Article

Theory & Psychology

A cultural-existential 21(3) 355­–376
© The Author(s) 2011
approach to therapy: Reprints and permission:
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Merleau-Ponty’s DOI: 10.1177/0959354310397570

tap.sagepub.com

phenomenology of
embodiment and its
implications for practice

Andrew J. Felder
University of California, Los Angeles

Brent Dean Robbins

Point Park University

Abstract
Maurice Merleau-Ponty’s phenomenological philosophy provides the basis for a form of cultural-
existential therapy.  Through an examination of Merleau-Ponty’s analysis of the phantom limb and
anosognosia, we develop a cultural-existential approach to “psychopathology” and its treatment.
In the course of this analysis, ego-syntonic labels are seen in the light of culture-syntonic
considerations, depth analysis is married to breadth analysis, empathic understanding is re-
understood through a dialectical mode of understanding, medical and psychological analyses are
recast within a cultural analysis, and being is resituated within a flesh ontology.  Whereas a cultural-
existential psychotherapy may compassionately rally around a therapy of situated individuals, it
also calls for mindful attention to a therapeutics of culture.

Keywords
existentialism, Merleau-Ponty, multiculturalism, phantom limb, psychotherapy

In the United States, contemporary psychotherapy is practiced within a framework of

particular cultural-historical values. The trend toward cognitive, behavioral, supportive,
and didactic interventions serves to support a Western discourse of values associated
with individualism, rationalism, low-context communication, and pragmatic doing over

Corresponding author:
Andrew J. Felder, UCLA, Counseling and Psychological Services, John Wooden Center West, 221 Westwood
Plaza, Los Angeles, CA 90095-1556, USA.
Email: andrfeld@aol.com
356 Theory & Psychology 21(3)

against being (Dodd, 1987; Triandis, 2003). In the quest for a more context-sensitive
approach to therapy, the exploration of alternatives can be generative. Toward this end,
we examine how Merleau-Ponty’s existential considerations of “psychopathological”
existence and psychoanalytic thought might help expand the cultural and contextual
horizons of therapy. By engaging in a dialogue with the phenomenal and cultural com-
plexity comprising what Merleau-Ponty (1964/1968) calls the flesh of the world, we
suggest that practitioners can faithfully gear their intuitive, interpretative, and “depth”-
oriented contributions to working alliances with patients. For example, a psychodynamic
practitioner’s understanding of defenses, syntonic and dystonic aspects of selfhood, ana-
lytic versus empathic interventions, and “psychological” interpretations can be re-
visioned in an intercultural and existential light—in the light of what we refer to as a
cultural-existential approach to therapy. Our emphasis will not be placed upon specific
therapeutic techniques for deployment in clinical settings. Rather, our aim is to explore
how the philosophy of Merleau-Ponty may help to situate therapy within a more cultur-
ally and contextually inclusive ground for many kinds of practices.

A brief history of existential phenomenology and its

applications to therapy
The effort to ground therapy in existential phenomenological philosophy is of course noth-
ing new. Ludwig Binswanger (1963) and Medard Boss (1963, 1979) had some success
with their varied attempts to re-vision psychoanalysis from out of Heidegger’s ontology,
although Boss’s Daseinsanalysis was most faithful to Heidegger’s philosophical terms.
Nevertheless, Heidegger (2001) rejected the notion that his ontology could be applied to
the ontic science of psychology, a concern which led Boss to envision psychology instead
as a neighbor of philosophy rather than a discipline founded on a philosophical ontology or
anthropology (Sipiora, 2000). In contrast, it can be argued that Merleau-Ponty’s flesh
ontology poses no such difficulties, since Merleau-Ponty himself was in constant dialogue
with psychoanalytic and experimental psychology, psychiatry, and neuroscience from his
earliest work, The Structure of Behavior (1942/1963), to his swan song, The Visible and the
Invisible (1964/1968), which was left unfinished at his untimely death. Yet, to the best of
our knowledge, no scholar or practitioner has yet attempted to articulate systematically
how Merleau-Ponty’s philosophy can serve the function of grounding a contemporary exis-
tential therapy sensitive to culture and context.
Merleau-Ponty stands as one of the most influential figures in 20th-century continental
philosophy, and his thought can be better comprehended as in dialogue with his predeces-
sors and contemporaries, including Edmund Husserl, Martin Heidegger, Jean-Paul Sartre,
and Jacques Lacan, among others. Whereas Husserl shared with Freud a common influ-
ence in the figure of Franz Brentano (Wertz, 1993), their work is only tangentially related;
they do not reference one another. Sartre (1962/1996) attempted to develop his own version
of existential psychoanalysis to rival Freud’s, and he soundly rejected the notion of an
unconscious. In contrast, Merleau-Ponty (1964/1968) took Freud’s notion of the uncon-
scious very seriously and stated that psychoanalysis and phenomenology aim toward the
same latency. Merleau-Ponty differed from his younger colleague Jacques Lacan in that he
remained rooted in the phenomenologist’s emphasis upon the primacy of perception,
Felder and Robbins 357

whereas Lacan gave precedence to language and rejected any psychoanalysis based in
consciousness (Phillips, 1996)—a difference with radical implications for the practice of
therapy. Lacanian analysis has its parallels with a therapy founded in phenomenology, but
ultimately it lacks the fidelity to experience, to which the phenomenologically oriented
practitioner is necessarily wedded. Lacanian analysis has a more radically Freudian empha-
sis upon puns, parapraxes, and other linguistic avenues to the unconscious (Fink, 1996).
Many psychotherapists have drawn liberally from existential and phenomenological
philosophy, including Rollo May (1983), R.D. Laing (1960), J.H. van den Berg (1972),
Viktor Frankl (2006), Irvin Yalom (1980), James Bugental (1980), Kirk Schneider (2007),
and Erik Craig (2000), to name a few. But none of these distinguished therapists did the
work of clearly articulating the implications of Merleau-Ponty’s philosophy for psycho-
therapeutic practice. Among these, Laing is, perhaps arguably, the most exemplary in his
attempt to draw out the implications of existential-phenomenology for understanding the
cultural-historical situatedness of psychotherapy. However, Laing was largely an unsys-
tematic thinker (Bortle, 2001), and, for good or ill, never fully realized his vision of an
existential psychotherapy (Burston, 1996). He certainly did not, in his writing, explore the
work of Merleau-Ponty in any kind of scholarly depth. The work of realizing the implica-
tions of Merleau-Ponty’s philosophy for practice is a task that remains to be done.
Some may find it easy to see affinities between our conclusions and other approaches
to therapy. For example, therapies inspired by systems theory, such as Michael White and
David Epston’s (1990) narrative therapy and Lynn Hoffman’s (1981) approach to family
therapy, share much in common with the holistic elements of phenomenologically
informed therapy. However, they lack the ontological and epistemological rigor of a
therapy founded on a systematic thinker such as Merleau-Ponty, and for that reason their
work is more vulnerable to co-optation into positivist frameworks that miss the essential
point of their “postmodern” attitude. We believe work such as theirs can be better illumi-
nated and supported by the scholarly work characteristic of our paper. Lynn Hoffman
(personal communication, September 3, 2005), for example, has expressed an interest in
such a philosophical grounding for her work, and for this reason has been consulting
with John Shotter, whose own philosophically informed work in communications has
been grounded primarily in Merleau-Ponty and Wittgenstein. No doubt, one can identify
a similar need for almost any approach to therapy that has not yet radically articulated the
philosophical foundations of its practice.

