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Taking subjectivity seriously: towards a unification of phenomenology, psychiatry, and neuroscience

Abstract

Nearly all psychiatric diseases involve alterations in subjective, lived experience. The scientific study of the biological basis of mental illness has generally focused on objective measures and observable behaviors, limiting the potential for our understanding of brain mechanisms of disease states and possible treatments. However, applying methods designed principally to interpret objective behavioral measures to the measurement and extrapolation of subjective states presents a number of challenges. In order to help bridge this gap, we draw on the tradition of phenomenology, a philosophical movement concerned with elucidating the structure of lived experience, which emerged in the early 20th century and influenced philosophy of mind, cognitive science, and psychiatry. A number of early phenomenologically-oriented psychiatrists made influential contributions to the field, but this approach retreated to the background as psychiatry moved towards more operationalized disease classifications. Recently, clinical-phenomenological research and viewpoints have re-emerged in the field. We argue that the potential for phenomenological research and methods to generate productive hypotheses about the neurobiological basis of psychiatric diseases has thus far been underappreciated. Using specific examples drawing on the subjective experience of mania and psychosis, we demonstrate that phenomenologically-oriented clinical studies can generate novel and fruitful propositions for neuroscientific investigation. Additionally, we outline a proposal for more rigorously integrating phenomenological investigations of subjective experience with the methods of modern neuroscience research, advocating a cross-species approach with a key role for human subjects research. Collaborative interaction between phenomenology, psychiatry, and neuroscience has the potential to move these fields towards a unified understanding of the biological basis of mental illness.

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Fig. 1: Reciprocal interactions between phenomenology, psychiatry, and neuroscience.

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Acknowledgements

This work was funded through support from the National Institutes of Health—National Institute of Mental Health (R25MH08646) and the Leon Levy Foundation provided to both authors. The funders had no role in the conceptualization or preparation of this manuscript. The authors thank Dr. Deborah Cabaniss and Dr. Samantha Keil for feedback and suggestions on earlier drafts of the manuscript. The authors have no financial conflicts of interest to declare. The figure was prepared using BioRender with publication permissions.

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EJK and GHD contributed equally to the conceptualization, literature review, initial drafting, and revision of this manuscript.

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Correspondence to Evan J. Kyzar or George H. Denfield.

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Kyzar, E.J., Denfield, G.H. Taking subjectivity seriously: towards a unification of phenomenology, psychiatry, and neuroscience. Mol Psychiatry 28, 10–16 (2023). https://doi.org/10.1038/s41380-022-01891-2

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