Body Dysmorphia and the Phenomenology of Embodiment

ABSTRACT

This paper explores the relationship between phenomenology and body dysmorphia. This is, to explain, a disorder in which the sufferer perceives, and is obsessed by, defects in appearance which are either non-existent or severely exaggerated. I will see how Husserl’s and Sartre’s analyses of embodiment can explain the radical uncertainty, and anxiety, about appearance that underscores this condition. Their accounts of the body-as-lived reveal first of all an essential intimacy between body and self that the “objective”, material, view of the body covers over. Second, however, their analyses show that there is always also an essential elusiveness of the body before our attempts to grasp or know it. Taken together, these points indicate how body dysmorphia arises. If there is an essential project of the self to know the body, but this is necessarily frustrated, then we can see how an obsession and anxiety surrounding bodily appearance can emerge.

Notes

1 Phillips, The Broken Mirror, 27, quoting The Diagnostic and Statistical Manual of Mental Disorders, 1987.

2 Morris, ‘The Phenomenology of Body Dysmorphic Disorder’, 171.

3 With the exception of work by Morris herself, and by Fuchs. Their positions, and their relation to the current analysis, will be discussed in more detail later in the paper.

4 As seen, for instance, regarding depression in Mathew Ratcliffe’s Experiences of Depression: A Study in Phenomenology.

5 Although the medical categorization and definition of BDD only came much later (see Phillips).

6 Pankejeff and Brunswick, The Wolf-man by the Wolf-man, 265. Also, Phillips, The Broken Mirror, 13, 83.

7 Freud, as Sergei Pankejeff points out in his autobiography, was largely uninterested in his appearance concerns, but draws upon a dream Pankejeff had, involving a tree full of white wolves, to develop his theory of sexuality and the unconscious.

8 Phillips, The Broken Mirror, Chapter 7.

9 Ibid., 89.

10 Ibid.

11 There is other evidence for this point, that BDD is defined by vacillation, which could not be included for reasons of space. For example, the belief in certain cases that one’s fingers are getting bigger or smaller over time (Phillips, 63–4), or the desire, on the part of sufferers, for other people to agree that the defect is present. Likewise, it is common for sufferers of BDD to claim they look “OK”, or even attractive, at certain times and then exceptionally ugly the next (Phillips, 57). Similarly, BDD often involves patients who believe they are balding, but never those who are actually bald.

12 This “vacillation”, as defining the condition, would also explain why skin and hair are the most common preoccupations in BDD, as they are most subject to change.

13 Morelli, cited in Phillips, The Broken Mirror, 16, 315.

14 Heidegger, Being and Time, 50.

15 See Husserl, Ideas Pertaining to a Pure Phenomenology and to a Phenomenological Philosophy: Second Book, from here on referred to as Ideas II.

16 Morris, ‘The Phenomenology of Body Dysmorphic Disorder’, 174–5. Morris, drawing upon Sartre, actually identifies five different dimensions of the body. For reasons of space we will mention only the three most relevant to BDD.

17 Morris, ‘The Phenomenology of Body Dysmorphic Disorder’, 176.

18 Fuchs, ‘The Phenomenology of Shame, Guilt and the Body in Body Dysmorphic Disorder and Depression’, 234.

19 Ibid., 228.

20 This is also the order of priority in Part three, Chapter two, of Sartre’s Being and Nothingness, where analysis of the “Body-for-itself” precedes that of the “Body-for-Others”.

21 Zahavi, Self-awareness and Alterity, 92.

22 In Ideas II, Husserl points out that even in imaging a Minotaur we always imagine him from a certain perspective, moving towards or away from us. Likewise, on this point, Merleau-Ponty, Phenomenology of Perception, 77, suggests that saying there is a disembodied perspective on an object is the equivalent of claiming that the object is invisible.

23 Husserl, Ideas II, 61.

24 Zahavi, Self-awareness and Alterity, 96.

25 In a similar way, our lived experience, and perception, of “distance” is not necessarily identical to the objectively measurable area to be covered, for instance in feet and miles. Rather, how far away, or how close, something seems is also relative to the familiarity of the route to get to it, and the perceived difficulty of traversing a certain area.

26 Heidegger, Being and Time, 236.

27 Ibid., 243.

28 Sartre, Being and Nothingness, 317.

29 Morris in ‘The Phenomenology of Body Dysmorphic Disorder’, 182–83, also touches upon the issue of the body’s elusiveness to the self and its connection to body dysmorphia. She describes this in terms of “inapprehensibility”, and the inability to attain “certainty” about how we look. However, her analysis is focused on a kind of elusiveness regarding the “body-for-others”, rather than the elusiveness concerning the “body-for itself”. For reasons stated earlier, though, we are concerned here primarily only with the connection between BDD and the latter.

30 Husserl, Ideas II, 167.

31 Stein, On the Problem of Empathy, 41.

32 Morris’ explanation in ‘The Phenomenology of Body Dysmorphic Disorder’, 182–83, for why “certainty” cannot be attained regarding the body also seems similarly based on contingent factors. She cites the constitution of mirrors, the fact that we can be certain only at the moment we’re looking in the mirror (and cannot look in the mirror all the time) and the possibility of others lying to us as reasons for the body’s elusiveness. She does this rather than explaining elusiveness in terms of an essential constitutional factor regarding our embodiment. In short, then, while correctly identifying lack of certainty about appearance as key to BDD, she does not ultimately explain why fundamentally some kind of certainty cannot be attained there.

33 Sartre, Being and Nothingness, 358.

34 Stein, On the Problem of Empathy, 41.

35 Merleau-Ponty, Phenomenology of Perception, 105.

36 Ibid., 103.

37 Ibid., 103.

38 Ibid., 103–04.

39 Stein, On the Problem of Empathy, 41.

40 This also explains why sufferers often want others to confirm the true horror of what they fear, but cannot ever know, to be the case. That is, it explains as Morris puts it, citing Phillips, “the seemingly strange behaviour of trying to persuade others that his view of the defect is right” (Morris, ‘The Phenomenology of Body Dysmorphic Disorder’, 183; Phillips, The Broken Mirror, 118–19). For then at least the horror would be limited, as opposed to potentially unbounded.