Between a suffering body and a body in a state of need: Aulagnier’s theory of discourses on the body applied to primitive mental states

ABSTRACT

In her theory of discourses on the body, Aulagnier makes the comparison of the concept of ‘a suffering body’ and the concept of ‘a body in a state of need’. The last type is what she thinks is often found in addiction, anorexia and in borderline states, conditions marked by a radical negativity. On the other hand, ‘a suffering body’ is a concept that indicates a relation and two bodies, mother’s and child’s, that communicate. Suffering and infantile sexuality is a first attempt to accept separation by weaving a net of fantasy over the abyss of lack and separation. If pleasure and suffering are lacking as representations, the sensory reactions may exist physiologically but without psychical existence. The concepts of ‘a suffering body’ and 'a body in a state of need' will enable us to think about important structural differences between neurotic-, borderline- and psychotic conditions. As a foundation for her concepts lies a metapsychological elaborations of three kinds of processes for representation: the primal-, the primary- and the secondary process.     

The minimal self hypothesis

For millennia self has been conjectured to be necessary for consciousness. But scant empirical evidence has been adduced to support this hypothesis. Inconsistent explications of “self” and failure to design apt experiments have impeded progress. Advocates of phenomenological psychiatry, however, have helped explicate “self,” and employed it to explain some psychopathological symptoms. In those studies, “self” is understood in a minimalist sense, sheer “for-me-ness.” Unfortunately, explication of the “minimal self” (MS) has relied on conceptual analysis, and applications to psychopathology have been hermeneutic, allowing for many degrees of interpretive latitude. The result is that MS’s current scientific status is analogous to that of the “atom,” at the time when “atom” was just beginning to undergo transformation from a philosophical to a scientific concept. Fortunately, there is now an opportunity to promote a similar transformation for “MS.” Discovery of the brain’s Default Mode Network (DMN) opened the door to neuroimaging investigations of self. Taking the DMN and other forms of intrinsic activity as a starting point, an empirical foothold can be established, one that spurs experimental research and that enables extension of research into multiple phenomena. New experimental protocols that posit “MS” can help explain phenomena hitherto not thought to be related to self, thereby hastening development of a mature science of self. In particular, targeting phenomena wherein consciousness is lost and recovered, as in some cases of Unresponsive Wakefulness Syndrome (UWS), allow for design of neuroimaging probes that enable detection of MS during non-conscious states. These probes, as well as other experimental protocols applied to NREM Sleep, General Anesthesia (GA), and the waking state, provide some evidence to suggest that not only can self and consciousness dissociate, MS might be a necessary precondition for conscious experience. Finally, these findings have implications for the science of consciousness: it has been suggested that “levels of consciousness” (LoC) is not a legitimate concept for the science of consciousness. But because we have the conceptual and methodological tools with which to refine investigations of MS, we have the means to identify a possible foundation—a bifurcation point—for consciousness, as well as the means by which to measure degrees of distance from that foundation. These neuroimaging investigations of MS position us to better assess whether LoC has a role to play in a mature science of consciousness.     

The Dr. John Hall story: a case study in putative “Haunted People Syndrome”

ABSTRACT

Research suggests a “Haunted People Syndrome (HP-S)” defined by recurrent and systematic perceptions of anomalous subjective and objective anomalies. Such signs or symptoms are traditionally attributed to “spirits and the supernatural,” but these themes are hypothesised to morph to “surveillance and stalking” in reports of “group-(or gang) stalking,” We tested this premise with a quali-quantitative exercise that mapped group-stalking experiences from a published first-hand account to a Rasch measure of haunt-type anomalies. This comparison found significant agreement in the specific “signs or symptoms” of both phenomena. Meta-patterns likewise showed clear conceptual similarities between the phenomenology of haunts and group-stalking. Findings are consistent with the idea that both anomalous episodes involve the same, or similar, attentional or perceptual processes and thereby support the viability of the HP-S construct.     

Transcranial parenchymal sonography in patients with Chronic Disorders of Consciousness: Association with neuroimaging data,and beyond

Differential diagnosis of patients with Chronic Disorders of Consciousness (DoC) is rather challenging, owing to the lack of objective approaches highlighting residual awareness. Sophisticated functional neuroimaging have provided high diagnostic value, but their application in the clinical setting is limited due to their relative complexity, cost, availability and poor collaboration of persons with DoC. By using a specific ultrasound-based methodology, namely Transcranial B-mode Parenchymal Sonography (TCS), it is possible to obtain images of the main parenchymal brain structures. We assessed the TCS abnormalities in three patients with DoC, demonstrating widespread alterations of brain parenchyma morphology that matched to MRI findings and were associated with the degree of consciousness disorders. Thus, TCS might represent a valuable tool for routine assessment and follow-up of brain structures functioning of patients with DoC, potentially helping in differential diagnosis and prognosis.