Existential and cultural considerations: A distinguishable

yet indivisible unity
Contrary to post-structural critiques of existential-phenomenology as a-cultural and
a-historical (Alcoff, 2000), cultural-historical meaning was indeed addressed and under-
stood by Merleau-Ponty in The Phenomenology of Perception (1945/1962). According to
Merleau-Ponty, culture provides “available meanings” that are the basis for language and
creative expression. Yet these “available meanings” can also serve to constrain possibili-
ties of expression. When culture acts to shut down the production of meaning, Merleau-
Ponty refers to this process through the metaphor of “sedimentation.” “Sedimentation” is
a term that evokes both the foundational nature of these meanings and their tendency
358 Theory & Psychology 21(3)

toward ossification and stagnation. The cultural elision1 of the sensual underpinnings of
signification may have the effect of foreclosing the emergence of latent meaning that is
otherwise brought forth through the dialogue between embodied subjects and the things
of the world.2 In these instances, for Merleau-Ponty, the world then ceases to speak. This
silencing of the world is occasioned by modes of discourse (e.g., scientific, philosophical,
or routine styles of communication) that restrain diverse ways of speaking the sense3 of
being in the world and mute differentiated, emotive ways of “singing the world.” Simply
stated, Merleau-Ponty (1945/1962) unequivocally asserted that scientific discourses “hide
from us, in the first place the ‘cultural world’ or the ‘human world’ in which nevertheless
almost our whole life is led” (p. 23).
Merleau-Ponty clearly did not espouse a culturally insensitive psychology, because he
was critical of epistemological frameworks—from empiricism to rationalism—which, in
striving for univocal or objectified truths, nevertheless foreclose a sensitivity to the shift-
ing personal and cultural contexts within which meanings manifest themselves to per-
ception. A different mode of thinking is required to free up perception and expression in
such a way that sedimented meanings can be transcended. This style of thinking is a kind
of reflexivity which is not merely intellectual or cognitive, but embodied—perhaps best
expressed, in phenomenological discourse, as the felt sense of having a maximum hold
on a sensible thing within a given horizon.
In conclusion, then, Merleau-Ponty does indeed locate experience and meaning within
the fabric of cultural discourse and the sensorial depth of the living present.4 With this
understanding, we can begin to focus on an examination of his existentially tempered
perspective on psychopathologies of existence. Afterwards, we will develop an inaugural
articulation of practices consonant with the beginnings of a cultural-existential approach
to therapy with an emphasis on dialogue with the psychodynamic tradition.

Existential renderings of “psychopathology” and “psychodynamics”

The term “psychopathology,” by virtue of its compound construction, invites psycho-
therapy practitioners to locate “pathology” within the “psychological” space of the per-
son exhibiting the symptoms of distress. It exemplifies how a technical vocabulary5
located within a modernist cultural discourse is invested with meaning. In this case, the
nomenclature of “psychopathology” indexes or gathers a way of seeing and understand-
ing which presupposes that persons are discrete beings disconnected from things, places,
and people. This way of seeing accounts for our cultural tendency to attribute causality
for “pathology” to the person instead of the environment or culture—a pervasive cogni-
tive bias in Western culture known as the “fundamental attribution error”6 (Triandis,
2003). Rather than decontextualize subjectivity and symptoms of human distress in this
manner, Merleau-Ponty held that human experience is radically situated.

Inside and outside are inseparable. The world is wholly inside and I am wholly outside of
myself . . . . In so far as, when I reflect on the essence of subjectivity, I find it bound up with
that of the body and that of the world, this is because my existence as subjectivity is merely one
with my existence as a body and with the existence of the world, and because the subject that I
am, when taken concretely, is inseparable from this body and this world. (Merleau-Ponty,
1945/1962, pp. 407–408)
Felder and Robbins 359

Here it can be said that Merleau-Ponty foreshadows his post-Cartesian re-thinking of

embodiment in The Visible and the Invisible (1964/1968). Therein, Merleau-Ponty re-
casts his understanding of the embodied subject as “flesh.” In doing so, he develops a
preobjective understanding which moves beyond the notion of subject–object division.
Instead, it describes “the flesh as an ultimate notion, that is not the union or compound
of two substances, but thinkable by itself” (p. 140), because the flesh of the body and the
flesh of the world coil over each other as an entwining process of unfolding. Reflection
upon one or the other is made possible through a dehiscence—something like a bursting
open, as in a seed pod, or another kind of rupture. This dehiscence occurs in moments
where flesh is sighting aspects of itself by enacting a division between itself as a seer and
itself as a “visible” aspect of inquiry. Within this framework, any traditional discussion
of “psychopathology” would be partially disclosive at best. By contrast, a wholistic
notion of “pathology” is sensitive to fields and systems where there can be failures of
reciprocity or ruptures which disperse what might be otherwise harmonious and synchro-
nous interconnections of meaning and flesh. These failures or ruptures, after Merleau-
Ponty’s ontology, can be referred to as types of flesh pathology.
In this case, we suggest that flesh pathology occurs when reflection is deprived of its
possibilities for sensually and dialectically inquiring into the ongoing fullness of the liv-
ing present. When reflection is diminished in this way, the plurality of sources compris-
ing experience remain “unconscious” or invisible. By extension, the power of reflection
to lift important contexts of experience into language is rendered inert. Speaking may
then devolve into lifeless “spoken words” in which the generative interplay arising
between enfleshed inquiry and cultural contexts are relegated to a narrow or sedimented
space of attributions about experience. The obstruction of this generative expansion
upon constricted meanings renders mute the ground of signification which Merleau-
Ponty calls “wild meaning.”
When the plurivocal, sensuous, and imaginal possibilities of the “signifying inten-
tion” are bounded by circumscribed and prescribed conventions for naming and identify-
ing selves, others, and situations, one’s sense of identity becomes reified. Moreover, one
may begin to view the world horizon as inhospitable. The pragmatic invitations to live
authentic meanings found in things, spaces, and places may be passed over or deemed
unlivable when culturally insensitive ascriptions and barriers accrue around ways of
being and around one’s sense of livable identities. The danger here is that one is deliv-
ered over to an abandonment of the flesh—an abandonment of dialectically seeing, feel-
ing, speaking, and creating meaningful ways of being and being with others. No longer
able to grasp the flesh of the world in properly situated human terms, symptoms of dis-
integrated and de-vitalized living arise. It is to this issue which we now turn.

“Psychological” symptoms
In The Phenomenology of Perception (1945/1962), Merleau-Ponty engages in an “exis-
tential psychoanalysis” of the phantom limb phenomenon and anosognosia symptomol-
ogy. According to Merleau-Ponty, the meaning and expression of such symptoms are to
be derived not from a mentalistic analysis, but rather from a “return to existence” as the
referential setting of understanding. In order to grasp the significance of his existential
360 Theory & Psychology 21(3)

analyses it is important to note that they are preceded by an explication of the “inten-
tional arc” and its relationship to “psychological” symptoms.

