{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:57:44Z","timestamp":1791190664482,"version":"4.1.0"},"reference-count":20,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychopathology"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1159\/psp\/aelag005","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:45:43Z","timestamp":1787139943000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Imaginative Vulnerability and Symbolic Mediation: A Phenomenological Analysis in Schizophrenia-Spectrum Conditions"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3682-7259","authenticated-orcid":false,"given":"Birgit","family":"Bundesen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keld Stehr","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo \u00c6renlund","family":"S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian Porsdam","family":"Mann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"K\u00f8ster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.678397"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1080\/17454832.2020.1719168"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0349.2012.00891.x"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1177\/1468798419833096"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-024-01511-6"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.schbul.a007017"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbx032"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.808009"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2023.12.024"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1080\/08039488.2024.2423761"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2018.1437609"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.18261\/issn.2535-7913-2020-02-05"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1159\/000502098"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8295.1912.tb00057.x"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s11245-025-10252-x"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1080\/00377319709517514"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s11097-020-09723-w"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1159\/000454928"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1080\/02699206.2025.2451961"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1159\/000488463"}],"container-title":["Psychopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/psp\/aelag005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:47:59Z","timestamp":1791190079000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/psp\/aelag005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":20,"URL":"https:\/\/doi.org\/10.1159\/psp\/aelag005","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.33135995","asserted-by":"subject"}]},"ISSN":["0254-4962","1423-033X"],"issn-type":[{"value":"0254-4962","type":"print"},{"value":"1423-033X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]}}}