Papers by Tudi Gozé
Psychopathology, 2017, 50, 6.
Background: According to Karl Jaspers, psychopathology requires a comprehensive method, understoo... more Background: According to Karl Jaspers, psychopathology requires a comprehensive method, understood as a systematic exploration of the first-person perspective of the patient's experience. At the same time, however, schizophrenia for Jaspers is characterized by its radical incomprehensibility. In addition, Rümke's so-called “praecox feeling” paradoxically combines the incomprehensibility of schizophrenic experience and the evidence of its pathological manifestation in the encounter. Aim: Through a re-examination of the notions of affectivity and interaffective contact we propose a coherent theoretical model to explain the clinician's paradoxical understanding of schizophrenia. Method: Phenomenological tradition regards affectivity as an encompassing phenomenon that connects body, self, world, and others. In our view, only a thorough and systematic link between corporeity and affectivity is able to explain embodied affective resonance as a basis of empathic comprehension. By drawing on the phenomenology of Marc Richir, we will systematically unfold the complex nature of affectivity and lead it back to a twofold constitution of corporeality. Conclusion: The Richirian account on affectivity can be fruitfully put into discussion with other recent phenomenological models on schizophrenia. It might be able to exhibit affectivity as the operative ground of minimal self-disturbance and thus argue for its intersubjective dimension.
Psicopatologia Fenomenológica Contemporânea, 2017
" Praecox Feeling " (" Praecox Gefühl ") was a notion introduced by the Dutch psychiatrist H.C. R... more " Praecox Feeling " (" Praecox Gefühl ") was a notion introduced by the Dutch psychiatrist H.C. Rümke as an attempt to emphasize schizophrenic gestalt as a key feature for diagnosis. Our purpose is to decrypt Rümke's work and to offer a critique based on a case study. From a phenomenological framework, we attempt to show the relevance and the limits of this concept in order to enlighten contemporary nosographic issues. Rümke suggested that symptoms themselves are not reliable for a rigorous diagnosis of schizophrenia. He proposed the term of Praecox Feeling to describe the bizarreness experimented by the clinician from the first minutes of the encounter with a person with schizophrenia. This notion refers to Karl Jaspers " radical incomprehensibility " of mental disorder. Our point is to take seriously this incomprehensibility to think a second person approach to diagnosis. To explore this track, we will focus our interest on the clinician subjective experience of schizophrenic encounter. In this regard, we will not think bizarreness as polarized on the patient's side, but rather as an in-between event. Since then psychopathologic comprehension call for an epistemology of human contact and minimal-social space. Schizophrenic encounter needs then to be revisited in a more dynamic and embodied way.
Psychopathology, 2017
Background: According to Karl Jaspers, psychopathology
requires a comprehensive method, understo... more Background: According to Karl Jaspers, psychopathology
requires a comprehensive method, understood as a systematic
exploration of the first-person perspective of the patient’s
experience. At the same time, however, schizophrenia
for Jaspers is characterized by its radical incomprehensibility.
In addition, Rümke’s so-called “praecox feeling”
paradoxically combines the incomprehensibility of schizophrenic
experience and the evidence of its pathological
manifestation in the encounter. Aim: Through a re-examination
of the notions of affectivity and interaffective contact
we propose a coherent theoretical model to explain the clinician’s
paradoxical understanding of schizophrenia. Method:
Phenomenological tradition regards affectivity as an encompassing
phenomenon that connects body, self, world,
and others. In our view, only a thorough and systematic link
between corporeity and affectivity is able to explain embodied affective resonance as a basis of empathic comprehension.
By drawing on the phenomenology of Marc Richir,
we will systematically unfold the complex nature of affectivity
and lead it back to a twofold constitution of corporeality.
Conclusion: The Richirian account on affectivity can be
fruitfully put into discussion with other recent phenomenological
models on schizophrenia. It might be able to exhibit
affectivity as the operative ground of minimal self-disturbance
and thus argue for its intersubjective dimension.
