Meaning Making and Variation in Depression: Depressive Suicidal Thoughts as Meaningful

The understanding of meaning within psychopathologies seems inevitable, since psychiatric disorders pertain to the way of how one interacts, understands, feels, or makes sense of the world and oneself. But within the DSM-V and ICD-11 the patient is often overlooked, and only conforms to the disease in a reductionist view, thereby missing the real core of the pathology, which is the patient herself (Bizzari 2019). A phenomenologically inspired enactive perspective offers the idea that psychiatric disorders are disorders of sense-making, affecting the way in which people relate to themselves, their world, and other people; as such, an enactive approach puts the patient in the foreground with their lived-experience (de Haan 2017). Accordingly, we can conceive psychopathologies not only as a deviance from ‘normal’ behaviour, but also as something so ingrained in how we act upon and engage with the world, through a constant sense-making that “discloses a meaningful, value-imbued world” (de Haan 2017) in an individual first-person intuitive process. Therefore, this thesis will revolve around contemporary phenomenological research including, just to name a few: Thomas Fuchs, Matthew Ratcliffe, Sanneke De Haan, and with the works of these aims at establishing a foundation that will lead to an analysis of how distorted sense-making shows that meaning is an integral part of psychopathology. Therefore, I will show how a skewered meaningfulness in the world greatly impacts the lived experience, and I will analyse the specific meaning of subjective experience such as embodiment, intercorporeality, intersubjectivity, and interaffectivity, notably by using the tool of phenomenological qualitative interview. In particular, I will make use of a specific case study: depression, a psychopathology that involves a huge disruption in each of these structures. I will argue that it seems to be not a loss of meaning, but rather it seems to be an indirect pre-reflective distortion that in turn changes or shifts the feeling of meaning, and that the lived experience in depression is full of variation. Then, I will focus on suicidal thoughts in depression, and I will show how this alteration of the self can only find meaning in suicide and suicidal thoughts, by tying up the misconceptions of a lack of meaning, and shifting it unto a first-person perspective of generating meaning. The final aim is a clearer understanding of both meaning and sense-making in depression, that might offer a more nuanced perspective of how they work when the self is somehow disrupted. Thus, I will show that a phenomenological enactive approach within psychopathology will further the understanding of mental disorders.