Phenomenology of the Body in Cotard’s Syndrome

Current classification and diagnostic systems, such as DSM-5 and ICD-10, attach little importance to the evident transformation of corporeality we observe in depressive patients. For example, DSM-5 makes reference to the body in only two of its nine diagnostic criteria. Classical authors, however, such as Kraepelin, Bleuler and Schneider regarded the change in corporeality as one of the three key phenomena. In 1968 W. M. Pfeiffer, compared the depressive symptomatology of patients from Germany and Indonesia and concluded that the ‘fundamental depressive syndrome’ is constituted by only three phenomena: mood alteration, disruption of vegetative functions and ‘abnormal body feelings’. In 1971, we obtained a similar result in an empirical study carried out at the University of Concepción, Chile. We described a ‘nuclear depressive syndrome’ upon observing that the symptomatology of depressive patients hospitalized over the course of 5 years could be ordered into three key phenomena: disturbance of the embodied experience (despondency, anxiety, lack of strength, pains, cold, nausea, etc.), disturbance of the ability to act and to feel (psychic and motor retardation, anhedonia, etc.), and, finally, disturbance of the temporality of the body, whose biorhythms are altered, inverted or suspended. Some years later (1983), P. Berner described the ‘endomorphic depressive axial syndrome’, which is extraordinarily similar to our ‘nuclear depressive syndrome’: all symptomatology can be ordered in two fundamental phenomena, namely, a disturbance of the embodied experience (‘Befindlichkeit’) and the biorhythmic disturbances. Given the transcendence of the transformation of the lived body in depression, we searched (1980) to deepen in the knowledge of this disturbance by means of a phenomenological analysis of a depressive stupor. Now, we attempt to make a similar study of an opposite form of depression: nihilistic delusion or Cotard’s syndrome. The basic experiences of the described patient in relation to the own body and to the other person (inter-subjectivity) are analysed following Husserl’s and Lévinas’ philosophy of consciousness and of body.