H2 receptor antagonists can be associated with central adverse drug reactions (ADRs), like confus... more H2 receptor antagonists can be associated with central adverse drug reactions (ADRs), like confusion, delirium, hallucinations, slurred speech or headaches. We report here a ‘serious’ case of severe mania leading to hospitalization in a 42-year-old alcohol-dependent man, 4 days after ranitidine introduction. Review of litera-ture showed that this ‘very rare’ ADR occurs mainly in patients with predisposing factors: age, decrease in renal and/or hepatic function, polymedication, alcohol. Knowledge of this ADR can be particularly important for these drugs widely used as self-medication.
Mania associated to Ranitidine: a case report and review of literature. Available from: https://www.researchgate.net/publication/301343344_Mania_associated_to_Ranitidine_a_case_report_and_review_of_literature [accessed Aug 27, 2016].
Rendre explicites les liens qui unissent psychothérapie institutionnelle et phénoménologie est un... more Rendre explicites les liens qui unissent psychothérapie institutionnelle et phénoménologie est une tâche ardue tant ces deux traditions se sont interpénétrées. C'est au microscope qu'il faudrait progresser dans cette botte de foin, examiner avec rigueur les trajectoires et rencontres de ceux qui en ont fait la fécondité. Clarifions d'abord le champ et mettons-nous d'accord : nous traiterons ici (dans ce modeste aperçu) de la psychothérapie institutionnelle non comme d'une technique déjà sédimentée dans l'histoire mais plutôt comme d'un mouvement, un projet tant clinique que politique. À ce propos, François Tosquelles nous mettait en garde : « La psychothérapie institutionnelle en soi, cela n'existe pas. » Il ne s'agit donc pas pour nous de s'appesantir sur un passé réifié en fétiche mais de tisser des liens vivants pour les cliniciens d'aujourd'hui.
Empan, 2014
Distribution électronique Cairn.info pour ERES.
Conference Presentations by Tudi Gozé
For Karl Jaspers, schizophrenia is characterized by its radical incomprehensibility, at both refl... more For Karl Jaspers, schizophrenia is characterized by its radical incomprehensibility, at both reflexive and pre-reflexive levels of intersubjective awareness. According to Bleuler, the most severe cases of schizophrenic autism could be associated with an absence of a genuine affective contact. If we take seriously this radical otherness, how is it epistemologicaly possible to think a second person perspective in psychopathology? In contrast to current opinion which locates mental states as affectivity within our head, phenomenologicaly oriented psychopathology regards it as encompassing phenomena that connects body, self, and world. This phenomenological tradition has been largely influenced by Martin Heidegger's notion of Stimmung. This means that the Being is " in the world " in a certain affective disposition which always-already colors the world of familiarity. The Stimmung qualify the tonality of Dasein's openness to the world and the others. The phenomenological literature of the early 20th offered a rich and comprehensive perspective on affectivity in schizophrenia. By focusing on the existential dimension of affectivity, this approach remains partially insufficient to understand the somatic and emotional dimensions involved in affectivity, and thus may neglect corporeity. In our opinion, Maurice Merleau-Ponty's phenomenology of flesh opened a new perspective in understanding the relationship of being and the world as an embodied phenomenon. Thus, affectivity, and the affective relationship between my own flesh and other's flesh could constitute a crucial basis for intersubjectivity. This model, applied to social understanding, is regarded as an intertwinement of embodied affectivity. How to understand this embodied affective resonance? How to explain that affectivity is so "contagious"? Following such an embodied intersubjective approach, affectivity remains problematic in Merleau-Ponty's philosophy. The French philosopher Marc Richir (1943-2015) proposed an internal division of the Stimmung able to rethink the affectivity's relationship to internal (Innenleiblichkeit) and external (Aussenleiblichkeit) flesh body. This work will be an opportunity to discuss the psychiatric relevance of Richir's work, which remains insufficiently known or translated.