Let us therefore say . . . that the life of consciousness—cognitive life, the life of desire or perceptual
life—is subtended by an “intentional arc” which projects about us our past, our future, our human
setting, our physical, ideological and moral situation, or rather which results in our being situated
in all these respects. It is this intentional arc which brings about the unity of the senses, of
intelligence, of sensibility and motility. And it is this which “goes limp” in illness. (p. 136)

Here, Merleau-Ponty posits that the intentional setting of one’s existence includes the
interplay of temporality, spatiality, biology, and cultural codes which participate in both
organizing and being organized by the synaesthetic and motor intelligence of bodily sub-
jects. By extension, ongoing shifts in the sensible and visible field of flesh can both think
themselves within and be thought of by the flesh of the body. In and through this intimate
dialectic, one is able to reflectively and prereflectively fashion particular projects or forms
of existence. Symptomology ensues when an aspect of one’s intentional arc registers that
limiting conditions have enervated the intentional threads tied to vital ways of bodily
being in the world. Put differently, when bodily momentum for transcending the lost sense
of belonging to generative spaces or the lost sense of connection to valued identities is
substantially impeded or diminished, meaningful and compensatory symptoms arise.
Merleau-Ponty demonstrates how, in such instances, people undergoing symptoms tend
to refuse acknowledgement of such losses. In these cases, the corollary constellation of
emotions are “shot through with intelligence”—in other words, they contain implicit
meanings—and, as we shall argue, require reciprocal acts of cultural-existential reflection
as a starting point for resuscitating the limp threads of the intentional arc.

Phantom limb and anosognosia phenomena

In part I of The Phenomenology of Perception (1945/1962), Merleau-Ponty reworks his
understanding of body–mind relations through, among other things, an examination of
the phantom limb (experience of a severed limb as if it were present) and anosognosia
(ignoring a paralyzed arm). Rather than rely on the traditional physiological explanations
of the phantom limb and anosognosia, he situates them in existential terms which impli-
cate lived meanings and, as we shall demonstrate, also imply cultural valuations.
To begin, Merleau-Ponty develops the thesis that full-bodied presence makes possible
one’s being in the world. Bodily expression is not merely the outcome of instinctual and
reflexive responses. Rather, physiological aspects of existence are organized around a
human order of lived “psychological” meanings. These lived meanings are embedded in
settings or situations which do not have a fixed and determinate significance and there-
fore do not evoke instinctual responses in a narrow stimulus–response manner. Situations
exhibit an open and positive ambiguity. Unlike cause–effect chains linking an objective
stimulus to a prefigured response, situations supply and accrue their significance in a
dialectical relation with the sense-giving (Sinngebung) activities of embodied subjects.
In The Visible and the Invisible such objective stimuli are described as “field beings, with
many dimensions and . . . with many modes of being,” according to Dorothea Olkowski
(1982, p. 108). Mindful of this body–world entwinement, Merleau-Ponty raises phantom
Felder and Robbins 361

limb and anosognosic symptoms to intelligibility, as will be seen, through an understand-

ing of being-in-the-world.

Being-in-the-world.  For the person experiencing a phantom limb, Merleau-Ponty asks how
it is possible that the presence of the missing limb is still felt to be there. He also asks
what makes anosognosia possible. Separately, physiological and “psychological” expla-
nations are unable to fully account for this phenomenon. Nevertheless, separate and
seemingly complete explanatory accounts exist. With respect to the phantom limb, to be
sure, it “happens that the imaginary arm is enormous after the operation, but that it sub-
sequently shrinks and is absorbed into the stump ‘as the patient consents to accept his
[sic] mutilation’” (Merleau-Pomty, 1945/1962, p. 76). In cases of anosognosia, a “psy-
chological” explanation is also available:

Subjects who systematically ignore their paralyzed right hand, and hold out their left hand
when asked for their right, refer to the paralyzed arm as “a long cold snake”, which rules out
any hypothesis of real anesthesia and suggests one in terms of the refusal to recognize
deficiency. (pp. 76–77)

Well aware of the tendency to one-sidedly psychologize such symptoms, Merleau-Ponty

counters by re-stating an opposing physiological account: “[N]o psychological explana-
tion can overlook the fact that severance of the nerves to the brain abolishes the phantom
limb” (p. 77). Thus, for Merleau-Ponty, both the “psychological” and physiological must
be considered together in order for these symptoms to be understood.
How then, Merleau-Ponty asks, can both “psychic determining factors” and physio-
logical factors account for the existence of an imaginary limb? He goes beyond his argu-
ment that the “psychological” and physical simply “gear into each other.” This assertion
requires an understanding of what it is that unites the non-spatial “psychic facts” (e.g.,
the body for-itself)—such as volitions to refuse or accept the injury, emotions linked to
trauma, and fixations which impede memory of the injury—with the material “physio-
logical facts” (e.g., the body in-itself) of nervous influxes. A common ground is neces-
sary in order for these seemingly parallel but separate processes to function in an
integrated fashion. For Merleau-Ponty, the evidence of this common ground resides in
his realization that human actions do not arise as simple responses to objective stimuli.
Instead, human reflexes and actions encounter these stimuli as meaningful, “but only
when taken as a situation” (Merleau-Ponty, 1945/1962, p. 79).
That physiology and “psychology” emerge from a situation is evident in the case of
telescoping. In about 50% of cases of phantom limb, the limb gradually fades away by
progressively shrinking or recoiling back into the stump. In the final stages, the phantom
operates perceptually as only a phantom hand that hangs from the stump (Jensen, Krebs,
Nielsen, & Rasmussen, 1983; Weiss & Fishman, 1963). Ramachandran and Hirstein
(1998) tell a remarkable story about a man with a “telescoped” phantom limb:

One of our patients . . . had his right forearm amputated below the elbow, and his hand was
usually telescoped into the stump just below the elbow. However, if he attempted to shake hands
or reach out to grab a cup, his phantom would extend to normal length. Indeed, in one instance,
when we suddenly pulled the cup away he yelped in pain, claiming that we had wrenched the cup
away from his phantom fingers, causing his arm to telescope unexpectedly. (p. 1606)
362 Theory & Psychology 21(3)

