Psychopathology and Corporality: The Possibilities of Intersubjectivity for Restoring Experience. The Cases of Schizophrenia and Autism




© Springer International Publishing AG 2017
Pascual Ángel Gargiulo and Humberto Luis Mesones-Arroyo (eds.)Psychiatry and Neuroscience Update – Vol. II10.1007/978-3-319-53126-7_2


2. Psychopathology and Corporality: The Possibilities of Intersubjectivity for Restoring Experience. The Cases of Schizophrenia and Autism



Ivana Anton Mlinar1, 2  


(1)
Department of Philosophy, National University of Cuyo, Centro Universitario – M5502JMA, Mendoza, Argentina

(2)
CONICET (National Council of Scientific and Technical Investigations), Buenos Aires, Argentina

 



 

Ivana Anton Mlinar



Abstract

Starting from a phenomenological analysis of the lived body [Leib], and then coming to the phenomenological genesis of verbalization, it can be shown that the self and intersubjectivity have their original sense and constituent possibility in pre-linguistic experience, essentially tied to corporality, and not in reflexive structures of superior strata. Moreover, the phenomenological approach points out that psychic pathologies cannot be understood as mere brain illnesses, but that they have their own “place” in the lived relation between subject and world, which is mediated by corporality [Leiblichkeit]. When the latter loses its transparency, experience is affected and the intersubjective world, able to be experienced, gets lost. On the basis of these phenomenological principles contrasted with some fruitful therapies, I intend to show that there is evidence to maintain that a minimal self and intersubjectivity do not get lost even in extreme psychic illnesses (such as schizophrenia and autism), in which precisely personality and intersubjectivity—including linguistic and communication capacities—as such are disrupted. And consequently, these assumptions should become not only premises to overcome the prevailing medical and even psychiatric dichotomy between bodily functions and mental states—which disregards the person in its unitary, concrete and bodily [leiblich] existence—but also the condition of the possibility of effectiveness of a therapy.


Keywords
Phenomenology of corporalityIntersubjectivityMinimal selfSchizophreniaAutism



Introduction


In the presence of a person, in its figure, its behavior, its gestures—the corporal becomes the base for interpersonality: this body, this corporal being in front of me is the other, and not its cover or support. One of the big contributions of phenomenology from Husserl on is the acknowledgement of the body and corporality [Leiblichkeit] in its subjective character [1, 2]. The body is certainly not conscious as “something” mine, rather as the unnoticed background of my turning toward [Zuwendung] the world and the others. That is why, in turn, corporality in a broad sense transcends the body as such and refers to the relationship anchored in it between the person, the world, and all their relational circumstances. Hence, psychic illness seems to have its own “place” in this lived relation between subject and world, which, in that sense, is mediated by corporality [Leiblichkeit].

This paper intends to show, first, the phenomenological genesis of verbalization, with its origin in lived experience. Second, genetic analysis brings to light that both the self and intersubjectivity have their original sense and constituent possibility in pre-linguistic experience—essentially tied to corporality— which, in turn, could be confirmed in psychopathologies such as schizophrenia and autism, in which personality and intersubjectivity as such are affected. Finally, this phenomenological analysis seems to support the principle that both ipseity—or a minimal self—and a minimal intersubjectivity never get lost, this way not only making a consequent practice of therapies possible, but, moreover, offering a unitary perspective of the psychiatric patient as person and not as a “piece of nature”—whether a brain or a mere body to heal.


Corporality and the Phenomenological Genesis of Language


Things and the world exhibit a variable orientation in relation to the absolute here instituted by the body. Our experience of them is adjusted to our bodily movements, which motivate the multiplicity of their appearances. Consequently, every perspectival appearance presupposes in turn that the experiencing subject is himself given in space, that is (a bit paradoxically phrased), perceptual intentionality presupposes an embodied subject [3] (p. 176), [4] (p. 284). But this does not mean that the subject should be a kind of presence or activity in a spatial object [5] (p. 240). In other words: the body as center of orientation and movement and, correspondingly, the kinesthetic system (my potentiality of mobility) should not be identified with the position and the movement attributed to our objectified body, since this occurs in an objective space already constituted as being independent of my orientation and movement. Quite the contrary: my original body-consciousness, my subjectivity, my concrete self-awareness implies that the function (movement, action) of the body is originally experienced as a spontaneous field of activity, as the activity of the ego [6] (p. 540), as an “I can” [7] (p. 14).

In psychiatry and well as in medicine, however, a perspective prevails of investigation of the body [Körper] as substrate (and not of corporality [Leiblichkeit] in a phenomenological sense) in which material conditions of alteration of psychic experience are sought. The dichotomy between bodily functions and mental states consequently disregards the person in its unitary, concrete, and bodily [leiblich] existence [8, 9].

