Between Skins E-Book

Nicola Diamond

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 474

Veröffentlichungsjahr: 2013

Beschreibung

Between Skins challenges individualistic accounts of the body in psychoanalysis. Drawing on philosophy, contemporary neurobiology and developmental research, Nicola Diamond explores the ways in which bodily processes and skin experience are inseparable from the field of language and environmental context.

• The first book to address epistemological implications for a new understanding of the body and embodiment - offers a new perspective on the division between mind, body and world
• Brings together a philosophical phenomenological account of body experience with key concepts from psychoanalysis, developmental research and neuroscience
• Responds to a growing interest in the body and psychoanalysis, and considers some limitations in neuro-biological accounts of brain-body processes for psychoanalytical understanding

Leseprobe

Contents

Introduction

Why Between Skins?

This Book Sets Out To . . .

Links with Psychoanalysis and Why Psychoanalysis?

Towards Sociality

Embodied Cultural Differences

Relating to the Clinical Field

The Structure of the Book

Note

Part I: The Framework: Neuroscience and Interdisciplinary Connections

1 Introducing Interdisciplinary Connections

Interdisciplinary Connections

Philosophical Concerns in This Enquiry

The Irreducible Organic Component and How It Figures for Us

Neuroscience: One of the Important Bed-Mates

Challenging a Top-Down Approach

The Brain–Body Map

Psychoanalysis: The Brain–Body Map and Body Image

Body Image versus Body Schema

Why I Do Not Adopt Gallagher and Cole’s Terminology

Working Towards a Brain–Body Mapping

Avoiding Mentalist Reduction

Moving Towards a Brain–Body–Ego Relational Perspective: An Imaginary Lived Geography

And Finally

Note

2 Nurture/Nature

The Complex Interdependence of Organism and Environment

Attachment, Developmental Psychology and Intercorporeality

Intercorporeality: The Philosophical Contribution, Developmental Psychology, Mirror Neurons

Biology and Sexuality: Regulation and Deregulation of Biorelational Processes

Notes

3 Bodily Expression and Language Relations

Affective Bodily Relations

Bodily Proto-Conversation: Sensory Semiotics as the Basis for Language

Bodily Expression as a Form of Language

Absence, the Symbol and the Somatic

In the Beginning Was the Body: Lakoff and Johnson

Somatic Access to the Symbol

The ‘Maternal’ and the ‘Other’

Notes

4 Setting the Scene: The Problem of the Binary Divide

Inside versus Outside in Early Klein

The Context of the Freud–Klein Controversies, 1941–1945

Persistent Dualism in Developments of Bion and Psychosomatics

An ‘Over-Mental’ View in Anglo-American Psychoanalysis

Body versus Speech in Lacan

Note

Part II: The Vital Order: Moving Away from Interiority and Biology as Bedrock

5 The Vital Order and the Biological Functions

Biology versus Sexuality: An Untenable Division?

Introduction to Jean Laplanche

Setting Up the Solution Finds the Problem

Excess: The Marginal Effect as an Increase in Excitation Relating to Emergent Sexuality

Between Skins: The Alien Entity and the Flesh

To Sum Up

6 The Problem of Dualism and the Division between the Vital and the Psychic Order

7 The Vital Revisited: Deconstructing the Vital Order from Within

The Reversal and Implications: The Vital is Not the Prop but Now Requires Propping

Reframing the Vital Order: The Lack of Preordained Limit and Excess

The Other, Temporal Delay and Somatic Lack

The Vital Bodily Processes Open onto Memory

Identity as Difference: The Vital Order as Vital Field

Notes

8 Rebuilding the Vital Field

The Edifice: Intercorporeality

Sensory Semiotic Vital Set-Ups

On the Way to Language

Alexithymia from the View of the Proto-Conversation as the Basis for Linguistic Access

Notes

9 Body Memory and Know-How

Putting In Question an A Priori Unity to Body Experience

Procedural Body Memory Know-How and Anti-Knowledge

Trauma and Body Memory

Body Memory and Deferred Action Reconfigurations

Note

10 Attachment and Sexuality: Regulation versus Deregulation

The Relationship between Attachment and Sexuality

Sexual Arousal and Loss

Body-Based Trauma and Deregulation

Introduction to the Uncanny in the Somatic Sphere

Part III: Exteriority: The Body Surface

11 The Skin: An Introduction

The Skin Surface

Brain–Body Maps

Mirroring the Body Surface: From Neuroscience to Psychoanalysis

A Broad Definition of Body Image

Brain–Body Maps and the Skin Ego

Notes

12 Didier Anzieu and The Skin Ego

The Laplanche–Anzieu Propping Connection

Summary of The Skin Ego

A Relational Turn in Anzieu’s Thinking

Clinical Cases Charting Skin Ego Disturbances

Challenges to the Main Account

13 Permeable Skin

Doubling in Tactile Sensation and the Auto-Affective Turn

A Revision of Narcissism and the Body: A Relational and Multi-Personal Perspective

To Conclude

14 The Emergence of Skin as a Support Matrix

Anzieu’s Clinical Examples and Additions

A Skin Surface Projection

15 Skin Narratives

The Mobile Skin and Matrix Structure

Skin Narratives and Trauma

Skin States

The Case of Debbie

16 Skin Relation

Touch and Attachment

Skin Relations

What Is Required for a Relational Skin?

In Summary

Note

17 Skin Writing and Touch as Analogous to Language

Trauma and Disturbances in Tactility and Differentiation

The Alien Entity in the Skin: Unheimlich as the Skin

Body Image and Unheimlich

A Literal-Littoral Skin Surface

What Is Between Skins?

18 Psychosomatics and Conversion: The Question of the Symbol

Joyce McDougall: Psychosomatics versus Conversion

Symbolic Processing

Bodily Enactment

The Body Speaks the Subject

Somatic Access to the Symbol and Symbolic Processing

Symbolic Categories: Different Types of Somatic Symptom Formation

No Neat Compartmentalization

The Body and the Hole in the Symbolic

Summing Up

Note

Conclusion: Have We Reached a Destination?

