Merleau-Ponty and me: some

REFLECTIONS
phenomenological reflections
upon my recent bone marrow
transplant
Ron Morstyn

Objective: During my illness and transplant I experienced an overwhelming

existential crisis involving a complex intertwining of meaning and body which
was often ignored, rejected, or misunderstood by others and at times by myself,
which led to painful feelings of alienation. My treatment and my own
conceptualizations seemed founded on assumptions of a separation of body
and mind that were not true to what I was experiencing. I searched for a more
accurate understanding, which I eventually found in the writings of the French
existential philosopher Merleau-Ponty.
Conclusions: Merleau-Ponty’s extensive elaboration of the deep ambiguity of
our existence as body-subjects provides an alternative model to those of the
mind/body dichotomy currently in vogue in medicine and psychiatry. I found
his writings a useful framework within which to comprehend my experiences. I
wanted to write about these experiences and how they relate to Merleau-Ponty’s
insights because I found that those individuals who were able to relate to me at
this level of existential ambiguity were invaluable to my recovery.
Key words: consciousness, existentialism, illness, Merleau-Ponty,
phenomenology.

I
n November 2006 I underwent a bone marrow transplant for myelofi-
brosis, a potentially terminal illness. Since then I have been trying to
find a way to describe the changes in awareness and perception that
occurred during my diagnosis and treatment. As a practising psychiatrist, I
tried to conceptualize these experiences within the frameworks that I knew
within medicine and psychiatry but surprisingly discovered that a good
deal of additional insight was available in the literature of ‘20th Century
Continental Philosophy’ and in particular the works of the French
philosopher Merleau-Ponty (1908
1961).

Australasian Psychiatry . Vol 17, No 3 . June 2009

Ron Morstyn
Consultant Psychiatrist and Psychotherapist, Sydney, NSW,
Australia.
Correspondence: Dr Ron Morstyn, Suite 1011
1012, 155 King
Street, Sydney, NSW 2000, Australia.
Email: ronmorstyn@bigpond.com
During my hospitalization I felt viewed from either a physically diseased
body (‘objectivist’) view or a detached subject (‘intellectualist’) view. It
reminded me of having my car repaired, with the mechanic-doctors
looking at the car and largely ignoring me while idealist-doctors, psychol-
ogists and social workers tried to be sympathetic to my ownership of a
defective car while ignoring the car itself. Neither of these approaches
seemed to remotely address what I was experiencing.
Merleau-Ponty’s work provided me with a new way of thinking about my
experience. In his best known book, Phenomenology of Perception,1
Merleau-Ponty argues that views of existence, which separate subject
from object, represent second-order abstractions that do not reflect ‘lived
experience’. Building on the work of Edmund Husserl, using a methodol-
ogy of ‘phenomenological reduction’, which requires a conscious effort to
loosen or suspend our attachments to commonsense, including scientific

