Far from being a purely speculative exercise, philosophy is important for practical purposes in our discipline, including conceptual clarification of disputed psychiatric terms, awareness of basic theoretical tenets underlying psychiatric classification and practice, acknowledgment and management of differences in values between clinicians and patients, facilitation of ethical choices, refinement of understanding, and sense-making of the patients’ peculiar way to express their own mental suffering. This chapter illustrates the role of phenomenological and hermeneutic clarification in order to shed light on the construction of mental symptoms. In particular, we consider the role of the patients’ “position-taking” regarding their abnormal mental experience in shaping the final form of their mental symptoms. We start from analyzing the difficulties encountered by descriptive psychopathology in the search of pathognomonic symptoms, showing that both apparent (e.g., hallucinations and delusions) and subtler phenomena (e.g., basic self-disturbances) are not specificand risk overdiagnosis or the use of too large and vague diagnostic concepts. A phenomenological and hermeneutic stance is useful to enhance the characterization of mental symptoms by taking into account subtle formal differences, the gestaltic dialectic between the phenomenon and its background, and the way patients take a position toward their personal abnormal experiences.