Individuals suffering from depression consistently report experiencing a lack of connectedness with others. David Karp (2017, 73), in his memoir and study of depression, has gone so far to describe depression as “an illness of isolation, a disease of disconnectedness”. It has become common, in phenomenological circles, to attribute this social impairment to the depressed individual experiencing their body as corporealized, acting as a barrier between them and the world around them (Fuchs 2005, 2016). In this paper, I offer an (...) alternative view of the experience of social disconnectedness in depression, suggesting that rather than necessarily experiencing their body as object-like, the depressed individual’s bodily is saturated with experiences of lethargy, tiredness, heaviness, sadness, hopelessness and so on, to the exclusion of being able to bodily connect to others. I suggest that depression does not involve a complete social impairment but a specific impairment of affective forms of interpersonal experience. (shrink)

The DSM characterizes major depressive disorder partly in temporal terms: the depressive mood must last for at least two weeks, and also must impact the subject "most of the day, nearly every day." However, from the standpoint of phenomenological psychopathology, the long-lasting quality of the condition hardly captures the distinctiveness of depression. While the DSM refers to objective time as measured by clocks and calendars, what is especially striking about depression is the distortions to lived time that it involves. But (...) is there any relation between a) these disruptions to temporal experience and b) the tendency for depressive symptoms to persist and endure? To explore the connection between lived time and objective time, I investigate the embodied and enactive nature of intentionality among subjects suffering from depression. What I call 'affective framing' is a spontaneous, pre-reflective way of filtering information that involves bodily attunement and allows subjects to focus their attention on what they feel is important. I will argue that affective framing ordinarily has a forward-looking temporal structure and a "teleological direction" that is rooted in our embodiment. However, depression involves a distortion in future-directed intentionality, so that a subject becomes temporally desituated and cut off from the future. This contributes to many of the characteristic features of depression, including apparent lack of motivation, inability to imagine future possibilities, alterations in lived time, and a sense that one is "stuck." To gain a better understanding of this disruption to the futuredirected structure of affective framing in cases of depression, I look to concepts from complex dynamic systems theory and the notion of 'habit.' My proposed account aims to shed light on how a disruption to future-directedness impacts bodily attunement and reinforces depression as a long-term condition. (shrink)

This paper seeks to illuminate the nature of empathy by reflecting upon the phenomenology of depression. I propose that depression involves alteration of an aspect of experience that is seldom reflected upon or discussed, thus making it hard to understand. This alteration involves impairment or loss of a capacity for interpersonal relatedness that mutual empathy depends upon. The sufferer thus feels cut off from other people, and may remark on their indifference, hostility or inability to understand. Drawing upon the example (...) of depression, I argue that empathy is not principally a matter of ‘simulating’ another person’s experience. It is better conceived of as a perception-like exploration of others’ experiences that develops progressively through certain styles of interpersonal interaction. (shrink)

This paper utilizes the enactivist notion of ‘sense-making’ to discuss the nature of depression and examine some implications for treatment. As I understand it, sensemaking is fully embodied, fundamentally affective, and thoroughly embedded in a social environment. I begin by presenting an enactivist conceptualization of affective intentionality and describing how this general mode of intentional directedness to the world is disrupted in cases of major depressive disorder. Next, I utilize this enactivist framework to unpack the notion of ‘temporal desituatedness,’ and (...) maintain that the characteristic symptoms of depression result from a disruption to the future-directed structure of affective intentionality. This can be conceptualized as a loss of “online intelligence” and a shrinking of the field of affordances. Then, I argue that two of the standard modes of treatments for depression, medication and cognitive behavioral therapy, are not fully sufficient means of restoring online intelligence, and that these limitations stem partly from the approaches’ implicit commitment to a brain-bound, overly cognitivist view of the mind. I recommend expressive arts interventions such as dance-movement therapy and music therapy as important supplementary treatment methods that deserve further consideration. Insofar as they revitalize subjects’ bodies and emotions, cultivate an openness to the future, and promote self-insight and social synchrony, these treatment modes not only reflect key insights of enactivism, but also offer great potential for lasting healing. (shrink)

Depression is an affective disorder involving a significant change in an individual’s emotional and affective experiences. While the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition mentions that social impairment may occur in depression, first-person reports of depression consistently name isolation from others as a key feature of depression. I present a phenomenological analysis of how certain interpersonal relations are experienced in depression. In particular, I consider whether depressed individuals are able to enter into “we-experiences” with other people. We-experiences (...) are experiences had with two or more people as a we, experiences that allow one to enter into robustly shared experiences with others. I claim that the ability to enter into we-experiences is eroded in depression due to an overwhelming feeling of being different to and misunderstood by others. As such, I suggest that depression should be conceived of as fixing an individual in their first-person singular perspective, thus inhibiting their ability to experience in the first-person plural and to feel a sense of connectedness or togetherness with others as part of a we. By attending to on-going impacts of a diminished ability to enter into we-experiences, we can provide a situated and more nuanced account of the changes of interpersonal relations in depression that captures the progressive nature of the disorder. In turn, this analysis furthers our understanding of the emergence, frustration, and erosion of actual and habitual we-experiences. (shrink)