This patient’s retractable phantom limb cannot be explained by traditional physiological

theories, nor by conventional psychological theories of the phantom limb. If the limb
were caused by stimulation of the terminals of the severed axons in the stump (Mitchell,
1871, 1872), the limb would not telescope and certainly would not be capable of retract-
ing as it does. However, if the phantom were simply a product of a kind of Freudian
denial (Parkes, 1972; Zuk, 1956), then the felt limb would remain whole rather than
show up in experience in such a truncated form.
As noted by Ramachandran and Hirstein (1998), phantom limbs are neither the prod-
uct of only “epigenetic factors such as remapping and painful stump neuromas” nor are
they simply “the ghostly persistence of a genetically specified body image” (pp. 1624–
1625). They appear to be some combination of both these physiological and “psycho-
logical” factors. Merleau-Ponty’s description suggests that these factors emerge through
a situation. In the case example given, the phantom limb appears within the pragmatic
situation of grasping a cup of water or shaking hands. These situations provide claims
upon the body to respond in accordance with these pragmatic demands of the world, and
the phantom limb serves this function, albeit in virtual form. Remarkably, those with
congenitally missing limbs also tend to feel these pragmatic claims, despite never having
directly experienced having the limb (e.g., Weinstein, Sersen, & Vetter, 1964). For exam-
ple, Ramanchandran (1993) describes the case of a woman who had been missing her
arms since birth, yet whose phantom limbs expressed themselves through gesture during
conversations.
An analysis of “pre-objective” perception is necessary for understanding how both
“psychological” and physical orientations to the world presuppose and yet cannot account
for the meanings of situations. Merleau-Ponty refers to this pre-objective view as “being-
in-the-world.” Being-in-the-world allows for a unity between the psychic and the physical
insofar as one’s identity is informed by a dynamic relational connection to the world rather
than an objective connection to the world which mechanically prefigures perception and
reflex responses. The meanings aimed at by the embodied subject, and correlatively solic-
ited by, for instance, a cup of water or a hand offered in greeting, are thus organized by
one’s interconnected commitments to a world-based identity. Whereas being-in-the-world
infuses the flesh of the body with a significative intention, it is also important to remember
that the world is correlatively asking for practical recognition by one’s embodied being.
This existential analysis not only lends itself to a unitary understanding of meaning
construction, it also provides a framework for understanding how a lack of reciprocity
between the meanings aimed at and the available cultural meanings give rise to symp-
toms. The lens of being-in-the-world illuminates how the disjunctive relationship
between bodily existence and the home and horizon of culture are revealed in symptoms,
or flesh pathology. It also dovetails with Merleau-Ponty’s articulation of the intentional
arc inasmuch as being-in-the-world subtends human meaning and expression.

Cultural reflections
Despite the insightfulness of Merleau-Ponty’s analyses, he did not explicitly address his
understanding of cultural contributions to anosognosic and phantom limb symptom for-
mation at an applied level. The task here will be to advance that discussion.
Felder and Robbins 363

To review, bodily existence opens onto the world. Certain styles of bodily existence
also make possible one’s belonging to culturally framed niches of existence. Loss of
bodily powers can result in a narrowing of one’s possibilities for inhabiting previous
forms of existence. At these times, according to Merleau-Ponty (1945/1962), a “circuit
of existence” may be abruptly closed off. One may no longer “belong to the same world
and [move] in it with all [one’s] powers” (p. 78). Consequently, one may lose contact
with preferred forms of existence. In the case of a paralyzed limb, the person experienc-
ing anosognosia attempts to evade his or her “deficiency” by enacting a prereflective
“refusal of disablement.” The person experiencing anosognosia may also leave his or
her “paralysed arm out of account in order not to feel . . . [the] handicap” (p. 81).
Likewise, reliance upon a phantom limb allows for the avoidance of thematic awareness
through a “refusal of mutilation,” albeit through the eruption of the phantom limb’s
response to a pragmatic call to engage a situation. Repression is understood as an exis-
tential event rather than the activity of an internalized ego. From this existential vantage
point, exclusionary cultural restrictions and practical limitations participate in the act of
repression. One’s “refusal of disablement” might then be re-understood as an attempt at
refusing the consequences of exclusionary cultural practices.

What it is in us which refuses mutilation and disablement is an I committed to a certain physical

and inter-human world, who continues to tend towards his world despite handicaps and
amputations and who, to this extent, does not recognize them de jure. . . . To have a phantom
arm is to remain open to all the actions of which the arm alone is capable; it is to retain the
practical field which one enjoyed [italics added] before the mutilation [italics added]. The body
is the vehicle of being in the world. . . . (Merleau-Ponty, 1945/1962, p. 81)

In order to maintain this repression, one shifts “from first person existence to a sort of
abstraction of that existence which lives on a former experience” (p. 83). Or, in the case
of a person with congenital defects, one lives through the whole-bodied experience of
other whole, gesturing, and situated bodies which are retained as models in one’s own
bodily schema.7 In doing so, one remains committed to an untenable stance. Repression
supports this illusion by making a thing formerly “manipulatable for me” into a thing
“manipulatable in itself.” Instead of a doorknob signifying a thing I can (or cannot)
manipulate, it becomes a thing “one can manipulate.” In this way, one attempts to hold
on to a former identity—a “habit body”—or to the abstract world of a collective and
anonymous body by ignoring the “body at this moment.” Repression is thereby enacted
in a way that severs links to the awareness that there are culturally constructed situations
which no longer solicit the person as fully functioning bodily being-in-the-world. That is
to say, the disabled body is “unconscious” to the extent that it lacks reflection on the
phenomenal field of cultural artifacts which instead reference and call for the former
“able-bodied” possibilities of responding.
The conclusion could be drawn that one’s identity, grounded in the “will to have a
sound body or the rejection of an infirm” (Merleau-Ponty, 1945/1962, p. 81), is the
source of this repression. The temporal observation that the “imaginary arm is then,
like repressed experience, a former present which cannot decide to recede into the
past” (p. 85) seemingly lends support to the provisional conclusion that a sound habit
body was preferred over the body of the present moment. And yet, from the
364 Theory & Psychology 21(3)

perspective of bodily being-in-the-world and flesh ontology, this would be a one-sided

account. As Merleau-Ponty states, “I am conscious of the world through the medium
of the body” (p. 82). This statement stands as a reminder to reference the flesh of the
world when assessing the will to maintain or disavow an identity. In this way, it can be
argued that “psychopathology” or flesh pathology is constructed within the phenome-
nal field which includes not only social artifacts and social relationships with others,
but also normative cultural codings about various forms of bodily being-in-the-world.
What, then, might the experiences of a phantom limb and anosognosia reveal about
allegiances to identity within a particular cultural world? What is most apparent in
Merleau-Ponty’s descriptions of the phantom limb and anonognosic phenomena is the
notion that something is being rejected and that a particular culturally-based language
accompanies the act of rejection. Merleau-Ponty (1945/1962) states that acts of expres-
sion, be they spoken or gestural, are bearers of meaning. And, as stated earlier, he stresses
that the sense-giving intentions found in acts of expression are articulated in and through
the fund of available meanings provided for by a culture.

