Patients suffering from the Cotard syndrome can deny being alive, having guts, thinking or even existing. They can also complain that the world or time have ceased to exist. In this article, I argue that even though the leading neurocognitive accounts have difficulties meeting that task, we should, and we can, make sense of these bizarre delusions. To that effect, I draw on the close connection between the Cotard syndrome and a more common condition known as depersonalisation. Even though they (...) are not delusional, depersonalised patients seem to have experiences that are quite similar to those of Cotard patients. I argue that these experiences are essentially characterised by a lack of subjective character and of two other structural features of experience, which I call ‘the present character’ and ‘the actual character’. Cotard's nihilistic delusions simply consist in taking these anomalous experiences at face value. (shrink)

Basic self-awareness is the kind of self-awareness reflected in our standard use of the first-person. Patients suffering from severe forms of depersonalization often feel reluctant to use the first-person and can even, in delusional cases, avoid it altogether, systematically referring to themselves in the third-person. Even though it has been neglected since then, depersonalization has been extensively studied, more than a century ago, and used as probe for understanding the nature and the causal mechanisms of basic self-awareness. In this paper, (...) I argue that depersonalized patients indeed have an impaired basic self-awareness, and that their study allows us both to favor one specific theory of basic self-awareness and to understand what is wrong with its rivals. According to the favored theory, which I call Cartesian, we are basically self-aware in virtue of being acquainted with ourselves through introspection. (shrink)

Basic self-awareness is the kind of self-awareness reflected in our standard use of the first-person. Patients suffering from severe forms of depersonalization often feel reluctant to use the first-person and can even, in delusional cases, avoid it altogether, systematically referring to themselves in the third-person. Even though it has been neglected since then, depersonalization has been extensively studied, more than a century ago, and used as probe for understanding the nature and the causal mechanisms of basic self-awareness. In this paper, (...) I argue that depersonalized patients indeed have an impaired basic self-awareness, and that their study allows us both to favor one specific theory of basic self-awareness and to understand what is wrong with its rivals. According to the favored theory, which I call Cartesian, we are basically self-aware in virtue of being acquainted with ourselves through introspection. (shrink)

This paper traces the manner in which the word ‘psychotherapy’ was invented and how it became taken up and disseminated in the English-, French- and German-speaking medical worlds at the end of the 19th century. It explores how it was used as an appellation for a variety of practices, and then increasingly became perceived as a distinct entity in its own right. Finally it shows how the fate of the word ‘psychotherapy’ enables Freud’s invention of ‘psychoanalysis’ to be located.

If I see, hear, or touch a sparrow, the sparrow seems real to me. Unlike Bigfoot or Santa Claus, it seems to exist; I will therefore judge that it does indeed exist. The “sense of existence” refers to the kind of awareness that typically grounds such ordinary judgments of existence or “reality.” The sense of existence has been invoked by Humeans, Kantians, Ideologists, and the phenomenological tradition to make substantial philosophical claims. However, it is extremely controversial; its very existence has (...) been called into question. This paper aims to clarify the nature and reality of the sense of existence by studying a psychiatric condition in which the sense appears to be disrupted: depersonalization disorder (DPD). (shrink)

Psychoanalysis is sometimes thought to rely on a “pragmatic theory of truth,” whose chief assumption should be that the effectiveness of a treatment counts as evidence for the truth of the interpretations provided during each treatment, and/or the psychoanalytic ontology of mind itself. While there is some support for this claim in psychoanalytic views both on the nature of psychic reality and on clinical practice, it needs qualification. It should not be taken to imply that the theory is true because (...) or insofar as it (clinically) works. What I mean to show is, rather, that psychoanalysis is a distinctive illustration of the pragmatist concept that effective explanations are, in Dewey’s words, “experimental,” and adjust themselves to real processes while changing reality, and indeed by changing reality. Truth enjoys, in psychoanalysis, a peculiar status, being what one might call an emergent property of a relational process. But not just any relational process, even if it “works,” will produce truth. The key of psychoanalytic treatment is transference, and the main pragmatic character of transference is what one may call its theatrical quality. I try to clarify this through a comparison of Freud’s and Pierre Janet’s clinical approaches. (shrink)

It is often said that the advent of the Freudian talking cure around 1900 revolutionised the psychiatric setting by giving patients a voice. Less known is that for decades prior to the popularisation of this technique, several researchers had been experimenting with another, written practice aimed at probing the mind. This was particularly the case in France. Alongside neurologist Jean-Martin Charcot’s spectacular staging of hypnotised bodies, ‘automatic writing’ became widely used in fin-de-siècle clinics and laboratories, with French psychologists regularly asking (...) entranced patients to scribble down words to validate their nascent theories on the divided self. This article traces the emergence of automatic writing in French psychological discourse at the close of the 19th century. By focusing on the early work of Dr Pierre Janet and some of his contemporaries, it re-examines the role played by this practice in what Henri Ellenberger famously called ‘The Discovery of the Unconscious’. It also considers the various levels of reconstruction at play in recent historical accounts. What does it mean to give subjects a (written) voice? How does automatic writing differ from the Freudian talking cure as respective expressions of the unspeakable? And how might these questions inform future historical practice? (shrink)

Illness and trauma challenge self-narratives. Traumatized individuals, unable to speak about their experiences, suffer in isolation. In this paper, I explore Kristeva’s theories of the speaking subject and signification, with its symbolic and semiotic modalities, to understand how a person comes to speak the unspeakable. In discussing the origin of the speaking subject, Kristeva employs Plato’s chora (related to choreo , “to make room for”). The chora reflects the mother’s preparation of the child’s entry into language and forms an interior (...) darkroom, the reservoir of lived experience, from which self-narratives issue. Unable to speak of their suffering, traumatized individuals need someone to help them make room for a time of remembrance, someone who is a willing and capable listener. I call such a person a healing witness . Through the mediating presence of the healing witness, fragmented memories of trauma are recreated and incorporated into self-narratives that are sharable with others. Unfortunately, opportunities for witnessing are vanishing. In the last section, I examine the failure of modern media and communication technologies to bear (“hold,” “carry,” “transport”) acts of witnessing. I argue that they perturb the semiotic. According to Kristeva, meaning arises from the dialectical tension between the semiotic (drives and affects) and the symbolic (logic and rules) and is threatened by arid discourse, psychosomatic illnesses, and outbreaks of violence when the semiotic is not represented . Unless we open technology to the imaginary, we risk losing the capacity to bear witness to one another and to create narratives and connections that are meaningful. (shrink)