This is intended to teach psychiatric phenomenology for psychiatry post graduates.

1. FEELING
active
experience of somatic sensation,
touch..
passive
subjective experience of emotion

2. EMOTION
Memory & feeling intertwined
Transitory and spontaneous
experience similar to but not
identical to feeling
↓
As it need not incorporate
physical accompaniments of
experience

3. AFFECT
• Expression of emotion
• Broad term covering mood,
feeling, attitude, preferences
and evaluations
• External manifestations
associate with specific feelings
like laugh, cry, fear

4. MOOD
• Prolonged prevailing state or
disposition
• State of self in relation to
environment
• Normal mood is an enormous range of
variation
• Pathological mood- from which the
patient suffers or mood causing
disturbance or suffering to others(is
person suffering?), extent to which it
is acceptable( is it appropriate?)

5. Mood associated with physical
constitution which creates
tendecy(personality)
for eg- cyclothymic personality is
more prone to morbid elation,
overactivity or tacitum dejection
and retardation

6. THEORIES OF EMOTION
• JAMES LANGE THEORYEmotions are result of self
awareness of physical and
bodily changes in presence of
stimulus
CAR HEART
POUNDFEAR(EMOTION)
CANNAN BARD THEORY-

7. SCHACHTER & SINGER‟S 2
FACTOR THEORY
• SOCIAL CONTEXT
• PHYSIOLOGICAL AROUSAL
COGNITION
FEAR
FUNNY
THIS THEORY has implication for
clinical evaluation of mood disorders

8. BASIC EMOTIONS
According to ekman & colleagues(1971) there are 6
basic emotions
1) Anger
2) Disgust
3) Fear
4) Happiness
5) Sadness
6) Surprise
In papua new guinea there was little distinction
between surprise & fear( changes with location)
Change also with culture but the general theme is
universal.
Eg- Ingesting something repulsive is a disgust
everywhere

9. MOOD
COMMUNICATION
• NO MAN IS AN ISLAND, ENTIRE
OF ITSELF- JOHN DONNE
• Our feelings affected by those
around us, not accidental but
signalled as non verbal
message
• Affect itself is not directed but
expression of affect is conveyed

10. MIRROR NEURONS
“The most important
scientific discovery since
DNA?”
Found in primates & birds
and later inferred in
humans

11. Non verbal message
•
- through face(eyes
mainly), gestures, posture, tone
of voice, general appearance
especially clothes
• Interviewer‟s mood influences
patient‟s mood

13. Mirror neurons are the source of
empathy.
When we see a facial gesture, our
brains automatically mirror the
face and send a message to the
limbic system. Once this
emotional reaction has kicked in,
we understand the other because
we have become the other.

14. Broca‟s Area shows that
gestures and language are
simultaneous. When we hear
a word our action neurons
fire. This is called embodied
semantics.
THE KISS OF DEATH

15. Area F5 of the premotor cortex, similar to
Broca‟s Area in the human brain
• Also inferior parietal cortex

16. Let‟s replicate the
experiments
WORK IN PAIRS THROUGHOUT
1. Both grasp a small object, such
as a pen
2. Now one of you grasp whilst
the other watches only
3. Now just look at the object
without grasping it

17. Around 20% of the neurons that fired
when you grasped the object also fired
when you watched your partner grasp
that object. These are mirror neurons.
Some “logically related” mirror
neurons, the same ones, will also have
fired when you saw the object which
may have been about to be grasped.

18. And the conclusion to
all this?
ACTION
PERCEPTION
INTENTION
are all the same thing as far as the
brain is concerned.
It is holistic. This is how we
empathise, by simulating others‟
actions and their possible intentions.

19. IMITATION
• Piaget suggested that babies
learn to imitate
• Rizolatti & craighero said these
mirror neurons important for
culture and language
acquisition
• Mirror neurons tell us that babies
imitate to learn – from the first hour
of their lives

20. PATHOLOGICAL CHANGES
IN BASIC EMOTIONS
• CHANGE IN EMOTION
INTENSITY- dysphoria or
euphoria
• Diminution of feeling

21. • Anhedonia- loss of capacity to
experience joy & pleasure
• Euphoria- state of excessive
unreasonable cheerfulness
• Delayed grief- prolongation of
initial numb phase
• Lability of mood- both
heightening or an intensification
of emotions with instability in
persistence of emotions &
inappropriate

22. • Pathological laughter/crying
unprovoked emotion not related
to any identifiable social
situation
• Cause- gelastic epilepsy,
acquired brain injury
• Pathological crying occurs
either discretely or together

23. • Parathymia- reacts to bad news
with cheerfulness
• Paramimia- lack of unity
between various modes of
expression of emotion

24. • Blunting- lack of emotional
sensitivity
• Flattening- limitation of usefull
range of expressed emotion

25. • Retardation- slowing down of
ability to initiate thoughts or
action
• Smiling depression- degree of
depression concealed
consciously due to habitual
emotion masking or to avoid
treatment

26. • Diurnal variation seen in mood
disorder- worse in morning
• Alexithymia- difficulty in
identifying & describing their
own feeling,measured by
toronto alexithymia scale(4
factors) namely
1) Difficulty identifying feelings
2) Externaay oriented thinking
3) Difficulty expressing feelings
4) Reduced daydreaming

27. Localised &somatised affect
• Vital feelings- make us aware of
our „vital self ‟, feeling of mood
that emanates from body- most
commonly headache but also
abdomen, chest, eyes
• Coenestopathic statesdistressing feeling from one
local part of the body leading to
change in normal quality of
physical feeling from certain
body part without any local
lesion

28. • Free floating anxiety- powerfull
affect seems to have no general
goal & asso with no object.
Patient describes of feeling
generally anxious, not anxious
about anything in particular but
just anxious

29. • Somatisation- selective
perception & focus on somatic
manifestations of disorders with
denial or minimisation of
affective & cognitive changes
• Prosopoaffectiveagnosiaselective deficiency in
appreciating emotional
experience displayed in face of
others

30. •
Emotional dysprosody
Receptive
Selective deficit
In recognising
Emotional tone
in speech
Expressive
impairment in
production of
emotional
tone in speech

31. CYCLOTHYMIA
• Patient shows mood swings
over many years in both
directions that is gloom &
elation but severity does not
amount to that seen in manicdepressive illness

32. MANIA
• Elation of mood, overactivity,
acceleration of thinking
• Rarely patient complains
• Early enjoyable and relief but
later on unplesant and even
frightening