John Cutting, Virginia Moreira, Jean Naudin, and Michel Cermolacce

 

[Journal für Philosophie & Psychiatrie, August 2017, Original paper]

Abstract

Psychotic subjects, schizophrenic and depressive, albeit in different ways, have a fundamentally different experience of the world, their body, themselves and others from that of normals. Two psychopathologists – Eugene Minkowski and Arthur Tatossian – focused on the contribution of an anomalous experience of thingness to their overall psychotic state. In this article we examine Tatossian’s writings on the subject and strongly commend his original insights into psychosis in general.

 

Keywords: Thingness, schizophrenia, depressive psychosis, Arthur Tatossian

Introduction

In this article we consider the psychopathology of thingness, with particular respect to the writings of Arthur Tatossian, a French psychopathologist relatively unknown in the Anglo-American literature.

Phenomenological philosophers such as Heidegger (1951/1971) and Scheler (1927/2009; 1927/1973) have considered the matter of thingness in detail.  Heidegger considered a thing to be a constellation of divine, cosmic, material and human elements – a ‘fourfold’ of such. We take the view that thingness is a more banal matter.  One of the author’s patients (Unnithan et al 1991) was preoccupied with the most humdrum things one can imagine – radiator taps, door handles, chimney pots. 

For this reason we are inclined to say that Scheler was more to the point. In The Human Place in the Cosmos (Scheler, 1927/2009, p.31) he opined that only human beings, as opposed to non-human animals or God, had the experience of thingness, and that was because only human beings, amongst other animals, possessed Geist [spirit and higher intelligence], as this was an ‘objectivization’ facility which could render thingness itself. His further view, expressed in Idealism and Realism (Scheler, 1927/1973, p.353), was that thingness is a late construct in the course of humanity. For example, primitive people invariably enquire of events: Who caused this. They assume an animate or divine origin. Nowadays we rather ask: What caused so-and-so. We seek inanimate factors. Science, moreover, takes this a step further and deconstructs the thing itself into fields of forces and the like. Thingness, it would seem, stands half way between the animate/divine world view of our ancestors and the scientific Weltanschauung of no-thingness.

It was the insight of Eugene Minkowski (1890-1972), one of the first phenomenological psychopathologists, and the pre-eminent French psychopathologist of the first half of the 20th Century, taken up by Arthur Tatossian (1929-1995), the pre-eminent French psychopathologist of the second half of the 20th Century, to appreciate that psychopathological conditions such as schizophrenia and depressive psychosis altered the afflicted subject’s entire experience of the world, and, in particular, the sense of thingness. 

In this article we try to convey the extraordinary experiences undergone by schizophrenics and psychotic depressives, and to commend the view that much of this strangeness is attributable either to an upsurge in the appearance of thingness in realms of the human condition in which, in everyday life, this is alien – schizophrenia – or to an absence or attenuation of thingness which does prevail in realms of everyday life – depressive psychosis. The core of the article is an extraordinary case description of a schizophrenic woman by Tatossian (1957/2014). We are also interested in the schizophrenics’ and depressives’ experience of body, external world, other people and self, as these feature highly in Tatossian’s writings.

Hélène J:  Chosification [exaggerated thingness] in schizophrenia

Arthur Tatossian’s patient Hélène J (Tatossian, 1957/2014) is a seminal contribution to phenomenological psychopathology, in the same league as Minkowski’s (1923/1958) ‘cas de mélancholie schizophrénique’, Binswanger’s (1957) cases of Ellen West and Lola Voss, and Blankenburg’s (1971) patient, Anne.

Hélène J was a French Jew who was born in Marseilles in 1920. Her father died young, her mother remarried, and she suffered the tribulations of seeing her brother and stepfather deported during the Second World War, from which they never returned, and being herself in hiding in the French Alps. The first indication of a psychotic breakdown came at the end of the war, and she remained in such a state throughout the late 1940’s and 1950’s.

In terms of descriptive psychopathology she had delusions of persecution (mother and neighbours interfering with her clothes), bodily delusions of numerous sorts (e.g. three quarters of one shoulder missing), delusions of influence (telecommunications affecting her) and auditory hallucinations. But many of her experiences and beliefs are scarcely captured by conventional descriptive psychopathology.

The supreme merit of Tatossian’s analysis of the case is not only that he tracks down the extraordinary content of what Hélène J wrote and said, showing up the impoverishment of descriptive psychopathology in this regard, but the way he traces them back to a single, all-pervasive theme – a transformation of world, body, and other people, and all the realms that they partake of, into one realm alone, that of thingness, in Heideggerian terms, Vorhandenheit [present to hand].

