정신의학 문헌에서 살펴본 “조현(Attunement)”의 의미 : 현상학적-인류학적 시각에서 바라본 조현병

• 영문명: Understanding of “Attunement Disorder” from Phenomenological-Anthropological Perspective : Inquiry into the Use of the Term “Attunement” in Psychiatric Literature
• 발행기관: 대한신경정신의학회
• 저자명: 정성훈 손정우 김용식
• 간행물 정보: 『신경정신의학』제52권 제5호, 279~291쪽, 전체 13쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2013.09.30

영문 초록

The Korean Neuropsychiatric Association has decided that the existing nomenclature “Schizophrenia” should be replaced with “Attunement disorder” in order to mitigate prejudices from the general public. In this process, “attunement” was meant to express the harmonious relationship and organic integration among the various substructures of global mental functioning. However, the term “attunement” and related concepts had occupied an important position in discourses surrounding the fundamental concept of schizophrenia. In this regard, the historical vicissitudes of the term “attunement” in the context of schizophrenia research was discussed. The term “attunement” is an English translation of Heideggerian expressions “Befindlichkeit” and “Stimmung”. It is used by Heidegger to convey the emotional experience of Dasein’s inextricable entanglement with the surrounding interpersonal world. Heidegger’s philosophical works formed the theoretical foundation for the so-called Phenomenological-anthropological psychiatry. Psychiatrists influenced by this approach argue that patients with schizophrenia suffer from a sense of alienation and bewilderment resulting from loss of normal attunement. In addition, they stress that the loss of attunement brings about distorted self-experience, which leads to strange and uncanny life experiences exiled from intersubjectivity based society. From the phenomenological perspective, mind or consciousness is not a solipsistic Cartesian reason confined to the brain, but an intentional existence embedded in the interpersonal and intersubjective worlds. In the developmental period, intentional relationship between the consciousness and the world has been acquired from repeated shared experiences with other people via intersubjectivity. The intersubjective experiences also contribute to maintenance of solid attunement even after reaching mature adulthood. Whatever the reason, losing the tacit understanding of the world will cause disintegration of the foundation of intersubjectivity and confusion with regard to the certainties of self and the world. This state was described as “Attunement disorder”. Recent emphasis on neurobiological understanding of schizophrenia has impeded the proper appreciation of Phenomenological-anthropological understanding of schizophrenia, one of the valuable heritages of psychiatry. Meanwhile, the concept of phenomenological understanding or embedded cognition has recently gained renewed attention among neuroscientists studying neurobiological correlates of consciousness. Standing on the pivotal point witnessing the conceptual change from “Schizophrenia” to “Attunement disorder”, reappraisal of the past heritage from modern perspectives would be a valuable endeavor for advancement of psychiatry

목차

서 론

조현병의 근본 병리 : 셀프경험의 이상

셀프와 지향성

상호주관성에 대한 개념적 고찰

상호주관성과 주체, 그리고 의도

조현병에서 보이는 셀프의 장애

상호주관성-존재의 이해-셀프경험

Attunement Disorder

결론 및 요약

REFERENCES

키워드

Schizophrenia Attunement Phenomenology Self Intersubjectivity