fuchs 2005 corporealized and disembodied minds

FUCHS / CORPOREALIZED AND DISEMBODIED MINDS ■ 95

© 2005 by The Johns Hopkins University Press

Thomas Fuchs

Corporealized andDisembodied Minds

A PhenomenologicalView of the Body in

Melancholia andSchizophrenia

ABSTRACT: The article starts with a phenomenologicalaccount of the implicit functioning of the body ineveryday perception and performance, turning thephysical body into a living medium of the subject’srelation to the world. This transparency of the body isconceptualized as a mediated immediacy, based on thecoupling and synthesis of single elements of percep-tion and movement to form the integrated intentionalarcs by which we are directed toward the world.However, this mediacy of embodied consciousness isvulnerable to disturbances of the mediating processesinvolved, leading to different forms of opacity of thebody and, subsequently, an alienation of the self fromthe world. Thus, the body may regain its pure materi-ality and turn into an obstacle; this is the case insevere depression, which may be described as a reifi-cation or corporealization of the lived body. On theother hand, the subject may also be detached from themediating processes that it normally embodies, result-ing in what may be called a disembodied mind; thiscondition is often found in schizophrenic patients.The loss of the implicit or transparent structure of thebody is described in both contrasting cases, with spe-cial emphasis on disturbances of embodied intersub-jectivity.

KEYWORDS: lived body, transparency, opacity, melan-cholia, schizophrenia, intersubjectivity

HUMAN SUBJECTIVITY is embedded in theworld, with the body acting as its medi-ator. Consciousness as the luminosity

which reveals the world to a subject is the resultof this mediation. Miraculously, our body, a sol-id and material object, is capable of a transfor-mation that turns matter into mind and lets theworld appear. By multifarious assimilations, sen-sorimotor interactions and their further process-ing, the body becomes transparent to the worldwe are living in and allows us to act in it.

The meaning of this transparency of the bodyshould be noted carefully: It implies that con-sciousness is not the final link of a chain ofdeanimated physical processes as Descartesthought it to be. The mind is not a transmundaneasylum of pure subjectivity, but it is the integra-tion of all these living bodily processes, whichrender themselves transparent to the world. Ofcourse, I cannot see my seeing; the biochemicalalterations of the retina and the processing of itssensory input in the brain cannot be observed bythe subject either. But in perceiving the subjectembodies or enacts these processes. Their invisi-

Angelia Fell

new muse

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bility precisely means their transparency. It isthrough them that we perceive, and they areimplicitly present in our act of perceiving, in away similar to the single letters through whichwe read a word without being aware of them.

Embodied consciousness may thus be charac-terized, using a term of Plessner (1981), as medi-ated immediacy. The body is the medium throughwhich we perceive and interact with the world.The constituting processes inherent in consciousexperience are normally unconscious, that is, onlyimplicitly present in our relation to the world. Itis by their means that we perceive the world assuch, and are capable of acting in it according toour goals, as autonomous agents. On the otherhand, this mediacy of embodied consciousness isnot a matter of course, but vulnerable to distur-bances of the mediating processes involved. Sen-sory dysfunctions, motor paralyses, or other le-sions may affect single ways of access to theworld that are normally opened by the body.Moreover, there are major mental disorders inwhich the mediacy of the body is affected as awhole, leading to different forms of opacity. In-stead of being transparent, the body may, as itwere, regain its materiality and turn into an ob-stacle; this is the case in severe depression ormelancholia, which may be described as a corpo-realization of the lived body (Fuchs 2002a). Onthe other hand, the subject may also be separatedfrom the mediating processes that it normallyembodies, resulting in what may be called a dis-embodied mind; this is a condition often foundin schizophrenic patients (Stanghellini 2004). Inboth cases, the relation of the subject to theworld is deprived of its immediacy, leading to afundamental alienation of the self.

In the first part of my paper, I take a closerlook at some of the mediating processes involvedin embodiment, drawing mainly on the phenom-enological literature, with a side glance to neuro-biological findings. On this basis, I analyze in thesecond part the opacity of the body in melancho-lia and in schizophrenia, respectively.

The Transparency ofEmbodied Consciousness

As a medium revealing the world to a subject,the body has to fulfill different tasks: On the one

hand, it has to establish a mutual connection orrelationship between subject and world. On theother hand, the difference between the two polesof the relationship should not be lost, so thatthey are not simply melting into one. Finally, asthe carrier of this relationship, the body never-theless has to conceal itself in order to establishtransparency. How are these tasks effected? Con-sider a simple perceptual example, namely theexperience of feeling the bark of a tree. First,there has to be an affection of the body, broughtabout by its sense of touch. This affection is atthe same time a basic self-feeling of the body, anauto-affection in Michel Henry’s (1963) terms,or the pathic moment of perception, as ErwinStraus (1966) put it. This self-feeling or auto-affection is present in every perception; aware-ness of the world always includes a tacit aware-ness of oneself in relation to the world. In a sense,the embodied subject is itself this relationshipthat relates to itself, to use Kierkegaard’s terms(1989). The self-referentiality that is rooted inthe auto-affectivity of the body is indeed impart-ed to all our perceptions, actions, and thoughts.

