The Interpersonal Root of Psychosis: Using Phenomenology To Illuminate a Predictive Processing Account

This poster presents an example of how phenomenology can be used alongside radical predictive processing (PP) to illuminate an account of psychosis, highlighting the importance of the interpersonal in the formation of psychotic experience, which leads to questions about the kind of interpersonal environments (interventions) that treat them.

I use Mathew Ratcliffe’s (2017) theory to show how our experience is structured through distinct affective profiles of different kinds of intentional states (e.g. perception, imagination). It provides an account of how we know we are in a particular type of intentional state; through the recognition of its distinct affective profile. The affective profile of perception is constituted by a pattern of anticipation and fulfilment. Other affective profiles, like imagination, deviate from this tight structure. This fits with a PP framework, but uses the phenomenology of intentionality to develop how this prediction feels. Crucial to the anticipation-fulfilment structure of perception is the interpersonal world, in playing a background corroborative function; it grounds the sense of perception as ‘the consensus world’. Fleshing out PP in this phenomenological way proposes how our awareness of perceptual experience (through patterns of anticipation-fulfilment) is constituted by a trust of the interpersonal world. This leads to the link between traumatic interpersonal experience and distorted experiences of perception: psychosis. I propose how this anticipation- fulfilment structure can become dysregulated due to the baseline trust of ‘the consensus world’ (interpersonal interaction) being subverted, through trauma: others become threatening rather than corroborative. In doing this, I apply the PP framework to Ratcliffe’s account, theorising how we predict our own intentional states, based on the kind of affective profiles that we expect different kinds of states to have. This suggests how a mind becomes psychotic, once the sense of perception feels different, because the baseline expectation of others – that constitutes this sense – is subverted, confusing a person’s own expectations of what kinds of states they are in. This shows how pervasive this is to the overall structure of experience, and the crucial role that others play in maintaining this structure; provoking important questions about psychiatry as an interpersonal backdrop.