Phenomenology of atmospheres. The felt meanings of clinical encounters

C. Costa1, S. Carmenates2, L. Madeira2,3, G. Stanghellini4,5

1 Centro Hospitalar Psiquiátrico de Lisboa, Portugal; 2 Department of Psychiatry, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Portugal; 3 College of Medicine University of Lisbon, Portugal; 4 “G. d’Annunzio” University of Chieti, Italy; 5 “D. Portales” University of Santiago, Chile


Operational criteria and structured interviews had a positive impact on psychiatry as they contributed to cleanse the profoundly unscientific and irrational attitude towards systematic assessment and diagnosis. The technical approach to the psychiatric interview focuses on the search for specific symptoms. Yet, it is blind to the essential aspects of the clinical encounter. Subjective and intersubjective features are dismissed even if they have psychopathological meaning. It is this same objectifying intention that compromises the attention needed to notice the aesthetic properties of the clinical encounter and restricts linguistic contexts risking tautology. Atmospheres are examples of such phenomena that should be salvaged to allow indepth psychopathological assessment. In this paper, we focus on a phenomenological definition of ‘”atmospheres”. First, we review the ontological polarities that make this phenomenon so difficult to be grasped conceptually. Next, we describe the clinical encounter as an aesthetic experience and explicate the relevance of the role of tact in sensing atmospheres and the role of metaphors in articulating them. Herein resides the need to bring aesthetics into the clinical encounter: one must dodge scientific rationalism in order to preserve the phenomenological understanding and achieve an understanding of the meaning of a clinical situation as felt, rather than simply assessing objective signs and symptoms.

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