This remark is essential in order to understand that every sense—that is, to have a world and to relate to others, phenomenologically expressed: to mean (noetic, or intentionally understood) and that what is meant (noematic)—has its origin in this experience, in the lived relationship between the subject and the world that is conveyed through body and space. On this originary articulated experience, on this sphere of sense, ride predication and judgment, that is, linguistic acts, language [10]. Thus, it becomes clear that while not every noema actually is the linguistic meaning of an expression, none is excluded from becoming one. Therefore, pre-linguistic experience is not a featureless blur, but is pre-organized into rough types, which afford a toehold for further development [10, 11]. That is why this pre-linguistic stratum of experience becomes so important, then, as the cradle of sense; it is the origin of the constitution of the things, of the word to me, and, therefore, here that can be traced every pathology and, consequently, every therapy should be anchored.


Corporality and Intersubjectivity


My possible and effective experience of the world intertwines with the information I receive from the other one’s experience, and that has for me the character of an appresentation. The appresentation transcends the given so that it intends in an empty way something that could be given in a subsequent moment. For example, the perception of the side of a cube also appresents the other sides because it refers us to them. Now, what it is in the world for me results from the convergence of the presentations and the appresentations of the foreign experience that are given to me with the expression of the foreign body or the language.

How is it possible to perceive an other as other and not as an object? A physical body is apprehended as lived body [Leib] through a motivated association because of its similarity to my own lived body, on the ground that it moves and is affected in an analogous way. Without any active intervention of the “I”, the sense originarily instituted with respect to my own body is transferred to the analogous physical body. We win in this way the foreign lived body of an “I” that animates it, as another “I”. This means that perceiving the foreign body as an other is to experience his body as a zero point of appearances. That is why the foreign body is the first intersubjective, then it is the most primitive step to objectivation: it constitutes the first—indeed still imperfect—object, the first intersubjectively identified of the experience of different subjects. What is in front of me is thus also a subject, in front of whom I myself am and who has my own body in an external way of appearance. As we see, the person, an other, is constituted in the experience before all conceptual and general thinking [6] (p. 110), before any language. Intersubjectivity emerges as an interpersonal space, as a synthesis of the centered and an off-center perspective. The importance of this genetic analysis lies in the fact that it makes it possible to understand subjectivity and self-awareness as a structure that always implicitly includes the other. Additionally, this structure does not appear as a fixed “I”, kind of an “acquired property”, but rather as a continual movement and an intentional production of the adjustment of perspectives.

In this interpersonal space, the experience is generated, and it should allow both the arrival to language and the off-center perspective, that is, the constitution both of the “I” and also of the other and the objective world. The interpersonal space is also ontogenetically the first in the process of the development of subjectivity.

It can be seen why the phenomenological distinction between body [Körper] and lived body [Leib] becomes crucial to understand psychic illness, because it is precisely in the extent to which the lived body [Leib] emerges disturbing as physical body [Körper] that it can complicate and distort the experience of the world and the others. In other words, the more the body becomes independent, the less free becomes the person in her relationships with the world. Fuchs [8], for instance, presents and analyzes these principles in some mental illnesses such as melancholy, schizophrenia, old age depression and aging paranoia. Therefore, at the same time, corporality—in this phenomenological sense—is the field where one should go to meet the patient, to try to restore his experience, as we will see.


Psychopathology, Corporality, and Person


If psychic illness seems to have its proper “place” in the lived relation between subject and world, which is mediated by corporality [Leiblichkeit], it is because the specific human faculties of objectivation and of self-relativization, as well as of free will and of commitment are precisely associated with the retracement of the body to its mediating function, with the transparency of corporality in front of the world. When corporality loses this transparency, experience becomes affected, and submerges the person in her own world because of having lost the intersubjectively experienceable world. We consider the expressions of the sick person no more as free, sense-directed intentions, but we look for mental or organic causes for them. As a result, corporality obtains, however, a decisive meaning for a treatment full of understanding of the psychotically-changed person. It becomes possible to grasp the structural changes in the body–environment–relationship of the sick person, and then its lack of freedom, its inability, turn out to be understandable, together with the fact that this sick person can see the world and react differently. We follow then, departing from the body, the particular way in which the world builds up and reality is constituted.

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Oct 20, 2017 | Posted by in PSYCHIATRY | Comments Off on Psychopathology and Corporality: The Possibilities of Intersubjectivity for Restoring Experience. The Cases of Schizophrenia and Autism

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