What nature does not provide, cultural background does. Available meanings, in other
words former acts of expression, establish between speaking subjects a common world, to
which the words being actually uttered in their novelty refer as does the gesture to the
perceptible world. (p. 186)

The actions named in Merleau-Ponty’s existential discussion of repression include rejec-

tion, refusals of acceptance, imaginings of soundness, and unawareness of the past. The
significant linguistic descriptors accompanying Merleau-Ponty’s analysis of those per-
sons carrying out these actions include handicap, infirm, mutilation, deficiency, and
disablement. If these combined patterns of language and action are viewed as the sub-
ject’s unreflective effort to reproduce power-laden Western discourses (Foucault,
1976/1978) about sound bodies, they can also be viewed as supporting practices of deni-
gration and exclusion (Foucault, 1961/1965). Viewed from this culturally informed
framework, it can be argued that the “handicapped” subject who practices repression,
and who is thereby unconscious of bodily losses, may have been motivated to avoid
exclusionary practices—particularly in light of the pejorative cultural coding about limb
status embedded in the language of disablement.
Unable to function as a person dialogically free to reinterpret, modify, or think in a
differentiated manner about “disability,” symptoms arise as the “handicapped” person’s
intentional arc goes limp. “For to name a thing [deficient] is to tear oneself away from its
individual and unique characteristics to see it as an essence or category” (Merleau-Ponty,
1945/1962, p. 176). The naming of one as “infirm” solicits, through the “spoken word,”
a debilitating sedimented self-recognition, and recognition by others, of one’s culturally
marginalized difference. Unlike the “speaking word,” which acknowledges how “exis-
tence is polarized into a certain ‘significance’ which cannot be defined in terms of any
natural object” (p. 197), the spoken word of disablement in the West codifies the status
of those experiencing limb loss or dysfunction as deficiency. It is this disenfranchising
univocity of culturally sanctioned identity attributions that can occasion a “psychologi-
cal” upheaval. Interference with one’s free relation to the past, present, and future as well
as to the meaningful settings threaded through one’s intentional arc can occur in the wake
Felder and Robbins 365

of such core identity disruptions. The trauma of reconfiguring a life vis-à-vis the abrupt
encounter with a non-inclusive cultural world not only disrupts the intentional arc, it also
may call into question how habitable the home and horizon of culture is.
Indeed, Braithwaite and Braithwaite (2003) discuss the social barriers faced by those
dealing with the advent of a “disability.” Overcoming the stigma of isolation requires the
recognition that exclusion may begin as one’s prior social circle increasingly exhibits
discomfort with one’s diminished identity status. With time, it becomes apparent to the
marginalized person that he or she is “now interacting as a member of a different culture”
(p. 171). Next, we will discuss what this can mean for a cultural-existential therapy that
is sensitive to the discursively embedded nature of identity.

Cultural-existential praxis
If Merleau-Ponty’s analysis of the intentional arc and flesh is deemed relevant to “psy-
chological” symptom formation, what are the implications for conceptualizing and inter-
preting identity and selfhood issues in cultural-existential therapy?
Thus far, it has been suggested that a discussion of psychopathology should avoid the
narrowness of the fundamental attribution error and, instead, take up a field-sensitive
flesh pathology perspective. To take on this perspective, practitioners must dilate the
aperture of their diagnostic lens. In so doing, the notion of depth analysis would be
expanded to a breadth analysis attentive to the cultural flesh of the patient’s8 world.
When conducting character analysis, a Western psychotherapist might prereflectively
operate from a depth presupposition that privileges the importance of a patient’s strivings
to develop and maintain an identity (Josephs, 1995). If, however, the practitioner the-
matically takes up the breadth of a patient’s life, a radical supplementation of psycho-
therapy can occur: psychological defenses can be understood to be not only in the service
of maintaining a particular set of identity practices but also culture-based identity pre-
scriptions and inscriptions.
As previously discussed, Merleau-Ponty describes the efforts undertaken to fend off
awareness of limb loss or limb paralysis. The enactment of evasion, refusal, and unwill-
ingness to accept these losses constitutes a repression “driving into the unconscious” the
awareness of becoming an “invalid.” The defensive fixation on having a “sound” body
allows for the belief that one is still open to and belongs to a prior form of existence. This
defensive repression is also extended to the world of practical objects. The patient alters
his or her perception of usable things by focusing on the intactness of their general use-
value, while simultaneously splitting off awareness of the dreaded loss of their use-value
for the patient. “New perceptions, new emotions even, replace the old ones, but this pro-
cess of renewal touches only the content . . . of experience and not its structure” (Merleau-
Ponty, 1945/1962, p. 83).

Identity
If the existential structure of one’s existence consists of maintaining an identity based on
a mosaic of intact bodily powers which link one to a particular cultural world, then the
loss of bodily powers threatens to create a tear in the intentional threads tying a person to
366 Theory & Psychology 21(3)

the flesh of a meaningful world. Whereas a conventional psychotherapist may tend to

locate pathology within the patient’s effort to resist thematic awareness of a de-gestalted
identity, it may well be that a culturally maintained breach of connection to community
is primarily at issue. The patient’s defense mechanisms may thus reflect a desire to retain
even an illusory sense of power and integrity by resisting submission to an exclusionary
cultural-symbolic system—particularly when the identity of such individuals is recoded
on the basis of lost productivity and functionality over against the qualities of their
evolving personhood.
These defense mechanisms may indeed reflect a pattern of resistance responses
which might be intrinsic to cultures that stress doing over being. In such cases, a
patient9 may feel initially helpless to modify or change the background order of a cul-
ture inscribing him or her as deficient. Consequently, resistance may instead reflect an
attempt to resurrect freedom practices within a marginalized social system, and not just
a mere enactment of “psychological” defense against unmanageable anxiety and loss.10
Here, the loss of vital possibilities linked to stability or fluidity of identity can be emo-
tionally problematic. Such losses can be viewed, according to Josephs (1995), as
“identity spoilage,” wherein one’s sense of self is challenged by disillusioning experi-
ences. These jarring experiences of cultural denigration and exclusion can be regis-
tered as a significant identity loss. Given the cultural order’s participation in sanctioning
the process of marginalization, the meaning of identity terms like “ego-syntonic” and
“ego-dystonic” become ambiguous. By instead taking up the ambiguity of syntonic
and dystonic experiences as a positive indeterminacy, the psychotherapist may then
want to reflect on how the dynamics of culture-syntonic and culture-dystonic codings
inform the patient’s defensive tactics of identity maintenance. Having done so, the
psychotherapist might then reflect upon the relevance of a therapy geared toward the
individual, the local cultural spaces, and/or the broad macro-level cultural spaces. In
this way, the resonances and disjunctions between the interrelated aspects of the flesh
of the world and the flesh of the body can be interrogated and addressed in a more
experientially coherent manner.
Given the problematic status of whether experiences should be counted as “psycho-
logically” or culturally motivated, how might a therapist organize practice so that it fits
within a culturally informed framework that is attentive to flesh pathology?

