Psychopathology · 2026
Imaginative Vulnerability and Symbolic Mediation: A Phenomenological Analysis in Schizophrenia-Spectrum Conditions.
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Bundesen Birgit, Nielsen Keld Stehr, Sørensen Bo Ærenlund, Mann Sebastian Porsdam, Køster Allan
Аннотация
INTRODUCTION: Imagination depends on symbolic mediation that sustains an as-if mode of experience. In schizophrenia-spectrum conditions, this mediation is structurally vulnerable, rendering imaginative activity unstable under intensified activation. Arts-based interventions have rarely specified the conditions under which imaginative activity remains symbolically mediated rather than becoming overwhelming. The present study examines how imaginative vulnerability is regulated in group-based creative writing.
METHODS: The analysis draws on retrospective phenomenological interviews with 50 participants with schizophrenia-spectrum diagnoses from the REWRITALIZE programme and applies a phenomenologically grounded qualitative approach organised around three conditions of symbolic mediation: aesthetic distance, relational holding, and the as-if frame.
RESULTS: Destabilisation emerges as a structural possibility when symbolic mediation becomes insufficiently coordinated across form, relation, and frame. Four modes of destabilisation are identified: affective flooding, boundary permeability, frame slippage, and cognitive or social overload. These configurations reflect strain within a shared symbolic and relational field in which imaginative material loses its mediating function and acquires immediacy or intrusiveness. When aesthetic distance, holding, and the as-if frame remain sufficiently coordinated, imaginative activity retains a representational character and enables articulation, modulation, and continuity while maintaining difficulty.
CONCLUSION: Creative writing functions as a phenomenological amplifier of imaginative vulnerability and symbolic stability alike. The study contributes to phenomenological psychopathology by showing that destabilisation reflects not a deficit of imagination, but a failure of symbolic mediation under intensified activation, and by clarifying how symbolic and relational conditions regulate imaginative processes in schizophrenia-spectrum conditions.
METHODS: The analysis draws on retrospective phenomenological interviews with 50 participants with schizophrenia-spectrum diagnoses from the REWRITALIZE programme and applies a phenomenologically grounded qualitative approach organised around three conditions of symbolic mediation: aesthetic distance, relational holding, and the as-if frame.
RESULTS: Destabilisation emerges as a structural possibility when symbolic mediation becomes insufficiently coordinated across form, relation, and frame. Four modes of destabilisation are identified: affective flooding, boundary permeability, frame slippage, and cognitive or social overload. These configurations reflect strain within a shared symbolic and relational field in which imaginative material loses its mediating function and acquires immediacy or intrusiveness. When aesthetic distance, holding, and the as-if frame remain sufficiently coordinated, imaginative activity retains a representational character and enables articulation, modulation, and continuity while maintaining difficulty.
CONCLUSION: Creative writing functions as a phenomenological amplifier of imaginative vulnerability and symbolic stability alike. The study contributes to phenomenological psychopathology by showing that destabilisation reflects not a deficit of imagination, but a failure of symbolic mediation under intensified activation, and by clarifying how symbolic and relational conditions regulate imaginative processes in schizophrenia-spectrum conditions.