Response to Fernandez, ‘The Phenomenology of Psychopathological Embodiment’

Thomas Fuchs

 

Introduction

The account and critique of some of my major concepts offered by Fernandez (2016) gives me a welcome opportunity for several clari­fications. The lived body, embodied subjectivity, and intersubjectivity are indeed fundamental principles of my psychopathological research. For its aim is a novel conception of psychiatric illnesses as disturb­ances of being-in-the-world which are not occurring in a mental or inner realm, be it the psyche or the brain, but are played out in the subject’s relations to the world and to others as mediated through the body. Thus, the phenomenology of the lived body gains central importance for psychopathology, as well as the concepts of embodi­ment and enactivism which describe, as complementary approaches, the biological or systemic aspect of the relations between organism and environment (Fuchs, 2011a,b; Fuchs and Schlimme, 2009). It is these concepts which Fernandez has taken as the topic of his analysis and critique.

 

 

 

General Comments

To begin with, the mediating function of the body requires that the body itself with its organs and actions withdraws into the background of awareness, thus realizing what may be called the ‘mediated immediacy’ of our relation to the world. In other words, the body becomes transparent for the situation we are related or directed to (Polanyi, 1967; Leder, 1990; Fuchs, 2001; 2005). This transparency of the body does not mean that we could not attend to our body at any time and experience its sensations and impulses, enjoying them or suffering from them, as the case may be. An oscillation of the body between foreground and background of the field of awareness is rather characteristic for everyday life. As Fernandez rightly recognizes, it may also be described in Plessner’s terms of Leib and Körper (Plessner, 1981): our bodily existence moves between the poles of unimpeded mediality of the body-as-subject (Leib) and attention to the body-as-object (Körper) which thus shows itself as an object among others, with its materiality and resistance, as a body which we may use deliberately like an instrument, but which may also escape our control, be it in tiredness, lack of skill, clumsiness, illness, or other disturb­ances of bodily existence.

Such disturbances also arise in psychopathological conditions, and they may be described in various ways. One notion suitable for this may be corporealization (i.e. a constriction and reification of the body, as in severe depression; cf. Fuchs, 2005), other notions are dis­embodiment (loss of implicit bodily functioning, alienation of one’s body, as in schizophrenia; cf. Stanghellini, 2004; Fuchs, 2005), patho­logical explication (otherwise mediating or tacit bodily processes coming to the fore, also in schizophrenia), hyperreflexivity (exaggera­ted attention on the body, e.g. in hypochondria or schizophrenia; cf. Fuchs, 2011c), exposition of the body to the gazes of others (dys­morphophobia, social phobia; cf. Fuchs, 2002), instrumentalization of the body (as for compensating a lack of self-worth in anorexia), and others. It is true that these various alterations usually direct the aware­ness from the world back to the body or to the disturbed mediating functions, thus shifting the balance between Leib and Körper to the latter. However, ‘corporealization’ is only one notion particularly suitable for describing the body in severe depression, but does not play the unique role for my psychopathology which Fernandez ascribes to it.

It is also true that the concepts drawn from Plessner, Merleau-Ponty, and others, when applied to psychopathology, describe mostly dys­functional or distressing conditions; therefore the notion of Körper may receive a more negative connotation than is the case in Plessner. This is by no means to say that the polarity of Leib and Körper should be pathologized as such — after all, this polarity is an essential part of what Plessner calls the ‘excentric positionality’ of the human being, namely the capacity to objectivize his own body, to become aware of its exterior side, or to use it as an instrument, for example when train­ing new skills. Being able to have one’s body, not only to be it, is also a fundamental condition of the development of human culture. Never­theless, the disturbances of the unquestioned being-in-the-world which permeate psychopathology are usually also connected with an ‘opacity’ of otherwise mediating bodily functions which turn the lived into the more or less objectified or ‘corporeal body’ (Körper).

