other benefits too. The proposition that such beliefs or commitments are meaning-rich, rather than meaning-less, has a long history in psychology. It can be tracked back all the way to the disagreement between Binswanger and Jaspers about the ‘understandability’ of psychotic phenomena. In most histories, which focus on Jaspers’ subsequent influence on the psychiatric classification system, his account would appear to have won out. But Binswanger’s argument for being with the person with psychosis, in order to understand the world from their point of view, has been accumulating a growing clinical currency in recent years.

In the context of what psychologists and psychiatrists are learning about both the developmental and the traumatic histories of many people who go on to experience difficulties with distressing anomalous experiences, it is not difficult to see that externally strange-seeming beliefs might have positive benefits in the immediate world of the distressed person. They might explain otherwise-inconceivable events, for example (‘The intolerably bad thing which happened only happened because of extraordinary and unforeseeable events’), provide a functional heuristic for navigating a real-world problem (‘This situation which other people seem to cope with, but which is intolerable to me, is different for me because I am different’), or offer a protective narrative for coping with future threats (‘I am dangerous, stay away from me’). For me, it is interesting to consider how such beliefs often maintain a relationship to other people’s reality by way of a metaphorical mechanism (hence grounding them in our shared cultural frameworks for making sense of the world) and that they have to be negotiated in the context of interpersonal relationships (allowing us to see that the person’s commitment to these beliefs is often dynamic and context-specific).

From a phenomenological perspective, of course, the concept of factually-erroneous cognitions is challenging. Factual according to what standard, or from what perspective? Clinically, one would defer to the cultural and social context here, rather than make a comparison with facts. Even the concept of a cognition itself requires some careful framing; from a phenomenological point of view, cognitions are intersubjective events, capturing a meaning-full relationship between person and world. These issues are longstanding complexities in the relationship between psychology and phenomenology, and I’ve written about them elsewhere, so I’d like to sidestep them here (if you’re interested, see Larkin, Eatough & Osborn, 2011).

What’s interesting to me is that my colleagues and I on the project team share a concern with an overarching question: how might these phenomena best be understood? For Lisa, Ema, and to some extent Magdalena, the question is primarily a conceptual one. I’m hoping that one aspect of my contribution to PERFECT will be translational. I think that a good answer to the question is one which – at one level – resonates persuasively with the personal experience of people who, at times, hold and struggle with such beliefs. This is one area where I hope that my different perspective on these issues can help to broaden the scope and impact of PERFECT’s outcomes. I’ve been really interested to read a recent article by Bernini and Woods (2014), reflecting on the interdisciplinary evolution of a project at Durham, which focused on auditory verbal hallucinations (hearing voices). If you’re interested in interdisciplinary work, it’s well worth a read. This is largely thanks to the very positive and constructive description which it provides of the team’s movement towards a shared language for - and hence to an integrated account of - their work. I’m really excited to be at the beginning of a similar process with PERFECT, and I’m looking forward to learning a lot from my new colleagues.

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