So, for example, in the natural, everyday, sane lay-out of the world, other people are independent, maybe capricious, agents of their own fate, abiding in the realm of Thou-ness, in Schelerian and Buberian terms, or, in Heidegger’s formulation, Mitsein. They are also, in some instances, servants, denizens of a realm of useful entities, resident in Heidegger’s realm of Zuhandenheit [ready-to-hand].  But they are never things. Human bodies, moreover, although things when dead, and with thing-like appearance when looked at, are predominantly agents of a human being’s enmeshment in its surroundings – Dasein and its Umwelt, in Heideggerian terms – as well as a handy tool – Zuhandenheit. The human self, furthermore, is an intimate, cherished representation of everything going on in all other realms, as far apart from a thing as it is possible to get.

None of this survives the depredations of schizophrenia, in Tatossian’s analysis.

The first casualty, in Hélène J’s case, was her body. Bits of it simply disappeared – three-quarters of her shoulder, for example. Other parts began to separate from the integrated core, loosened, underwent autonomous slippage and movement, and were subject to transpositions with other body parts. The body, moreover, became transparent, as she herself said:

Je suis une femme transparente. 

She furthermore lost any sense of intimacy with her body, which now became an object of public scrutiny. In short, as Tatossian wrote:

She saw her body simply as a thing. 

Hélène J’s experience of the world also underwent massive changes, chief amongst which was an overwhelming sense of de-naturation:

In nothing she ever wrote did nature appear as something she recognised.  Hélène simply had no feeling for nature and this absence was a mode of her existence, not a choice in literary style (p.76).

Living in a port such as Marseilles one would expect that the sea would play a significant part in her daily life, but the only aspect of her surroundings that impinged on her was the town itself, and she even took the ships for floating cars:

Not only had her surroundings lost any sense of individuality or uniqueness, but her environment [‘Umwelt’] had completely disappeared, leaving in its stead ‘a universe composed of multiple but indefinite parts’.  This universe had the further characteristics of being ‘parcelled up’, ‘not quite right’, isolated, ‘like a distant country in sunshine, with all the workers on strike, as if everything had come to a standstill’.  Even more cataclysmic was the fact that the stark contents of this ‘Mort-vivant’ [zombified world] were not actually familiar things but mere signs of something vague, closer in kind to ‘no-things’ than ‘some-things’.  Any apparent singularity was anyway public property:

The radio spoke to the entire world, a book or a magazine could be bought by anyone, trams and buses were vehicles for everybody (p.85).

Simultaneously with a Verweltlichung’ [unworlding] of an individual’s sense of being part of the world there was a ‘mondanisation’ [a process whereby that individual became society’s property].

Next to suffer was Hélène J’s experience of other people. In her own words:

They are nothing but robots.  I recognise this by their lack of reaction (p.61). 

An otherness was partly preserved, but not in the form of individuality. ‘The other is universally the same’, she said, with, furthermore, a ‘theatrical’ or ‘jouée’ [put on] sort of guise. Any other person in Hélène J’s world – whether real, imagined or hallucinated – was a ‘collective’ ‘like the workers in a factory’. At one stage in the course of her condition, she had a sense that there was an actual person pulling the strings of all this, someone whom she referred to by various names, including ‘mari’, a manipulator of the marionettes and herself who populated this world. But neither ‘mari’ nor the others were normal individuals, with, for example, a particular nationality or distinguishing features, but were rather a melange of historical and contemporary celebrities – e.g. Spartacus, members of the British royal family. Tatossian made a connection here between Hélène’s mode of interpersonal relationships and Heidegger’s (1927/1962, p.153) way of being which he called ‘man’ [one, as in ‘one should pay ones taxes]. Hélène’s dealings with others is of this nature – a public and stylized submission to the norms of everyman. One might note, in this connection, that all her composites were male.

Hélène’s notions of space and time also underwent a profound transformation, in line with her over-arching embroilment in the thingness of everything.

The spatiality of a sane person is not the same as the spatiality of things. The space experienced by a normal person is essentially their potential for movement (Scheler, 1927/1973, p.333). It is experienced as a void outside the person and its extent varies according to the strength of this potential. For example, it constricts with age. The spatiality of things is entirely different. It is integral to them, not outside them. In effect the thing is the actual bit of space that it takes up. Moreover the thing occupies the same bit of space wherever it is and this space does not change. Hélène rather had the spatiality of a thing not a person. Her spontaneous room for manoeuvre was blighted by a sense of stasis coupled with a feeling that she could be anywhere and it would all be the same.