doi: 10.1080/10398560902866617
# 2009 The Royal Australian and New Zealand College of Psychiatrists 237
 assumptions about existence, he shows how we can
reach the awareness that ‘‘the world is not what I
think, but what I live through’’.1 He demonstrates
that ‘intentionality’ or meaning is contained within
our bodily existence prior to any act of self-reflection
or abstraction. During my illness, meaning and body
were inextricably intertwined in a painful existential
crisis.
SUBJECTIVE EMBODIMENT
According to Merleau-Ponty’s philosophy of ambiguity,
it is the body which through its dynamic relations to a
lived situation constitutes the first meanings an intellect
may grasp, as if by proxy, in any later attempt to codify
the experience in symbols.2
Merleau-Ponty wrote that we are ‘‘condemned to
meaning’’1 and that the ‘‘phenomenological reduc-
tion’’ consists of ‘‘rediscovering my actual presence to
myself’’.1 Rabil writes ‘‘the meaning of the eidetic
[phenomenological] reduction for Merleau-Ponty is
precisely that it leads us back to this world which is
already there and in which we are involved’’.3
In my case, the suspension of belief in the natural,
commonsense world that Merleau-Ponty describes as
the pre-requisite for a ‘‘phenomenological reduction’’
came about because of a number of factors.
I was isolated in a single room for several weeks;
inseparably tethered to an IV pole which would set
off a loud alarm at seemingly random intervals; there
was the constant threat of death and deterioration; I
experienced physical pain and nausea, extreme fati-
gue; alteration of sensations such as being unable to
taste food for several months; the complete upset of
normal waking and sleep cycles; the complex side-
effects of a variety of medications; physical changes in
my body (e.g. a football-sized spleen) and the neces-
sary disappearance of what Merleau-Ponty would refer
to as ‘sedimented’ (i.e. routine) habits and behaviours.
I could no longer consider the world in the common-
sense way as being separate from my existence in it. I
could no longer disappear as a ‘subject’ in the way that
. June 2009
I usually had in daily living where my perceptions were
equated with external reality and my body was gen-
erally invisible to me. The meaning of everything was
disturbed by new forms of spatial and temporal
Vol 17, No 3
experience. The banal ceiling structure immediately
above my bed took on a new significance as the first
thing I saw after awaking from disturbing hallucina-
tory dreams. The normal divisions of time dissolved
Australasian Psychiatry .
and I was ‘‘relearning to look at the world’’.1
Mundane concerns took on global importance such as
struggling to the toilet, getting dressed, watching TV
or looking out of the window at some helicopters
taking off from an airfield. Samuel Beckett4 portrays
this profundity of the mundane in his book Malone
238
Dies in which the narrator, a dying man lying in bed,
realizes he has dropped his walking stick: ‘‘Now that I
have lost my stick I realize what it is I have lost and all
it meant to me. And thence ascend, painfully, to an
understanding of the Stick, shorn of all its accidents,
such as I had never dreamt of. What a broadening of
the mind.’’ At these times perception becomes as
Merleau-Ponty describes a ‘‘violent act’’.1
SELF-ALIENATION AS A RESULT OF PAIN
Regardless of the setting in which he suffers (home,
hospital, or torture room), and regardless of the cause of
his suffering (disease, burns, torture, or the malfunction-
ing of the pain network itself), the person in great pain
experiences his own body as the agent of his agony.5
I had an internal haemorrhage that caused intense
pain for several weeks for which I was offered various
narcotic and non-narcotic medications. Initially I took
an ‘objectivist’ view of my pain and decided it was
merely a matter of taking sufficient quantities of the
right medication from a patient-controlled narcotic
pump. However, the pain became exacerbated rather
than subdued. The narcotic-induced consciousness
was full of confusion, nightmares and memories. An
‘intellectualist’ approach to force myself to think my
way out of pain by putting a different cognitive spin
on it was equally futile. Some other transplant patients
I spoke to were similarly disappointed. I realized that
the more I struggled to consign the pain to ‘mind’ or
‘body’, the more I was alienating myself from myself
and the more disturbed I felt.
AMBIGUITY OF EXISTENCE AT 3AM
The basic contention is that, even consciousness, as
awareness of the world and of men in the world, is not a
disengaged consciousness, but one immersed into the
very situation it perceives, experiences, judges, or reflects
upon . . . According to Merleau-Ponty, not only does not
man ever judge a situation from a disinterested point of
view, but his very viewing of the situation also modifies
