Veiling Existence With Clothing

Abstract

Our aim is to discuss the notion of freedom in severe depression. We will address it considering several phenomenological conceptions of the matter, from Binswanger's nicht können to more recent Ratcliffe's loss of existential feelings and also by clinging to our own clinical experience, in particular a case of melancholic depression in a 67-year-old woman.

Our patient suffered a clear melancholic syndrome, with an intense psychomotor inhibition, she felt uncapable of doing anything, spent hours brooding over menial tasks and thought much about dying, because she sensed the world as being devoid of possibilities and the future closed, experiences she considered “not related to disease” but to her own “incurable moral failure”.

In order to discuss the notion of freedom in depression, we will particularly focus on one of her psychopathologic phenomena, the empoverishment delusion-like experience of having run-out of proper clothing, which we consider was based on a inhibited “perception” of reality, an unreflective experience of corporeal “not being able”, a loss of the motivational force of intentionality. However, we will argue that this unreflective, pre-given experience showed striking connections to the patient's sub-depressive personhood, a classical Tellenbach's typus melancholicus.

An hermeneutical analysis of her existence will be performed using the anthropologic person-centered dialectic model developed by one of the authors, and building on it, we will introduce the distinction between lived experience (Erlebnis) and factual experience (Erfahrung) which we consider it is essential to enlighten the nature of the loss of freedom that severe depression entails.

Disclosure of interest

The authors have not supplied their declaration of competing interest.