Her temporality was constrained in a similar way. A living organism’s temporality, according to Scheler (1927/1973 p.346), is the potential for self-modification, and the sane person’s ‘now’ is a confluence of past experiences abutting their future possibilities. Hélène’s ‘now’ is a fixed point in a series of other fixed points. As she says:

Je suis en quelque sorte localisée maintenant (p.71).

The present is all-consuming; the past and future a mirage.

Finally, who is the psychotic Hélène? On this point the best analysis is a later article: Analyses phénoménologiques de la conscience délirante (Tatossian, 1963/2014, 1964/2014, 1965/2014), p.143-160.

The key features of the schizophrenic self, according to Tatossian are: 1) relative to a sane subject it takes an apragmatic and neutral view on the world – i.e. the world is not a battleground of competing values; 2) this detached attitude is particularly marked when action is involved – the schizophrenic acts independently of the cues and lures which beset a normal person, for example, food outlets when hungry; 3) instead, the schizophrenic self is an active searcher after truth, exquisitely illustrated in Schreber’s (1903/1988) Memoirs, a truth of philosophical proportions way above any knowledge of vital relevance; 4) the schizophrenic self is concerned with universal essences, not particular things or persons; 5) the schizophrenic self is preoccupied with names and signs, signifiers detached from what they signify; and 6) the schizophrenic self ‘talks like a philosopher’, of which fraternity the Husserl of Ideas 1 (Husserl 1913/1941) is indistinguishable, according to Tatossian, from the schizophrenic’s actual modus vivendi.

Depression and thingness

Tatossian’s writings on depression (Tatossian, 1975/2016; 1979/1997; 1983/2016) are mainly commentaries on the work of other psychopathologists on the matter. Nevertheless, in addition to his knack of extracting the core thesis in someone else’s work, his own views shine through.

What he abstracts from Binswanger (1960), Tellenbach (1974), Maldiney (1976) and Kraus (1982), in particular, are the following phenomenological ‘facts’ about depression. Some are directly addressed to the issue of thingness in depression, some seem, on the face of it, more peripheral, but, as we shall see, turn out to be highly relevant.

The depressive, and he goes along with Binswanger and Tellenbach in lumping all depressives in one nosological category, is he or she whose objectivity is not populated by things, but remains at the phase, in Heidegger’s terminology, of Zuhandenheit [useful items]; thingness is not achieved (Tatossian, 1979/1997, p.71). Commenting on Tellenbach (Tatossian, 1979/1997, p82, he remarks:

Tools have not become things and the Zuhandenheit has not yet become Vorhandenheit. 

The depressive, furthermore, is someone who is more attuned to communal values than the sane, unlike the schizophrenic, who has lost this facility (Tatossian, 1979/1997, p 56). This takes the form of a hypersensitivity to the morals of society (Tatossian, 1979/1997, p 62).

These two theses – the depressive as stuck in a pre-thingness mode of objectivity, and the depressive as overly attuned to community and other values – seem to us to be the bedrock of Tatossian’s insight into depression. They are, furthermore, strongly supported by the opinions of other psychopathologists, preceding him, contemporary with him, and post-dating his work. Minkowski (1933/1970), for example, cited several examples of depressed patients’ feeling that some person had an over-obtrusive influence on them:

I feel as if when you insist on something I must submit to your will …  I am caught up in your affairs …  I am like a ghost, but a magnetic ghost, automatically attracted by all sorts of things going around. (Minkowski, 1933/1970, p 329). 

Tellenbach’s over-riding thesis is that depressives, or melancholics as he calls them, have a pre-morbid personality which is overly reliant on conforming to some other’s life situation, and when this is challenged by a life event which threatens to bring down the status quo – loss of job, departure of child – the ‘typus melancholicus’, the personality disorder, slips into melancholy itself.

O’Connor et al (2007) commented that the depressive subject felt unduly beholden to other people, as if their ‘moral system were on overdrive’. On the lack of thingliness or chosification in depression, consider these subjects from the series of one of the authors (Cutting 1997), one of whom announced that she had no bowels and another that the ace of diamonds in a pack of cards was missing.

