Courtet Philippe, Guillaume Sébastien
PSNREC, University of Montpellier, INSERM, CHU de Montpellier, Montpellier, France.
Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.
Front Psychiatry. 2020 Jul 31;11:758. doi: 10.3389/fpsyt.2020.00758. eCollection 2020.
In the painting "Lucretia," Artemisia Gentileschi, one of the major painters of the 17 century, depicts Lucretia's suicide. This artwork empathic vision offers the spectator the apprehension of a unique phenomenon where psychological pain is transformed into self-aggression. To understand why the body becomes an object to attack, it is important to study the role of interoception and self-awareness in the suicidal process. This essay discusses how bodily representations are crucial for interacting efficiently and safely with the outside world and for establishing the sense of self. It presents some of the available evidence showing that alterations in the body representation and in the sensations perceived by it contribute to suicide. Indeed, neuroimaging studies show that social environmental factors and their biological consequences in the body (e.g., increased neuroinflammation) can alter the neural networks of suicidal behavior by increasing the sensitivity to psychological pain and the disconnection from self-awareness. Therefore, body image, sensations and awareness as well as psychological pain should be examined to improve the understanding of the dynamic interactions between body, brain, and mind that underly suicidal behavior. This conceptualization brings clinical and therapeutic perspectives in a domain where they are urgently needed.
在画作《卢克雷齐娅》中,17世纪的主要画家之一阿特米西亚·真蒂莱斯基描绘了卢克雷齐娅的自杀场景。这幅作品以共情的视角让观者领会到一种独特的现象,即心理痛苦如何转化为自我攻击。要理解为何身体会成为攻击的对象,研究内感受和自我意识在自杀过程中的作用至关重要。本文探讨了身体表征对于与外部世界进行有效且安全的互动以及建立自我意识的关键作用。文中呈现了一些现有证据,表明身体表征及其所感知的感觉的改变会导致自杀。的确,神经影像学研究表明,社会环境因素及其在身体上产生的生物学后果(例如神经炎症增加)会通过提高对心理痛苦的敏感性以及与自我意识的脱节来改变自杀行为的神经网络。因此,应该审视身体意象、感觉和意识以及心理痛苦,以增进对构成自杀行为基础的身体、大脑和心理之间动态相互作用的理解。这种概念化在一个迫切需要临床和治疗视角的领域带来了这些视角。