The Body as Interface

Somatization and the Symptom

Have We Reached a Destination?

Note

References and Further Reading

Index

This edition first published 2013© John Wiley & Sons, Ltd 2013

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Library of Congress Cataloging-in-Publication Data

Diamond, Nicola.Between skins : the body in psychoanalysis–contemporary developments / Dr. Nicola Diamond. pages cmIncludes bibliographical references and index.

ISBN 978-0-470-01942-9 (cloth)1. Body image. 2. Human body. 3. Somesthesia. 4. Body schema–Psychological aspects. 5. Mind and body. 6. Psychoanalysis. I. Title.BF175.5.B64D53 2013155.2–dc23

2013000738

A catalogue record for this book is available from the British Library.

Cover image: © Edvard March/CorbisCover design by Richard Boxall Design Associates

Introduction

When Selma first came to see me she was suffering a severe case of vaginismus.1 Her vaginal walls were in a state of involuntary constriction and this had been a lifelong developmental complaint. She was 22 at the time and, embarking on her first serious relationship, her anxiety about her ‘condition’ had intensified.   She had been through a battery of medical tests and investigations but no organic cause could be found. Selma described to me how she had been a very shy and timid child who would, as she put it, ‘hide under mum’s skirt’ when any stranger arrived at the house. She explained how she was tied to her mother’s ‘apron strings’ and cried incessantly at nursery. Separation had been a struggle from the first, and after two years of therapy she continued to seek out comfort in the safe and familiar.   An incident had occurred when she was five that stuck out in her memory. When she was with her father on one of his weekend visits (her mother and father had separated when she was three) she fell over while they were in the park and cried. Although not badly injured, she was withdrawn and preoccupied for days after.   In the analysis Selma described her fears. As a child, she feared spiders and small animals. As an adult this fear had continued; she was scared of cats and asked if there were any in the building before entering into the analysis. She feared anything that had not become part of the familiar – the alien and other – and most of all she feared damage being done to her bodily integrity. For example, at seven she had been on a picnic for her birthday party but had got so ‘paranoid’ about an ant that she believed had crawled into her anal orifice that she spent most of the event in tears and refused to sit down on the grass from that day forth.   From her early clinging to her mother and anxiety of separation in her anxious, insecure attachment style, she very readily felt unprotected and associated danger and lack of protection with her father with whom she did not live or feel close to, a fear which she then generalized to include all male figures. This insecurity of attachment that overlay her primordial fear of harm to her bodily integrity became a preoccupying narcissistic fragility as she began to experience what she described as ‘strange’ sensations, which made her feel uncomfortable, and her reaction was to tense up. These feelings were undoubtedly sexual and from early on she did not like them. She remembered as a girl of 10 seeing a sex scene with a boy touching a girl and she had to switch off the television. ‘The feelings were unbearable’; she could not risk any sexual feelings, and her anxiety developed into a way of shutting herself off from anything sexual, culminating in her inability to open up to a man. The fear of irreparable damage if she let in the other was too great. However, before her analysis it was not possible to be conscious of this, so she expressed the relational experience somatically, shoring herself up once and for all, or so it seemed.   Selma described how she had always felt less trusting of men and when she started relations she would ‘clam up’. The previous counsellor had suggested that she had experienced abuse, but there was no evidence of this in her experience or history, and I came to the conclusion that this was going nowhere, that is searching for a concrete event as a cause rather than understanding the qualitative relational disturbance being expressed. I said to Selma: ‘You say “clam up” – it is also like that with your vagina which states “no entry – all trespassing is prohibited”’.   The therapy was long, involving an exploration of her fears of irreparable damage by the other, working on separation from the primary family (by leaving home, as this was one of the achievements during the analysis) and challenging her defences by opening herself little by little to sexual sensation and a sexual relationship with her partner which was now experienced as threatening but not intolerably so. Selma struggled with the relational fears that were connected to bodily ones – being taken over – invaded and destroyed – by the other and so on. Conjointly with this relational reworking (through the dynamics in the analytic relationship), she also addressed her phobic responses by a gradual counter-action involving bodily self exploration with and without her partner. In consequence, the vaginismus slowly reduced its rigid grip and greater muscular flexibility become more possible; the vaginal contractions proved to be much more than simply a habituated involuntary reflex response.

This brief extract from one of my clinical cases raises some questions. How is it that a relational closure in the context of others becomes a lifelong contraction in the vaginal walls? How is it that a relational experience with others is expressed as somatic condition? What is the link between the experience of separation, affective and sensual states, meaning and the body? How does an attachment and sexual history coalesce in a physiological state and response?

As an experienced clinician focused on working with ‘psychosomatic’ or ‘conversion’ states, I have become increasingly frustrated with the way bodily symptoms are not well understood and not adequately addressed as a form of communication in their own right. From an academic standpoint the theoretical impasses in the psychoanalytic and psychosomatic literature and research are still only too plain to see; dualistic forms of thinking where divisions between mind/body and world are still upheld. I believe there is the need for a more relational understanding of the formation of bodily symptoms: how somatic expression is a communication of which the subject is unconscious. The body is capable of complexity, and biology is more malleable and can be transformed by an interpersonal and social field.

I have thus embarked on this ambitious interdisciplinary investigation into the nature of the body as a way of: (1) fundamentally challenging ­persisting dualisms; (2) putting forward an alternative and possibly more viable model of the body; (3) offering something to our understanding of ‘conversion’ and ‘psychosomatic’ symptoms that are seen in the clinic and are present in everyday life; and (4) hopefully encouraging a more creative exchange between the disciplines so that links between the different fields can be made.

WhyBetween Skins?

‘Between skins’ is about the way we exist with one another, how bodies connect, how biological processes communicate and how the skin as an exposed surface has direct contact with the field of others. This book investigates how relations with others and the social world can really get under and inside our skins.

The reference to ‘between skins’ is both to the skin as an exteriorized surface in intimate relation with others (and with the wider social environment) and to the ‘interior’ of the body, which is also profoundly affected by social interaction and environmental relations. What is implied is that any lining of or process in the body, whether derived from ‘without’ or ‘within’, can be rendered vulnerable to relational exposure.