Contemporary research in psychiatry has a growing interest in prodromal or emerging phases of sch... more Contemporary research in psychiatry has a growing interest in prodromal or emerging phases of schizophrenia. However, the large variety of clinical expressions of these attenuated forms of the psychotic syndrome is an obstacle to the development of precise protocols for an empirical and epidemiological research. Thus, many researchers have insisted on the need for conceptual research and first-person comprehension of beginning psychosis. Already in 1958, the psychopathologist Klaus Conrad proposed a coherent model of a phenomenological understanding of early psychosis. The challenge of this paper will be to discuss the relevance of this model for contemporary psychopathological research. Hence, we shall examine in detail the notion of delusional affectivity (Wahnstimmung) in the light of contemporary research in phenomenology. This notion accounts for the feeling on strangeness arising insidiously during the prodromal, non-symptomatic phase of schizophrenia. It concerns the ineffable feeling that something is brewing up-something catastrophic for the self. However, Conrad's analysis has neglected the embodied and intersubjective dimension of Wahnstimmung. In order to analyse this phenomenon, we will refer to an analysis of embodiment, and namely of affectivity and minimal-self. The latters are conceived as conditions of possibility for a minimal intersubjective relationship. Maurice Merleau-Ponty's philosophy of the flesh will help us to understand the embodied dimension of self-world relatedness and its crossing in inter-corporal space. We will finally see how the recasting of the notion of affectivity in Marc Richir can allow us to develop new tracks for the understanding of delusional affectivity.
Objective: A re-examination of the classical notion of the Praecox Feeling (PF) coined by H.C. Rü... more Objective: A re-examination of the classical notion of the Praecox Feeling (PF) coined by H.C. Rümke in 1941.PF denotes a specific unease arising in the encounter with a person with schizophrenia and, in Rümke's and others' account enables a skillful clinician to diagnose schizophrenia in the first minute of an interview.
Purpose: The notion of PF, although quite popular in the classical nosography and psychopathology, gradually lost its clinical significance with the introduction of the operational criteria for diagnosis in the 1980's with the DSM-III. Our study aims to examine the relevance of this phenomenon for contemporary clinical practice.
Methodology: We have set an international and multicentric survey (France, USA, the UK) based on a questionnaire addressed to junior and senior psychiatrists and examining the role of pre-reflective judgement, feelings and intentions in decision making in diagnosing schizophrenia (in 2017). In addition, we have examined the 50+ years of literature concerning the subject (in French, German and English).
Results: Preliminary results indicate that about half of the psychiatrists experience some sort of PF (the majority of senior and the minority of junior psychiatrists). We address the problem of validity in the absence of reliability and the notion of expertise in clinical diagnosis.
Conclusions: The PF is still used in clinical practice and phenomenology is important in understanding psychiatric judgement.
O movimento desalienista, termo que devemos ao psiquiatra francês Lucien Bonnafé, aglomera um con... more O movimento desalienista, termo que devemos ao psiquiatra francês Lucien Bonnafé, aglomera um conjunto muito heterogêneo de movimentos intelectuais, clínicos e políticos visando pôr em questão a instituição psiquiátrica a partir da segunda metade do século XX. Na França, este movimento assumiu um lugar significativo no pensamento psiquiátrico após a segunda guerra mundial. Pode-se reunir nesta vanguarda os movimentos da antipsiquiatria e a psicoterapia instituicional. O movimento da psicoterapia institucional nasceu da constatação que a instituição psiquiátrica, se ela não faz o objeto de uma reflexão crítica e clínica constante, pode ser responsável pelo agravamento das doenças mentais e, em primeiro lugar, das psicoses graves. Esta constatação tomou uma dimensão trágica durante a segunda guerra mundial quando aproximadamente 40 000 doentes mentais sucumbiram à fome nos hospitais psiquiátricos franceses de 1940 a 1944. Este resultado se explica, em parte, pela indiferença e esquecimento contra os quais não se levantaram mais que raros protestos. Se, ao final da guerra, estas constatações vão mobilizar a vanguarda psiquiátrica, o movimento da psicoterapia institucional e aquele da antipsiquiatria farão escolhas teóricas e políticas diferentes. Notadamente, sobre a questão espinhosa da natureza das doenças mentais. O objeto dessa intervenção será de tentar fazer dialogar estas duas correntes a partir do que as enraízam comumente na fenomenologia.
