2002, Number 4
Salud Mental 2002; 25 (4)
Fenomenología de la corporalidad en la depresión delirante
Dörr-Zegers O
Full text
Language: Spanish
References: 34
Page: 1-9
PDF size: 374.36 Kb.
ABSTRACT
It is surprising that in the current systems of classification and diagnosis, such as DSM IV and ICD 10, so little importance is given to that evident transformation of corporality that we observe in our depressive patients. So, for example, DSM IV makes a reference to the body in only two of the nine diagnostic criteria. Not so the classical authors, such as Kraepelin and Bleuler, who, in their respective descriptions of the depressive illness considered the change of corporality as one of the three fundamental phenomena, while Schneider insisted that the only specific manifestation of this illness was the compromise of the "vital feelings", that is to say, those nearer to the body experience.In 1968 another German author, Pfeiffer, compared the depressive symptomatology in an important number of patients from Germany and Indonesia, with the purpose of determining something like a "fundamental depressive syndrome". His conclusion was that this was constituted by only three phenomena, the alteration of the mood, the disruption of the vegetative functions, and "abnormal body feelings", such as pains and paresthesias. We (1971) obtained a similar result in an empirical and phenomenological study carried out in the University of Concepción, where we described a "nuclear depressive syndrome" when observing that the symptomatology of all the depressive patients hospitalised during five years was ordered around three fundamental phenomena: a disturbance of the experience of the body that ranges from discouragement to anxiety, including lack of forces, pains, cold, nauseas, etc.; a disturbance of the capacity to act and feel (psychic and motor retardation, anhedonia, etc.); and finally, the disturbance of the temporality of the body, whose rhythms are altered, inverted or suspended to a greater or lesser degree.
We could confirm these results in studies carried out in 1979 and 1980. Some years later Peter Berner (1983) described the "endomorphic depressive axial syndrome", that is extraordinarily similar to the "nuclear depressive syndrome" described by us. They state that all the endomorphic depressive symptomatology is ordered in only two fundamental phenomena, namely the disturbance of the experience of the body and the alteration of the biological rhythms. The only difference between the two definitions lies in the fact that Berner combine into one concept the alteration of the body experience and that of the capacity to act and feel.
All of the above show us the transcendence of the compromise of the corporality in the endomorphic depressive syndromes, as well as the need to deepen in the knowledge of the disturbances through phenomenological studies. In 1980 we published with Tellenbach the results of a phenomenological analysis of the corporality of the depressive stupor. Today we would like to complement that study with the analysis of the corporality in a form of depression in a certain way polar with respect to stupor: delusional depression with nihilistic ideas. With this object, we proceed to report a typical case where the symptomatology revolves around the idea of being dead. The patient makes impressive statements: "The thing is that everything about me is dead; let us just say I am dead... I do not have sense of touch, smell, or taste. My body is so light that it is as if it doesn’t exist... When I take my children in my arms I do not feel them... (And) when I speak, words automatically come out, but other people’s words do not enter my head. etc." We divided the analysis into two parts: the relationship with one’s body, and that with others and the world.
The relationship with one’s body
The fundamental experiences of our patient are: that she does not feel her body, and that her body is weightless; she identifies both with death. This phenomenon can be understood starting from the fact that we are a conscience incarnate. Husserl (1913) affirms: "The perceiving, when I consider it purely as a consciousness, and disregard my body and bodily organs, appears like something which is, in itself, inessential: an empty looking at the object itself on the part of an empty ‘Ego’ which comes into a remarkable contact with the object" (§ 39). And later he expresses that "only by virtue of its experienced relation to the organism does consciousness become real human or brute consciousness, and only thereby does it acquire a place in the space belonging to nature and the time belonging to nature the time which is physically measured" (§ 53). It is the body, the flesh, materiality itself, that prevents consciousness from floating in the air, devoid of any content. The extreme experience of our patient of feeling dead in life turns out to be the demonstration of the indissoluble bond between consciousness and body, because one cannot think or feel from nowhere, without this body that has weight and gets tired and sleeps.
The relationship with the world and with others
Our patient claims she does not feel her children when she takes them in her arms, to lack sense organs ("I do not have sense of touch, smell, or taste for food"), and she specifies the relationship with others: "When I speak, words automatically come out, but other people’s words do not enter my head". To understand this phenomenon, let us return again to Husserl (Ideas I, § 53): "We also recall that only by virtue of the connection joining a consciousness and an organism to make up an empirically intuited unity within Nature is any such thing as mutual understanding between animate beings pertaining to a world possible". That is to say, the opening to intersubjectivity is produced from the body. Starting from my body I will be able to constitute the world surrounding me, through which the other bodies are spatialized. From the phenomenological point of view, the earth is in the centre of the world, and my body, as point zero, is in the centre of the centre. But in turn, from the perception of the other I can be aware of my body, so when I do not feel the other, my body appears to be dead. When ceasing to be properly a carnal subject, the Ego, that subject emerging from the primordial experience of the "there is", the "il y a" from Lévinas, is dissolved, since it can exist only as a body.
REFERENCES