Between Skins exploits the metaphor and the lived materiality of ‘between skins’, in order to show how skin-to-skin contact becomes a relational space where an affective connection is created between persons and the outside world: how so-called internal bodily processes do not inhabit a pure interiority but are altered by ‘outside’ influences from the very beginning and how the skin in both senses as an interior and an external surface is in the world and thereby becomes intertwined with the relational field of others and with social models of the body.

Reference will be made throughout to Merleau-Ponty, a philosopher and phenomenologist, a true revolutionary and innovative interdisciplinary thinker who explored the intersection between the life sciences and was sympathetic to psychoanalysis. He likened the body to a glove turned inside out, dedicated as he was to exploring the structure of inside and outside in respect to body and social field. He depicted the way the body is – in the world – and how the world of others inhabits the very heart of bodily life. This book will work to show how Merleau-Ponty’s trope can be used to describe the lived materiality of the flesh.

Between Skins opens up inside to outside and vice versa and asks the following questions: How do biology and the field of the social interconnect? How is psyche linked to body and world? How do others get literally and metaphorically under our skins, live in our sensations, affect our bodily experience and processes? How do feelings and meanings structure bodily perception, motility and function? How do cultural images and forms of life organize bodily experience and process?

This Book Sets Out To . . .

Between Skins signposts a paradigmatic shift that has taken place in ­psychoanalysis and allied disciplines. This is the move from a one-person psychology to a relational as well as a multi-personal perspective. The book foregrounds how this shift in focus translates into a new model of the body. What will emerge is a rigorous challenge to individualistic accounts of the body in order to show how the body (including biology) is social in nature.

The fact of our interpersonal being as both intersubjective and intercorporeal implies a radical departure from a one-person, one-body approach. Intersubjectivity and intercorporeality will be explained and illustrated as the book unfolds, but put most simply these terms describe how subjective and bodily states are fundamentally interpersonal and that feelings, ­meanings and even neurobiological processes are open to others and profoundly ­influenced by them.

The biologist Jacob von Uexküll has been seminal in conceiving the organism in relation to its environment. He showed how organism and environment are fundamentally interdependent and proposed that biology and language/meaning systems coexist. Exploring what is known as ­biosemiotics, he observed the growing and greater complexity of semiotic systems, especially in human societies (Uexküll 1926, 1957).

Starting from the connection between body and environment, and not the organism in isolation, implies a paradigmatic shift in an understanding of biology. It is a fundamentally different way of thinking about the relation between internal and external processes, inside and outside, bodily self and others, temporal–spatial relations and about the relation of the body to semiotic or signifying processes. The brain is not located in a vat but ­situated in a body and world, and this radically challenges the way the mind–body–world question is addressed.

Links with Psychoanalysis and Why Psychoanalysis?

In Anglo-American psychoanalysis the way the interior of the body connects to the external world and how the outer world relates to inner experience is the basis of much theorizing. So, for example, ‘internalization, ‘incorporation’, ‘projection’ and ‘expulsion’ are terms that are commonly used. The experience of receiving communications like a ‘projection’ or a ‘counter-transference’ in the clinical literature is increasingly described as somatic in affect and in effect. However, such an approach has, traditionally, unwittingly resorted to a binary of inside/outside where there exists no aperture from within the organism, psyche or subject for a relation with the outside environment and world of others. Without this issue being worked through, the ‘projections’ of feelings and bodily states end up having to jump over an unbridgeable gulf.

Between Skins, in exploring the radical nature and consequences of an intercorporeal approach, will focus specifically on how biology can be rethought from within psychoanalytic models of understanding. Why psychoanalytic models of the body? Because psychoanalysis potentially offers a non-reductionist view, involving complexity, and processes that do not rely on consciousness or awareness and where memory, emotion, image, fantasy and meaning play a crucial role in bodily experience.

Psychoanalytic models attempt to understand the relation between biology and how we become emotional about our bodies. It examines the ways we represent, imagine and fantasize about the body, and hence gives meaning to bodily experiences. In this respect psychoanalysis provides an analysis of the multiple layers of bodily experience and process. Such a complex understanding is required for exploring the peculiar nature of bodily symptoms that are seen in the clinic and that exist in everyday experience. These symptoms can present with alterations in sensation and often function but have no known organic aetiology or are not adequately understood by a reduction to an organic causation alone.

In examining figure(s) of the body in psychoanalysis, interdisciplinary connections will be created between attachment studies, the neurosciences, philosophy and the social sciences. As part of this project, it will be ­necessary to challenge the residual dualism that stubbornly persists in psychoanalysis and even to some extent arguably in neuroscience.

In this book I identify a persisting dualism in psychoanalysis, one which splits the body off from the so-called ‘mind’ and world and which in consequence renders psychic life and the representation of the body reified and abstract. Through the exploration an alternative figure of the organism will emerge, which shows how biology does not belong to a closed system but is open to affect, memory, meaning, the field of others and the cultural world. The materiality of the body and the importance of somatic experience and expression will be reinstated with a difference. For the soma will be situated in a relational context and therefore be inseparable from others, affective communication and meaning.

Towards Sociality

In addressing the interpersonal field of micro-relations in depth, macro-­relations can no longer be ignored: they set the scene of the wider context. Ultimately there is an extensive sensory field, where sensory-affective communication takes place between bodies and sensory information is constructed and transmitted by cultural, multisensory media and other organizational sites.

These sensory transmissions are actively received as sensory communications in bodily ways and these communications inform bodily experience. In referring to ‘sensory transmissions’, my emphasis is on non-verbal communication systems. The power and importance of linguistic expression is recognized, but my aim is to understand language more broadly, not as ­linguistic processes alone.

This project of relating the body to culture connects with other recent writings. Lafrance (2009), Manning (2009) and Pile (2011) all draw on ­psychoanalysis as a more satisfactory way of linking the body with sociality, particularly by way of the skin as the zone of exchange(s). My work ­continues with this theme but with specific application to the clinical context and to furthering interdisciplinary connections.

