Work

From self-narration to a worldview: a phenomenological, narratological, and linguistic case study of a patient with a complex clinical picture of bipolar disorder

Year: 2026

Type: article

Abstract: Background: Comorbidity of bipolar disorder and aspects of neurodevelopmental disorders present unique challenges and opportunities in understanding the formation and maintenance of selfhood and worldview in psychopathology. Traditional cognitive models often overlook the narrative and phenomenological dimensions of patient experience, particularly how autobiographical narration and emotionally charged worldviews mediate lived experience. Objectives: This study aims to explore (i) how worldviews are shaped by emotion and memory in psychiatric illness, and (ii) how narrative forms provide existential coherence in psychopathology. The research adopts a multidisciplinary approach integrating psychiatric, phenomenological, linguistic, narratological, and hermeneutic perspectives, through an in-depth case study. Methods: A single-case study design was employed, focusing on "Benjamin," a 60-year-old male with a lifelong history of bipolar disorder type I and suspected Asperger's syndrome. Data sources included clinical interviews, autobiographical writings (five book-length texts), and clinical observation. Analyses were conducted using phenomenological, narratological, and linguistic frameworks to trace the evolution from self-narration to worldview construction. Results: Benjamin's case illustrates a transition from immediate self-description to the development of a coherent, philosophy-like worldview. His autobiographical narratives reveal the interplay between minimal and narrative self, with mood episodes influencing both self-experience and identity coherence. Emotional memories-regardless of factual accuracy-serve as organizing phenomena, providing existential structure and meaning. The study highlights the limitations of cognitive schema theory and underscores the importance of narrative scaffolding and affect-logic in shaping worldviews. Conclusions: The study demonstrates how a multidisciplinary analysis of autobiographical narration can be useful for characterizing emotionally charged worldviews when working with individuals with complex, comorbid and chronic psychiatric disorders. Integrating phenomenological and narratological approaches yields a deeper understanding of selfhood and meaning-making in psychopathology, with implications for clinical assessment and intervention.

Source: Frontiers in Psychiatry

DOI: 10.3389/fpsyt.2025.1648141