Phenomenology of the Broken Body

Espen Dahl, Cassandra Falke, Thor Eirik Eriksen, Espen Dahl, Cassandra Falke, Thor Eirik Eriksen

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429869945
• Edition: 1
• Topic: Philosophie
• Subtopic: Histoire et théorie de la philosophie

Some fundamental aspects of the lived body only become evident when it breaks down through illness, weakness or pain. From a phenomenological point of view, various breakdowns are worth analyzing for their own sake, and discussing them also opens up overlooked dimensions of our bodily constitution. This book brings together different approaches that shed light on the phenomenology of the lived body—its normality and abnormality, health and sickness, its activity as well as its passivity. The contributors integrate phenomenological insights with discussions about bodily brokenness in philosophy, theology, medical science and literary theory. Phenomenology of the Broken Body demonstrates how the broken body sheds fresh light on the nuances of embodied experience in ordinary life and ultimately questions phenomenology's preunderstanding of the body.

Section III

Recovery and Life’s Margins

9 Suffering’s Double Disclosure and the Normality of Experience

James McGuirk

Introduction

My intention in the present chapter is to offer some reflections on approaches to the phenomenon of suffering in phenomenological discourses, as well as the implications of these approaches for the ways we understand the structure of normality in experience. Analyses of suffering, I will show, are doubly disclosive in the sense of proffering insight into the nature of certain pathologies, illnesses, and injuries as well as delineating some of the most fundamental aspects of everyday experience from which suffering alienates us. Such analyses are, in other words, disclosive of suffering itself, as well as offering a via negativa to understanding aspects of ordinary world experience.¹ But we will also see that the doubleness of this disclosure is more dialectic than binary as a result of the possibility for sufferers to reclaim or reconstitute normality in the face of pathology or illness.

The article is divided into three parts. The first two parts deal with different ways in which the relationship between suffering and normality have been conceptualized in different phenomenological discourses. The first part deals with the contribution made by phenomenology to psychopathology and specifically to the articulation of the lived experience of mental illness. Work in phenomenological psychopathology has been clinically fruitful in articulating the first-person presentation of specific pathologies, but has also proved important in illuminating subjective and intersubjective lived experience in a more global way. It does so by allowing close analyses of pathological experience to throw light on aspects of experience we take for granted pre-reflectively, but which we are often opaque for us from the point of view of ordinary reflection. In the second part, I take up work done on the phenomenology of illness whose focus is less on pathological and normal subjective world experience as such, but on the capacity of the subject to live with suffering and loss in the context of illness. One of the central focal areas of this work has been to draw attention to the way a sense of the normal can be reconstituted in spite of the loss of capacity that accompanies illness and suffering. The point here is not to conceive of suffering in terms of alienation from the normal, but as something woven into ordinary experience in a way that challenges a clear-cut delineation, not only of the categories of health and illness, but of normal and abnormal. In the third and final part, I attempt to reconcile these positions by arguing that while we should avoid thinking of normal and abnormal in absolute terms, we must be equally careful to avoid conceiving of the normal as endlessly malleable through modification or reconceptualization. The normal is not a purely objective criteria imposed from without, but nor is it wholly emergent from within the subject’s capacity to re-orient itself in the world. Both the normal and its felt loss in suffering, are comprehensible only in the interface between subject, world and others, in which each moment exerts a constraining force on the others. As such, the realization of the normal is both dynamic and limited.

The Normal and the Abnormal: Perspectives from Phenomenological Psychopathology

The first of the approaches to which we turn our attention is one concerned with psychopathology and the implications of articulations of the lived experience of the sufferer for understanding subjectivity and intersubjectivity generally. While Husserl and Merleau-Ponty deliberately developed their phenomenological research in dialogue with empirical psychology and psychiatry respectively, phenomenological psychopathology can also point to a long history as a discrete area of inquiry emerging to a great extent from Karl Jaspers’s famous two- volume General Psychopathology from 1913.² General Psychopathology is not exclusively a work in the phenomenological tradition, and indeed Jaspers is often skeptical about what a phenomenological approach can contribute to pathologies such as schizophrenia, but the work is nevertheless important for its attempt to anchor our understanding of mental illness in the context of the human experience of life as a meaningful unity. And given his commitment to the subject matter of psychopathology as “actual conscious psychic events”³ and “the intentional relationship of the I to what confronts it,”⁴ it is arguable that the spirit of Jaspers’ work is more phenomenological than even his own comments on phenomenology would suggest. The General Psychopathology has also inspired a great many thinkers including Eugene Minkowski, Ludwig Binswanger, Kimura Bin and, more recently, Josef Parnas, Louis Sass and Thomas Fuchs, all of whom have made significant contributions to psychopathology by using phenomenological resources to closely describe the lived experience of pathologies such as schizophrenia, depression and dementia.

Despite the volume of work done from within this paradigm, it would be wrong to suggest that the phenomenological approach has ever been anything more than marginal within psychiatry. Mainstream psychiatry and psychopathology tend to be dominated by the so-called biomedical paradigm, with its materialist orientation and its emphasis on the bio-chemical etiology of mental illness.⁵ This approach has dominated for several reasons, one of which is that it has simply been effective in the analysis and treatment of mental disorders. However, what it neglects, and what phenomenological psychopathology specifically offers, is attention to the lived experience of mental illness. The medical paradigm tends to thematically ignore the disturbance that pathology entails in the lifeworld of a living subject. It ignores, in other words, the suffering of the disorder in the context of a life. Let me be clear here. I do not mean to say that proponents of the biomedical approach are blind or indifferent to the suffering of patients with depression, schizophrenia or any other pathology. Psychiatrists are human beings and they see first-hand the devastation that mental disorder can bring about. The point is rather that the paradigm itself is set up not to take suffering into account when investigating, explaining and treating pathology. That the patient suffers is not in doubt. What is in doubt is whether the suffering itself can tell us anything clinically interesting. The question is whether an articulation of the sense of suffering can contribute to our understanding of what the pathology is or if suffering is merely a by-product of pathology properly understood.