Embodied Cultural Differences

There is no neutral body. Others profoundly affect us and leave their marks which live on somatically. Before we are born contexts are already there, preparing to define us, and the moment we take a breath and are visible and tangible to a world, cultural markings are already at work, engendering, discriminating by colour and bodily type, classifying and so on.

The relation between body and inscription will be what Between Skins sets out to better understand and account for: how these social delineations get inside us and under our skins. In challenging the overarching and determining power of the a priori biological bedrock (prior to experience and as a founding given order), what will be revealed is an aspect of the body more open to protean potential, the way bodily processes in their function and form can be open to influence, alteration and transformation.

Relating to the Clinical Field

By applying the developing analysis of embodiment to clinical examples throughout, I will explore how somatic states and the social intersect in lived experience. The aim is to open up ways of analysing the body’s symptoms in the consulting room and in the social world at large. My work both as an academic in psychosocial studies and as an experienced clinician in psychoanalytic and related work makes it possible for me to develop conceptual understanding and to explore the links between theory and clinical reality.

Sexuality in relation to the body has a central place in psychoanalysis. In this exploration sexuality will be addressed, but not exclusively. On the one hand I shall question the way current Anglo-American trends in psycho­analysis leave out the body and sexuality. On the other hand, I view embodied motivational processes more broadly and in their complexity, and shall also address the relationship between attachment and sexuality. My approach to understanding the psychosocial formation of somatic symptoms will be multifaceted.

The Structure of the Book

Finally, some comments on the structure and style of this book. An organism is traditionally viewed in terms of a body whose content is held in and sealed off from the outside world by a skin. Between Skins begins with the interior of the body – the vital order, that is the internal bodily processes that are essential for life (Part II) – and moves on to the skin as the protective sac (Part III). However, as the book progresses this conventional structure – from the inside to the outside of the body – is reversed, or inverted, to reveal how the outside world is in fact not sealed off but already inside and endemic to the body’s interior, that is the outside is already inside.

Furthermore, the skin that initially resembles a fortress and functions like a barricade, with the inversion, starts to look radically permeable, letting the outside in and leaking vital contents into the world. Here the skin is no longer defined by what it contains, is not referred inwards but is left simply facing outwards, now utterly exposed in its absolute exteriority to relations with others, the containing envelope transformed, turned inside out. With this restructuring there also emerges another bodily figure, which is no longer located in a fixed place, all closed up, but instead is relationally situated within an environmental field, existing as more plastic and protean in nature.

The body of the book at first replicates the traditional bodily structure only to invert and eschew it, reinscribing and advocating in the very act of writing a new and different bodily configuration. The manifested textual body – form and structure – thus reiterates the book’s content, its core theme and argument.

Human development is not simply linear; it can jump ahead of itself with a sudden leap forward and then possibly regress backwards, and so on. So, in a related vein, a non-linear developmental movement forwards and then backwards at times characterizes the act of writing in this book.

The book opens with an introduction to contemporary developments in an interdisciplinary context, setting the scene for where the analysis will eventually go. This context is to help the reader gain an overall picture so that detailed points can be understood within a wider frame.

For a true leap forward, we have first to take a step back, for traditional impasses have to be faced and thoroughly worked through. This takes the form of persisting mind/body dualisms in psychoanalysis. From these impasses there is a foundational reworking, a shifting of basic premises and therefore the possibility for a genuine forward development towards a new emerging bodily figure. So the uneven development ends up doing the job that has to be done, that is, to make sure the old problems are rigorously challenged and are properly unravelled along the way.

The aim here is to show up the failure in the traditional approach to the body question, in order to offer a convincing and viable alternative. The aim of this journey, with all its twists and turns, is to engage with the complexity of the field and to attempt to readdress the body in psychoanalysis, to link this with contemporary interdisciplinary developments and clinical actualities.

A ‘grand project’ of this type will inevitably fall short; the claims and arguments made are necessarily tentative and are offered as provocations with the aim of inciting controversy and debate to further thinking and possible links between disciplines.

Note

1 When referring to clinical cases throughout I use an approach that is employed by some French psychoanalysts and termed a bricolage (Levi-Strauss refers to bricolage as drawing on materials at hand to create new ensembles: see ­Levi-Strauss 1968). In this context, this occurs when a composite figure is created out of material cleverly drawn from different analytic cases and combined with fictional narrative. This ensures that names, places, situations and individuals cannot be identified, while at the same time the analytic expertise in collecting ‘material fragments’ and re-narrating them ensures the integrity and clinical validity of the individual case study.

Part I

The Framework

Neuroscience and Interdisciplinary Connections

1

Introducing Interdisciplinary Connections

Interdisciplinary Connections

Here I signpost interdisciplinary links. The more detailed clarification and explanation of concepts and themes will become clearer later on. The ­exploration of interdisciplinary connections will, hopefully, be of interest to the interdisciplinary fields relating to neuroscience, philosophy and cultural studies, but I shall aim to contribute specifically to the fields of psychosocial studies and relational psychoanalysis.

While making various disciplinary connections, it is impossible to do ­justice to each specialist field; being a Jack(y) of all trades and master of few makes it difficult to please each specialization. One’s strength, it is hoped, is to be found in the links made between disciplines and in the opening up of the borders and the blurring of boundaries where possible.

It may at first appear odd to make links between such apparently different disciplines as philosophy, neuroscience, psychoanalysis and social and cultural studies, yet I would argue this is not the case. A relationship between the disciplines and their view of the body can be established, though this does not imply that the different approaches are always readily compatible. The aim of this book is to weave these distinctive fields into a creative exchange with one another in order to stimulate further debate and developments. It does not set out to claim definitive answers.

Philosophy is both a study of ontology (an understanding of the being of things) and a way of unpacking founding axioms. Philosophical ­investigation can be carried out on any discipline in order to identify and expose its founding assumptions.

Definitions of the body are frequently based on presuppositions that derive from philosophy and can be exposed as such. Mind/body divides have a basis in metaphysical thinking and such philosophical notions can be found in neuroscience in spite of scientific claims to the contrary. Likewise psychoanalysis and the social sciences can be influenced by ­dualistic divisions.