The zuhanden mode of grappling with what is around us is nothing other than the awareness of an environment, which the German biologist von Uexküll (1934/1992) characterized as the animal’s interaction with its surroundings. (Both Heidegger and Scheler knew of his work). The human being, according to Scheler (1927/2009), has the self-same facility, but also has the ability to stand back from this and objectivize a world. For these reasons the zuhanden mode of dealing with matters is developmentally prior to the vorhanden mode, which only humans possess. According to Scheler (1927/2009) non-human animals cannot objectivize their situation.

A depressive’s core phenomenology is part de-chosification – nihilistic delusions in descriptive psychopathology parlance – and part a preoccupation with and responsibility for persons, not things – delusions of guilt in conventional descriptive terms. This is the inverse of the situation in schizophrenia, where excessive chosification takes place coupled with a loss of social attunement. Tatossian grasped all this, as we shall see in the discussion.

One might question whether the examples of no-thingness given above – statements as to the absence of bowels and a missing card in a pack – are what the authors claim they are. A sense of ones physiological functions is a zuhanden experience, a window on ones internal goings-on, presumably shared with animals. But the nihilistic delusion that one has no bowels is not a denial of some zuhanden experience. Patients with an organic cause of nihilistic delusions – see below – retain the zuhanden element in experience and lose the vorhanden component. They say, for example, that ‘I have no arm’ but retain a sense of heaviness or pain. What is lost is the thingliness of the limb, not its proprioceptive or emotional quality. There is no reason to suppose that ‘functional’ depressives are different in this respect.

Discussion

We are concerned here with three overriding issues: 1) What is thingness? 2) Is there a pervasive anomalous thingness in psychopathological disorders? And 3) If so, what is its contribution to the experience of schizophrenics and psychotic depressives, and, indeed, to the very nature of these conditions?

What is thingness: It seems to us that thingness is a particular sort of objectivity in the world, among other sorts of objectivities. It is an irreducible ontological category or givenness, best formulated amongst philosophers by Heidegger’s term Vorhandenheit – a static sense of ‘already-thereness’ – but without his further atavistic and causal elaborations. A thing is neither alive nor dead. It has never been alive, and has nothing to do with gods, sky and earth. It is a figment of human invention, and, despite the modern trend to blur the boundary between humans and non-human animals, it is not something that the non-human animal possesses as an ontological category. The non-human animal does share other objectivities with humans – toolness, emotionality, for example – and does not share other objectivities – mathematical symbolism, for example. Even among human beings thingness is a late addition to their ontological armamentarium. Anthropological studies, such as Levy-Bruhl’s (1927), point overwhelmingly to earlier human beings’ sole take on the world as a god-infested vivarium. 

This formulation, in our view, is premature, if not wrong. The thingness of things is a rock solid givenness in our lives and cannot be spirited away. And, as with other givennesses – emotions, toolness, mathematical symbols – it has its own unique blend of ontological properties – its particular spatiality, (thingness is essentially a bit of congealed spatiality), its own temporality (essentially atemporal), its special sort of causation (man-made) and its inherent existential status (external worldliness). In a sane human being it jostles for position amongst the other modes of being – toolness, emotionality, mathematic symbolicness – and that is that.

Anomalous thingness in psychopathology

What is clear in psychopathological states of mind, exquisitely portrayed in Tatossian’s account of the schizophrenic status of Hélène J, and his deliberations about depressive psychosis, is that the experience of thingness either intrudes into regions of being to which, under normal circumstances, it is alien, or else it deserts realms where, normally, it is indigenous. Thingness itself is not anomalous under these circumstances. What is anomalous is the over-extension of, or retreat from, its customary remit.

There are other psychopathological conditions – unilateral brain damage – where the thingliness of objects deviates from normal. A patient with right hemisphere damage, for example, experienced the left side of his body as ‘a piece of scaffolding’ (Ehrenwald 1930). A subject with a left-sided lesion (Hecaen and Ajuriaguerra 1952) reported:

It’s as if I haven’t any right arm and hand, but only a weight where the arm should be. 

Another, with the same lateralised lesion:

My right side is replaced by pain. The half corresponding to the world is abolished. Nothing exists there. 

Excess chosification and de-chosification are clearly illustrated here, mimicking what happens in schizophrenia and depression respectively.

Our main focus however, is anomalous thingness in psychosis, and, in particular, Tatossian’s contributions to unravelling its nature. We shall consider four regions of the human being – body, external world, other people and self – and how the experience of these is transformed by the intrusion of anomalous thingness in schizophrenia and depression.

