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THE CONCEPTUAL HISTORY OF BODY IMAGE AND THE SELF

Abstract

Professor Michael R Trimble Emeritus Professor of Behavioural Neurology at the Institute of Neurology, Queen Square, London, and Honorary Consultant Physician to the Department of Psychological Medicine at The National Hospital for Neurology and Neurosurgery, Queen Square, London.

Interests: Neuropsychopharmacology with special reference to neuropsychiatric disorders: epilepsy, its relationship to disturbances of behaviour and its treatment, and the effects of antiepileptic drugs and other treatment for epilepsy on the brain and behaviour. Other research and clinical interests include movement disorders and their treatment, especially the development of psychiatric disorders in Parkinson's disease and Gilles de la Tourette Syndrome. Psychiatric disorders following accidents, including head injuries, dementia and the clinical interface between pseudodementia and dementia: and the spectrum of presentations in neurology and psychiatry of patients with medically unexplained neurological symptoms. Many such patients turn out to have one or other form of somatoform disorder.

Fellow of the Royal College of Physicians, Fellow of the Royal College of Psychiatrists, and a Member of the Association of British Neurologists. Fellow of the American Psychiatric Association and a member of the American Neurological Association. Three Research degrees: MD (in medicine), Bsc (in neuroanatomy), and MPhil (in psychiatry). Past council member of the British Association of Psychopharmacology, council member of the CINP between 1998 and 2001, Chairman of the British Neuropsychiatry Association 2001–2004, and currently Vice President of the World Federation of Societies of Biological Psychiatry.

His publications include two editions of Biological Psychiatry (1988 and 1996), John Wiley & Sons, Chichester, and six other single author titles dealing with the interface between neurology and psychiatry, especially in the field of epilepsy. He has edited 25 books covering similar areas.

His books include Somatoform Disorders – a medico-legal guide, Cambridge University Press 2004, the Neuropsychiatry of Epilepsy edited with Professor B Schmitz, Cambridge University Press and Psychiatrische Epileptologie, Thieme, written with Professor B Schmitz. He is an Ambassador for epilepsy (International League Against Epilepsy Award), and received a life time achievement award from the International Neuropsychiatry Association. His new book is entitled “Why Humans Like to Cry – Tragedy, Evolution and the Brain”, Oxford University Press 2012.

Disturbances of the body image have been rather neglected over the years and there is much confusion in terminology. Thus, our physical bodies, (the actual body in extended space) differs significantly from our body image, (the body as viewed in a mirror) or from the body image in the brain. The latter would represent neuronal activity coincident in space with the perceived body, namely the collection of somatic sensations present at any one moment in consciousness.

Much confusion may have been brought to the topic by the term “Body Schema”, a term used by Head and Holmes, which initially became associated in particular with the parietal cortex. A further category namely the body concept relates to our beliefs concerning our physical bodies.

Disturbances of the body image are central to neuropsychiatry since they cover a broad spectrum from the obviously neurological (such as phantom phenomena) to the body image disturbances noted in schizophrenia, and disorders such as anorexia nervosa or gender dysphoria.

The presentation will try to unravel some of these problems and finish by emphasising the concept of embodiment and the now interesting areas of motor cognition interlinked with such concepts as intentionality.

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