Dualism has dominated Western models of mind and body, and these models need to be challenged if a view of the body free of the dualist impasse is to be advanced. I shall look at the residual dualism in psychoanalysis. The main term to be introduced in Parts II and III is propping. This is a term coined by the French psychoanalyst Jean Laplanche and derived from the German word used by Freud, Anlehnung. Put simply, propping describes how the sexual drive and the more complex psychical representation of the body initially emerge out of the biological body processes, at first by leaning and finding support in, and then by deviating from, them. This results in a sexual drive ‘proper’ which is more closely linked to psychical/‘mental’ forms of representing the body. I explore how the term ‘propping’, despite being used as a border term to link body and psyche, does not in fact ­overcome dualism but resurrects the undissolvable divide.

The term ‘propping’ is important, as it also impacts on other important formulations, for example the work of the French psychoanalyst Didier Anzieu, who accounts for the emergence of the skin ego. Part III will be devoted to a discussion of his work and the skin envelope. The popularity of the propping concept as way of resolving the body/mind problem spread to social, cultural and film studies, so critical discussion of this term has ­relevance for these fields as well. I shall try to show up how dualism is a problem and how it can be worked through from within psychoanalytic thinking, drawing on interdisciplinary developments to support my argument.

In providing a preliminary overview of the context for writing the book, I have already introduced terms that may be unfamiliar and not yet adequately explicated. These are terms that describe interpersonal reality, like ‘­intersubjectivity’ and ‘intercorporeality’. Later I shall also refer to the ‘­mirror neurons’. These specialized neurons, it is claimed, provide a neurobiological basis for intercorporeality. I ask readers to bear with me: these concepts in their complexity will be explained as the argument unfolds.

For now suffice it to say that all such terms describe how the body, and even the biological processes, are bound to others. Mirroring and observing the actions of others is the way we learn about our own bodies. Furthermore it is through the other that biological processes and affective bodily experiences become patterned and structured. I explore how the interpersonal and social field is primary and profoundly influences the biological processes.

What is identified in this book is the emergent relational ontology regarding the body that cuts across the apparent disparate disciplines of philosophy, neuroscience, psychoanalysis and psychosocial and cultural studies. I have referred to this interdisciplinary development as a paradigmatic shift, a Copernican turn for these disciplines, that has resulted in a move away from the view of a physical body cut off from the psyche and the world towards that of a bio-psychosocial body.

There is the twentieth-century turn that brought about the paradigmatic shift described above, which philosophical developments made possible. As early as 1917 the German philosopher Edmund Husserl identified ­intersubjectivity. This is taken up by the philosopher Martin Heidegger, whose book Being and Time (1927; Heidegger 1962) examines the interpersonal field and intersubjective being. Maurice Merleau-Ponty ­developed an understanding of bodily being as profoundly bound up with others, ­referring to intercorporeality in ‘the child’s relations with others’ (1951; Merleau-Ponty 1964).

Since then Anglo-American and European researchers in developmental and cognitive psychology, psychoanalysts and neuroscientists have described and expanded upon relational models of the body. These different fields (including the philosophical) are in fact all connected in that they share the relational paradigmatic shift regarding the body.

In developmental psychology Colwyn Trevarthen (1978, 1979) is well known for importing the term ‘intersubjectivity’ from phenomenology and relating it to the early non-verbal bodily relation between infant and ­caretaker. Meltzoff and Moore (1977) refer to intercorporeal gestural ­mirroring in empirical research on infant–adult interaction.

Merleau-Ponty’s observation of intercorporeality has profoundly influenced neuroscientists, the most well known being the Italian neuroscientists Rizzolatti, Gallese and Iacoboni, and led to the discovery of the mirror neurons (Rizzolatti et al. 1996; Gallese et al. 2004; Iacoboni 2005). It is claimed that the neurobiological basis of intercorporeal being is to be found in the functioning of the mirror neuron.

In French psychoanalysis Jacques Lacan (1977b) had already proposed the mirror phase in 1936 (published in English 1966), and Merleau-Ponty, who was sympathetic to psychoanalysis, took up Lacan and described how intercorporeal being is the basis for the body image (in French, 1951; Merleau-Ponty 1964). Later, from different traditions in psychoanalysis Anglo-Americans Atwood and Stolorow (1984) related intersubjectivity to the analytic relationship, and Schore (1994) linked neuroscience and attachment to explore the biological relational basis in the early attachment ­relationship. In British attachment theory and Anglo-American relational psychoanalysis, a focus on intercorporeal and intersubjective approaches has flourished.

Intercorporeal and relational models have likewise influenced psychosocial and cultural studies, notably through the work of Massumi (2002) and the rise of the ‘affective turn’, which, arguably, has brought affectivity and the body into the limelight of social analysis.

Between Skins charts the move from dualistic thinking and the earlier ­psychoanalytic theories of propping to an emerging multidisciplinary and relational model of the body. The connections sought between the different disciplines is in no way spurious, for there are shared philosophical problems and revolutionary shifts that lie at the foundations of the different disciplines.

The problem is that there has been uneven development: the old dualistic models keep returning and the radical implications of the paradigmatic shifts have not been sufficiently understood. My purpose here is to show how links can be legitimately made between the disciplines to reveal a more viable body model.

Finally in such a context, where the body is not an island but tied to a relational field, what also needs to be considered is the relation between the body and language. This was referred to early on as biosemiotics and in later thinking as non-verbal and bodily forms of social communication.

Philosophical Concerns in This Enquiry

This work will address the ontological presuppositions that exist in the models of the body which are examined. It is worth looking at philosophical assumptions that underlie basic axioms, for when a set of suppositions are accepted unquestioningly they are taken for granted as givens, as mere ­assertions. Investigating the beliefs that lie at the basis of a paradigm enables us to reflect and evaluate their status.