Body: What is the body asks Tatossian (1982/2016, p 93). It is a dual entity, he replies, comprising what, in German, are referred to as Leib and Körper, or in French and English and other European languages which have only one word for body, body-subject (or the ‘body that I am’) and body-object (or the ‘body that I have’).

In schizophrenia, the subject-body or the ‘body that I am’ evaporates. In its place the object-body or the ‘body that I have’ is all that is left. In Tatossian’s words (1957/2014, p 56):

The body becomes a fragment of universal nature, it becomes a thing. 

In depression, the inverse occurs:

The object-body, the body as deployable instrument for the subject, disappears, leaving only the subject-body behind. (Tatossian, 1983/2016, p 104)

World: What is the world? Tatossian (1983/2016, p.102) appreciated that the human being had a world, whilst the non-human animal only had an environment – an Umwelt – because the human being could distance himself or herself from its body-as-subject and see its body as an object exactly as other people saw it, thereby forming an inter-subjective community with shared viewpoints. In this respect Tatossian aligned himself with Scheler rather than Husserl or Heidegger among the three fathers of phenomenological philosophy. Despite comments in The Fundamental Concepts of Metaphysics (Heidegger, 1983/1995, p 343) that the ‘world-openness of man contrasts with an animal’s being absorbed in its encircling ring’, elsewhere (Heidegger, 1927/1962, p 93) he equates the human world with an environment. Husserl also constrains the world, albeit in a different way, as the correlate of a human being’s idea. Scheler, in The Human Place in the Cosmos (Scheler, 1927/2009, p 33), emphasized that the human being had a world because it stood back from its body, psyche and environment and thereby forged an openness and freedom which were the very building blocks of a world.

In schizophrenia, the world as experienced undergoes a seismic transformation. The cause of this we shall consider below, but its experiential actuality is largely the result of two profound changes in how the inventory of worldly objects is now constituted. One is a de-vivification and the other is an essentialization. Tatossian was alert to both of these. Hélène J had lost any sense of a natural environment and existed in a world of zombified people and lifeless objects. Here are some comments on this theme by patients encountered by one of the authors:

‘My husband looked like a ghost’, ‘people were deformed, squarish, like in plaster’, ‘people looked deformed as if they had had plastic surgery’. (Cutting and Dunne 1989). 

The essentialization is apparent in Hélène J’s experience of other people and in her hallucinations. No-one she met was an individual person, but was rather a mélange of celebrity figures, ancient and contemporary. Even the things which she hallucinated were not the sort of things experienced by the sane in everyday life, but things present in their completeness without the perspectival nuances of actual perceiving (Tatossian 1958/2014, p 139). Consider these visual hallucinations of schizophrenic patients reported to one of the authors (Cutting 1997, p 93-4):

Little matchstick men made of copper fighting with each other. 

Thought bubbles like in a cartoon.

Pterodactyls, green and slimy.

The objects are nothing like anything a normal person would perceive naturally, but are rather idealistic representations of the sort of things that populate the sane world.

In depression the thingliness of things disappears. There is no-thing – nihilistic delusions proliferate – because, as Tatossian, (1979/1997, p.82) says:

Tools have not become things and the Zuhandenheit has not yet become Vorhandenheit.

Here are examples:

Everything in history and in books is as if they never were.

No world outside the bedroom.

Nothing’s going to happen; no-one carries any money.

Nothing works in the house; nothing to wear; no clothes.

(Cutting 1997, p 139)

Other people: The nature of the other is a constant preoccupation in 20th Century philosophy. Every major philosopher had a view on this, with little agreement between. Restricting ourselves to the three fathers of phenomenological philosophy, we can begin with Husserl:

Someone else ... is the existing other for me in the transcendental attitude: the alter ego demonstrated precisely within the experiencing intentionality of my ego ... in my own experience I experience not only myself but others ... In myself I experience and know the other; in me he becomes constituted, (Husserl 1950/1995, p 148-9).

This is not the only view Husserl took in his complete works, but represents a genuine stance on the matter at this time. Heidegger (1927/1962, p 160-1) took an almost diametrically opposite view:

Being-with [others] is essentially for the sake of others ... knowing oneself is grounded in being-with ... and comes across in its environmental circumstances. 