Furthermore, touching an object requires notonly an affection of the body, but also a distinc-tion of the perceiver and the perceived. At firstsight, this is brought about by the resistance ofthe tree to the touching hand. But this felt resis-tance presupposes an implicit awareness of thebody’s own movement, a sense of agency. Be-cause the world is disclosed by the interactionsof the body with its environment, there has to bean awareness of the source of action. Agency isbased on a bodily sense of potentiality—of beingable to move—as well as on the actual proprio-ceptive and kinesthetic sensations of movement.On the neurophysiologic level, it is realized,among others, by mechanisms of forward mod-eling, efferent copy, and action monitoring (Geor-gieff & Jeannerod 1998; Jeannerod 1994). Agen-cy as self-movement of the body is the necessarycomplement to its self-affection; together theyform the basic self-awareness or self-referentiali-ty of embodied consciousness.

Now it is through the affection of my movingbody that I can feel the roughness and structureof the bark. Slightly shifting my attention, I cometo experience the modification of my touchinghand as the surface I am palpating. Auto-affec-


tion turns into hetero-affection, or in Straus’terms, the “pathic” turns into the “gnostic” mo-ment of perception (Straus 1966). Through myfeeling I perceive the surface of the tree; and aswe can see in a blind person reading Brailleletters, the single touchings may even becomecarriers of significance. Thus both self-affectionand self-movement of the body are operative inthe intentional arc by which the embodied selfrelates to the world. But while reading, the blindperson is not aware of her fingertips any more.Instead she intends the words through her mov-ing fingers; they have acquired semantic trans-parency, so to speak.

Michael Polanyi (1967, 1969) has analyzedthis transparent structure of embodied percep-tion as an interplay between the “distal” pole,that is, the thematic, explicit, or focal object ofawareness, and the “proximal” or bodily pole,which recedes from awareness and is knownonly in a tacit, implicit, and prereflective manner.The following quotation from Polanyi conveysthe essence of this transparency:

Our body is the only assembly of things known al-most exclusively by relying on our awareness of themfor attending to something else . . . Every time wemake sense of the world, we rely on our tacit knowl-edge of impacts made by the world on our body andthe complex responses of our body on these impacts.(1969, 147f)

Transparency is based on an “as-structure”: Wecome to experience our bodily affections as theobjects that we perceive or act upon. Drew Leder(1990) has elaborated this structure in detail inhis phenomenology of the “absent body”: Inas-much as we perceive or act through an organ, hewrites, “it necessarily recedes from the perceptu-al field it discloses.” Thus as a medium, the bodywithdraws in the tacit dimension; “it concealsitself precisely in the act of revealing what isOther” (Leder 1990, 14, 22). The transparencyof the body arises precisely from the embodiednature of mind.

Now this implicit or transparent structure isnot just an innate property of the body, butdevelops and constantly changes over time. Thishas come to be explored mainly in the last de-cade under the heading of “implicit” or “proce-dural memory” (Schacter 1987, 1996). It meansan unconscious knowing-how, based on process-

es of gestalt formation that finally enable us tograsp meaningful schemas, or perform integrat-ed actions, without still being aware of theirsingle elements. What was once analyzed, per-ceived, or performed piece by piece is integratedand incorporated as a novel skill. Thus, we havelearned to read single letters as words and sen-tences. Or we know how to dance without stillnoticing the single movements or being able toexplain it.

The tacit knowledge or knowing-how of thebody implies all the taken for granted that hasbecome part of our body repertoires, habits, anddispositions. By repetition and practice, an im-plication has taken place, connecting single ele-ments of movement and perception to unifiedwholes (Fuchs 2001). The couplings are learnedand forgotten at the same time, thus simplifyingour everyday performance. We do not have tothink of how we do something, and are free todirect ourselves to the aims we choose. Implicitknowledge thus corresponds to Husserl’s “pas-sive syntheses” (Husserl 2001) or Merleau-Pon-ty’s “operative intentionality,” as a chain of con-nected elements which carry the intentional arcof perception or action (Merleau-Ponty 1945/1962, xvii, 137, 243).

On the neurobiological level, these implica-tions are mainly based on intramodal and inter-modal connections between different modules,especially on sensorimotor feedback loops. ForBraille readers, for example, the cortical repre-sentation of the reading finger is extended andcoupled with language centers (Pascual-Leoneand Torres 1993). For musicians, the connectivi-ty between acoustic and motor areas is increased;hence, hearing a melody may automatically evokethe corresponding motor programs of the fingers(Bangert and Altenmueller 2003). Finally, pat-terns of movements are stored in the basal gan-glia as a “sequence memory,” allowing for thefluid interplay of agent and object in complexseries of maneuvers (Ennen 2003). As a result,the body schema, for example, of the pianist hasincorporated the instrument, so that he lives in itlike a limb and inhabits the expressive musicalspace it opens, without paying attention to his orher single movements. One of the principal func-tions of the brain is the intra- and intermodaltransformation of single elements into integrated

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wholes, thus providing the basis for the transpar-ent or “as” structure of the body (Fuchs 2002b).