it . . . That ambiguity prevails is not the outcome of
confused thinking on his part; the truth is that existence
is itself ambiguous; beginning from the Cogito down to
the last and most material level of being, that which is
experienced is not clear.6
The ambiguity of existence, the multitude of meanings
that it can adopt, became most evident at around 3am.
It is a time when I found myself alone, and awake with
the noticeable absence of the usual daytime routines of
investigations, treatments, meals and visits. The ward
was dark and quiet. There was the occasional noise or
disturbance, perhaps an emergency, perhaps a death,
but otherwise silence. For comfort I would turn to my
small bedside radio and listen to classical music or read
Bertrand Russell’s History of Western Philosophy, which I
found strangely comforting at such times. There was
plenty of time, for reflection and there was a great
sense of solitude, at times overwhelmingly painful and
at other times familiar and comforting.
ALIENATION AND CONNECTION IN THE
INTERSUBJECTIVE REALM
Co-existence must in all cases be experienced on both
sides . . . if the interworld is not an inconceivable in-itself
and must exist for both of us, then again communication
breaks down, and each of us operates in his own private
world like two players playing on two chessboards a
hundred miles apart.1
I had many relationships in hospital and I certainly did
not expect or want all of them to be deep and
meaningful. During times of crisis, those individuals
willing to engage with me were helpful, and those that
were not ended up reinforcing my sense of alienation.
For example, I discovered, thanks to my brother, that I
had not been told about a promising new drug to
diminish side-effects from my chemotherapy. I
believed the drug had not been offered largely for
economic reasons but there was an unwillingness to
engage in a mutually honest discussion of the ambi-
guities of current medical practice and the doctor
refused to consider himself anything other than an
impartial observer, which left me feeling alienated.
Ultimately, though, I was able to make private
arrangements to receive the drug, for which I was
very grateful.
Cognitive-behavioural ‘intellectualist’ approaches
assumed I was a detached subject who could think
and feel whatsoever I chose. A nurse recommended
that I ‘think positive’ or otherwise my cancer would
get worse. Merleau-Ponty argues that meaning is
something that exists within our physical embodiment
prior to any self-reflection and therefore cannot be
imposed at will. The nurse’s admonition was not
helpful and made me angry. McGrath et al. have
recognized ‘‘that urging patients to ‘think positive’
may be neither welcome nor helpful’’.7
There were some doctors and other carers who were
prepared to engage more deeply. The doctor who had
first suggested I have a transplant helped me with my
struggles with ambiguity for several years. One doctor
took the time to help me realize the difference between
personal time and clock time, which was invaluable.
Another doctor was able to connect with me through
his own philosophical interests and personal under-
standing.
However, not unexpectedly, it was my wife of 30 years
who intuitively was able to accept and understand the
crisis I was going through the most. For a few hours
each day we would watch old movies from our child-
hood on a laptop, and we would almost seamlessly
discuss the most profound and superficial topics. This
evoked a simpler childhood time where, as Merleau-
Ponty writes, ‘‘The child lives in a world which he
unhesitatingly believes accessible to all around him’’.1
He reminds us ‘‘that the unsophisticated thinking of
our earliest years remains as an indispensable acquisi-
tion underlying that of maturity, if there is to be for
the adult one single intersubjective world’’.1 These
shared times with my wife of temporary intersubjec-
tive unity provided enormous relief and were vital to
my emotional survival. However, I am also painfully
aware that many people do not have access to this kind
of support.
REFERENCES
1. Merleau-Ponty M. Phenomenology of Perception. New York: Routledge, 2002.
2. Kaelin EF. An Existential Aesthetic: The Theories of Sartre and Merleau-Ponty. Madison,
WI: The University of Wisconsin Press, 1962.
3. Rabil A Jr. Merleau-Ponty: Existentialist of the Social World. New York: Columbia
University Press, 1967.
4. Beckett S. Malone Dies. New York: Grove Press, 1956.
5. Scarry E. The Body in Pain: The Making and Unmaking of the World. Oxford: Oxford
University Press, 1985.
6. Barral MR. Merleau-Ponty: The Role of the Body-Subject in Interpersonal Relations.
Pittsburgh, PA: Duquesne University Press, 1965.
7. McGrath C, Jordens CFC, Montgomery K, Kerridge IH. ‘Right’ way to ‘do’ illness?
Thinking critically about positive thinking. Internal Medicine Journal 2006; 36: 665
668.
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