This paper, endorsing the dialogical perspective in psychotherapy, provides a synopsis of the PHD psychotherapy method, based on the integration of phenomenology, hermeneutics and psychodynamics. The first section covers the background knowledge required for PHD psychotherapy, consolidating and extending three basic concepts: life-world (the originary domain of a person’s experience), dialectical principle (psychopathological symptoms are the result of a disproportion between the occurrence of alterity and the person’s capacity to make sense of it), dialogical principle (individual human consciousness is inherently dialogical since it is formed in the dynamic interrelation of self and other). The second section describes the know-how or practical implementation of these principles, including (1) the phenomenological unfolding (P) of the patient’s experiences, which equips the clinician and patient with a systematic knowledge of the abnormal phenomena that affect the patient and are part of her life-world; (2) the hermeneutic moment (H), which focuses on the patient’s default interpretation of her experiences and then encourages her to actively take a different perspective towards her experiences, aiming at the resignification of these experiences in order to restore a sense of agency or responsibility; (3) the (psycho-)dynamic moment (D), which aims to contextualize the patient’s psychopathological experiences and position-taking within the personal life-history in which they are embedded, and to trace back psychopathological symptoms to the limit-situation from which they emerge. The final section discusses the “something more” or knowing how-to-be that is required of a clinician who aims to apply this therapeutic method; it includes a concise discussion of how psychotherapeutic dialogue is a kind of practice that moves in unpredictable directions to experience something new for both partners.

1.
Stanghellini
G
.
Phenomenology: a method for care?
Philos Psychiatry Psychol
.
2011
;
18
(
1
):
25
9
. 1071-6076
2.
Stanghellini
G
. Philosophical resources for the psychiatric interview. In:
Fulford
KW
,
Davies
M
,
Gipps
RG
,
Graham
G
,
Sadler
JZ
,
Stanghellini
G
, et al, editors
.
The Oxford Handbook of Philosophy and Psychiatry
.
Oxford
:
Oxford University Press
;
2013
b. pp.
321
56
.
3.
Stanghellini
G
.
Lost in Dialogue: Anthropology, Psychopathology and Care
.
Oxford University Press
;
2016
a.
4.
Stanghellini
G
. Phenomenological psychopathology and care: from person-centered dialectical psychopathology to the PHD method for psychotherapy. In:
Stanghellini
G
,
Aragona
M
, editors
.
An Experiential Approach to Psychopathology: What Is It Like to Suffer from Mental Disorders
.
New York
:
Springer
;
2016
b. pp.
361
78
.
5.
Stanghellini
G
,
Mancini
M
.
The therapeutic interview in mental health. A values-based and person-centered approach
.
Cambridge
:
Cambridge University Press
;
2017
.
6.
Stanghellini
G
. Phenomenological psychopathology and psychotherapy. In:
Stanghellini
G
,
Broome
MR
,
Fernandez
AF
,
Fusar Poli
P
,
Raballo
A
,
Rosfort
R
, editors
.
Oxford Handbook of Phenomenological Psychopathology. e-pub online
.
2018
.
7.
Stanghellini
G
,
Rossi
R
.
Pheno-phenotypes: a holistic approach to the psychopathology of schizophrenia
.
Curr Opin Psychiatry
.
2014
May
;
27
(
3
):
236
41
.
[PubMed]
0951-7367
8.
Sass
L
,
Pienkos
E
,
Skodlar
B
,
Stanghellini
G
,
Fuchs
T
,
Parnas
J
, et al
EAWE: Examination of Anomalous World Experience
.
Psychopathology
.
2017
;
50
(
1
):
10
54
.
[PubMed]
0254-4962
9.
Husserl
E
.
The Crisis of European Sciences and Transcendental Phenomenology: An Introduction to Phenomenological Philosophy
.
Evanston (IL)
:
Northwestern University Press
;
1936/1970
.
10.
Schutz
A
,
Luckmann
T
.
The Structures of the Life-World
.
Volume I
.
Evanston (IL)
:
Northwestern University Press
;
1973
.
11.
Blankenburg
W
.
Der Verlust der natürlichen Selbstverständlichkeit: Ein Beitrag zur Psychopathologie symptomarmer Schizophrenien
.