In other words, the other is implicitly known before I know anything about myself, and I am, furthermore, beholden to the other. Again Heidegger’s position is more nuanced.  In other writings he gives the impression that any individual is not beholden to anyone. Nevertheless, we can take Heidegger’s view here as an actual philosophical position on the issue. Scheler (1926/2009, p 246-7) took a middle view:

What occurs is an immediate flow of experiences, undifferentiated between mine and thine ... Within this there is an ‘I’ and a ‘Thou’ in a general sense, but which individual self it may be that owns a given experience, whether it is our own or another’s, is something that is not necessarily apparent in the experience as immediately presented ... Only very slowly does he raise his mental head, as it were, above this stream and finds himself as a being who has feelings, ideas, and tendencies of his own. And this only occurs to the extent that the child objectifies the experience. 

In other words, the self and other are not either primary or secondary to the other but emerge simultaneously from an I-thou flux through objectivization.

Tatossian (1965/2014 p 159) clearly realized that Husserl’s formulation of the supposed normal state of affairs was wrong because it precisely captured not the normal but the schizophrenic situation.  He further saw that if, as Husserl asserted, consciousness dealt only with the essence of anything (Tatossian, 1965/2014, p 152), then a consciousness which was deemed to constitute other people would produce generalised and not individual people, which is exactly what happens in schizophrenia (Hélène J’s ‘people’ being Spartacus and other members of the Royal Family), a point which further renders Husserl’s formulation an accurate portrayal of what populates the world of schizophrenics but not sane people.

What of the depressive’s entourage of people? Tatossian, unlike Minkowski before him, was able to see that if schizophrenia were a condition in which lack of attunement to the communal mode of being was its root cause, depression might stem from an excess of this.  Consider this extract from Minkowski’s Lived Time (Minkowski, 1933/1970), p 293-4):

Schizoidism and schizophrenia ... are determined by a weakening of syntonous factors [his term for the propensity to immerse oneself in the ‘we’] ... It is difficult to imagine an attitude erring from an excess of syntony. 

Is it difficult? Not at all. Tatossian (1979/1997, p 62), following Tellenbach and Kraus, appreciates that at the core of a depressive illness there is a hypersensitivity to the morals of society, and therefore overrides Minkowski’s reluctance to imagine a psychopathological state in which syntony [reliance on the situation of others] is excessive. Is this not a profound window on depressive illness, whose delusions of guilt are precisely an over-solicitous concern for the welfare of others:

Let down family and therefore an insect for extermination.

Violated religious rules.  I feel as if I’m not here, a complete shadow.

Disgraced family and would be put on display in Madame Tussauds.

(Cutting 1997, p 313)  

Moreover, is this not an example of Heidegger’s designation of ‘normative’ otherness being revealed as depressive psychopathology in the same way as Husserl’s alleged ‘normal’ otherness was uncovered as schizophrenic psychopathology?

Self. In a normal person the self is a chamber of past thoughts, current experiences and options for the future. It is a unique and private domain, a refuge from the vicissitudes of the world, and completely separate from other domains and other people. In schizophrenia and depression none of this obtains. 

In schizophrenia (Tatossian, 1964/2014, p 152) there are three main ways in which the self differs from that of a sane person – its infallibility, its universality and its indifference to practical concerns. It is infallible because it is now deemed a creator of the world and other people and, as such, it knows everything. It is universal and so are the objects of its creation (for example, the general sorts of things which appear as the contents of its visual hallucinations, and the composite personages who substitute for other people, as we saw above) because it is now in the mode of constituting objectivity in exactly the way Husserl formulated the way a normal person would when subject to the transcendental reduction in his fifth Cartesian Meditation (Husserl, 1950/1995, p 48-9), and in this mode can only deal with essences. It is indifferent to practical concerns because, again, it is tantamount to a phenomenologically reduced person in which the real issues that confront any person have been bracketed off.

The schizophrenic self, paradoxically, becomes both more potent, because it is now a world-creator, but at the same time its status as a private, unique domain evaporates as it is invaded by the very objects and pseudo-personages that it has created. What Tatossian (1965/2014, p 153) calls the empirical self certainly disappears amid a plethora of subjective aggrandisements, and so does the sense of ambiguity and opaqueness in other people and the world. 