Aim: A rebound of scientific interest has appeared during the last decades about a nosographic wa... more Aim: A rebound of scientific interest has appeared during the last decades about a nosographic way of thinking psychiatric diagnosis. However, the clinical core of schizophrenia remains an enigma. A blind spot around which gravitates psychopathology since its beginning. Each theoretical breakthrough has always revealed new mysteries. Praecox Feeling (Praecox Gefühl) was a notion introduced by the Dutch psychiatrist H.C. Rümke as an attempt to characterize schizophrenic gestalt as a key feature for diagnosis. Our purpose was to decrypt Rümke's work in its historical and epistemological context and to offer a detailed critique. From a phenomenological framework, we attempted to show the relevance and the limits of this concept in order to enlighten contemporary nosographic issues. Argument: Rümke suggested that symptoms themselves are not reliable for a rigorous diagnosis of schizophrenia. He proposed the term of Praecox Feeling to describe the feeling experimented by the clinician from the first minutes of the interview. This is not an objective clinical sign, but rather a pre-semiologic recognition of symptom's schizophrenic quality. Qualified as " indefinable " since it is non-verbal and then inaccessible to a third person perspective. We comprehend the term feeling as an affective tonality (Heidegger's Stimmung), a kind of "atmosphere" that would characterize the patient by its dissonance with the examiner's atmosphere. Even if this phenomenon has previously shown his relevance in clinical work, can we accept a diagnosis system only based on this affective discordance? Is a first impression diagnosis possible or desirable? Conclusion: Praecox Feeling phenomenon needs to be revisited in a more dynamic and embodied way. Human subjectivity should be first explored as inter-subjectivity, inextricably self-being and being-with (Heidegger). In this way of thinking, Praecox Feeling, considered as a strangeness of contact would not only belong to the patient, and would appear as an event in intersubjective relation, lying immediately in an inter-corporeity (Merleau-Ponty).
Thesis Chapters by Tudi Gozé
La bizarrerie de contact est un phénomène énigmatique de la clinique psychiatrique courante. À ce... more La bizarrerie de contact est un phénomène énigmatique de la clinique psychiatrique courante. À ce jour il n’existe pas d’étude explorant son intérêt en psychopathologie et sa validité pour le diagnostic de la schizophrénie. Notre méthodologie consistera à l’étude de la notion connexe de Praecox Gefühl dans la psychopathologie classique et de son rapport au trouble générateur de la schizophrénie. Nous proposerons ensuite, en vue de l’analyse du phénomène de la bizarrerie de contact, l’examen de la structure phénoménologique de la rencontre intersubjective habituelle. La mise en œuvre d’une approche phénoménologique de la corporéité et de l’affectivité, à l’aide des travaux de Maurice Merleau-Ponty et de Marc Richir, nous permettra de penser de manière originale l’espace du contact intersubjectif et la constitution du soi- minimal. Cette étude conceptuelle nous permettra ensuite d’émettre des hypothèses à l’égard du contact schizophrénique. L’analyse psychopathologique du contact nous a permis de dépasser les limites d’une psychologie positiviste inefficace à rendre intelligible ce type de phénomène limite et ambigu.
Papers and Commentaries in Peer Reviewed Journals by Tudi Gozé
This paper argues that intuition plays a role in the diagnosis of schizophrenia and presents its ... more This paper argues that intuition plays a role in the diagnosis of schizophrenia and presents its phenomenological rationale. A discussion of self-assessment questionnaires and empirical studies in the clinical setting provides evidence that despite the prevalence of operational diagnosis, the intuitive judgment of schizophrenia continues to take place. Two related notions of intuitive diagnosis are presented: Minkowski's diagnostic by penetration and Rümke's praecox feeling. Further on, the paper explores and clarifies the phenome-nology behind the praecox feeling. First, it is argued, intuitive diagnosis is neither a feeling nor an experience, but a typification operating at an implicit level. Second, it is not simply subjective as spatially it takes place in the in-between of the clinical interaction. Finally, it is not just momentary, but temporally extended, and, hence, partly reflective. The paper suggests that intuitive diagnosis requires critical testing on the side of the psychiatrist to either confirm or falsify it through reflective operations. In conclusion, the merits and shortcomings of intuitive vs. operational diagnosis are presented.
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Papers by Tudi Gozé
requires a comprehensive method, understood as a systematic
exploration of the first-person perspective of the patient’s
experience. At the same time, however, schizophrenia
for Jaspers is characterized by its radical incomprehensibility.
In addition, Rümke’s so-called “praecox feeling”
paradoxically combines the incomprehensibility of schizophrenic
experience and the evidence of its pathological
manifestation in the encounter. Aim: Through a re-examination
of the notions of affectivity and interaffective contact
we propose a coherent theoretical model to explain the clinician’s
paradoxical understanding of schizophrenia. Method:
Phenomenological tradition regards affectivity as an encompassing
phenomenon that connects body, self, world,
and others. In our view, only a thorough and systematic link
between corporeity and affectivity is able to explain embodied affective resonance as a basis of empathic comprehension.
