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In this paper the question of autonomy in delusional disorders is investigated using a phenomenological approach. I refer to the distinction between freedom of intentional action, and freedom of the will, and develop phenomenological descriptions of lived autonomy, taking into account the distinction between a pre-reflective and a reflective type. Drawing on a case report, I deliver finely-grained phenomenological descriptions of lived autonomy and experienced self-determination when acting on delusions. This analysis seeks to demonstrate that a person with delusions can be described as responsible for her behaviour on a 'framed' level (level of freedom of intentional action), even though she is not autonomous on a higher ('framing') level (level of freedom of the will), if, and only if, the goods of agency for herself and others are respected. In these cases the person with delusions is very nearly comparable to people in love, who are also not free to choose their convictions, and who could also be rightly held responsible for the behaviour flowing from their convictions. [ABSTRACT FROM AUTHOR]

The mind-body problem lies at the heart of the clinical practice of both psychiatry and psychosomatic medicine. In their recent publication, Schwartz and Wiggins address the question of how to understand life as central to the mind-body problem. Drawing on their own use of the phenomenological method, we propose that the mind-body problem is not resolved by a general, evocative appeal to an all encompassing life-concept, but rather falters precisely at the insurmountable difference between "natural" and a "reflective" experience built into phenomenological method itself. Drawing on the works of phenomenologically oriented thinkers, we describe life as inherently "teleological" without collapsing life with our subjective perspective, or stepping over our epistemological limits. From the phenomenology it can be demonstrated that the hypothetical teleological qualities are a reflective reconstruction modelled on human behavioural structure. [ABSTRACT FROM AUTHOR]

In this paper I investigate the topic of paranoid atmospheres. This subject is especially of interest with respect to persons who are deluded, and also, I will demonstrate, sheds light upon the psychiatrist's "gaze" and knowledge of delusions. In my argument I will follow a path initially outlined by Karl Jaspers (1883-1969): modern psychiatric diagnosis of delusions is a diagnosis of form and not content. Jaspers' emphasis on the form of delusions enables psychiatrists to be self-critical about their professional knowledge and, consequently, prevent the development of dogmatic attitudes. In accord with Jaspers, my argument will focus on the basic structure of delusions and highlight the difference between delusional realities and non-delusional realities, a difference that follows from the possibility of self-criticism of one's own conscious and explicit convictions. I will demonstrate the importance of self-criticism with regard to paranoid atmospheres and also to psychiatric knowledge. In this manner, an understanding of delusions as lived experience will be developed, which argues that an escalation of the influence of delusional convictions, resulting in a profoundly paranoid atmosphere, is most problematic for the deluded person. To acknowledge this insight mirrors the need for a self-critique of psychiatric discourse, encourages an empathic and respectful relationship between professionals and deluded patients, and enables deluded persons to restrict their paranoid atmosphere. It is the main conclusion of my paper that a deluded person cannot do (with respect to his delusional convictions) what a psychiatrist must do (with respect to his psychiatric knowledge and his own existential convictions) in order to prevent a profoundly paranoid atmosphere in their relationship: be self-critical. [ABSTRACT FROM AUTHOR]