In Being and Time Heidegger (1962) points out that regional ontology, whether in the life sciences or the humanities, makes assumptions about the nature of the ‘Being’ under study. There are assumptions in science about the ‘Being’ of biology, as there are assumptions in psychoanalysis as to the ‘Being’ of the psyche. Heidegger notes how fundamental ontology which raises the general question of what ‘Being’ is underlies every regional ­ontology. Therefore an investigation of the very question what Being is has some relevance to every discipline.

As part of the journey ahead I deal with the fact that, despite ­revolutionary shifts, the mind/body and body/world splits persist as a residual dualism. This is an interdisciplinary problem, but I shall address this particularly in psychoanalytic models of the body. One of my main tasks will be to work through the impasses set up in these dualistic models. I hope to add ­something to the debates that still rage, but this book does not set out to be an exhaustive study or to resolve the issues. It will, however, raise core concerns.

In my entry on ‘Biology’ in Feminism and Psychoanalysis: A Critical Dictionary I wrote:

Since the eighteenth century, biology has referred to the scientific study of organic life, the logos founding the law of nature. Biology can either be an open-ended scientific discipline, the ‘study of life’, or it can refer to a fixed and determined biological order. From its inception, psychoanalysis has made ­reference to the biological sciences. As a physician and neurologist, Freud was familiar with the natural and physical sciences of his day, and particular ­influences like Darwinism, and the physicality school of Brücke, ­Bois-Raymond, Helmholtz and others are well documented . There is a tension between the Freud who is in search of a biological bedrock and the Freud who develops a field of psychoanalytic enquiry. (Diamond 1992: 22)

One of the themes of this book is that if biology is understood as chiefly ‘logos founding the law of nature’, in other words as holdfast biological bedrock, the consequences are that biology remains fixed and determinate, a law entire unto itself. Such a figure of biology shows itself as not malleable to change. This will be contrasted with another model of biology, more open from the first, where it has insufficiencies from the beginning and is ­dependent on a relationship between two or more person-bodies where organism and environment are interdependent (Uexküll 1926).

The more open model, I suggest, allows a link between biology and semiotics and more complex language-based systems. Once the full implications of the more radical and open biological model are taken on board, the ­dualistic view is called into question and the biological bedrock model is fundamentally rewritten and reworked at its very foundations.

My aim is to foreground how the somatic terrain is much more open than has previously been understood, how somatic capacities can be altered by interaction with the fields of others and how this affects the development of bodily processes, their form and mode of expression. I suggest that the ­bodily symptom that is presented at the clinic and in everyday life in fact reveals a developmental interpersonal and social history. Reference to the ‘psychosomatic condition’ can be replaced by the term ‘sociosomatic symptom’.

The Irreducible Organic Component and How It Figures for Us

Despite the inevitable interpenetration of the biological and social domains, there is always the ‘facticity’ (Heidegger) of the body: death is imminent, bodily processes can break down as pathological cell and tissue processes manifest themselves as cancer, for example, and so on. Merleau-Ponty referred to the irreducibility of the body that sets limits to existence that no one can ultimately control.

So despite the focus on somatic aperture, on biological plasticity and on the ramifications of interdisciplinary developments that open the body onto a relational field, there is always an aspect of the body that is irreducibly organic and cannot ultimately escape death. This aspect is inevitable, leaving the human being and all living beings ultimately helpless and entirely vulnerable.

One of the possible meanings of the Lacanian ‘real’ is an aspect of the body that resists any form of comprehension, is fundamentally irreducible and ungraspable. Whereas I refer to the body that defies processing control or meaning and can never be tamed, to unbound body states that can be unleashed and can roam wild. These are associated with body phantasmagoria, the most macabre and estranged body experiences, reflecting the extremes of alterity, where any stabilized body identity is lost. Alexandra Lemma (2010) points out that the unbounded grotesque body is well explored in the phantasmagoria of the flesh in David Cronenberg’s films.

Neuroscience: One of the Important Bed-Mates

In the flourishing field known as neuropsychoanalysis, headed by key ­thinkers and researchers like Mark Solms and involving many important neuroscientists and psychoanalysts, there are both tensions and differences in perspective as well as the attempt to produce a coherent and integrated model. One tension is the discrepancy between a one-person body and ­two-person body model and in this context between taking the individual organism as the primary unit of analysis, in contrast to the focus on what goes on between organisms. In the first model the biological determinants and ­psychic dynamics ‘internal’ to the organism take precedence, while in the second model intercorporeal relations play a central role and the impact of environmental influence is highlighted. It is the latter model that I favour and foreground in this book.

In addressing psychoanalysis and neuroscience I do not take neuroscience as the master discourse and I do not limit the analysis to neurobiological descriptions of dynamic brain processes. Instead I focus on a genuine ­interdisciplinary approach to psychoanalysis, drawing on social science and ­philosophy as well as neuroscientific findings. I also recognize the fact that psychoanalysis in its richness and complexity can at times inform ­neuroscience, and not only vice versa.

I will try and avoid neuroscientific reductionism which can lead to the ­following problems: (1) describing physiological, neurological and anatomical processes and features in depth as a way of explaining phenomena: as a method on its own, this does not explain the psychobiological experience, its phenomenology and meaning; it does not capture bodily perception and certainly none of its complexity; (2) the body is regarded too much as a reactive system to stimuli and hence descriptions of brain processes can be too mechanistic.

I reiterate the importance of exploring how meaning can play an active role in bodily experience and process. The broader role of semiotics and language (understood in a broad sense and not reducible to linguistic phenomena) in body processes will be a key area in my exploration. It is not enough to resort to what I consider reifications of ‘psyche’ or ‘mind’ as meaning creators. This does not adequately take into account the way the social field and the world of others influence meaning-making.

In exploring interdisciplinary connections between neuroscience and ­psychoanalytic, social and philosophical thinking, I acknowledge the controversy as to the viability of such a project. With the recent upsurge of popularity in neuroscience within psychoanalysis and in areas of the social sciences there has been scepticism as to the scientific status of such applied neuroscience and questions regarding its usefulness in social and ­psychoanalytic studies.

