Abstract
Philosophical phenomenology is an approach that is related to psychiatric phenomenology, but differs in its breadth and objectives. With a foundation in the work of European philosophers such as Merleau-Ponty and Sartre, it aims to describe the nature of experiences generally, not just in mental illness, and emphasises the personal rather than the objective and impersonal qualities of experience.
Matthew Ratcliffe is a philosopher who has written extensively on the experience of psychopathological states and this book is the culmination of much of his work on depression over recent years. It uses this philosophical phenomenological stance to explore material derived from published accounts of depression and from an internet questionnaire conducted by Ratcliffe.
It is strange at first to read accounts of such depressive experiences taken at face value, without the references to aetiology or search for inferred meanings common to psychiatric practice and derived from psychiatric models of depression. However, Ratcliffe responds to this issue and also to questions of what depression actually is, both in the conceptual and the diagnostic senses, before launching into the substance of the book.
Here he makes a patient and thorough exploration of the experience of depression. Central to his description are a qualitative change in the sense of being in the world and of a loss of possibilities, a concept developed from Husserl. Ratcliffe goes on to explore various aspects of depression, including the loss of hope, guilt, altered experiences of time and changes in interpersonal relationships. It is gratifying that he succeeds in rising above common mind–body concepts to give particular importance to the physical experience of depression, considering the body as both a source of experience and the means by which we experience the world. To justify this approach he detours into a discussion of neurobiology and, while this makes some strong points, the argument feels a little out of place in this book.
Having developed a number of consistent themes through the book, in the closing chapters Ratcliffe moves on to a well-described examination of the nature of empathy and its relevance to psychiatric treatment. He ends by using these themes to inform our understanding of depression and other psychiatric diagnoses – an attempt to bring together traditional phenomenology and modern questions about the nature of mental illness.
Overall this provides a detailed exploration of the nature and experience of depression using rigorous philosophical methods. It is easy to assume that a psychiatric understanding of depression and its phenomenology would prepare the reader for this. However, while Ratcliffe explains his approach clearly, the differences in perspective that come with the philosophical approach are challenging, and we wonder whether this hurdle would be harder or, paradoxically, easier for the non-psychiatric reader. Whichever is the case, the book provides thought-provoking material and will deepen even an experienced reader’s understanding of the nature of depression.