Body image in neurology: from cenesthesia to specular image. Clinical and theoretical contributions of psychoanalysis

In neurology, the terms body schema and body image currently refer to two different body representations. These representations are meant to allow humans individuals to automatically adjust their bodies to space in sensorimotor activities and also have a semantic knowledge of their bodies and their body-space relationships. The term body image is also used in psychoanalysis, in a quite different maner. From the psychoanalytical point of view, body image is one of the registers of identity and the Other's regard plays a primordial role in the subject's acquisition of this identity. The crucial role of this gaze appears in the term specular image. After reminding the reader of history and the predecessors of these terms, we consider the implications of the concept of specular image in neurology. We show that neurological pathology may have effects upon specular image, up to and including a disorganization of the structure of specular image when brain lesions affect body schema. This perspective permits to find out a coherence and a logic in some psychiatric-like symptoms of right hemispheric brain lesions. (C) 2004 Elsevier SAS. Tous droits reserves.