By drawing on the phenomenology of Marc Richir,
we will systematically unfold the complex nature of affectivity
and lead it back to a twofold constitution of corporeality.
Conclusion: The Richirian account on affectivity can be
fruitfully put into discussion with other recent phenomenological
models on schizophrenia. It might be able to exhibit
affectivity as the operative ground of minimal self-disturbance
and thus argue for its intersubjective dimension.
Mania associated to Ranitidine: a case report and review of literature. Available from: https://www.researchgate.net/publication/301343344_Mania_associated_to_Ranitidine_a_case_report_and_review_of_literature [accessed Aug 27, 2016].
Conference Presentations by Tudi Gozé
Purpose: The notion of PF, although quite popular in the classical nosography and psychopathology, gradually lost its clinical significance with the introduction of the operational criteria for diagnosis in the 1980's with the DSM-III. Our study aims to examine the relevance of this phenomenon for contemporary clinical practice.
Methodology: We have set an international and multicentric survey (France, USA, the UK) based on a questionnaire addressed to junior and senior psychiatrists and examining the role of pre-reflective judgement, feelings and intentions in decision making in diagnosing schizophrenia (in 2017). In addition, we have examined the 50+ years of literature concerning the subject (in French, German and English).
Results: Preliminary results indicate that about half of the psychiatrists experience some sort of PF (the majority of senior and the minority of junior psychiatrists). We address the problem of validity in the absence of reliability and the notion of expertise in clinical diagnosis.
Conclusions: The PF is still used in clinical practice and phenomenology is important in understanding psychiatric judgement.
Thesis Chapters by Tudi Gozé
Papers and Commentaries in Peer Reviewed Journals by Tudi Gozé
requires a comprehensive method, understood as a systematic
exploration of the first-person perspective of the patient’s
experience. At the same time, however, schizophrenia
for Jaspers is characterized by its radical incomprehensibility.
In addition, Rümke’s so-called “praecox feeling”
paradoxically combines the incomprehensibility of schizophrenic
experience and the evidence of its pathological
manifestation in the encounter. Aim: Through a re-examination
of the notions of affectivity and interaffective contact
we propose a coherent theoretical model to explain the clinician’s
paradoxical understanding of schizophrenia. Method:
Phenomenological tradition regards affectivity as an encompassing
phenomenon that connects body, self, world,
and others. In our view, only a thorough and systematic link
between corporeity and affectivity is able to explain embodied affective resonance as a basis of empathic comprehension.
By drawing on the phenomenology of Marc Richir,
we will systematically unfold the complex nature of affectivity
and lead it back to a twofold constitution of corporeality.
Conclusion: The Richirian account on affectivity can be
fruitfully put into discussion with other recent phenomenological
models on schizophrenia. It might be able to exhibit
affectivity as the operative ground of minimal self-disturbance
and thus argue for its intersubjective dimension.
Mania associated to Ranitidine: a case report and review of literature. Available from: https://www.researchgate.net/publication/301343344_Mania_associated_to_Ranitidine_a_case_report_and_review_of_literature [accessed Aug 27, 2016].
Purpose: The notion of PF, although quite popular in the classical nosography and psychopathology, gradually lost its clinical significance with the introduction of the operational criteria for diagnosis in the 1980's with the DSM-III. Our study aims to examine the relevance of this phenomenon for contemporary clinical practice.
Methodology: We have set an international and multicentric survey (France, USA, the UK) based on a questionnaire addressed to junior and senior psychiatrists and examining the role of pre-reflective judgement, feelings and intentions in decision making in diagnosing schizophrenia (in 2017). In addition, we have examined the 50+ years of literature concerning the subject (in French, German and English).
Results: Preliminary results indicate that about half of the psychiatrists experience some sort of PF (the majority of senior and the minority of junior psychiatrists). We address the problem of validity in the absence of reliability and the notion of expertise in clinical diagnosis.
Conclusions: The PF is still used in clinical practice and phenomenology is important in understanding psychiatric judgement.