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The phenomenology of depression and the nature of empathy

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Abstract

This paper seeks to illuminate the nature of empathy by reflecting upon the phenomenology of depression. I propose that depression involves alteration of an aspect of experience that is seldom reflected upon or discussed, thus making it hard to understand. This alteration involves impairment or loss of a capacity for interpersonal relatedness that mutual empathy depends upon. The sufferer thus feels cut off from other people, and may remark on their indifference, hostility or inability to understand. Drawing upon the example of depression, I argue that empathy is not principally a matter of ‘simulating’ another person’s experience. It is better conceived of as a perception-like exploration of others’ experiences that develops progressively through certain styles of interpersonal interaction.

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Notes

  1. An influential account along such lines is that of Goldman, who refers to the “simulation (or empathy) theory” and thus treats the two as synonymous (2006, p. 17).

  2. The term ‘mirror empathy’ refers to mirror neurons, which are hypothesised to facilitate an appreciation of the meaning of expressions, gestures and goal-directed actions by matching perceived actions with complementary activity in the perceiver’s own motor system. See Ratcliffe (2007, Chapter 5) for further discussion of mirror neurons and intersubjectivity.

  3. See also Gallagher (2012) for a detailed critique of simulationist approaches to empathy. Gallagher criticizes ‘mirror’ simulation too, which—he argues—does not qualify as ‘simulation’ at all.

  4. See, for example, Gallagher (2008), Krueger (2012) and Stout (2012) for recent defences of the claim that we perceive certain kinds of mental state.

  5. The perceptual view is perhaps also in tension with the insistence that empathy is, as Thompson (2007, p. 388) puts it, “a sui generis kind of intentional experience”. If empathy is a type of intentional state in its own right, then empathizing might resemble perceiving in some respects, just as imagining and remembering do. However, as a distinctive kind of intentional state, empathy is no more a kind of perception than they are.

  6. Shenk suggests that people struggle to describe depression because some depression experiences have little in common with others, and that the term ‘depression’ thus conveys little of what a given individual is experiencing. Although I focus upon another reason here, I agree that the heterogeneity of depression plays a role too.

  7. The study was part of the AHRC- and DFG-funded project ‘Emotional Experience in Depression: a Philosophical Study’. The questionnaire was posted on the website of the mental health charity SANE and involved self-selection of participants. The testimonies quoted here are a representative sample taken from over 150 detailed responses. Two-thirds of the respondents stated that they were depressed at the time of writing.

  8. See Ratcliffe (2008, Chapter 4) for discussion of the relationship between experience of bodily dispositions and experience of worldly possibilities.

  9. Although I focus upon depression here, I do not wish to suggest that the ‘world’ is only altered in depression. Many psychiatric illnesses are world-affecting. For instance, experiential changes associated with schizophrenia are difficult to empathize with for the same reason (Pienkos and Sass 2012). Furthermore, it is not only psychiatric illnesses that involve disturbances of world. That we seldom reflect upon or describe them does not imply that they are rare. Circumstances such as jet lag, somatic illness, bad hangovers, grief and trauma can all, I suggest, involve some degree of ‘world’ disturbance.

  10. This should not be construed in an additive way, as a quasi-perceptual grasp of experience plus interaction. The former is enabled by the latter; you perceive through the interaction (De Jaegher 2008).

  11. Some accounts of interpersonal interaction maintain that, in certain circumstances, the interaction process takes on a degree of autonomy and enables understanding in a way that cannot be analyzed in terms of individuals’ abilities to understand each other. De Jaegher and Di Paolo (2007) refer to this as “participatory sense-making”. Fuchs and de Jaegher (2009) emphasize its reliance upon various bodily capacities, including affect, gesture and expression, all of which feed into a dynamic, unitary process characterized by both synchronization and disruption. They use the term “mutual incorporation” to stress the extent of reciprocity between participants’ bodies, whereas Froese and Fuchs (2012, p. 211) prefer the term “extended body”, to capture how participants’ bodies can become “inextricably entwined in a dynamical whole”. Such claims are congenial to the account of empathy proposed here. However, even if it were to turn out that interaction is not—as these authors maintain—an “emergent process”, the view that empathy is facilitated by interaction would be unaffected.

  12. The case of empathizing with pain is complicated by the distinction between somatosensory and affective aspects of pain. See de Vignemont and Jacob (2012) for discussion.

  13. Halpern (2001) recognizes that empathetic appreciation can be a mutually transformative process and stresses the significance of this in clinical contexts. The clinician who empathises with the distress of others will need to regulate and cope with the ways in which interaction shapes her own experience.

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Acknowledgments

Thanks to Fredrik Svenaeus, conference audiences at the Universities of Södertörn, and two anonymous referees for helpful comments on an earlier version of this paper. I am also grateful to the mental health charity SANE for hosting the questionnaire study that I draw upon in this paper, to all those who responded, and to the AHRC and DFG for funding this research.

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Ratcliffe, M. The phenomenology of depression and the nature of empathy. Med Health Care and Philos 17, 269–280 (2014). https://doi.org/10.1007/s11019-013-9499-8

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