To complete this short outline of the body’stransparency, I will point out its role in affectivi-ty and intersubjectivity. When I am moved by anemotion, I do not think of my body; yet beingafraid is not possible without feeling a bodilytension or trembling, a beating of the heart or ashortness of breath, and a tendency to withdraw.It is through these sensations that I am anxiouslydirected toward a frightening situation. In emo-tions, we experience atmospheres, situations, andsocial relationships in a holistic way; but we doso through our bodily sensations, by bodily reso-nance or affectability. Thus, there is an implicitor “as” structure effective here as well, carryingthe intentional arc of emotions. In Heidegger’sterms, mood and emotions are “world-disclo-sive,” but they can be so only for an embodiedsubject. Similarly, as Leder points out, corporealstates such as hunger, thirst or sexual craving arenot simply internal sensations but modes to ex-perience a state of lacking something neededfrom the environment. “Such biological urgescolour the perceived world,” pointing to possiblesources of gratification and satisfaction (Leder1990, 21).

The “as” structure of the body is also effectivein expression and communication. Thus, we un-derstand the gestures and facial expression ofothers immediately but cannot tell from whichdetails; through the sounds of their voices, turn-ing into carriers of meaning, we understand whatthey want to say. Moreover, there is an implicitresonance between their expressions and our ownbodily and emotional reactions. By an emotionalcontagion (Hatfield, Cacioppo, and Rapson1994), another’s tears may make me feel sad, or Imay be infected by his laughter. The body worksas a tacitly “felt mirror” of the other. It elicits anoninferential process of empathic perceptionthat Merleau-Ponty called “transfer of the cor-poreal schema” and which he attributed to aprimordial sphere of “intercorporeality”:

The communication or comprehension of gesturescomes about through the reciprocity of my intentionsand the gestures of others, of my gestures and theintentions discernible in the conduct of other people. It

is as if the other person’s intentions inhabited my bodyand mine his. (Merleau-Ponty 1945/1962; my italics)

We may speak of a “mutual incorporation” (Le-der 1990, 82) in which our own body schemaextends and embodies the other. Infant researchhas shown that even newborn babies are able toimitate the facial expressions of others. By themimetic capacity of their body, they transposethe seen gestures and mimics of others into theirown proprioception and movement (Meltzoff andMoore 1977, 1989). Because bodily mimesisevokes corresponding feelings, a mutual emo-tional resonance or attunement ensues. By tacitlyimitating the mother’s expression, voice, andmovements, the baby gradually learns to feelwhat she feels. By this implicit learning, the in-fant’s body gradually becomes a medium forempathy and the nonverbal understanding ofothers (Fuchs 2001, 2003).

It is important to note that in this context the“as” structure of the body has turned into an“as-if” structure. Already in agency, the prepara-tion of action implies a virtual modeling of therelevant motor schema. When I am preparing fora jump over a ditch, my body produces a phan-tom of the movement and projects it into space,as if it were already there. A similar modeling ofaction occurs in the face of objects to be dealtwith, for example, a cup or a football. Lookingat such objects means to tacitly simulate poten-tial action (Gallese and Umiltà 2002). On theneurobiological level, this may also be demon-strated by positron emission tomography (PET)brain imaging: While subjects are looking at tools,the cortical premotor areas normally active intheir handling are activated as well (Grafton etal. 1997). Now in intersubjective perception, thebody acquires the capacity to put itself virtuallyin the place of another body and to transpose theperceived actions into its own motor schema.Again a correlate may be found on the neuronallevel: The “mirror matching system” discoveredin the premotor cortex seems to provide the coremechanism for this sensorimotor integration (Riz-zolatti et al. 1996). “Although we do not overtlyreproduce the observed action, nevertheless ourmotor system becomes active as if we were exe-cuting that very same action that we are observ-


ing . . . action observation implies action simula-tion” (Gallese 2001).

Moreover, it is not just the movements, butprecisely the intentional, goal-directed actions ofothers by which the mirror matching system isactivated, for example, reaching for a cup orbiting an apple (Gallese 2001). Thus, observingthe other’s movements and gestures implies atransmission of intentions as well. We use theoperative intentionality of our body as an instru-ment for understanding the other’s intentions.The similarity of the representational mechanisminvolved in the preparation of our own actionand the observation of actions performed byothers may explain how we can understand themas “agents like us”, and engage in social interac-tions such as mutual imitation, learning by ob-servation or cooperative action. Thus in intercor-poreity, the “as-if” structure of the body becomesthe very medium of understanding.

