**7. Nature of the human person**

The nature of Human being has been discussed since antiquity. Mind–body relationship and nature of the human mind has given rise to numerous debates. All the research discussed till now from a biomedical viewpoint has presented empirical facts as opposed to the evaluative dimension of human person. Therefore it is important to understand the personalist emphasis provided by Dilthey and Husserl. Personalism [20] as a distinctive philosophy which emphasizes the centrality of personhood of human being and his dignity, has been explored prominently by Immanuel Kant and later by people who were influenced by him.

reality but also is used to *perform* or achieve certain ends based upon the context within which such an interaction happens. Discursive psychology helps us understand the clinical context in which an assessment of insight happens, for example a delusion or a thought insertion is attributed differently by the clinician and the suffering person. Language therefore is used to describe what the patient is experiencing as well as to interpret and inform his beliefs about the cause of the symptoms in the clinical context. It gives us tools to unravel the intended goals of the person with psychotic illness when he communicates his judgment about the

Insight in Psychosis: An Integrated Perspective http://dx.doi.org/10.5772/intechopen.79368 97

We are also enriched by the concept of narrative insight [27] which tries to understand the insight of the person suffering from psychosis as a tool by which she tries to make sense of her illness. These concepts of human discourse and narrative add complexity to the concept of insight while emphasizing the personal and interpersonal aspects during the assessment and

Considering the various arguments from neuroscience and anthropology, David [28] accepts that the "acceptance or awareness of the mental illness" component of his model can be influenced widely by the pre-existent interpretative frameworks in the suffering person's culture while the "acceptance of the kind or duration of treatment" component may also be depended more on the pre-morbid personality of the suffering person and may not be related to his or her neurobiological deficits due to the illness. Only the component of "acceptance or the relabeling of experience as pathological" may be closely related to the cognitive deficits due to the neurobiological disease process which may be consistent across cultures. This last point is corroborated by the empirical evidence from the developing world [29], that people with schizophrenia when assessed with multidimensional rating scales of insight more often accept the pathological nature of their symptoms but are hesitant to accept the biomedical

When we hold both sides of the argument (the biological and the personal) together it helps us to better understand the complexity of the concept of insight in psychosis. Such a composite view is presented in Jasperian phenomenological psychopathology (with its emphasis on "erklaren" and "verstehen" perspectives in investigating psychopathology), which is more holistic and person-centered than the narrow reductionist focus on symptoms in Kraepelinian descriptive psychopathology. The Jasperian model allows the impersonal disease to be combined with the personal illness, and the biological deficit to be combined with the failure of reasoning which evaluates personal choices and action [30]. Such an integrated view is more reflective of the kind of being that we are discussing about, i.e., the mystery of how the neurobiological and psycho-spiritual components come together in the complex entity we call the

The current chapter through a historical, neurobiological and personalist review of the concept of insight, however, raises many questions, while bringing some clarity to the discussion.

illness.

management of people with psychotic illness.

model of the mental illness as a whole.

Human Person.

Some of the questions are:

**9. Integrated view of insight in psychosis**

Wilhelm Dilthey [21] notably distinguished natural sciences from human sciences emphasizing that the approach needed for studying distinctly human aspects of men and women has to be different from the methods of natural science. He suggested due to the dual (i.e., biological and psychological) aspects of human nature it has to be studied from both an "erklaren" (causal explanation) perspective and "verstehen" (empathic understanding) perspective. While Erklaren-perspective deals with descriptive aspect of symptoms and tries to give causal explanation, Verstehen-perspective describes the meaningful nature of human experience and therefore is more akin to the personal aspects. Dilthey's ideas, as mentioned earlier, exercised tremendous influence on Jasper's psychopathology. Buber [22], another personalist contemporary of Dilthey, distinguished between two types of relationships possible for us, i.e., the "I-You" relationship and the "I-it" relationship. The "I-You" relationship emphasizes the uniqueness of human personal encounters with other personal beings which is not comparable to a human encounter with an impersonal object (an "it").

Lastly, Wojtyla [23] defined a person as a being towards which the only adequate attitude is one of love and respect. It is in this personalist background, Fulford claims that delusion (and by implication the related concept of insight) is a failure of practical-reason of the person rather than a cognitive deficit [24]. Practical reasoning is the opposite of theoretical reasoning which is concerned with facts, cause–effect relations and impersonal objective explanations, and is the reasoning needed in the practical life to subjectively evaluate choices for actions and therefore is related to values. So, according to Fulford there is a failure of practical reasoning which presents as wrong choices and actions in people with psychotic disorders. We here introduce the alternative viewpoint which emphasizes the regard for the personhood of a human being in the discussion of the Insight in psychosis.
