SEMIP 2 · Subjectivity and Self-Effectivity. Investigating Self-Determination in Mentally Ill People from the First-Person-Perspective

Subjectivity and Self-Effectivity. Investigating Self-Determination in Mentally Ill People from the First-Person-Perspective

Project context and objectives The major objective of the SEMIP-2 project was to develop phenomenological descriptions of lived self-determination to provide a framework for further investigation of alterations of lived self-determination associated with mental states such as suicidality or delusional states and chronic mental illnesses, such as depression, addiction and schizophrenia. The project was conducted at the Department of Philosophy, University of Graz by the researcher (Jann E. Schlimme) and the scientist in charge (Sonja Rinofner-Kreidl). The researcher received extensive training in phenomenology, including supervision of the researcher's studies on phenomenological approaches to ethical theory and psychotherapy, and phenomenological psychopathology, focusing on the mental life of people suffering from suicidality, severe depression, schizophrenia and/or delusions. The researcher was also supervised in a methodically critical approach to psychological concepts that are prominent in theories of well-being and empowerment (i.e. 'self-efficacy', 'decision-making capacity'), and philosophical theories of autonomy and self-determination. These studies enabled the researcher to address the project's major objectives. Project results A phenomenological description of lived self-determination was achieved and was used as a framework for describing possible changes to lived self-determination in altered mental states (i.e. suicidality) and chronic mental illnesses (i.e. depression, schizophrenia). From a phenomenological perspective, we continuously disclose our life-world (Lebenswelt) to ourselves by following certain typical structures and constitutive processes whose practical reliability is established over the course of countless repetitions and variations. This continuous disclosure is called habituality (Habitualität). However, we are usually unaware of these constitutive processes when perceiving, acting or communicating with others. Accordingly, we do not recognise that we habitually disclose our own life-worlds to ourselves in the manner of a 'familiar workspace' by relating our expectations, purposes and other aspects. In other words, our behaviour is prescribed by our embodied selves being embedded in familiar situations, thereby 'producing' our situation as a familiar workspace or life-world. Drawing on this basic description of mental life, lived self-determination can be described as founded upon the perception of action- or project-based properties, which are pre-reflectively valued as a result of the affective response to these non-axiological properties. Higher-order acts, such as willing acts, are based upon these more primitive structures of mental life, whether these acts are enacted pre-reflectively, within the familiar workspace, or reflectively, with explicit deliberation. Accordingly, we must distinguish between two types of lived self-determination, a pre-reflective type and a reflective type, which differ with respect to the explicitness of the action that is willed into existence. In the reflective type, the 'project as a project' or 'action as an action' is the explicit object of the willing act. Hence, one deliberates on the adequateness of a given project with respect to one's goals, interests and (moral) values. In the pre-reflective type, the actions to be accomplished are the objects of the willing act. This differentiation is in line with the classical distinction between freedom of intentional action and freedom of will. From this point of view, it is understandable why we are able to behave in a morally justified manner if we follow virtuous customs, habits or traditions. Nevertheless, deliberation is often required to recognise and effectively perform those actions that are in our best interest, including our moral interest. As agents interested in autonomous behaviour, we pre-reflectively anticipate the ability to explicitly evaluate our customary behaviour as morally justified (i.e. from some future perspective). This pre-reflective anticipation is given if we experience our intentional actions as autonomous - at least, if we do not act in a way that is explicitly forced upon us by external or internal causes or that we know we will be unable to evaluate in the future (i.e. in cases of intended suicide). The fact that we take this anticipation for granted does not imply that we would actually judge our behaviour as morally justified when explicitly evaluating it. Phenomenologists such as John J. Drummond and Heinrich Rombach claim that authenticity is a necessary component of living a virtuous (self-determined, self-responsible) life as an interpersonal being. Authentic behaviour means the successful realisation of the values a person values most (with respect to the person's situation and life-conduct). Because we, as human beings, are embedded in interpersonal situations, this interest implies 'goods of agency', suggesting that every person should decide truly and authentically for herself. Drawing on these descriptions of lived self-determination, it is reasonable to expect that an understanding of the altered habituality in chronic mental illnesses as incrementally acquired and established provides a useful way of describing the alterations, rearrangements and impairments of lived self-determination in everyday life in people suffering from these illnesses. Drawing on established phenomenological descriptions of mental illnesses (depression, schizophrenia, addiction) and first-hand accounts (i.e. autobiographical narratives, statements of afflicted persons published in other contexts), the researcher has developed descriptions of the altered scopes and styles of lived self-determination associated with these illnesses. These descriptions are useful, though preliminary; they require further support and approval from first-hand narratives in future investigations. However, there is strong evidence to conclude that this phenomenological approach allows us to bridge crucial features of lived self-determination, such as a person's manner of pre-reflectively evaluating or the style and scope of a person's experiential workspace, with clinical psychiatry and psychopathology. Project impact The project's results may be of interest for philosophers as well as policy-makers and others engaged with issues of mental health. Furthermore, mental health researchers and mental health professionals may draw upon the project's results to improve therapeutic strategies, especially with respect to the empowerment of persons suffering from chronic mental illnesses. Ultimately, we hope that our investigations will directly or indirectly improve the well-being of people suffering from chronic mental illnesses.

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