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Personality / Capacities

Bodily Experiences and Representations

Most of the time, you live in your body without thinking about it. You know where it ends and the world begins, you can tell hunger from anxiety, and the tightness in your chest before a hard conversation registers, at least dimly, as a feeling about the conversation. This capacity concerns that relationship between a person and their body: how the body is felt, pictured, owned, and used to make sense of inner life.

The PDM-3 added it as a new mental function, citing a growing clinical and research literature on the role of the body in psychological life (Lingiardi, Muzi, & Bornstein, 2026, p. 710). It covers conscious and unconscious perceptions, sensations, feelings, and thoughts about one’s body, along with the implicit awareness of the body as a complex whole with boundaries that separate the self from the physical and interpersonal world. The manual distinguishes implicit bodily experience, the constant background signals about the state of the organism that support a sense of identity and continuity, from explicit experience, such as the felt bodily echo of an emotion. It includes interoception, the sensing of signals from inside the body, and exteroception, the sensing of signals from outside, as well as body image (pp. 718–719).

For people whose gender identity differs from the sex they were assigned at birth, the PDM-3 is explicit that the rating should not focus on that incongruence itself, but on whether and how much the person experiences distress or altered feelings at a bodily level (p. 719). More broadly, nobody has a frictionless relationship with their body, and this capacity describes how flexibly a person can live with and think about theirs.

Across the Range

The PDM-3 offers three anchor points on its five-point scale (Lingiardi et al., 2026, pp. 719–720). Ratings of 4 and 2 fall between them.

5: Healthy
The person has both a background sense and a conscious awareness of their body as a whole with clear boundaries, which supports a sense of integrity. Bodily representations are woven into overall self-experience. Emotions can be told apart from bodily states, even under stress, and sensations from inside and outside the body are accurately perceived. The person can reflect on bodily experience and use it to make thoughtful decisions, especially in relationships.
3: Mild to moderate difficulties
Under stress or conflict, the person has notable trouble telling bodily states from emotional ones. There may be a sense of separation from the body or a weaker feeling that it is one’s own, along with some difficulty putting physical experience into thought and managing intense feelings. When something threatening or unprocessed happens, the body may become the focus of attention, expression, or worry, for example about shape, weight, or health.
1: Major to severe difficulties
The person has great difficulty feeling that self and body are one and that the body is theirs, and may not be able to tell bodily experiences from mental states. The body may feel unfamiliar, alien, or as if it is falling apart, and the person may feel like an outside observer of their own body and mind. Bodily sensations may be hard to notice. In the most severe cases, the body can become the subject of delusions or hallucinations, or the main outlet for overwhelming feelings, sometimes in ways that harm it.

How It Develops

According to the PDM-3, a sense of an embodied self grows out of constitutional factors, repeated sensorimotor experience, and the infant’s own body signals. The baby’s first experiences of being seen, touched, and held help create a mental space for representations, and if the caregiver can hold the baby’s bodily experience in mind, the child can develop a coherent sense of self rooted in the body. Before feelings are gradually differentiated into psychological states, they are felt as bodily sensations (Lingiardi et al., 2026, p. 719). A parent’s own interoceptive awareness supports what Winnicott called “handling,” the physical care through which a baby comes to know its body (p. 748). Developmental interferences such as early trauma can leave bodily meanings that cannot be put into words or fantasies, so that the body, and especially the skin, becomes a main way of handling unspeakable feelings (p. 719).

Adolescence is a second great reorganization. The PDM-3 puts it vividly: just as the infant’s mind develops from the body, in adolescence the body comes forcibly to the attention of the mind. Puberty disrupts the existing balance, and teenagers must take ownership of a body newly full of impulses, arousal, and desire. Body image has to be rebuilt, and the boundaries of the self, starting with the skin, redrawn (Tanzilli & Malberg, 2026, pp. 424–425).

In later life, the body changes again. Illness and treatment draw attention to it, appearance anxieties are common, especially for women in cultures that prize youth, and age stereotypes can feed dissatisfaction and withdrawal. People at the healthy end integrate these new bodily realities into their sense of self (Del Corno & Plotkin, 2026, p. 910).

How It Shows Up in Personality

The style most directly tied to this capacity is the somatizing style, in which the body becomes the “preferential” means of expressing painful experience (McWilliams & Shedler, 2026, p. 683). People with this style often find it hard to put feelings into words, and some have been described as relying on concrete “operational thinking,” with little fantasy life (p. 684). The PDM-3 suggests that their early caregivers may not have fostered a capacity to represent feelings verbally, leaving their bodies to say what their minds could not (p. 684).

Other styles involve the body in quieter ways. The PDM-3 describes people with hysterical-histrionic psychologies as sometimes carrying unconscious shame about their gendered body (p. 686), and notes that people with a narcissistic style often have hypochondriacal preoccupations and may become preoccupied with their bodily integrity in place of emotional investment in others (p. 689). People with an emotionally dysregulated style may enter dissociated or trance-like states (p. 697), and the PDM-3’s description of severe difficulty in this capacity includes the sense of watching one’s own body from outside, an experience linked to dissociative patterns and the defense of dissociation (Lingiardi et al., 2026, pp. 719–720).

