This is the most recent of the successful and influential Oxford University Press series ‘International Perspectives in Philosophy and Psychiatry’ and, in common with the others, it is well-written and a joy to read. In this marvellous book, Stanghellini considers both schizophrenia and bipolar affective disorder and in doing so reinvigorates and resurrects psychopathology as more than just the listing of symptoms: he proposes it as the ‘science of the meanings of abnormal human phenomena’ (p. 33). This process, through the particular analysis of these disorders as disorders of common sense, returns psychopathology to its rightful place as the science concerned with understanding our patients and their symptoms, rather than eliciting and charting them. He argues that phenomenology is the method clinicians and researchers can use to provide an in-depth understanding of the experiences of those with paranoid and affective psychoses. Therapeutic and theoretical advances are likely to depend on more structured and detailed approaches to mental states. Certainly, in psychiatry, there is a growing concern that the validity of our diagnostic categories has been at least partially sacrificed to improving the reliability of clinicians in detecting mental disorders. This improvement has been facilitated by operationalised diagnostic criteria and standardised interviews. This has occasionally led to the unintended but nevertheless unfortunate consequence that the symptoms that make up a given disorder can be viewed as discrete and atomistic, rather than as interrelated holistically within the patient and their social and physical environment. Phenomenology may help psychiatry to look beyond this current conception of symptoms as non-specific and isolated to more subtle and specific disorders of subjective experience. A delusion, for example, is not an abstract proposition but a world the patient inhabits.

Clinicians and biological psychiatrists should not be put off by the mention of philosophy or phenomenology. The book is not an esoteric, arcane or otherwise impractical read: rather, through the vignettes and the insights Stanghellini provides, it serves as a guide and a way for psychiatry to remember itself through a return to listening, and trying to understand, what our patients tell us. The data provided from such in-depth analysis of subjective experience, Stanghellini argues, can be of enormous benefit for both diagnosis and classification, as well as scientific psychopathology where neuroscientists need to clarify the object under investigation.

It is hard to think of any psychiatrist who would not gain from reading this book, and it has much in it to be recommended to carers and patients confronting the sometimes frightening and disorienting reality of psychosis. As Jaspers reminds us, ‘It is impossible to explain something without previously understanding it’.