In response to such concerns, I have tried to avoid the usual pitfalls, challenging neuroscience as master discourse, and any reductionism, while ­opting for a genuine interdisciplinary enquiry. However, beyond this, hypothetical models are part of any scientific exploration and evidence in the natural sciences is always being debated. The use of neuroscience in interdisciplinary research and by those who are not neuroscientists is ­evidently on more rocky ground, and scientific claims for evidence can be poorly made and substantiated.

The claims put forward in this book are suggestive. The neurological–social relations proposed are made to get the creative connections flowing further, to encourage debate, criticism and further research by specialists in the field(s). In this book the line between an imaginary and actual neurology is not clear-cut, but what is clear is the importance placed on the biosocial relation for understanding life and how it is lived.

Challenging a Top-Down Approach

In neuroscience the brain is central but always inextricably bound to body processes. As Jaak Panksepp (1998) implies, the brain is not suspended in a vat but exists in a body and a world. Despite the fact that in neuroscience there can be a tendency to localize brain functions, it is, of course, ­understood that in actuality these can be considered only in the context of processes across the brain and in complex brain–body dynamic relations.

In terms of brain functions, thinking has been related to synaptic links and the neural connections made. The cortical brain is described as ­connected to ‘higher’ social cognitive functioning but these processes cannot be regarded apart from the so-called subcortical brain where basic emotions are said to be located and are directly linked to affective bodily states, routed in body ­processes. These affective and bodily states have been aligned to the ‘instincts’.

‘Instincts’ as a term relates to the translation of Freud and the resulting Anglo-American readings of Freud. Neuroscientists such as Jaak Panksepp (1998) have discovered a number of neural emotive-motivational systems and this challenges Freud’s more limited dual classification of the life and death drive. In respect to brain development the subcortical brain ­processes related to primary motivational systems are developed in an ­interactive nurturing context and later become ‘integrated’ into higher cortical processes.

This book challenges an over-mentalist approach: ‘brain’ is not an equivalent for ‘mind’. In neuroscience the reification of the brain takes place when a top-down brain approach is advocated, a point of view that I question and do not subscribed to. As I have implied, the localization of brain functions has to be viewed in the context of brain–body processes. There are complex bidirectional loops involving sensory information from the environment, influences from sensory muscular and neural body processes, and ­interactions within complex brain dynamics.

Antonio Damasio and Gerald Edelman, both eminent neurobiologists, offer convincing arguments for the dependence of the brain on the body (Edelman 1992; Damasio 2000). Memory is not simply localized in the brain but exists throughout brain–body systems in interaction with the environment.

To counter the fallacy of a top-down approach: recent explorations into major organs such as the heart and the stomach have identified neural cells that are likened to brain cells in the heart and along the entire lining of the gut (Lacey and Lacey 1978; Gershon 1999; Lorimer 2001; McCraty 2004). Memory function and emotion have been related to the heart and the stimulation of hormonal changes in the body, while enzyme secretions ­generated by the stomach send messages to the brain concerning hunger, stimulations of hunger which may have no relation to the actual biological need to eat.

In highly developed robotics the patterning of sensorimotor coordination is possible only if memory systems are distributed throughout the ‘­organism’ which gives insight into the human body situation (Pfeifer and Bongard 2007; Pfeifer and Hoffman 2010).

The Brain–Body Map

The figure representing the layout of the body in relation to the ­sensorimotor cortex of the brain is typically caricatured as a man with huge hands, lips and tongue. This is known as the homunculus (Figure 1.1). The brain’s sensorimotor cortex strip is where the body map is said to lie (Figure 1.2). In the homunculus the exaggerated body parts reflect the concentration of sensory nerve endings, which lead to heightened sensitivity, in certain parts of the body. This brain map is routed through bodily processes and is ­precisely a brain–body map. For the brain–body map receives sensory and motor-neural information from the body and is also influenced by the way the body is mirrored and imaged.

Figure 1.1 Brain–body map, or sensory homunculus. Photo © Natural History Museum, London.

Figure 1.2 Brain–body map showing (a) somatosensory cortex in right cerebral hemisphere; (b) motor cortex in right cerebral hemisphere.

The sensorimotor cortex strip is one of the most interesting areas of the brain related to the representation of the body. The brain–body map is the neurobiological correlate of Freud’s body ego (Freud 1974 [1923]; Damasio 2000) which, I argue, is linked to the sensory body and is a construct. Figure 1.1 shows a body already influenced by representation. That it is ­represented as a man is, of course, related to the influence of social ­representations of the body; gender comes into the picture as the representation of the male body continues to enjoy hegemony in the way it is often used to stand for humankind, both male and female. The enlargement of the hands and lips relates to these being very sensitive areas; however, the genitals could arguably take up more representational space. Also, alterations can be brought about in the brain–body map, as there is neural plasticity (a fact which I shall make much of in this book).

How the body is stimulated and the use of body part(s) can alter sensitivity. There is a potential for any part of the body to become ‘invested’ and an exaggerated focus of attention a point Freud makes clearly. Developmental experiences can alter sensitivity in areas of the body, and this arguably has an effect in bringing about subtle changes in the brain–body map.

Although there is some basis in argument for a genetic brain map (Melzack 1999), the map is not determined by a genetic body map alone: there is significant neuroplasticity, as recent neuroscientific research has discovered (Ramachandran and Blakeslee 1999; Ramachandran and Rogers-Ramachandran 2000; see Part III). Price (2006) argues that congenital amputees are profoundly influenced by the image of the body derived from others, and proposes a developmental model where the body image derived from others plays a key role in the formation of the body map.

How the body is used, such as in motility and comportment, can influence the body map. The brain–body map is ‘normally’ influenced by sensory input derived from the interaction between body and environment. However, in cases where there is a loss of a limb, and therefore fresh sensory input is lacking, treatment using artificial limb and trickery with mirrors can ­activate the action–body memory and the mirror neurons, thereby creating a ‘­corrective’ corporeal image–sensory feedback mechanism which can reduce lower limb phantom pain and thus alter sensory perception of pain (Ramachandran and Rogers-Ramachandran 2000). This illustrates how the visual image derived from the environment can influence the construction of the brain–body map.