Interpretation
To begin, a practitioner mindful of cultural-existential perspectives will want to start
with the understanding that attention to existence reflects an attention to all the possible
modes of being available within a cultural flesh (Merleau-Ponty, 1964/1968, p. 105). The
practitioner’s capacity to distinguish between individualist and collectivist forms of self-
hood will help clarify whether a narrow or broad range of identities is culturally sanc-
tioned. In this way, the practitioner can discern whether or not allegiance to communal
identity takes precedence over emphasis upon individual uniqueness and desire. The
kinds of defense mechanisms at play and the impact of certain interventions or interpre-
tations can be best understood within the context of discursive formations of identity
operating both for therapist and patient.
Felder and Robbins 367

According to Lawrence Josephs (1995), the classical psychoanalytic view of defense

mechanisms calls for a calibrated timing of interpretations which distinguish between
“surface” or “depth” concerns. The psychotherapist is to be technically grounded in the
timing of interpretations that address deep psychic content or early developmental expe-
riences. Psychic material that is closer to conscious awareness is to be given priority.
Note, however, that these kinds of surface/depth considerations lend themselves to a one-
sided micro-level analysis of “interiority”: of “psychological” concerns and defenses.
By focusing upon internal drives, wishes, and motivations, the psychotherapist may
find himself or herself practicing as a cultural agent who intuits and conceptualizes from
the narrow individualist perspective of Western culture. If a psychotherapist, however,
takes up a macro level of interpretation that stresses the relational aspect of existence—
between patient and psychotherapist, patient and significant others, and patient and the
cultural practices at large—the patient’s being in the flesh of the world may come into
view. In this way the collectivist notion of identity as context-based and group-based
might offer a different style of seeing which may make apparent otherwise invisible
dynamics in the therapy. In order to affirmatively acknowledge such dynamics, a psycho-
therapist must be willing to surpass any ethnocentric narcissism—that is, privileging of
the values and practices of one’s own culture as superior—and become fairly well versed
in the identity codings of various cultural-symbolic systems. Having done so, the psy-
chotherapist who is openly aware of the limits of his or her cultural competence might
then go on to solicit the patient as a dialogical resource for blending the patient’s cultural
horizon with the psychotherapist’s pre-understanding. Viewing the patient from within a
field of culturally informed relations allows the intelligibility of the patient’s identity
maintenance practices to become visible. Put differently, the classical psychoanalytic
interpretive concern regarding surface and depth interpretations might be recalibrated to
include interpretations regarding the breadth horizon—or relational cultural horizon—of
the patient’s being-in-the-world.
We now turn to an illustration of a cultural-existential approach by describing work
with one of our patients, whom we will refer to as Ric. Later, we will review the dialecti-
cal aspect of a cultural-existential approach in a description of what we shall call the case
of Ciro. Both cases are descriptions of patients seen in psychotherapy by one of the
authors of this paper. Identifying information has been changed or removed to protect the
patient’s anonymity.

The case of Ric

Ric identified as a hearing- and sight-impaired 29-year-old bisexual Caucasian male
employed as a robotics engineer. He came to therapy shortly after being placed on proba-
tion at his place of work because of declining job performance. During the first session
with his hearing- and sight-enabled heterosexual male therapist, Ric came across as
rather affable but detached. His style of talking did not, however, seem to anticipate a
response from his therapist. When his therapist did speak, Ric would sit silently, some-
times with a look of confusion. Eventually Ric elaborated, saying rather hesitantly,
“Would you speak up? I don’t have my hearing aid with me.” And so began what later
turned out to be an important thread of the work with him.
368 Theory & Psychology 21(3)

By the end of the first hour, Ric conveyed his expectation that the impact of therapy
would be quick and easy. The therapist’s early attempts at treatment occasioned an
initial improvement in symptom severity. Initial interventions included psychoeduca-
tion regarding task and stress management, interpretations regarding the positive pur-
pose motivating Ric’s symptoms (e.g., amotivation, apathy, low self-confidence), and
emphasis on empathic attunement. Ric’s improvement was, however, only partial and
limited. It was not until after the contextual horizons referenced by his embodied iden-
tity, his interpersonal style, and his presenting concerns were addressed that his job
performance improved and his probationary status at work was lifted. In other words,
it was in and through the eventual expansion of Ric’s narrowly sedimented understand-
ing of his emotional, cultural, and personal history that he began to grasp how nature
and culture entwined to constrict the way in which he lived his alienated sense of
bodily being and identity.
Ric was identified as intellectually gifted since he was in elementary school. In accord
with the therapist’s interpretations and prompts, Ric was eventually able to emotionally
contemplate how being institutionally identified as “different” gave rise to the marginal-
ization he endured when his school bussed him to another site, away from the peers in his
mainstream classes. Whereas Ric began to feel as if he no longer belonged to the world
of his peers owing to the imposed physical separation from them, his sense of separation
transformed into feelings of rejection as newer peers displayed consistent disregard for
him. According to Ric, he began experiencing his sense of identity as one which was “off
the grid” and “further out there than other nerds.”
When Ric gained new insight into his practical and emotional isolation from his
childhood peers, he came to understand how the world no longer seemed to speak to
him as an embodied human. Instead, it regarded him as a brain apart from his body. In
addition, Ric suffered a hearing loss that prevented him from clearly hearing his peers
thus requiring him to wear a hearing aid. Even so, many of Ric’s peers did not make
the effort to raise their voices so that Ric could hear them and feel included. More and
more, Ric experienced his bodily sense of self as a socially unwanted impediment. His
sense of embodied identity spoilage grew. He began viewing himself as “deaf and
blind.” When his despondency and frustration became undeniably palpable, he began
turning off his hearing aid on a regular basis. As the reflective lens of therapy broad-
ened the contemplation of this latter issue, Ric began to understand how he had implic-
itly endorsed the socio-cultural coding of his identity as problematically different in a
culture-syntonic way.
Despite Ric’s efforts to retain a social circuit of existence by resorting to on-line rela-
tionships, he ironically accelerated his retreat into living out a person–world and mind–
body split. His decision to immerse himself in virtual on-line relationships magnified his
off-line social isolation, thereby allowing him to live out a life devoid of meaningful con-
nection to embodied others and to the sensual and physical powers of his body. In addi-
tion, Ric was also able to evade his limited bodily powers of hearing and sight during
on-line interactions or, instead, experience a phantom sense of auditory wholeness dur-
ing text-based interactions. He increasingly avoided off-line others and often declined to
participate in activities during recess and during physical education classes. These splits
in living widened when he was diagnosed with asthmatic and epileptic conditions. Ric’s
Felder and Robbins 369

unwillingness or inability to participate in physical activities coupled with his enrollment

in small gifted classes exposed him to rejection by his “able-bodied” peers. Furthermore,
Ric’s syntonic endorsement of his embodied mind as “off the grid” and his physical
being as an impediment was further magnified when his Catholic-affiliated mother dis-
approved of his self-identification as bisexual on moral grounds.
Over the course of therapy, Ric gradually acknowledged the suppressed emotionality
tied to his mother’s rejection as well as to the rejection by his peers. His acknowledgment
of accumulated pains did not, however, overwhelm him. Instead, he allowed into reflec-
tive awareness the socio-cultural horizons of his life and his lived bodily experience. It
was this reflective expansion which delivered Ric over to a liberating understanding of
his presenting symptoms. Through this newly contextualized experience of himself, he
was able to find new motivation to pursue relations with others, and he discovered an
awakening of joy in his vocation. Through Ric’s broad-based attention to the flesh of his
life—to his emotionally laden body and culture-bound existence—he overcame his flesh
pathology and its corollary limitations on his reflective ability.
In the next section we will consider more closely how the reflective work of therapist
and patient might look from a cultural-existential perspective.