Granted, these shifts from Leib to Körper should be further differ­entiated according to the type of disturbance, and, for this, more fine-grained notions may be developed, as suggested by Fernandez. Whether the lived body suffers a constricting rigidity, as in severe depression or melancholia, is certainly different from the anxious observation of bodily functions in hypochondria, from the instru­mentalizing submission of one’s body in anorexia, or from the painful awareness of one’s bodily exterior as in dysmorphophobia or social phobia. Moreover, the body as organism should also be delimitated conceptually; that means, the anatomical and physiological aspect of the body, for this is usually not disclosed from a subjective point of view, but from a third-person perspective as taken by the physician, physiologist, or neuroscientist.

On the other side, one should not forget that all too strict conceptual distinctions may be connected with a loss of the transitions and the dialectics which characterize human bodily existence. The lived body may not only become the object of attention as corporeal body, it even comes to the fore as a physiological organism in everyday experience, for example when the heart starts to pound, when digestive functions become noticeable, when an injury, bleeding, or fracture occurs, etc. The medical body is not an altogether different object, it rather ‘unfolds’ from the lived body, as it were. In this respect Fernandez’s critique (p. 54) seems not quite justified: the notion of the body-as-object or Körper is not used in my work inhomogeneously or incon­sistently. Rather, the resistant, heavy, or ill body and the anatomical or physiological body (organism) are only different stages of manifestation and objectification of the body as Körper. Fernandez himself concedes that: we are well capable of ‘attending and relating to our own bodies as biological organisms, especially when our biological body fails to function as expected’ (p. 62).

Similarly, the body as seen by others is, on the one hand, the medium of spontaneous expression of ourselves and our emotions in pre-reflective intercorporeality (Fuchs and Schlimme, 2009). On the other hand, the body may also serve as a means of more or less deliberate self-presentation, adornment, role-taking, play-acting, or dissimulation. Since we always live with the tacit or explicit aware­ness of the factual or possible presence of others, a completely sponta­neous, pre-reflective, and unquestioned bodily existence is the exception rather than the rule. Naturalness and artificiality are always intertwined. Again, in the intersubjective sphere the relation of the lived body and the instrumental body, or Leib and Körper, does not mean an ‘either-or’ which could be divided into distinct categories, but rather a fluid oscillation between the two poles.

The same applies to the critique of my allegedly inconsistent usage of the body-as-experienced and the body-as-organism (Fernandez refers here to my connection of ‘corporealization’ to the physiological stagnation and decline which characterize melancholia on the organ­ismic level, p. 55). The seeming ambiguity results from a comple­mentarity: the experienced body may be regarded as the ‘reverse side’ of the physiological body or organism, so that the process of corporealization may also be described from a biological point of view. Of course, a separate notion may be chosen for this aspect — I would not insist on the term ‘corporealization’ for describing the pathophysiology of depression. However, precisely if one does not want to separate both aspects by an ontological divide, it is important to take into account the complementary aspect of the processes one describes phenomenologically (Fuchs, 2011a). Therefore it is also fully correct to describe the ‘smoothly functioning biological pro­cesses of the body’ (p. 62) both as processes of the organic Körper on the one hand (Körper as thematized from a third-person point of view), and as fully transparent processes of the lived body or Leib on the other hand. Of course, the notion of organism is suitable for the first aspect too — but, as mentioned above, even the organismic aspect is derived and ‘unfolds’ from the experience of the resistant, heavy, material, injured, or bleeding body.

The notion of corporealization is not suitable, however, for describing the loss of the excentric position — here I have to correct a misunderstanding in Fernandez’s account. This position is by no means a mediating function as he assumes (pp. 53, 55–6, 69); on the contrary, it is the point of view which enables humans to reflect on the body’s mediation and thus allows for the oscillation between being and having one’s body. The excentric position is thus an ambiguous, sometimes even precarious position, but neither a mediating nor a pathological function. In severe and delusional depression, the subject collapses into the space of its own body (Fuchs, 2005), and this corporealization is accompanied by a loss of perspective-taking and self-distancing, or in other words, by a partial loss of the excentric position. However, this loss may not be described by the same term ‘corporealization’.

Comments on Fernandez’s Five Categories of the Body

In the following, I would like to briefly comment on Fernandez’s distinction of five senses of the notion of ‘body’ where he tries to show that the polarity of Leib and Körper is insufficient to account for the occurring phenomena.