Stuttgart
:
Ferdinand Enke Verlag
;
1971
.
12.
Stanghellini
G
.
For an anthropology of vulnerability
.
Psychopathology
.
1997
a;
30
(
1
):
1
11
.
[PubMed]
0254-4962
13.
Stanghellini
G
.
Antropologia della vulnerabilità
.
Milan
:
Feltrinelli
;
1997
b.
14.
Stanghellini
G
,
Bolton
D
,
Fulford
WK
.
Person-centered psychopathology of schizophrenia: building on Karl Jaspers’ understanding of patient’s attitude toward his illness
.
Schizophr Bull
.
2013
Mar
;
39
(
2
):
287
94
.
[PubMed]
0586-7614
15.
Stanghellini
G
,
Rosfort
R
.
Emotions and Personhood: Exploring Fragility – Making Sense of Vulnerability
.
Oxford, New York
:
Oxford University Press
;
2013
.
16.
Stanghellini
G
,
Rosfort
R
.
Disordered selves or persons with schizophrenia?
Curr Opin Psychiatry
.
2015
May
;
28
(
3
):
256
63
.
[PubMed]
0951-7367
17.
Binswanger
L
.
Drei Formen Missglueckten Daseins
.
Tuebingen
:
Niemeyer
;
1956
.
18.
Mayer-Gross
W
.
Über die Stellungnahme zur abgelaufenen akutens psychose: eine studie über verständliche Zusammenhänge in der Schizophrenie
.
Z Gesamte Neurol Psychiatr
.
1920
;
60
(
1
):
160
212
. 0303-4194
19.
Jaspers
K
(
Hoenig
J
,
Hamilton
MW
, translators
).
General Psychopathology
.
Baltimore (MD)
:
Johns Hopkins University Press
;
1997
. p.
424
. [
Originally published in 1913
.].
20.
Gadamer
HG
(
Weinsheimer
J
,
Marshall
DG
 2nd
, translators
).
Truth and Method
. revised edition.
New York
:
Continuum
;
2004
.
21.
Buber
M
.
I and Thou
.
New York
:
Scribner
;
1958
.
22.
Thomson
E
. Empathy ad Consciousness. In:
Thomson
E
, editor
.
Between Ourselves. Second-person issues in the study of consciousness. Journal of Consciousness Studies, 8, 5-7. Thorverton: Imprint Academic
.
2001
. pp.
1
32
.
23.
Husserl
E
. (
2002
). Zur Phänomenologischen Reduktionen. Texte aus dem Nachlass (1926–1935), ed. Sebastian Luft. Husserliana 34. Dordrecht: Kluwer.
24.
Stolorow
RD
,
Atwood
G
.
Contexts of Being: The Intersubjective Foundations of Psychological Life
.
Hillsdale (NJ)
:
The Analytic Press
;
1992
.
25.
Stern
DN
.
The Present Moment in Psychotherapy and Everyday Life
.
New York, London
:
Norton & C.
;
2004
.
26.
Meares
R
.
The conversational model: an outline
.
Am J Psychother
.
2004
;
58
(
1
):
51
66
.
[PubMed]
0002-9564
27.
Seikkula
J
,
Aaltonen
J
,
Alakare
B
,
Haarakangas
K
,
Keränen
J
,
Sutela
M
. Treating psychosis by means of Open Dialogue. In:
Friedman
S
, editor
.
The reflective team in action: Collaborative practice in family therapy
.
New York
:
Guilford Press
;
1995
. pp.
62
80
.
28.
Stolorow
RD
,
Atwood
GE
.
The intersubjective perspective
.
Psychoanal Rev
.
1996
Apr
;
83
(
2
):
181
94
.
[PubMed]
0033-2836
29.
Benjamin
J
.
Like subjects. Love objects
.
New Haven
:
Yale University Press
;
1995
.
30.
MacDonald
M
. From Recognition to Intersubjectivity: Hegel and Psychoanalysis. In:
Gipps
RG
,
Lacewings
M
, editors
.
Oxford Handbook of Philosophy and Psychoanalysis
.
2019
. pp.
45
61
.
31.
Ricoeur
P
.
