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从二阶共情理解精神病理学的批判视角:现象学与伦理学。

A critical perspective on second-order empathy in understanding psychopathology: phenomenology and ethics.

机构信息

Division of Philosophy and Ethics of Mental Health, University of Pretoria, Pretoria, South Africa,

出版信息

Theor Med Bioeth. 2015 Apr;36(2):97-116. doi: 10.1007/s11017-015-9323-y.

Abstract

The centenary of Karl Jaspers' General Psychopathology was recognised in 2013 with the publication of a volume of essays dedicated to his work (edited by Stanghellini and Fuchs). Leading phenomenological-psychopathologists and philosophers of psychiatry examined Jaspers notion of empathic understanding and his declaration that certain schizophrenic phenomena are 'un-understandable'. The consensus reached by the authors was that Jaspers operated with a narrow conception of phenomenology and empathy and that schizophrenic phenomena can be understood through what they variously called second-order and radical empathy. This article offers a critical examination of the second-order empathic stance along phenomenological and ethical lines. It asks: (1) Is second-order empathy (phenomenologically) possible? (2) Is the second-order empathic stance an ethically acceptable attitude towards persons diagnosed with schizophrenia? I argue that second-order empathy is an incoherent method that cannot be realised. Further, the attitude promoted by this method is ethically problematic insofar as the emphasis placed on radical otherness disinvests persons diagnosed with schizophrenia from a fair chance to participate in the public construction of their identity and, hence, to redress traditional symbolic injustices.

摘要

卡尔·雅斯贝尔斯的《普通精神病理学》出版百年纪念于 2013 年举行,出版了一卷专门讨论他的作品的论文(由 Stanghellini 和 Fuchs 编辑)。主要的现象学-精神病理学家和精神科哲学家长期研究雅斯贝尔斯的同理心理解概念,以及他关于某些精神分裂症现象是“无法理解”的断言。作者达成的共识是,雅斯贝尔斯对现象学和同理心的理解很狭隘,通过他们所说的二阶和激进同理心,可以理解精神分裂症现象。本文从现象学和伦理的角度对二阶同理心的立场进行了批判性的考察。它提出了以下问题:(1)二阶同理心(现象学上)是否可能?(2)二阶同理心的立场是否是对被诊断为精神分裂症的人的一种可以接受的伦理态度?我认为二阶同理心是一种不连贯的方法,无法实现。此外,这种方法所提倡的态度在伦理上存在问题,因为对激进的他者的强调剥夺了被诊断为精神分裂症的人参与公共构建自身身份的公平机会,从而纠正传统的象征性不公正。

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