Dialectical interventions
In order to free the patient for living in and beyond Western cultural individualism toward
the flesh of the world, we suggest a cultural-existential approach which allows for dia-
lectical interventions. By this, we mean an approach to psychotherapy that is not limited
to placing the patient in dialogue with various aspects of his or her interiority. The patient
should instead be encouraged to catch sight of the web of cultural discourses coiling over
and through his or her being.
It can be argued that the patient’s “psychological” world is a relative mirror of cultural
discourse. For example, Foucault (1976/1978) rejected any discourse-based psychology
that privileges the effect of one cultural discourse upon an individual over a plurality of
discourses. However, from our perspective, the individual’s actions are informed by
lived realities that both include and transcend cultural worldviews. Not only do persons
reproduce and resist cultural inscriptions, they also find themselves in atypical situations
that can elicit spontaneous and novel responses that may challenge conventional discur-
sive practices. Thinking and acting become personal by and through one’s bestowal of
meaning upon ambiguous situations, and these new meanings emerge as the person is
thrown up against new horizons of experience provided by shifting situations and shift-
ing states of mind (Evans & Lawlor, 2000). In light of these lived realities, we therefore
suggest that the strength of the existential-phenomenological analysis of experience be
married to the expansive power of a social-phenomenological cultural analysis under the
name of a cultural-existential psychotherapy.

The case of Ciro

By way of example, therapy with Ciro, a 28-year-old single Hispanic male of interna-
tional origin, illustrated how identity development can be arrested when one finds
370 Theory & Psychology 21(3)

oneself at the crossroads of competing and conflicting life contexts and cultural dis-
courses. In Ciro’s case, he found himself living in southern California struggling with
declining academic performance in his doctoral program and concomitant emotional
isolation from his family and significant others for several years. Ciro came to therapy
initially asking how he had arrived at such an existential state of decline and discon-
nection. In contrast to his abiding manner of expressing emotion through gesture, Ciro
conversely verbalized how genuinely puzzled he was about the significance of his
presenting concerns to his male psychotherapist of Mediterranean descent. At this
juncture, both therapist and patient acknowledged and endorsed the value of drawing
upon Ciro’s emotionally expressive style while also acknowledging its similarity to the
expressive cultural code of Ciro’s therapist.
In a telling disclosure, Ciro described a highly charged event about the partial loss of
one finger during an industrial accident. He not only described his confused efforts to
conceal the severing of his finger from the foreman while bleeding profusely, he also
described his efforts to conceal his emotional state from his parents: “I wanted every-
thing to go back to normal.” Moreover, he recalled “happy” dreams in which his severed
appendage had been sewn back. It was through an expansive reflection upon the mean-
ings diffused through his bodily reaction to this event that Ciro was able to draw together
the significance of the competing cultural claims upon his identity and being.
After some time in therapy, Ciro took up his therapist’s invitations to consider the
contexts for his emotional malaise and isolation and, by doing so, was able to overcome
the gap between his experience and knowledge. For example, he began to think about the
significance of his collective responsibility to his family given his role as the oldest
child. He reflected upon other contextual issues, which included the machismo embodied
by his father’s distinctly masculine conduct, his anxiety about the history of violence and
bombing which occurred in his country during the late 20th century, and the literary
sensibility encouraged by his father’s early readings of the French writer Antoine de
Saint-Exupéry’s The Little Prince. By reflecting on these culturally informed issues, Ciro
raised his awareness of the conflicted state of affairs that had stymied him.
Ciro gradually considered how his father’s staunch machismo and repudiation of tears
and emotions informed his concealment of vulnerability from himself and others. This
was no easy appropriation of identify for him, because the machismo was inextricably
linked with the history of political violence in Ciro’s home country. To express feeling
was to be seen as weak and vulnerable within a violent society at war with itself. Ciro’s
emotional “repression” therefore had to be understood as a symptom of a cultural phe-
nomenon in which masculine strength had become identified with desensitization to the
horror of men committing violent acts against other human beings. All the while, Ciro
was also pre-reflectively impacted by the simple truths about living a happy life gestured
to by de Saint-Exupéry’s character of the little Prince. These simple truths were revealed
in each of the Prince’s revelatory encounters with different worlds constructed by men,
where the masculine authority figures were each subtly called into question.
By thematizing these unthought aspects of the culturally informed flesh of his body
and world, Ciro found it possible to discover creative resolutions to the emotional malaise
at the heart of his lived cultural impasse. He was able to re-appropriate his culture’s form
of gender in a uniquely individualized manner once he explored the physiognomy of his
Felder and Robbins 371

enfleshed lifeworld and resolutely decided that emotional expression and critical thinking
could signify strength rather than weakness. His existential paralysis resolved after he
freed himself to dialogue with the forces referenced in his life by the nexus always already
linking the flesh of his sensual body with the flesh of his socio-cultural world.

Cultural-existential psychotherapy in practice

At the beginning of this paper, we drew upon Merleau-Ponty’s (1945/1962) examples of
the phantom limb and anosognosia for several reasons. First, Merleau-Ponty’s interpreta-
tion of these phenomena have stood the test of time. Contemporary neuroscience found
additional support for his original insights. Research makes evident that neither the phan-
tom limb nor anosognosia can be interpreted from a purely physiological or “psychologi-
cal” perspective, but can only be clearly understood when the body is seen as indivisibly
situated in a world of personal and cultural significances which call forth pragmatic
action. Secondly, and more importantly, the phantom limb and anosognosia are examples
of events that are secondary to what are clearly physiological dysfunctions. These
extreme examples illustrate that even in the case of a physiological disruption, situated
meanings configure the person’s possibilities for relating to the loss of bodily powers or
dis-figurements.
When considering the flesh pathology of phantom limbs and anosognosia, it seems
less of a leap to say that other psychological problems, even psychotic phenomena such
as in schizophrenia, are no less situated within personal and cultural horizons. As prior
literature has made apparent, auditory hallucinations are certainly linked to physiological
abnormalities, but their relative adaptation to the pragmatic cultural-historical world
must also be considered (Csordas, 1994; Thomas, Bracken, & Leudar, 2004). Csordas
(1994), for example, describes the case of a Navajo Indian who developed psychotic
symptoms after removal of a left temporal-parietal astrocytoma. However, because he
was situated within a cultural horizon that was capable of endowing this man’s hallucina-
tions with positive significance, he was able to use these abnormalities as a means of
elevating his status in the community. His case can be drastically contrasted with Dr.
Schreber, whose prestigious judicial career was ruined after a psychotic break and who
fought for years for his freedom from institutionalization. His quasi-religious hallucina-
tions may have been better addressed by more recent approaches which attempt to situate
these types of visions within the personal, spiritual, and cultural horizon of the patient
(Davies, Thomas, & Leudar, 1999; Leudar & Thomas, 2000).
A cultural-existential therapy can also draw upon traditions such as social network
therapy, which uses retribalization techniques in order to mobilize the community to
organize itself around a person in crisis (Reuvini, 1979; Speck & Attneave, 1973). Or,
when the community remains entrenched in sedimented practices which continue to mar-
ginalize and re-traumatize suffering individuals, a cultural therapeutics can be enacted.
Such a cultural therapeutics can articulate a breadth and depth analysis of the cultural
symptoms in need of critical examination and explore potential paths for cultural change
(Robbins, 2005; Romanyshyn, 1985; Sipiora, 2008). In these cases, the critical theory
strives in the hope that a shift in the cultural horizon may help restore some wholeness to
those rendered disabled or dysfunctional within the current cultural framework. Historical
372 Theory & Psychology 21(3)

precedence for this type of cultural change can be found in the civil rights movements,
which have persistently worked to liberate women, minorities, and those suffering from
physical disabilities by fighting for change in both social perception and social policy.