Finally, a comment on the brain–body map: it has been referred to in the singular, but in fact there can be a number of them, or rather a variety of configurations in play. As the question of body image in relation to the body map is addressed, this possibility of different and changing body images becomes apparent. The suggestion is that versions of the body influence brain–body mapping.

I shall consider the way the body is mirrored by the external environment, including how others play a role in this and in the development of the body image throughout the life span and the effects this has on the map. The brain–body map is not fixed. It can alter and can itself generate change. This is the effect of neural plasticity: the brain-body map(s) is not a static phenomenon.

Psychoanalysis: The Brain–Body Map and Body Image

I am interested in looking at the relationship between the neuroscientific exploration of the brain–body map and body image in the light of ­psychoanalytic insights regarding body image. As early as 1923 Freud noted that the neurobiological correlate of the body ego is located in the ‘cortical homunculus’ which lies across the sensorimotor cortex (see Figure 1.2 and Part III):

The ego is first and foremost a bodily ego; it is not merely a surface entity, but is itself the projection of a surface. If we wish to find an anatomical analogy for it we can best identify it with the ‘cortical homunculus’ of the anatomists, which stands on its head in the cortex, sticks up its heels, faces backwards and as we know, has its speech-area on the left hand side. (Freud 1974 [1923]: 16)

Neurobiological findings do suggest that this body-image ‘ego’ can be ­influenced by the mirror image and the mirror neurons imply that that this body-action image is based on the observation of others. The claim that ­mirror neurons are the neurobiological basis for an intercorporeal process links up with Merleau-Ponty’s observation of the mirror image derived from others and Lacan’s description of the mirror phase. I thus identify inter­disciplinary connections for an understanding of the interpersonal and social formation of body image, and suggest a possible relation with brain–body mapping, a point that will be more adequately fleshed out and ­discussed in Part III.

Lacan’s understanding of the idealized and constructed nature of the image helps explain how body representations may exaggerate, alter and morph into something else, making body image potentially dysmorphic and changeable in experience. From a neuroscience perspective Ramachandran and Blakeslee (1999) comment on the way neural plasticity permits rapid change to take place in brain–body mapping.

The psychiatrist and psychoanalyst Schilder’s earlier contribution to an understanding of body image is invaluable. Schilder combined Carl Wernicke’s concept of the somatopsyche and Sir Henry Head’s (1920) ­postural model of the body with Freud’s (1974 [1923]) idea that the ego is primarily a body ego to arrive at his own formulation of the fundamental role of the body image. In The Image and Appearance of the Human Body (1950 [1935]) Schilder argues that body image can be related to sensorial body states and makes it clear that the body image cannot be reduced to a reified mental experience.

Schilder proposes a dynamic body image which is not fixed and has ­plasticity. Furthermore the body image is not static but for Schilder exists in lived motility, and is informed by kinaesthetic, visceral and other ­sensorimotor messages from the body. I embrace this aspect of Schilder’s approach: his body image is not an abstract phenomenon in the realm of pure ideation; on the contrary, it is living and sentient, relating to motility and sensory states. Schilder’s body image, like the brain–body map, is a multisensory construct.

Body Image versus Body Schema

Whereas Schilder relates the body image to body schema and therefore does not make an absolute distinction between image and motility, Gallagher and Cole (1998 [1995]) have argued for clarity in definition, noting the ­confusion between Schilder’s body image and Head’s postural schema. They wish to separate out body image from (postural) body schema. Although Gallagher (1986) has argued that a clear conceptual distinction between body image and body schema is helpful in working out functional differences, he also emphasizes that the conceptual distinction should not imply that at the behavioural level image and schema are unconnected or that they do not sometimes affect one another.

One of the key issues for Gallagher and Cole is that the body schema maps the body for motility and functions automatically, without our ­awareness, sub-personally and non-consciously governing our posture and movement, whereas they wish to designate body image as perceptual, intentional and conscious. In other words, body schema is the basis of movement as such and body image the basis of subjective experience. In Gallagher and Cole’s formula, body schema has consistency in being basic to ongoing ­functional motility and the body image can perceptually alter according to ‘subjective’ state.

Why I Do Not Adopt Gallagher and Cole’s Terminology

Although Gallagher and Cole’s work is respected, there are various reasons why I shall employ another frame of reference and different terms. I would argue that complexity sets in when we consider a virtual geography that can alter and vary, and is not separable from motility. The many examples of clinical symptoms discussed throughout this book testify to the inseparability of lived body states.

Further, Gallagher and Cole’s thinking is situated in a cognitive f­ramework, and so clear-cut definitions of terms introduce complications when the framework adopted is not that of cognitive psychology. In ­contrast to Gallagher and Cole’s view, when body image is approached from a psychoanalytic perspective it is not mainly conscious or subjective. In Freud body image is unconscious as well as having a conscious aspect. Merleau-Ponty refers to the pre-reflective, and in this context the sense of body ‘self’ resides neither in a third-person nor a first-person perspective but can exist in an ambiguous position between embodied subject and other.

My approach is sympathetic to both Freud, who argues that body image can also be outside conscious awareness, and Merleau-Ponty, who believes that body image is not owned in a simple way by a unified ‘I’ but is ­predicated on the perspective of the other. A definition of body image that derives from and is endorsed by contemporary perspectives in psychoanalysis, phenomenological philosophy and neuroscience describes how body image(s) is (are) fundamentally influenced by others.

Body image is derived from the other (Lacan 1977a [1936]) and the space of the field of the Other,1 mirrored from ‘outside’, as inevitably bound to otherness. Lacan refers to the Other as a position no actual person can occupy. I use the term here to emphasize how the body is always predicated on an otherness which it cannot appropriate as owned and to indicate how the body is subjected to an irreducible exteriority that is always there: there is always a look coming from the outside field which cannot be eradicated. Because I adopt a two-person and multi-person approach, subjectivity is never truly autonomous; intersubjectivity and intercorporeality are always in play. I shall argue that the third comes first, in the sense that otherness from the first defines the body; the perspective of the first person-body depends on and derives from a third-person perspective.