Dr. Sanneke de Haan

Dr. de Haan erforscht einen enaktiven Ansatz für Psychiatrie und Psychotherapie, der die Vielfalt psychiatrischer Probleme — von Traumata über neurobiologische Faktoren bis zu sozialen Konflikten — in ihrem Zusammenspiel untersucht. Ihr Fokus liegt darauf, wie diese heterogenen Ursachen zusammenhängen und wie dieses Verständnis die klinische Praxis verbessern kann. Für Kliniken, Therapieeinrichtungen und psychiatrische Versorgungssysteme bietet dieser Ansatz eine theoretische Grundlage, um Behandlungskonzepte ganzheitlicher zu gestalten und die Wirksamkeit therapeutischer Interventionen zu erhöhen.

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• Ein enaktiver Ansatz für Psychiatrie und (Psycho-)Therapie

  Quelle ↗

  In their daily practice, psychiatrists are confronted with human problems triggered by factors as diverse as traumas, chemical imbalances, existential worries, genetic risks, and relational conflicts. One of the most interesting and difficult questions in the field of psychiatry is how these heterogeneous factors are related. This is no mere theoretical concern: what is seen as the primary cause of the problems typically influences the conception of the illness and the choice of treatment. One common way of relating these heterogeneous aspects is through neuro-reductionism: the assumption that in the end only what happens in the brain matters. Such a reductionist approach to psychiatry however has several pragmatic and ethical disadvantages; downplaying the causal role of psychological and existential processes and over-simplifying the complexity of the development of psychiatric problems. On the other hand, a mere non-theoretical pluralism will not be of help either as it does not provide any order or relation between the various factors. An integrative alternative could be developed from enactivism. Enactivism is a relatively new scientific paradigm in the cognitive sciences which draws on dynamical systems theory, phenomenology, and systems biology, amongst other disciplines. Its main tenet is that cognition should not be located exclusively within the brain, but that cognition rather depends on brain, body, and environment together: the idea is that cognitive processes emerge from the ongoing interactions of a person with their social and physical environment. As such, enactivism offers a promising non-reductive approach to the nature, causes, and treatment of psychiatric disorders. We will organize a 3-day workshop on an enactive approach to psychiatry and its practical relevance for psychiatric treatment, notably psychotherapy. We want to critically explore the potential merits and pitfalls of an enactive approach and use the interdisciplinary setting to tune the theory to the needs of psychiatric research and therapeutic practice. The scientific objectives of this workshop are thus to: (a) bring together philosophers, psychiatrists, and mental health therapists to discuss and elaborate an enactive theoretical foundation for psychiatry; (b) critically assess the framework’s integrative power (i.e. how well it connects psychiatry’s various heterogeneous aspects in a non-reductionist way); (c) further develop the enactive framework to better support psychiatry’s therapeutic practice.

• Becoming more oneself? Changes in personality following DBS treatment for psychiatric disorders: Experiences of OCD patients and general considerations

  2017

  PLoS ONE · DOI

  Does DBS change a patient's personality? This is one of the central questions in the debate on the ethics of treatment with Deep Brain Stimulation (DBS). At the moment, however, this important debate is hampered by the fact that there is relatively little data available concerning what patients actually experience following DBS treatment. There are a few qualitative studies with patients with Parkinson's disease and Primary Dystonia and some case reports, but there has been no qualitative study yet with patients suffering from psychiatric disorders. In this paper, we present the experiences of 18 patients with Obsessive-Compulsive Disorder (OCD) who are undergoing treatment with DBS. We will also discuss the inherent difficulties of how to define and assess changes in personality, in particular for patients with psychiatric disorders. We end with a discussion of the data and how these shed new light on the conceptual debate about how to define personality.

• The existential dimension in psychiatry: an enactive framework

  2017

  Mental Health Religion & Culture · DOI

  In his paper Psychiatry and religion: Consensus reached!, Verhagen advocates the relevance of spirituality and religion for the “origins, understanding, and treatment of psychiatric disorders”. In this comment, I argue for the broader claim that the existential dimension is important for understanding psychiatric disorders – of which religion can, but must not necessarily be, part. The existential dimension refers to our ability to relate to ourselves, our experiences, and our situation. This evaluative relation can play an important role in psychiatry: it can co-constitute the disorder, be affected by the disorder, and/or modulate the course of the disorder. Given this importance, it makes sense to explicitly recognize the existential dimension in our explanatory model of psychiatric disorders. The biopsychosocial model goes a long way in providing an integrative model, but there is room for improvement, especially when it comes to integration of its aspects, and acknowledging the existential aspect. I briefly introduce the research paradigm of enactivism, and suggest that an enactive framework is well-suited to incorporate this existential dimension – along with the traditional dimensions of the biopsychosocial model.