Loss of Transparency inMental Illness

So far I have described some of the mainstructures rendering the body transparent for theworld and the others, while at the same timeserving as a medium for our intentional activity.Now I explain how this transparency and media-cy may be clouded or lost in mental illness, lead-ing to some kind and degree of opacity of thebody instead. My first example concerns melan-cholic depression.1

Melancholia as a Corporealizationof the Self

In melancholia, the body loses the lightness,fluidity, and mobility of a medium and turns intoa heavy, solid body that puts up resistance to thesubject’s intentions and impulses. Its materiality,density, and weight, otherwise suspended andunnoticed in everyday performance, now cometo the fore and are felt painfully. Thus, melan-cholia may be described as a reification or corpo-realization of the lived body (Fuchs 2002a). Themelancholic patient experiences a local or gener-al oppression, anxiety, and rigidity (e.g., a feelingof an armor vest or tire around the chest, lump in

the throat, or pressure in the head). Sense per-ception and movement are weakened and finallywalled in by this rigidity, which is visible in thepatient’s gaze, face, or gestures. To act, patientshave to overcome their psychomotor inhibition andpush themselves to even minor tasks, compensat-ing by an effort of will what the body does not haveby itself any more. With growing inhibition, theirsensorimotor space is restricted to the nearestenvironment, culminating in depressive stupor.2

Corporealization thus means that the bodydoes not give access to the world, but stands inthe way as an obstacle, separated from its sur-roundings: The phenomenal space is not embod-ied any more. However, this is not only due topsychomotor inhibition (which would not distin-guish depression in principle from tiredness, pa-ralysis, or Parkinson disease3). Rather, the con-ative dimension of the body, that is, its seekingand striving for satisfaction, is missing. Normal-ly, it is this dimension that opens up the periper-sonal space as a realm of possibilities, “affor-dances”, and goals for action. In depressivepatients, however, drive, impulse, appetite, andlibido are reduced or lost, no more capable ofdisclosing potential sources of pleasure and satis-faction. As a result, the patient’s imagination, thesense of the possible, fails to generate futuregoals and plans, leaving the self confined to thepresent state of pure bodily restriction. Thus thedepressive person cannot transcend her body anymore, neither in space nor in time, which is whatwe normally do when the body serves as themedium for our intentions and actions.

In addition, a loss of vitality in many systemsof the organism occurs, which further restrictsthe space of the lived body. The exchange withthe environment is inhibited, excretions cease;processes of slowing down, shrinking, and dry-ing up prevail. All this literally means a corpore-alization, in the sense of resembling a corpse, adead body. Hence, depressed people are preoccu-pied with bodily malfunctions or possible diseas-es; hypochondriacal delusions mostly relate to arestriction, constipation, or shrinking of the body,which is experienced as decaying from within oreven dying. However, this decay also affects theself in its core: The depressive person cannot

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retain a position outside of her body, but isdragged into its ruin and destruction. She herselffeels shrinking, decaying, and rotting.

So far, the opacity of the body in melancholiaseems obvious. But there is also a more subtleloss of transparency: It concerns the bodily reso-nance or affectability that mediates our experi-ence of emotions and atmospheres, and is alsorequired for our affective attunement with oth-ers. In melancholia, the corporealized and frozenbody loses this capacity of emotional resonance.4

Loss of feeling means at least a partial loss ofself. Hence, affective depersonalization is the clin-ical core feature of the most serious melancholicepisodes (Kraus 2002; Stanghellini and Fuchs2004). These patients feel inanimate, detachedfrom their emotions and their environment. Theyare no longer capable of being moved and affect-ed by things or persons; the attractive and sym-pathetic qualities of their surroundings have van-ished. Thus they speak of a “feeling of not feeling”and complain of not even being able to experi-ence feelings for their family any longer.

The depersonalization in severe melancholiaculminates in the so-called nihilistic delusions orCotard’s syndrome, formerly called melancholiaanaesthetica (Enoch and Trethowan 1991). Itmay be understood as a separation of the “pure”,unaffected consciousness from the corporealizedbody, whose depressive heaviness now changesinto the opposite, namely, a feeling of lightnessor even a complete loss of bodily sensations:Proprioception, taste, smell, and even the senseof warmth or pain are missing. At the same time,the environment looks dead; persons and objectsseem hollow and unreal, the whole world is emp-tied. The patients may conclude that they havealready died and ought to be buried. Sometimesthey even deny their own existence or the exist-ence of the world. In such states of utter deper-sonalization, the mediacy of the lived body is lostcompletely, leaving a dead world behind:

A 61-year old patient of mine, suffering from recur-rent depression, felt that her inner body, her stomachand bowels had been contracted so that there was nohollow space left. The whole body, she said, was driedout and decayed, her limbs and muscles were com-pletely stiff; nothing did move any more. She sensed

neither heat nor cold and could no longer smell ortaste the meal. The surroundings seemed all pale andmeaningless to her. She even could no more imagineanything, neither the furnishings of her flat nor theface of her daughter whom she had seen only recently.Finally she was convinced that all her relatives haddied, that she was alone in the world and had to live ina dead body for ever.

To summarize, the person affected by melancho-lia collapses into the spatial boundaries of herown solid, material body (Stanghellini and Fuchs2004). Instead of transcending the body, she be-comes completely identified with it.5 Therefore,the heaviness and rigidity of the body is notsimply experienced as a lack of bodily function,as with a paralytic patient or with a patientaffected by Parkinson’s disease. For them, bodilyimpairment remains more or less peripheral totheir core self. The melancholic patient, however,is not able to detach herself from the experienceof bodily failure and therefore feels worthless,guilty, or decaying; she is corporealized in hervery self. Only in the nihilistic culmination ofmelancholia, the self disconnects from the corpo-realized body, but at the price of losing its senseof being alive.