(1)    As already mentioned, the notion of the body-as-organism is a necessary complement to the body-as-experienced. However, I would argue that it is not a completely or even ontologically different notion of the body, for it is well possible to derive it, at least to a certain degree, from experiences of the autonomous, resistant, or fragile body, that is, from the Körper as it comes to the fore in certain (often negative) experiences.

(2)    The body-as-expressive describes the lived body in the inter­corporeal encounter. However, Fernandez argues that the explicit awareness on one’s expressive body could also open up possi­bilities of interaction, instead of restricting one’s being-towards-others. Such is indeed the case both in the child seeking to act on stage in the presence of his parent (pp. 63–4) and in the case of the sportsman faking a pass to manipulate his competitor (p. 64). However, in such cases we are no longer dealing with the pre-reflectively lived body (Leib) and its spontaneous expressions, but with the deliberately used or instrumentalized body which thus adopts a ‘corporeal’ aspect (Körper). Granted, the aspect of having one’s body may well be functional in these cases (instead of having a decomposing effect on one’s performance); but it is no longer the body as purely expressive — at least if one takes ‘expression’ in its primary sense as mediating a spontaneous, pre-reflective intercorporeality.

(3)    Suggesting next the notion of the body-as-perceptive, Fernandez argues that this dimension does not comply with a mere polarity of transparency (Leib) and opacity (Körper). For, on the one hand, in sexual arousal a heightened awareness of one’s sensual body leads to an increased interest in the sexual partner. On the other hand, in Goldstein’s and Merleau-Ponty’s well-known case of Schneider (Merleau-Ponty, 1962), we find a patient whose awareness of his body is lacking, while at the same time losing the capacity of discriminatory stimulus perception and thus (as Fernandez interprets it) of perceiving the world.

However, both cases may well be explained by the concept of ‘mediated immediacy’ which does not mean a complete trans­parency or even absence of the body; rather it is precisely through the affection of the body that we perceive the world. This may be illustrated by an everyday example: if we temporarily lose the sensation in our hand because of a nerve compression, the hand does not only feel numb and somehow alien, it no longer functions as a medium of touch either. Instead of con­veying a sense of the touched surface, the movements of the hand will become awkward or clumsy, and it will appear as an alien, thing-like object — an obstacle instead of a medium. In general, the tacit self-awareness of one’s body is what mediates the per­ception of the world, while a loss of this self-affection results in a growing opacity of the body. Therefore both cases presented by Fernandez do not contradict the notion of the body’s transparency or mediated immediacy: in the first case, sexual arousal of the body may well be accompanied by hightened interest for the objects of desire (although with increasing desire the bodily awareness remains no longer tacit, as is also the case in hunger or thirst). In the second case, a lack of bodily awareness would also lead to a loss of perceptual capacities, for here the self-affection of the medium goes missing.

(4)    When discussing the body-as-motile, Fernandez argues that there are examples of inhibited bodily motility (for example in women) which comes to be experienced in a tacit way. Thus, it constrains one’s options of behaviour, yet without entering awareness in the way we would expect from a ‘corporealized’ body. This is certainly true, but I cannot find that it compromises the Leib/ Körper distinction. An impairment or disability may well recede into the background in just the way the body does in smooth functioning, provided that one gets used to the restriction. We also find this, for example, in the relieving posture which is adopted following an injury, inhibiting a painful movement even without conscious attention. Dysfunction may well become part of one’s implicit bodily habit. Again, the relation between Leib and Körper shows itself not as a fixed distinction, but as a con­tinuous alternation or turning into one another.

(5)    As an example of the mediating processes of embodied sub­jectivity, Fernandez first points to the loss of the excentric positionality in severe depression — a misunderstanding of ‘mediation’ which I have already clarified above. The other example is the case of Schneider again, namely his difficulty of executing abstract movements in a virtual or reflective space (such as moving one’s arm in a certain sequence and direction without an external goal), whereas he is still capable of concrete movements related to environmental affordances. The first would correspond to an instrumental use of the body as Körper, the second to movements of the lived body or Leib. Now in order to get access to abstract movements nevertheless, Schneider treats his body as an object whose appropriate limbs he has to ‘try out’ and ‘find’ through preparatory movements. Fernandez argues that in normal cases of abstract movements the body becomes an object as well, thus indicating a different kind of ‘having one’s body’ as in Schneider’s case. However, again I do not think that this compromises the principal distinction: we are only dealing with different degrees of objectification or ‘having’ — in Schneider’s case, the instrumental usage of the body is disturbed, which forces him to observe its single parts and movements with a particular attention, more than is necessary in normal abstract movement. Although the pathological case may not be equated with normal instrumentality, it does not force us to abandon the polarity of Leib and Körper as such.

