The person’s position-taking in the shaping of schizophrenic phenomena

Traditional psychopathological approaches to modelling the evolution of mental disorders, such as schizophrenia, often rest on the assumption that symptoms are the passive expression of an underlying disease process. In contrast, phenomenological approaches have highlighted the role that the person, as a meaning-making agent undergoing basic anomalous experiences, plays in the construction of their worlds – thus partly shaping the manifestation and course of illness. However, it remains to be explored how specific patterns of interaction between the person and his/her basic anomalous experiences unfold and play out. We appeal to the Husserlian notion of “position-taking” (Stellungnahme) to provide a framework for the investigation of the person’s attempts at healing as a fundamental component of the dialectics of symptom formation in the psychoses. Within this framework, psychotic symptoms are understood as the expression of the person’s efforts at making sense of, and adapting to, the existential challenges associated with the onset of anomalous self- and world-experiences. We draw on selected case studies and the testimony of one of the authors, to illustrate the potential clinical applications of this model. Finally, we outline some advantages of this approach, including its potential to address oft-neglected troubling experiences without threatening the person’s epistemic agency.