The German philosopher Helmut Plessner(1981) coined the term excentric position to char-acterize the ambiguous relationship of the em-bodied human subject with its environment. Ex-centricity is continuous oscillation between beinginside of one’s body, in the center of one’s world,and being outside of it, in reflective distancefrom pure centricity. This flexibility is based onthe human faculty of transcending the here andnow and adopting the other’s perspective on one-self. In severe melancholia, however, the excen-tric position collapses and gives way to an ego-centric state of corporealization that the patientis unable to transcend. Melancholic delusion isthe hallmark of this loss of intersubjectivity: Theother is separated by an abyss and cannot bereached any more.

Schizophrenia as a Disembodiment ofthe Self

Now I turn to my second example of opacity,the disturbance of the self in schizophrenia. Incontrast to the melancholic corporealization, phe-


nomenological analyses suggest that the schizo-phrenic person suffers from what may be called adisembodiment of the self. She does not “inhab-it” her body any more, in the sense of using astaken for granted its implicit structure, its habitsor automatic performances, as a medium forrelating to the world. Parnas and Sass have ana-lyzed, in a number of seminal papers, how theschizophrenic psychopathology may be derivedfrom a diminished self-affection on the one hand,and a compensatory “hyperreflexivity” on theother (Parnas 2000; Parnas and Sass 2001; Sass2000). The tacit self-awareness or self-referenti-ality present in every experience is weakened orlost, and an alienation of perception and actionresults. The result may be described as a frag-mentation of the intentional arcs of perceiving,feeling, thinking, and acting. This in turn leadsto a pathologic explication of the implicit ortransparent structure of the body. In what fol-lows, I analyze some of the resulting phenomena,before finally turning to schizophrenic disordersof embodied intersubjectivity.

Fragmentation of the Intentional Arc

“Explication of the implicit” is an experiencewell-known to us: By reducing a schema or ge-stalt to its single elements, the transparent “as”structure is lost, and we do not see, as it were, theforest for the trees any more. Thus, when look-ing for a typing error, we cannot attend to themeaning of the text at the same time. Or if werepeat a familiar word several times slowly andaloud it may sound strange to us: The implicitcoupling of syllables and meaning is dissolved. Inthe same way, when thematizing a part of thebody, it no longer functions as part of tacit knowl-edge. If the musician concentrates on his singlefingers, he stumbles in his run, as we do also ifwe concentrate on individual steps while runningdown the stairs. Explication thus disturbs formerfamiliarity and leads to an alienation or disinte-gration.

Now in schizophrenia a “pathologic explica-tion” occurs.6 Following Blankenburg (1971),the basic disturbance may be regarded as a lossof implicit knowledge and “common sense”, thatis, of familiarity with the world and with others.

Patients often experience a disintegration of hab-its or automatic performances, a “disautoma-tion”. The dissolution of implicit schemas maybe increased by secondary attention and hyperre-flexivity, similar to the examples mentioned be-fore (Sass 2000); in schizophrenia, however, thisdissolution is primarily rooted in the loss of tacitself-awareness, which is necessary for the inte-gration of passive syntheses to form the inten-tional arc.7 Pathologic explication is the result ofthe fragmentation of bodily intentionality itselfrather than the result of a compensatory hyper-reflexivity.

A case vignette from our department may il-lustrate this alteration (Buergy 2003):

A 32-year old patient reports that at the age of 16, hehad become more and more uncertain about whetherhis personal things really belonged to him or hadsomehow been exchanged by others. When buyingbooks, he was not sure if the salesman had not secret-ly replaced the ones he had chosen; so he had to givethem away and always buy new ones. When leavingthings on his school-desk inattentively, he later beganto doubt whether they were still the same, and had tothrow them away. More and more he lost the trust inhis environment. At the age of 21, he also began todoubt whether it were really his own arms that did awork or somebody else’s. He had to carefully observehis arms from the hands up to the body in order tomake sure that they were his own, and he repeatedlylooked behind himself in order to see if there was notsomebody else who moved them. Now he could nottrust his own hands any more, and doubted the sim-plest actions. He took endless time to dress, since hehad to touch the cloths several times and had torepeat his movements again and again to make surethey were his own. He did not know whether he heldhis trousers the right way and in which order to dress.Every movement was like an arithmetical problemthat had to be pondered over with extreme concentra-tion. So he became stuck in his everyday performanc-es and felt more and more desperate.

For this patient, the loss of the basic self-aware-ness first manifests in his distrust in the owner-ship of his belongings. In vain he struggles tofight the growing alienation of his personal sur-roundings. Then the tacit “mineness” or agencyof his own movements is weakened, and theunits of meaningful actions are deconstructed.To compensate for this disautomation, the pa-

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tient has to prepare and produce each singleaction deliberately, in a way that could be calleda “Cartesian” action of the mind on the body.But even then he cannot be sure that they are notactually performed by somebody else. The inten-tional arc mediated by the tacit bodily feeling of“I can” is broken. Schizophrenic patients oftenspeak of a split between their mind and theirbody, of feeling hollowed out, like a machine ora robot; for the sense of animation depends onbeing an incarnated subject, with integrated bodi-ly performances at one’s disposal. The disauto-mation of action may culminate in a loss ofagency, rendering the patients incapable of will-fully releasing any action they intend to perform.The resulting stupor sometimes resembles a se-vere melancholic inhibition, but is quite differ-ent, because the latter is not a disorder of will oragency but results from a loss of drive and im-pulse.