Concluding thoughts
In this paper, we have addressed how Merleau-Ponty’s thoroughgoing examination of
being-in-the-world gives rise to a form of existential analysis that allows for the develop-
ment of cultural-existential approaches to understanding human existence. By engaging
in high-context thinking, or rather thinking which moves beyond Western individualism
toward wholistic and collectivist understanding of human experience, we have been able
to reframe symptomology and “psychopathology” in terms of lived human consider-
ations. From this perspective, the ego-syntonic label was seen in the light of culture-
syntonic considerations; a depth analysis was married to a breadth analysis; empathic
understanding was recast in light of dialectical understanding; medical and “psychologi-
cal” analysis was re-viewed through cultural analysis; and being was resituated within a
flesh ontology. That is to say that while a cultural-existential psychotherapy may com-
passionately rally around a “psychological” therapeutic of individuals, it, at the same
time, continues to sound the clarion call for a therapeutics of culture. Moreover, it is in
and through the therapist’s incorporation of dialectical interventions that the cultural
flesh of the world can be retrieved from the shadows of forgetfulness, thereby providing
human beings—as “differently abled” people—relief from the narrowly focused glare of
the fundamental attribution error.

Funding
This research received no specific grant from any funding agency in the public, commercial, or
not-for-profit sectors.

Notes
  1. In David Abrams’ The Spell of the Sensuous (1996) he discusses how, for Merleau-Ponty, the
immediacy of direct experience allows for recuperation of the overlapping sensorial registers
of embodiment, “synaesthesia.” In and through such a retrieval, primordial preconceptual
experience would be recovered through “the full participation of [the] sensing body with the
sensuous terrain” (p. 60).
  2. In contrast, a dialectic between language and perception predominates in The Visible and the
Invisible (Merleau-Ponty, 1964/1968)
  3. In The Phenomenology of Perception (Merleau-Ponty, 1945/1962), Colin Smith translated sens
as having manifold significations, such as meaning, direction, manner, significance, and way.
  4. Merleau-Ponty (1945/1962) also articulated how the prereflective intentionality and motiva-
tion of the embodied subject participated in meaning construction.

 hat is why Husserl distinguishes between intentionality of act, which is that of our
T
judgements . . . and operative intentionality (fungierende Intentionalität), or that which
produces the natural and antepredicative unity of the world and of our life, being apparent in our
desires, our evaluations and in the landscape we see, more clearly than in objective knowledge,
and furnishing the text which our knowledge to translate into precise language. (p. xviii)
Felder and Robbins 373

  5. For additional discussion of psychiatry’s technical vocabulary, see R.D. Laing’s The Divided
Self (1960).
  6. The “fundamental attribution error” refers to the general human tendency to attribute the
causes of behaviors to the actor rather than the actor’s situation (Jones & Harris, 1967).
  7. Empirical evidence suggests that individuals with congenital phantom limbs develop their
phantoms through observation of the movements of other people (Funk, Shiffrar, & Brugger,
2005; Henderson & Smyth, 1948; Melzak, Israel, Lacroix, & Schulz, 1997). Furthermore,
research on “mirror neurons” has provided material evidence that regions of the brain respon-
sible for self-generated movement (e.g., the SMA, dorsal premotor cortex, supermarginal
gyrus, and superior parietal lobe) are also stimulated by the perceived movements of others
(see, e.g., Decety & Grèzes, 1999; Grèzes & Decety, 2001; Ruby & Decety, 2001). As noted by
Gallese, Keysers, and Rizzolatti (2004), “the description by Merleau-Ponty of what it means to
understand an action… expresses nicely the direct experiential understanding of the observed
actions mediated by the mirror mechanism” (p. 397). This kind of dialogue between neurosci-
ence and phenomenology was commonly employed by Merleau-Ponty in his work and contin-
ues in the work of some contemporary cognitive neuroscientists who pair phenomenology and
neuroscience as mutually constraining first-person and third-person perspectives of behavior
(see Roy, Petitot, Pachoud, & Varela, 1999).
  8. For Michel Foucault, the “subject” is a social construction produced by power relations, as
discussed in The History of Sexuality (1976/1978), or produced by discipline and conditioning,
as argued in Discipline and Punish (1975/1977).
  9. Choosing a general term that preserves the dignity and humanity of persons coming to therapy
is shot through with thorny philosophical assumptions. For example, the term “client” rests upon
the materialistic model of a business transaction. The term “analysand” implies a subjugated
relationship to one who is the expert at analyzing the analysand’s life. Following Murphy and
Dillon (2002), we have opted to use the term “patient,” not as a reference to the medical model,
but rather as a way of underscoring that the patient is seeking the attentiveness of a caring other.
10. From a one-sided psychological perspective, it can be argued that the process of grief would
explain defensive reaction to identity loss. By contrast, Kristeva (1987/1989) suggests that
mourning can be viewed as a conventional process that disposes of otherness or difference
by one’s acceptance of the symbolic order’s manner of responding to difference and loss.
Melancholia, on the other hand, stands as an act of refusal (e.g., resistance) which disallows
absorption of experienced alterity into symbolic order processes.

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Andrew J. Felder (PhD) completed a clinical fellowship at The Ohio State University, and then went
on to accept a position at George Mason University before coming to the University of California,
Los Angeles. He is presently a consulting editor for Janus Head. Previously, he worked with a vari-
ety of culture-based populations while with the Los Angeles Department of Children and Family
Services and while later working as Clinical Director for its sexual abuse treatment program.
Address: John Wooden Center West, University of California, Los Angeles, 221 Westwood Plaza,
PO Box 951556, Los Angeles, CA 90095-1556, USA. [email: andrfeld@aol.com]

Brent Dean Robbins (PhD) is Director of the Psychology Program and Assistant Professor of
Psychology at Point Park University in Pittsburgh, PA. He has a doctorate in Clinical Psychology
from Duquesne University, is recipient of the Harmi Carari Award of Division 32 of APA, and is
Editor-in-Chief of Janus Head: An Interdisciplinary Journal. He is editor of three forthcoming
volumes: Drugging Our Children (Praeger), The Legacy of R.D. Laing (Trivium), and Health
Psychology and Social Justice (Praeger). Address: Department of Humanities and Human
Sciences, Point Park University, 201 Wood Street, Point Park University, Pittsburgh, PA 15222,
USA. [email: brobbins@pointpark.edu]