It is precisely on this point that advocates of the phenomenological approach differ. They argue that articulating the nature of the first- person suffering of the patient is not only clinically helpful, but necessary if we are to have any hope of understanding or treating disorders. It is important to know why they make this claim. The phenomenologists’ focus on the suffering of pathology is not motivated by patient advocacy or on an attempt to supplement the clinical with a focus on care. The phenomenological description is not an addendum to the bio-chemical. It is understood, rather, as necessary to the development of a clinical picture of the disorder by giving as faithful a description of the lived experience of the disorder as possible. As Jaspers says,

The first step towards knowledge of the psyche is the selection, delimitation, differentiation and description of particular phenomena of experience which then, through the use of the allotted term, become defined and capable of identification time and again.⁶

For Jaspers, this is simply good science. If we are going to be able to classify pathology in ways that are nuanced and precise, it is important that we know as much as possible about the thing we are trying to understand. In other words, while it is necessary and desirable to articulate pathology in terms of somatic etiology, its meaning as pathology only makes sense with reference to the touchstone of experience.⁷

Jaspers’s aforementioned methodological commitment, combined with his admonition to “discount the theoretical prejudices ever present in our minds and train ourselves to pure appreciation of the facts”⁸ is very much in the spirit of Husserl’s stated aim to make phenomenology an “eidetic science of consciousness” through which the a priori of the contents of experience are brought to reflective presence. Within psychopathology, the approach has been used to articulate the subjective expression of a range of pathologies. One might think here of Thomas Fuchs’s articulation of depression in terms of a corporealization of the body in which the latter, rather than opening “space as a realm of possibilities, affordances, and goals for action … stands in the way as an obstacle.”⁹ Or the same author’s description of the felt disembodiment of mind in schizophrenia in which the sufferers sense of ownership (SO) of their actions becomes dislocated from their sense of agency (SA).¹⁰ Another researcher, Louis Sass, has emphasized the tendency of schizophrenics to exhibit hyperreflexivity, which is to say that psychophysical agency, which ordinarily recedes into the background of attentional focus, protrudes in a way that makes engagement with the world and with others difficult.¹¹ In the background to all of these descriptions, lies a commitment to the importance of intentionality in understanding (pathological) experience. Husserl’s idea of intentionality—that consciousness, by definition, transcends toward the world while the world, by definition, manifests itself as meaningful to consciousness—was ground-breaking within the phenomenology of mind, though it states nothing more than what we take for granted in our ordinary pre-reflective experience. Our experience of ourselves, the world, and others is enacted in the co-belonging of consciousness and world in ways that are generally established, uncontroversial, and unproblematic. Yet, it is precisely these established structures that become strained for the schizophrenic. Hyperreflexivity denotes the obtrusion of the tacit dimension of experience into the forefront of attention in a way that is seriously debilitating. As Sass puts it, “the perfectly normal sensations implicit in ongoing experience and action [are] now experienced in the perfectly abnormal condition of hyperreflexivity and altered self-affection.”¹²

These examples testify to the great potential of phenomenology in articulating the nature and structure of the experience of pathology, in ways that contribute enormously to our understanding and classification of these pathologies.

But the focus on pathology is disclosive in another way too, which has been at least as popular among phenomenologists. Articulating the experience of the schizophrenic not only helps us to understand schizophrenia, but also clarifies aspects of normal world experience that are often so obvious and tacit that we fail to attend to them in our normal self-apprehension. Contrasting the value of thought experiments with the use of empirical case studies in reflection on the nature of lived experience, Dan Zahavi and Josef Parnas put the point as follows:

If we are looking for phenomena that can shake our ingrained assumptions, and force us to … revise … our habitual way of thinking, there is no need to get lost in farfetched and unreliable fantasies. All we have to do is turn to psychopathology (along with neurology, developmental psychology, ethnology etc.) since all of these disciplines present us with rich sources of challenging material.¹³

Pathological experience shows itself as pathological against the background of aspects of experience that are so foundational that we fail to notice them. But, as Heidegger famously pointed out, it is often only in the kind of breakdown (including the breakdowns involved in pathology) of the normal progression of things that the ordinary aspects of experience can become reflectively available to us.¹⁴ Thus, while the pathological is experienced as pathological because of the ordinary nature of comportment which we take for granted, ordinary comportment only comes to our attention when something has gone wrong. The best-known exploitation of this insight in the phenomenological literature is perhaps Merleau-Ponty’s reflections on the work of psychiatrists Adhémar Gelb and Kurt Goldstein—most famously the case of Schneider—in order to articulate insights about ordinary perception and bodily self-affection.¹⁵ Unlike the phenomenological psychiatrists, Merleau-Ponty is not primarily interested in offering a clinically useful analysis of—in this case Schneider’s—pathology. He is, rather, interested in the way Schneider’s experience reveals aspects of the taken-for-granted experience of normal subje...

Table of contents

• Cover
• Half Title
• Series
• Title
• Copyright
• Contents
• Introduction
• Section I Vulnerable Bodies
• Section II Suffering Bodies
• Section III Recovery and Life’s Margins
• Bibliography
• Contributors
• Index