In perception, the loss of the “as”-structure ortransparency in schizophrenia manifests itself inan impaired capacity to recognize familiar pat-terns or gestalten, which in turn leads to anoverload of details. Thus, for example, the fea-tures of familiar faces may come to look odd ordistorted like masks. A schizophrenic patient ofMinkowski illustrates another example of patho-logic explication, the loss of semantic transpar-ency: “He can no longer read at all. He becomesattached to a word, a letter, and does not attendto the meaning of the sentence. He examineswhether all the ‘i’s have dots over them, whetherthere are accents where needed, whether all theletters have the same form” (Minkowski andTargowla 2001). Here the single elements losetheir function as carriers of intentional meaning.With growing alienation of the intentional arc,even the act of perceiving itself may come toawareness; then the patient is like the spectatorof his perceptive processes. “I become aware ofmy eye watching an object,” a patient reports(Stanghellini 2004, 113), or “I saw everything Idid like a film-camera” (Sass 1992, 132). Thisdisembodiment and alienation of perception turnsthe objects into mere appearances or phantoms;hence the artificial, enigmatic, and uncanny al-teration of the environment experienced espe-

cially in the early stages of the illness (Fuchs2005). Thus, instead of constituting an objectiveworld, schizophrenic perception gets trapped ina subjective or opaque view.

In a similar way, the mediating and world-disclosive function of emotions is disturbed orlost. As has been shown, it is through bodilysensations and resonance that we experience emo-tions and are emotionally related to our presentsituation; the same applies to drives and desires.This intentional arc of emotions and drives istypically fragmented in schizophrenia. Somaticsensations normally experienced as the tacit me-dium of an attitude or affect are detached fromtheir motivational context and obtain an object-like quality (Sass 2000). This leads to a sense ofartificiality and distance, both in the patient’sexperience of an emotion and in the expressionvisible to others. Even if the emotion is felt, itsmeaning remains obscure to the patient. Thus,one of my patients reported that she often felt apressure on her tear glands; she then had to crywithout being aware of a motive, and it felt as ifshe were made sad. Here the intentional contentof the emotion is only grafted on the sensationsubsequently, so to speak. Similarly, normal sen-sations of sexual desire, hunger, or other visceraland muscular sensations may lose their contex-tual meaning and come to be explicitly experi-enced as cenesthesias, strange, unpleasant, andobject-like states of tension, movement, pulling,pressure, or electric flow, which more and moreappear to be caused by an outside source manip-ulating the patient’s body.

Disorders of Embodied Intersubjectivity:A Short Circuit of Bodily Simulation?

The dissolution of the intentional arc finallyleads to the experience of alien influence, as wasalso the case in the patient mentioned earlierwho felt his arms moved by another person. Theloss of basic self-awareness and agency may gen-erate a sense of alien control characteristic ofschizophrenia, which I now attempt to explainas a disturbance of embodied intersubjectivity.

As I have pointed out, in the preparation ofaction as well as in intercorporeal perception,the “as”-structure of the body implies an “as-if”


structure. The body schema serves as a virtualmodel for simulating one’s own future actions aswell as for understanding the actions of others.In the latter case, as we have seen, this modelingimplies an implicit ascription of intentions toothers as well. Thus, simulation is the means ofunderstanding others by using one’s own body asa mirror of their intentions and attitudes; inother words, by simulation the body obtainsintersubjective transparency. As Merleau-Pontystates, it is “as if the other person’s intentionsinhabited my body, and mine his” (see above).Now we may hypothesize that in schizophrenia,with the weakening of the sense of agency, ashort circuit of action modeling occurs, and thecrucial discrimination between one’s own andanother’s agency is lost. Thus, the virtual “as if”stated by Merleau-Ponty becomes an actual “as-if” for the patient: “It is as if another personwere standing behind me and moving my arms.”This finally leads to the delusional misattribu-tion of movements to an alien agent. Delusionsof control are thus not based on mistaken cogni-tive inferences, but on an immediate sense ofalterity in the experienced movement itself.