In depression the self as a cosy, private domain of memories, experiences and projects also withers away, for the very opposite reasons to those we have just considered in schizophrenia. Here, Tatossian is not a helpful guide, whereas his compatriot Minkowski is spot on. The depressive feels as embroiled in and influenced by the affairs of others (Minkowski, 1933/1970, p 329) to the same extent as the schizophrenic feels responsible for the status of others.  Consider these two patients of Minkowski’s:

I do not sense myself any more. I do not exist any more … I have the impression of myself as a guy who is sitting down … but he is not really identical with me. I don’t feel that it is right to use the expressions ‘I’ and ‘me’. (Minkowski 1933/1970, p 329) 

Everything becomes an outside contract for me … I only have thoughts which come from outside … What everyone else does I do again … Now I am no longer myself because someone just passed. I am he. I am walking with him. (Minkowski 1933/1970, p 352-3) 

The depressive, like Heidegger’s formulation of the supposed ‘normal’ (Heidegger, 1927/1962, p 160), is no longer a self-contained individual but ‘for the sake of others’. The self is derelict:

I am not DP (her name) any more. I take my bag with me as though I would lose my identity.

Only in my imagination was I an engineer.

I feel as if I’m not here, a complete shadow.

Turned into a fox or cat or lesbian.

(Cutting 1997, p 313-4)

Conclusions

The purpose of this article was threefold 1) to promote the contribution of Arthur Tatossian to phenomenological psychiatry, as none of his articles has ever been translated into English; 2) to emphasize that a disordered experience of thingness underpins much of psychopathology; and 3) to illustrate the merits of a philosophical approach to psychopathology.

On the first point, Tatossian was undoubtedly one of a handful of ‘greats’ in 20th Century psychopathology. He saw that psychopathology was a philosophical issue, and not a psychological or medical problem. He had a sure grasp of what his predecessors were getting at, and, like Minkowski before him (Minkowski 1933/1970, p 346), realized that psychopathological disorders were philosophical formulations of normality gone awry. He appreciated, furthermore, that the psychotic person was not a pathological freak of nature but someone, with a cognitive apparatus just like you or me, but whose problem, unlike you or me, was a rigidity in sticking to one cognitive framework when what is needed to remain a ‘sane’ person is a versatility between frameworks.

On the second point, the delineation of the over-extension of the experience of thingness in schizophrenia and its contraction in the experience of depressives, Tatossian has few equals among his psychopathologist predecessors and contemporaries. Minkowski was closest to him in his insights, as he grasped (Minkowski, 1927/1987, p 201) that the essence of schizophrenia was a ‘morbid rationalisation’ and that depression was a reversion to animality:

You forced me, in making me talk, to become an animal. 

(Minkowski, 1933/1970, p 352)

It annoys me to be in such a way the ‘stupid creature’ [bête] of someone.

(Minkowski, 1933/1970, p 305)

Both Minkowski and Tatossian grasped, furthermore, that idealist philosophers, such as Husserl, were portraying schizophrenia, and not a state of sanity, and Minkowski certainly realized that Heidegger’s brand of philosophy was an accurate account of depression, but not an account of sanity.

On the third point, Tatossian made himself cognisant of both the phenomenological philosophers’ core precepts and the phenomenologically-inclined psychiatrists’ views and produced, in his various papers, what we regard as the best overview of the phenomenological movement in psychiatry. He was exquisitely attuned to the work of his predecessors and contemporaries in phenomenological psychopathology. His illuminating summaries of dense articles and books by Binswanger, Blankenburg and Kraus are a joy to read. He ploughed his own furrow initially, but later on when aware of what Blankenburg and Kraus, in particular, were working on, realized that he was on the same wavelength. He grasped the importance of Blankenburg’s notion of a loss of natural common sense and Kraus’ proposal that schizophrenics were functioning as if their knowledge of what was going on actually determined the objective situation.

In contemporary psychopathology, preoccupation is with a ‘lack of ipseity’ – a loss of a sense that anything belongs to me. Tatossian predated all this by appreciating the complete impersonal nature of anything going on in the life of the schizophrenic.

References

Binswanger L (1957) Schizophrenie. Pfullingen: Neske.

Binswanger L (1960) Melancholie und Manie.  Pfullingen: Neske.

Blankenburg W (1971) Der Verlust der natürlichen Selbstverständlichkeit. Stuttgart: Enke.

Cutting J (1997) The Principles of Psychopathology. Oxford: Oxford University Press.

Cutting J and Dunne F (1989) The subjective experience of schizophrenia. Schizophrenia Bulletin 15: 217-231.

Ehrenwald H (1930) Verändertes Erleben des Körperbildes mit konsekutiver Wahnbildung bei linkseitigel Hemiplegie. Monatsschrift für Psychiatrie und Neurologie 75: 89-97.

