The Patient's Experience of his ‘Mind’1

This Paper concerns ‘the mind’ as a subjective experience, especially as it is referred to in expressions such as ‘losing one's mind’, ‘doing one's nut’, and ‘blowing one's top’. These metaphors vividly express the close relationship between the mind, in this sense, and the head part of the body-image.

In sudden regressions there is usually a partial or complete loss of awareness and of conscious control, and I find that there are usually feelings or sensations in the head just before this happens. I hope to describe some common examples of these head experiences and also to speculate about the mechanisms involved.

The patient's fears about his mind are often of clinical importance. One has to inquire into what his ‘mind’ means to him. In the case of my kidneys I am certain that they exist although I have no subjective awareness of them as kidneys. In the case of my mind I have a good deal of subjective awareness of it but I cannot say that it exists in the same sense as my kidneys. If a patient is asked what he means by his mind he often says that it is what he thinks with and that it seems as if it is in his head. He is describing an experience similar in kind to that described by saying ‘My heart sank’ or ‘His words cut through me like a knife’. In the same way, when a patient says to me ‘What you said just now drove it all back up into my mind’ he is referring to real subjective experience, in this case ill-defined feelings seeming to rise up into his head. Feelings of this sort used to be regarded as real vapours or humours flowing about the body.

In everyday life one uses the word ‘mind’ both in a qualitative sense, for example in differentiating ‘mind’ from ‘heart’, and in a quantitative sense, in differentiating voluntarily directed thinking from daydreaming. One is much more likely to get a thick head from going round a museum and ‘trying to take too much in’ than from daydreaming, and this is in some way connected with having ‘used one's mind’ mor