A modest proposal for another phenomenological approach to psychopathology.
In 1912, Karl Jaspers published an article entitled "The Phenomenological Approach to Psychopathology." This and his subsequent text, General Psychopathology, was to exert a profound influence on the development of psychiatry in general and psychiatric nosology in particular. The current Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases both reflect, at least in part, that legacy. This article will argue that the descriptive psychopathology of Jaspers has been gradually transformed into a caricature which has substituted authority for enquiry and simplification for subtlety. We have been left with classificatory systems which impose reified categories increasingly at variance with clinical reality and increasingly divorced from the data generated by scientific enquiry. Returning to the phenomenological method, despite its contradictions, may open the way to clinical and research approaches which free us from the current straight jacket of orthodoxy which is impending our progress. (+info)
Jealous love and morbid jealousy.
Jealous love and morbid jealousy, although inextricably linked, cannot be considered the same: jealous love (trait jealousy) is the behavioral and cognitive-affective precondition of morbid jealousy (state jealousy). Love is jealous when it is devoured by the desire for the exclusive and total possession of the partner, whose unconditional and continued presence is avidly requested. This type of love, in addition, is permeated by the need to know what the other is thinking, in order to scrutinize every minimal flaw in the faithfulness of the partner even in his or her innermost thoughts and fantasies; in it, jealousy is virtually always present, even in the absence of a triggering event, because captative love, by its very nature, includes the expectation of a conflict which inevitably actually takes place in reality. Finally, jealousy emerges as an emotional event (jealous flash) in response to a more or less significant change in the behavior of the partner, and reveals to the jealous individual a dimension which was previously latent or inexistent. This intense and brief experience, leaves a more or less blurred memory behind, and tends to progressively repeat itself and take root as a feeling. (+info)
The green-eyed monster and malicious joy: the neuroanatomical bases of envy and gloating (schadenfreude).
Facing a protagonist's emotional mental state can trigger social emotions (or 'fortune of others' emotion), such as envy or gloating, which reflect one's assessment of the consequences of the other's fortune. Here we suggest that these social emotions are mediated by the mentalizing network. The present article explores the notion that the understanding of social competitive emotions is particularly impaired in patients with ventromedial (VM) prefrontal lesions. By manipulating a simple Theory of Mind (ToM) task, we tested the ability of patients with localized lesions to understand 'fortune of others' emotions: envy and gloating (schadenfreude). Patients were also assessed for their ability to recognize control physical and identification conditions. While envy is an example of a negative experience in the face of another's fortunes, gloat is thought to be a positive experience in the face of another's misfortune. Whereas in schadenfreude and envy the emotion of the self and the protagonist may be opposite, identification involves matching between the protagonist's and the observer's emotions. Patients with VM (N = 10) lesions (particularly in the right hemisphere), although showing intact performance on a basic first order ToM condition, and relatively preserved understanding of identification, did not recognize envy (F[6,76] = 3.491, P = 0.004) and gloating (F[6,76] = 3.738, P = 0.003). Impaired recognition of gloating involved additionally lesions in the inferior parietal lobule (P = 0.001). Furthermore, while patients with lesions in the left hemisphere were more impaired in recognizing gloating (a positive emotion), right hemisphere patients were more impaired in recognizing envy (a negative emotion), suggesting that the valence of these emotions may also be affected by the asymmetry of the lesion (F[6,68] = 2.002, P = 0.011). In addition, the ability to identify these emotions was related to perspective-taking abilities and ToM. We suggest that these results indicate that the mentalizing network including the VM has a fundamental role in mediating the understanding of competitive emotions such as envy and gloating. (+info)
When your gain is my pain and your pain is my gain: neural correlates of envy and schadenfreude.
Othello syndrome in patients with Parkinson's disease.
BACKGROUND: Othello syndrome (OS) is an organic delusional disorder with prevailing jealousy symptoms presumably appearing as side effect of antiparkinsonian therapy. The clinical spectrum of psychiatric symptoms in Parkinson's disease (PD) is very wide, including symptoms of depression and anxiety, hallucinations, delusions, with prevalent paranoid symptoms, agitation, delirium and sleep disorders. At our knowledge, just a few cases of patients with PD and OS were reported till now. METHODS: three neurologists working in a tertiary referral centre were asked to report cases of pathological jealousy as defined by the DSM IV criteria (Kaplan et al. 1994). The following data were collected retrospectively: sex, age at PD onset, age at OS onset, duration of PD, duration of PD treatment, duration of treatment with dopamine agonists (DAs), treatment of OS, past history of alcoholism, premorbid personality disorder, family history of psychiatric disorders and data about general cognitive condition. RESULTS: Five PD patients (three males) with OS were investigated. The mean age of the patients at the PD onset was 46.80+/-8.87 (SD), the mean age at the OS onset was 56.40+/-8.76 (SD). Before the onset of OS, all of them were taking dopamine agonists. The first patient was treated with pramipexole, apomorphine infusion and levodopa/carbidopa, the second with apomorphine infusion plus levodopa/carbidopa/entacapone, the third with pramipexole, the fourth and fifth with ropinirole. Decrease of dopamine agonist led to clinical improvement in three patients (complete reduction of the symptoms in two, reduction of symptoms in one patients). In two patients, the symptoms remained the same. In three patients atypical neuroleptics had to be added: clozapine in two and quetiapine in one patient. CONCLUSIONS: We believe that OS is a more common psychiatric side effect in PD patients on treatment with dopamine agonists than usually believed, particulary in those with early disease onset. It is a very disturbing symptom for patients and their partners, often underestimated by them, and should therefore be actively searched for. (+info)
Envy up, scorn down: how comparison divides us.