Conclusion

In sum, Fernandez’s paper confirms the relevance of distinguishing the body-as-subject from the body-as-object in the domain of psycho­pathology and offers a valuable discussion of some connected prob­lems. Certainly, more fine-grained distinctions of different phenomena and stages within this polarity are possible and suitable. However, if Fernandez argues that at least some of his examples ‘cross the boundaries between Leib and Körper’ (p. 72) and question the con­sistency of the distinction, he reveals a non-dialectical understanding of the polarity. There are no strict ‘boundaries’ between Leib and Körper, neither conceptually nor phenomenally, for these concepts describe a continuous mutual interlacement or, to use Merleau-Ponty’s term, a chiasmatic entanglement rather than a clear-cut opposition (Merleau-Ponty and Lefort, 1968). Therefore, even if the five categories of the body suggested by Fernandez may serve as useful further distinctions, I have shown that in each case the dialectic and interlacement of body-as-subject and body-as-object comes to the fore again, and we are not dispensed from carefully analysing the relation and weighting of the two poles in each particular condition.

References

Fuchs, T. (2001) The tacit dimension: Commentary to W. Blankenburg’s ‘Steps towards a psychopathology of common sense’, Philosophy, Psychiatry & Psychology, 8, pp. 323–326.

Fuchs, T. (2002) The phenomenology of shame, guilt and the body in body dysmorphic disorder and depression, Journal of Phenomenological Psychology, 33, pp. 223–243.

Fuchs, T. (2005) Corporealized and disembodied minds: A phenomenological view of the body in melancholia and schizophrenia, Philosophy, Psychiatry & Psychology, 12, pp. 95–107.

Fuchs, T. (2011a) The brain — A mediating organ, Journal of Consciousness Studies, 18 (7–8), pp. 196–221.

Fuchs, T. (2011b) Are mental illnesses diseases of the brain?, in Choudhury, S., Nagel, S.K. & Slaby, J. (eds.) Critical Neuroscience: Linking Neuroscience and Society through Critical Practice, pp. 331–344, London: Wiley-Blackwell.

Fuchs, T. (2011c) The psychopathology of hyperreflexivity, Journal of Speculative Philosophy, 24, pp. 239–255.

Fuchs, T. & Schlimme, J. (2009) Embodiment and psychopathology: A phenom­enological perspective, Current Opinion in Psychiatry, 22, pp. 570–575.

Leder, D. (1990) The Absent Body, Chicago, IL: University of Chicago Press.

Merleau-Ponty, M. (1962) Phenomenology of Perception, Smith, C. (trans.), London: Routledge and Kegan Paul.

Merleau-Ponty, M. & Lefort, C. (1968) The intertwining — the chiasm, in The Visible and the Invisible: Followed by Working Notes, pp. 130–155, Evanston, IL: Northwestern University Press.

Plessner, H. (1981) Die Stufen des Organischen und der Mensch, Frankfurt am Main: Suhrkamp.

Polanyi, M. (1967) The Tacit Dimension, Garden City, NY: Anchor Books.

Stanghellini, G. (2004) Disembodied Spirits and Deanimatied Bodies: The Psychopathology of Common Sense, Oxford: Oxford University Press.

Fernandez. A.V. (2016) The phenomenology of psychopathological embodiment: A critique of Thomas Fuchs’ concept of corporealization, Journal of Consciousness Studies, 23 (3–4).[1]

[1]     Editorial note: JCS will not be considering further papers in this particular debate. However, this paper will be uploaded to the JCS blog following publication (https://www.imprint.co.uk/category/jcs-blog/), where the authors concerned (and JCS readers generally) can continue to discuss the topic further.

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