Hecaen H and Ajuriaguerra J (1952) Méconnaissances et Hallucinations Corporelles. Paris: Masson.

Heidegger M (1927/1962) Being and Time. Oxford: Basis Blackwell.

Heidegger M (1951/1971) The thing. In: Poetry, Language, Thought. New York: Harper & Row, 165-186.

Heidegger M (1983/1995) The Fundamental Concepts of Metaphysics. Bloomington and Indianapolis: Indiana University Press.

Husserl E (1913/1941) Ideas 1. New York: Macmillan.

Husserl E (1950/1995) Cartesian Meditations. Dordrecht: Academic Press.

Kraus A (1982) Identity and psychosis of the manic-depressive.  In: de Koning A and Jenner FA (eds) Phenomenology and Psychiatry. London: Academic Press, 201-216.

Levy-Bruhl L (1927/1928) The Soul of the Primitive. London: George Allen and Unwin.

Maldiney H (1976) Psychose et présence. Revue de Métaphysic et Morale 81:513-565.

Minkowski E (1923/1958) Findings in a case of schizophrenic depression.  In: May R, Angel E and Ellenberger H E (eds)  Existence.  New York: Basic Books, 127-137.

Minkowski E (1927/1987) The essential disorder of schizophrenia. In: Cutting J and Shepherd M (eds) The Clinical Roots of the Schizophrenia Concept. Cambridge: Cambridge University Press, 188-212.

Minkowski E (1933/1970) Lived Time. Evanston ll: Northwestern University Press.

O’Connor L E, Berry J W, Lewis T, Mulherin K and Crisostomo P S (2007) Empathy and depression: the moral system on overdrive.  In: Farrow T F D and Woodruff P W R (eds) Empathy in Mental Illness.  Cambridge: Cambridge University Press, 49-75.

Scheler M (1926/2009) The Nature of Sympathy. New Brunswick and London: Transaction Publishers.

Scheler M (1927/1973) Idealism and Realism. In: Lachterman D R (ed) Max Scheler Selected Philosophical Essays.  Evanston: Northwestern University Press, 288-356.

Scheler M (1927/2009) The Human Place in the Cosmos. Evanston: Northwestern University Press.

Schreber D P (1903/1988) Memoirs of My Nervous Illness. Cambridge MA: Harvard University Press.

Tatossian A (1957/2014) Etude phénomologique d’un cas de schizophrénie paranoide. Psychiatrie Phénoménologique. Paris: MJW Fédition, 25-128.

Tatossian A (1958/2014) Approche phénomenologique du fait hallucinatoire. Psychiatrie Phénoménologique. Paris: MJW Fédition. 137-142.

Tatossian A (1963/2014) L’Alter ego et l’intersubjectivité. Psychiatrie Phénoménologique. Paris: MJW Fédition. 143-148.

Tatossian A (1964/2014) L’oeuvre de connaissance. Psychiatrie Phénoménologique. Paris: MJW Fédition. 148-152.

Tatossian A (1965/2014) Le problème de l’ego. Psychiatrie Phénoménologique. Paris: MJW Fédition. 152-160.

Tatossian A (1975/2016)  Phénoménologique de la depression. In: Tatossian A, Moreira V and Chamond J (eds). Clinique du Lebenswelt. Paris: MJW Fédition. 29-42.

Tatossian A (1979/1997) La Phénoménologie des Psychoses. Paris: L’Art du Comprendre.

Tatossian A (1982/2016)  Phénoménologie du corps.  In: Tatossian A, Moreira V and Chamond J (eds).  Clinique du Lebenswelt. Paris: MJW Fédition. 93-98.

Tatossian A (1983/2016)  Dépression, vécu dépressif et orientation thérapeutique. In: Tatossian A, Moreira V and Chamond J (eds). Clinique du Lebenswelt. Paris: MJW  Fédition. 99-116.

Tellenbach H (1974) Melancholie, 2nd edn. Berlin: Springer.

Unnithan S B, David A S and Cutting J (1991) Magnetic attraction of gaze: further evidence of hemispheric imbalance in schizophrenia. Behavioural Neurology 4: 63-66.

Von Uexküll J (1934/2992) A stroll through the worlds of animals and men; a picture book of invisible worlds. Semiotica 89 319-391.

Corresponding author

 J. Cutting, Mill Wood, Wall Hill, Forest Row, East Sussex. RH18 5EG, UK

 Email: jccutting@outlook.com