Narrative, Psychopathology and sociocultural environments

I am finally sitting down to write a paper I am for long aiming for. Hopefully, It will appear in a forthcoming book João Pereira and I are editing for Vernon Press. The basis ideia is to explore and attempt to overcome the fact that both the traditional and the contemporary understanding of schizophrenic condition manifest what one might call the two main tenets of neurobiological reductionism. The assumption, of an exclusively brain-to-mind direction of causality, implies that cultural or social factors can be no more than merely “pathoplastic” importance (see Kleinman, 1987; Sass, 1992, p. 358). While the assumption of lowered mental level implies that the subjectivity of such patients lacks real complexity and can readily be described in quantitative and pure deficit terms: as a mere dimming of diminishment of higher or more reflective forms of conscious life. 

What seems problematic is the often unreflected-upon ways in which the underlying nature and experience of these symptoms are being conceptualized, and in which their pathogenic role is being conceived. Too often, psychiatric discussion of schizophrenia and culture has taken place in a kind of phenomenological and theoretical vacuum⎯ without careful consideration of the qualitative specificity of schizophrenic experience or a sufficiently focused and coordinated appreciation of the sociocultural order. Here we shall claim the importance of taking the patient’s subjective experience of the disorder into account ⎯ acknowledging the limitations of a reductive explanation of such experiential dimension, we should attempt to open an effective dialogue with psychopathology and the sociocultural environment, and the means by which the later affect the former. Cultural forms and practices, understood as “patterns of meanings embodied in symbols”, seem to set of control mechanisms guiding experience and behaviour within a certain culture. To partake this cultural framework means thus, to sense solidarity or trust in others, or to speak, think, and gesture with that easy synthesis of spontaneity and convention that identifies one as a member of a given social group. Such developments may have, thus, consequences on everyday cognitive functioning.
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Fernando Pessoa (1888-1935) was a well known Portuguese poet, who lived closely the industrial turn, and whose work is a valuable poetic contribution to the Futuristic poetry in Europe. As it is known, Pessoa was diagnosed with dementia praecox, and in his poetry, he indeed manifests the lived dilacerations of self-experience,


I don’t know how many souls I have.
I’ve changed at every moment.
I always feel like a stranger.
I’ve never seen or found myself.
From being so much, I have only soul.
A man who has soul has no calm.
A man who sees is just what he sees.
A man who feels is not who he is.


Through the heteronym phenomenon, Pessoa creates a plurality of biological narratives, that I shall explore, in the upcoming paper, to illustrate that our capacity to understand intentional actions in terms of reasons has a decidedly sociocultural basis.