Manic temporality

Abstract

Time-consciousness has long been a focus of research in phenomenology and phenomenological psychology. We advance and extend this tradition of research by focusing on the character of temporal experience under conditions of mania. Symptom scales and diagnostic criteria for mania are peppered with temporally inflected language: increased rate of speech, racing thoughts, flight-of-ideas, hyperactivity. But what is the underlying structure of temporal experience in manic episodes? We tackle this question using a strategically hybrid approach. We recover and reconstruct three hypotheses regarding manic temporality that were advanced and modeled by two pioneers of clinical phenomenology: Eugène Minkowski (1885–1972) and Ludwig Binswanger (1881–1966). We then test, critique, and refine these hypotheses using heterophenomenological methods in an interview-based study of persons with a history of bipolar and a current diagnosis of acute mania. Our conclusions support a central hypothesis due to Minkowski and Binswanger, namely, that disturbance in the formal structure of temporal experience is a core feature of mania. We argue that a suitably refined variant of Binswanger’s model of disturbance in manic protention helps to explain a striking pattern of impaired insight and impaired reasoning in manic episodes.

Disturbed time experience during and after psychosis

“…Time experience has repeatedly been proposed as disturbed or altered in mental disorders (Minkowski, 1923; von Gebsattel, 1928; Lewis, 1932; Schilder, 1936; Straus, 1947; Hartocollis, 1975; Fuchs, 2001, Fuchs, 2005, Fuchs, 2007a, Fuchs, 2013; Wyllie, 2005; Kupke, 2005, Kupke, 2009; Zukauskas et al, 2009; Gallagher, 2012; Moskalewicz, 2015; Stanghellini et al, 2017; Martin et al, 2018; Vogel et al, 2018a, Vogel et al, 2018b), and particularly in schizophrenia (Bouman and Grünbaum, 1929; Minkowski, 1933; Blankenburg, 1971; Vogeley and Kupke, 2006; Fuchs, 2007b; Kupke, 2009; Stanghellini et al, 2015; Moskalewicz, 2018). Meta-analysis of time perception and temporal processing has suggested that patients with schizophrenia may be liable to a higher variability in the function of an internal clock mechanism (Thoenes and Oberfeld, 2017).…”

Racing and crowded thoughts in mood disorders: A data-oriented theoretical reappraisal

“…There are other perspectives that have not been explored during the last decade and remained to be studied. One of them is how the flow of time is experienced: in mania time is more often experienced as flowing quickly [64]. Our preliminary results [65] revealed that in controls, elevated rates of racing thoughts measured via the RCTQ were associated with the feeling that time passed fast, but in patients racing thoughts and time perception tasks were not correlated.…”

Misevaluating the Future: Affective Disorder and Decision-Making Capacity for Treatment – A Temporal Understanding

“…The analysis started with close reading of the transcribed texts and, through a process of textual coding, moved toward thematisation. The phenomenological method and analysis is described and illustrated in more detail elsewhere [22, 23, 26]. Interpretative phenomenological analysis aims to purposefully collect homogeneous samples to address a question about subjectivity or experiential structure.…”

“…Contemporary psychopathologists and philosophers of psychiatry continue to express significant interest in the theme [17-21]. This is a rich literature, but clarity and consistency remain problematic [22, 23], and, to our knowledge, the study of temporal experience has not, before our work, been extended to problems in DMC.…”