Of course this proposed short circuit wouldhave to be identified on the neurobiological levelas well.8 In fact, there is growing evidence for asubstantial overlap between the representationalnetworks underlying preparation and monitor-ing of one’s own action (“intention-in-action”)and the networks responsible for the observationof another person’s action (Blakemore and De-cety 2001; Chaminade et al. 2001; Chaminade,Meltzoff, and Decety 2002; Gallagher 2004; Jean-nerod 2001). This overlap in simulated actionrequires a secure self–other discrimination; a num-ber of neuroimaging studies have demonstrateda crucial role of the right inferior parietal cortexin this task. Thus PET studies by Farrer and Frith(2001) have shown contrasting activation in theright inferior parietal cortex for perception ofaction caused by others, and in the anterior insu-lae bilaterally when action is caused by oneself.Another PET study by Ruby and Decety (2001)found a specific activation of the left inferiorparietal lobe when the subject imitated anotherperson, whereas the right inferior parietal lobe

was activated when that person reciprocally imi-tated the subject. In contrast to this, Spence et al.(1997) found that schizophrenic patients withfeelings of alien control show increased activityin the right inferior parietal lobe during a move-ment task, as if their brain were activating theobservational mirroring system at the same time,resulting in a breakdown of the self–other dis-crimination. Moreover, Frith and Done (1989)as well as Mlakar, Jensterle, and Frith (1994),found in such patients an impaired propriocep-tive awareness of their own actions, pointing to aloss of agency that could make them vulnerablefor the proposed short circuit of action simula-tion.

What may we conclude from these prelimi-nary results? Obviously, bodily self-awarenessand the perception of the other share to a largepart the same neurobiological foundations. Thisis in precise accordance, on the phenomenologi-cal level, to Merleau-Ponty’s “transfer of thebody schema” in intersubjective perception. Theoperative intentionality of the body serves as aninstrument for understanding the other’s inten-tions; meaning is assigned to the other’s actionsby implicitly matching them to one’s own. How-ever, the virtual use of the body in the “as-if” -mode of action modeling is obviously vulnerableto misattributions. With the weakening or loss ofthe sense of agency, the crucial distinction of selfand other which has to be kept up in the “as-if”mode breaks down. Consequently, the agency ofone’s movements seems to come from the out-side, and an inversion of intentionality results(Fuchs 2003): Now another person’s intentionsliterally inhabit the patient’s body. Thus, accord-ing to the proposed hypothesis, the very capacityof the body to model the intentional behavior ofothers would be perverted into the experience ofalien control.

The disturbance of embodied intersubjectivityis not restricted to the domain of movement. Itmay also affect the sphere of expression andappearance, as is shown by the following case ofa 28-year-old female patient:

For some time I had a feeling as if my clothes did notseem appropriate any more. My gait had changed, Iwalked stiffly and did not know how to hold my

104 ■ PPP / VOL. 12, NO. 2 / JUNE 2005

hands. Then I often looked into the mirror and foundthat my facial expression had changed, and I began tothink that I might be regarded as a prostitute. Menlooked so strange at me . . . I took passport pictures ofmyself in order to examine whether I only imaginedthat. Then I began to feel a kind of charging ortension in my body when others came near to me, as ifit were passing over from them. Finally I thought Ishould be made a prostitute by brain manipulation . . .(Fuchs 2000, 165)

In this case, there is an “as-if” structure or inter-nal modeling involved as well. For our body alsoincorporates attitudes and role models by acquir-ing postures, expressions, and habits that wehave unconsciously taken over from others. Wemay even deliberately adopt such attitudes in asuitable situation, like an actor is used to doing.For example, the attitude of a judge implies acertain bodily posture, tone of voice, a feelingand comportment of seriousness, and so on. Ac-cording to G. H. Mead (1962), role taking essen-tially means to adopt attitudes from others, whichis accomplished by imitating their bodily expres-sion, comportment, clothing, and so on: our bodyis inhabited by their attitudes. Thus, our bodyimage usually includes a variety of stances andmodels that we are capable of adopting in the“as-if” mode. The experience of the mirror im-age is the paradigm of this virtuality, which al-ready by itself bears the seeds of alienation.

Now, for the patient, her own bodily stanceand expression somehow does not “fit” any more.Instead of being transparent for, or representingherself, her bodily exterior becomes opaque andalienated. The intercorporeal sphere has turnedunfamiliar and artificial, thus reminding her ofprostitution. Now the “as-if” mode of bodilystances again becomes the gateway for an inver-sion of intentionality: It is as if her attitude andappearance were made by others turning her intoa prostitute. As we can see, it is not only thesimulation of action, but also the body’s socialmodeling of expression and behavior that is vul-nerable to a short circuit of self and other, lead-ing finally to psychotic alienation.

A last case example may once more illustratethe break down of the “as-if” mode on which thetransfer of the body schema is based:

When I am looking into a mirror, I do not know anymore whether I am here looking at me there in themirror, or whether I am there in the mirror looking atme here. . . . If I look at someone else in the mirror, Iam not able to distinguish him from myself any more.When I am feeling worse, the distinction between meand a real other person gets lost, too. While watchingTV, I don’t know any more, whether I am speaking inthe TV-set or whether I am hearing the words here. Idon’t know whether the inside turns outwards, or theoutside inwards . . . Are there perhaps two ‘I’s? (Kimura1994, 194)