Across the levels of organization, somatic preoccupations appear throughout but become especially hard to treat at the borderline level; at the psychotic level, bodily concerns may take the form of somatic delusions (McWilliams & Shedler, 2026, p. 683).

How Different Thinkers See It

Sigmund Freud

The PDM-3 anchors this capacity in Freud’s statement in The Ego and the Id that the ego is first and foremost a bodily ego (Lingiardi et al., 2026, p. 718). That wording follows the later Standard Edition; Joan Riviere’s 1927 English translation, the first, has “body-ego.” In that translation Freud describes the body, and above all its surface, as a place from which both external and internal perceptions spring, and the translator’s authorized note explains that the ego is ultimately derived from bodily sensations, chiefly those from the surface of the body (Freud, 1927, p. 31).

D. W. Winnicott

Winnicott’s paper “Mind and Its Relation to the Psyche-Soma” (1954) is listed in the PDM-3’s M-Axis bibliography, though dated there to 1975 (Lingiardi et al., 2026, p. 745); the journal article appeared in 1954, the date the manual’s adolescent chapter gives (Tanzilli & Malberg, 2026, p. 459). One gloss describes his psyche-soma as the unification of the body with an imaginative elaboration of its parts, feelings, and functions (Arzy, 2021). His concept of “handling” links the caregiver’s physical care to the child’s growing sense of an embodied self (Lingiardi et al., 2026, p. 748).

Didier Anzieu

The psychoanalyst Didier Anzieu proposed the “skin ego”: just as the skin supports and contains the body, a psychic envelope supports and contains the mind. In Gunnar Karlsson’s summary, the skin ego grows from the infant’s sensory contact with a holding caregiver and from a fantasy of a shared skin that keeps mother and baby together while also marking their separateness (Karlsson, 2026). Alessandra Lemma’s work on the skin and body modification, cited in the PDM-3, extends this line of thought (Lingiardi et al., 2026, p. 743; Tanzilli & Malberg, 2026, pp. 424–425).

Interoception research and neuroscience

Neuroscientists define interoception as the process by which the nervous system senses, interprets, and integrates signals from within the body, across conscious and unconscious levels. Problems in interoception are increasingly recognized in anxiety, mood, eating, addictive, and somatic symptom disorders (Khalsa et al., 2018). The PDM-3 draws on this language, and on the related idea of parental “embodied mentalizing,” in which a caregiver makes sense of a baby’s nonverbal, bodily communications (Lingiardi et al., 2026, p. 719). McWilliams names Antonio Damasio among the neuropsychoanalytic scholars giving clinicians a new language for these phenomena (McWilliams, 2004, p. 145).

Examples

Kai and the body as a battleground

In a PDM-3 case illustration, Kai, a 27-year-old nonbinary person of African descent, grew up amid rigid gender expectations and rejection. The authors caution that a traditional psychoanalytic reading might pathologize Kai’s nonbinary identity itself, a mistake they compare to past misreadings of other subordinated identities. Kai’s distress showed partly through eating symptoms, which the clinician understood in part as an unconscious attempt to reshape the body, and through an early identification with stereotyped feminine images that deepened their dysphoria. Therapy, including work on dreams and body image, helped Kai develop a freer relationship with their body and experiment more creatively with gender expression. Kai was rated 2 on this capacity.

Lingiardi & McWilliams (Eds.), PDM-3 Online Supplement (2026), pp. 55–57, 62

Grace takes in her own appearance

Grace, a 48-year-old woman with classic good looks, had never been told she was exceptionally pretty and had not learned how the world responds to beauty. As her therapist named the privilege and the burdens of her appearance, she came to a more realistic picture of herself and her body and could deal better with attempts to exploit her. She was rated 3 on this capacity.

Lingiardi & McWilliams (Eds.), PDM-3 Online Supplement (2026), pp. 47–48, 53

History

The body has been part of psychoanalysis from the start: Freud called the ego “first and foremost a body-ego” in The Ego and the Id, published in German in 1923 and in English in 1927 (Freud, 1927, p. 31). Winnicott’s psyche-soma paper was published in 1954 (Winnicott, 1954), and Anzieu’s Le Moi-peau (1985) appeared in English as The Skin Ego in 1989 (Anzieu, 1989; Karlsson, 2026). Interoception itself has a longer scientific history: the term was first defined by Charles Sherrington in 1906 (Khalsa et al., 2018).

Yet neither earlier edition of the PDM made the body a separate mental capacity. The first PDM’s nine categories and the PDM-2’s 12 capacities did not include it (Stern, 2009; Gori et al., 2025). The PDM-3 added bodily experiences and representations in response to the growing clinical and empirical literature, placing it first in the domain of identity and relationships (Lingiardi et al., 2026, pp. 710–711). Its bibliography includes research applying the PDM to subjective and bodily experience in eating disorders (Lingiardi et al., 2026, p. 743), and its adolescent chapter lists body-image measures such as the Body Appreciation Scale and the Body Shape Questionnaire as tools for this capacity (Tanzilli & Malberg, 2026, p. 450).

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