Freud and Philosophy: an essay on interpretation New Haven
.
Yale University Press
;
1970
.
32.
Seikkula
J.
(
2011
) Becoming Dialogical: Psychotherapy or a Way of Life? The Australian and New Zealand Journal of Family Therapy 179, 32,3: 179–193.
33.
Stanghellini
G
,
Rossi Monti
M
.
Explication or explanation?
Philos Psychiatry Psychol
.
2009
;
16
(
3
):
237
9
. 1071-6076
34.
Minkowski
E
. Etude sur la structure des états de dépression: les depréssions ambivalentes. In:
Minkowski
E
, editor
.
Structure des dépressions
.
Paris
:
Nouvel Object
;
1993
. [
Originally published in 1930
.].
35.
Sass
LA
.
Self and world in schizophrenia: three classic approaches
.
Philos Psychiatry Psychol
.
2001
;
8
(
4
):
251
70
. 1071-6076
36.
Kendler
KS
. Introduction: why does psychiatry need philosophy? In:
Kendler
KS
,
Parnas
J
, editors
.
Philosophical Issues in Psychiatry: Explanation, Phenomenology, and Nosology
.
Baltimore (MD)
:
Johns Hopkins University Press
;
2008
. pp.
1
16
.
37.
Stanghellini
G
. The ethics of incomprehensibility. In:
Stanghellini
G
,
Fuchs
T
, editors
.
One Century of Karl Jaspers’ General Psychopathology
.
Oxford University Press
;
2013
a. pp.
166
83
.
38.
Stanghellini
G
.
A hermeneutic framework for psychopathology
.
Psychopathology
.
2010
;
43
(
5
):
319
26
.
[PubMed]
0254-4962
39.
Jaspers
K
.
Psychologie der Weltanschauungen
.
Berlin
:
Springer
;
1925
.
40.
Binswanger
L
.
Lebensfunktion und innere Lebensgeschichte. Mschr. Psychiat. u
.
Neurol.
1928
;
63
:
52
79
.
41.
Tellenbach
H
.
Melancholy: History of the Problem, Endogeneity, Typology, Pathogenesis, Clinical Considerations
.
Pittsburg (PA)
:
Duquesne University Press
;
1961/1980
.
42.
Kretschmer
E
.
Der sensitive Beziehungswahn. Ein Beitrag zur Paranoidefrage und zur psychiatrischen Charakterlehre
.
Berlin
:
Springer
;
1919
.
43.
Fuchs
T
.
Existential vulnerability: toward a psychopathology of limit situations
.
Psychopathology
.
2013
;
46
(
5
):
301
8
.
[PubMed]
0254-4962
44.
Agamben
G
.
Signatura Rerum: Sul Metodo
.
Turin
:
Bollati Boringhieri
;
2008
.
45.
Auerbach
E
. Philologie und Weltiteratur. In Weltliterature: Festgabe fuer Fritz Strich zum 70. Geburtag.
46.
Foucault
M
(
Hurley
R
, translator
).
The care of the self. The history of sexuality 3
.
New York
:
Pantheon Books
;
1986
.
47.
Stern
DN
,
Sander
LW
,
Nahum
JP
,
Harrison
AM
,
Lyons-Ruth
K
,
Morgan
AC
, et al;
The Process of Change Study Group
.
Non-interpretive mechanisms in psychoanalytic therapy. The ‘something more’ than interpretation
.
Int J Psychoanal
.
1998
Oct
;
79
(
Pt 5
):
903
21
.
[PubMed]
0020-7578
48.
Hölderlin
F
(
Sieburth
R
, translator
).
Hymns and Fragments
.
Princeton
:
Princeton University Press
;
1984
.
49.
Stanghellini
G
.
The portrait of the psychiatrist as a globally minded citizen
.
Curr Opin Psychiatry
.
2013
b
Sep
;
26
(
5
):
498
501
.
[PubMed]
0951-7367
50.
Heidegger
M
.
Being and Time
.
Albany
:
The State University of New York Press
;
2010
. [
Originally published in 1927
.].
51.
Merleau-Ponty
M
.
The Phenomenology of Perception
.
London
:
Routledge & Kegan Paul
;
1945/1962
.
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