Here it is precisely the virtuality of the mirrorimage that undermines the “as-if” mode andbegins to shake the sense of self. While lookingat the mirror, the patient cannot maintain hisown embodied centre any more. This is general-ized to the perception of virtual images in the TV,and to the perception of others. The “as-if” modeof the transfer of the body schema breaks down,resulting in a disembodiment and split of the self.As we can see, the conditions of the possibility ofsuch a break-down are rooted in the dialecticalstructure of intersubjectivity and intercorporeity.Of course, when we look at another person, wedo not become her; the distinction of perceiverand perceived implies a continuous oscillationbetween one’s own embodied center and the sim-ulation of the other’s stance and perspective.One could also say that every perception of theother implies a disembodiment inhibited in statunascendi. It is this dialectical tension of man’s“excentric position” (Plessner 1981) that theschizophrenic person cannot keep up any more.Whereas melancholics are imprisoned in theircorporealized centricity, the schizophrenic pa-tient is lost “in the orbit”, in a disembodied,imaginary, and delusional view from the outside.Thus, it is precisely the highly developed socialperception of man, his capacity to take the viewof others and to put himself in their position bybodily simulation, that renders him vulnerablefor the loss of his self in schizophrenia.9

ConclusionI have described two different ways in which

the transparency of the body turns into opacity.In melancholia, the self is corporealized, impris-


oned, as it were, in its rigid and solid body as in aplatonic dungeon, and it becomes unable to tran-scend the body any more. In contrast to this, adisembodiment of the self occurs in schizophre-nia, caused by a loss of the basic self-awarenessin which all intentional acts are normally embed-ded. This results in a fragmentation and dissolu-tion of the intentional arc, and in a pathologicexplication of the implicit structure of the body.The “mediated immediacy” of the subject’s rela-tion to the world is lost. By an inversion ofintentionality, the remaining fragments of theintentional arc may even acquire the quality ofalien influence and control. Thus, in melancholiathe opacity and solidity of the body excludes theworld, whereas in schizophrenia the body as amedium distorts reality in a way that renders theperson all the more vulnerable to its impact andfinally entangles her in an imaginary view fromthe outside.

Both in melancholia and in schizophrenia, theself is fundamentally affected by the opacity ofthe body, and a state of depersonalization results(Stanghellini and Fuchs 2004). But in the melan-cholic patient, this state is caused by an inabilityto transcend the body and get in touch with herenvironment. She is identified with her state ofloss of feeling, and feels painfully guilty about it.Except for extreme cases, there is no second selfdetached from its body that remains uninvolvedand observes this state from the outside. On thecontrary, schizophrenic depersonalization resultsfrom a divorce of the self from its body that itcomes to experience as a Cartesian machine thatmay be steered by anonymous and alien forces. Themelancholic patient is imprisoned in his own body,whereas the schizophrenic patient does not inhab-it his body any more. Thus, in their distinctiveways both melancholia and schizophrenia illus-trate the essentially embodied nature of the self.

Notes1. In present psychiatric nosology, melancholia is

depressive episode with a typical syndrome includingpsychomotor inhibition and loss of emotional reso-nance, drive, appetite, and weight. This corresponds toa large extent to the former “endogenous depression”.Although its strict separation from other forms ofdepression is no longer tenable, the following descrip-

tion of depressive experience applies mainly to thistype, not for example, to dysthymia or depressive ad-justment disorder.

2. On the other hand, the restriction of the bodymay be counteracted by physical exercise, which helpsto unfold bodily vigor and expansion, with a demon-strable relieving effect on depression (Byrne and Byrne1993).

3. In this way, Leder has described what he calls the“dys-appearance” of the body in illness in general(Leder 1990, 83ff): The sick body stands between thesubject and the world, as “an obstinate force interfer-ing with our projects” (p. 84). However, as we will see,depression adds more to this general phenomenon:Here the patient herself is identified with the failureand opacity of the body; she cannot retain an indepen-dent position, which acquits her of failure and guilt.

4. The only remaining emotions, such as guilt, anx-iety, or hopelessness, show common characteristic fea-tures: (1) they do not connect, but separate the subjectfrom the world and from the others, (2) they are rigidand immovable in character, and (3) they are part ofthe prevailing mood rather than specific feelings; there-fore their intentional objects are just as ubiquitous asarbitrary. In advanced stages of depression, such emo-tions turn into continuous states of agony, and it maybe doubted whether they could still be called emotionsat all.

5. Kraus (2002) and Stanghellini (2004, 140ff.)have therefore analyzed the melancholic depersonal-ization in terms of a disorder of identity: The premor-bid overidentification of the melancholic type with hissocial role (as an “exoskeleton”, as it were) collapses inthe illness, leading to a perception of himself as emptyor dead.

6. See also Fuchs (2001). A similar approach hasbeen taken by Stanghellini (2004, 175f.).

7. In a recent paper, I described the fragmentationof the intentional arc as a disintegration of the tempo-ral microstructure of consciousness (connecting reten-tions and protentions) as described by Husserl in his“Phenomenology of the inner time consciousness”(Fuchs in press).

8. See Gallagher (2004) for a detailed discussion.9. The etiology of this disembodiment in schizo-

phrenia is an issue that cannot be dealt with here.Growing evidence points to the assumption that it maybe based on an early neurodevelopmental disorder,with disruptions of neural connectivity and faulty mat-uration of the brain, manifesting itself in early motorabnormalities and impaired learning of cognitive andsocial skills (see de Haan and Bakker 2004 for a recentoverview). Thus, there seems to be an early weakeningof the embodiment or “incarnation” of the self.

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