Matthew Ratcliffe has argued that existential feelings form a distinct class of bodily and non-conceptual feelings that pre-intentionally structure our intentional experience of others, the world, and ourselves. In this article, I will identify and discuss three interrelated areas of concern for Ratcliffe’s theory of existential feelings. First, the distinct senses in which existential feelings are felt as background bodily feelings and as spaces of possibility calls for further clarification. Second, the nature of the suggested bi-directional relationship between existential feelings (...) and intentional experience remains ambiguous. Third, viewed in light of existential guilt, the categorically non-conceptual nature of existential feelings may not be as definite as presumed. The aim of the article is to draw critical attention to aspects of the theory that would benefit from further development, and therefore, to advance the ongoing discussion about existential feelings. (shrink)

The concept of bodily doubt has been proposed as a model for describing the experience of illness. According to this model, bodily doubt determines any experience of illness, whether somatic or mental. However, the phenomenology of mental disorders presents a series of experiential disturbances beyond doubt at the bodily level. The hypothesis to be investigated in this article concerns the formulation of an adequate concept of doubt from the point of view of these disorders. Often, psychiatric patients experience their condition (...) of suffering primarily in terms of a doubt about the totality of their experiences, and not just in relation to the bodily aspect. On the other hand, cognitive, affective and behavioural elements also play a fundamental role in determining mental disorders. In order to identify the peculiarities of the notion of doubt in this context, this paper sets out to reconstruct and analyze the phenomenological literature on somatic and mental illness, as well as non-reductionist approaches to cognition (4EA) and its disorders. (shrink)

The phenomenology of atmospheres is recently gaining attention in debates on situated affectivity. Atmospheres are defined as holistic affective qualities of situations that integrate disparate affective forces into an identifiable and unitary gestalt. They point to a blurred, pathic, relational, and pre-individual form of experience which has been described in terms of ecological affordances. Despite its relevance in diverse areas of research such as architecture, phenomenological psychiatry and aesthetics, a thorough analysis of the phenomena of affective atmospheres from an enactive-ecological (...) perspective is missing in the literature. This article aims at clarifying how and to what extent affective atmospheres can be accommodated into ecological-enactive understandings of the environment in terms of affordances. To do so, I review four perspectives on ecological affordances – the gibsonian account, the relational account, affective affordances, and the Skill Intentionality Framework (SIF) – and contrast them with the ontological and epistemológical principles that ground the phenomenology of atmospheres. I argue that only the field perspective developed in SIF is compatible with the phenomenology of atmospheres. From this perspective, affective atmospheres can be understood as phenomenological counterparts of context sensitivity, that is, as the holistic and pathic background feelings that make certain affordances more salient than others. As a conclusion, the analysis in this article shows the potential of the phenomenology of atmospheres to enrich the ecological-enactive cognition framework. It also highlights the opportunity to construct a situated understanding of affectivity that is informed by phenomenological perspectives. (shrink)

In light of the recent calls for integrating phenomenology and psychiatry, I will address the problem of heterogeneity in major depressive disorder (MDD) using the phenomenological account of depression put forth by Fernandez (Fernandez, 2014). I will first go over the distinction between two of the major specifiers of major depressive disorder, namely melancholic and atypical depression. Then, I review the account of depression developed by Fernandez, which considers some of the people diagnosed with MDD to have an erosion of (...) the capacity for the category of moods as opposed to a particular kind of mood. I will apply this conception to the diagnostic and statistical manual criteria for melancholic and atypical depression, and consider how reactive and unreactive depressed moods can be clarified using this conception. I argue that we can help our understanding of MDD by viewing melancholic depression as primarily characterized by structural erosion of the person’s situatedness (observed as a lack of mood reactivity) and atypical depression as a state in which the capacity for moods in general has not been eroded (hence, the retention of mood reactivity), with the psychopathology rooted only in the content of experience (the moods themselves). I discuss how this conception related to other phenomenological accounts of depression and why it can be useful in making sense of some clinical observations between the two specifiers, namely the differences in illness severity and symptoms of depersonalization and derealization, before concluding the work by considering its relationship with the operationalized approach of the DSM. (shrink)

This paper argues that phenomenological insights regarding selfhood are relevant to the informed consent process in the treatment of depression using electro-convulsive therapy. One of the most significant side-effects associated with ECT is retrograde amnesia. Unfortunately, the current informed consent model does not adequately appreciate the full extent in which memory loss disturbs lived-experience. Through the philosophy of Merleau-Ponty, it is possible to appreciate the way in which memory loss affects a person’s self-experience, with emphasis given to one’s pre-reflective and (...) embodied, relationship with things in the world. This paper aims to demonstrate that proper informed consent should acknowledge the extent to which repeated ECT treatments affect a patient’s sense self. (shrink)