This is not a book for the generalist. It is a specialist text on ‘existential feelings’, written in the tradition of Husserl, Biswanger and Merleau-Ponty. The author's aim is to ‘offer a phenomenological analysis of existential feeling and show how this can be fruitfully applied to psychiatry and refined in the process’ (p. 9). The analysis is conducted in a treacherous territory. It is difficult enough to attempt to distinguish between the concepts of ‘feelings’, ‘emotions’, ‘mood’ and ‘affect’, given how often these terms are conflated and misunderstood. But to add ‘existential feelings’ as opposed to physical/physiological feelings into this mix is to complicate matters further. This is the central problem with this book – its currency is imprecise language whereas the analytic work required for a book's success demands rigour and exactitude.

The psychological literature on emotions is well developed, from the James–Lange through to the Cannon–Bard theory and finally to the modern cognitive appraisal theories initially described by Schachter. For William James and Carl Lange, the physiological changes that occur as a result of autonomic response to a given situation are the actual experienced emotions. Thus, we are fearful because our hearts beat rapidly. Walter Cannon and Philip Bard challenged this view in the 1920s. Their hypothesis was that in confronting a stimulus, a subject has a simultaneous emotional response that leads to behaviour. In other words, emotions are simultaneous with the provoking stimuli. Schachter's two-stage theory adds context and cognitive appraisal into the picture such that it is the environmental context that determines the emotional label of particular physiological changes. In this book, Ratcliffe argues for William James' identification of feelings with emotions and in the process assumes that physiological changes as understood by James are synonymous with ‘existential feelings’. I doubt that this is the case. Ratcliffe does not fully take on board the well-established criticisms of James' theory, many of which are derived from empirical findings.

Ratcliffe also argues that Capgras and Cotard syndromes are best understood in the light of his elucidation of existential feelings. For Ratcliffe, Capgras syndrome ‘arises due to changed existential feeling, involving the diminution or absence of possibilities for interpersonal relatedness’ (p. 143) and this is similarly true for Cotard syndrome as it is for depersonalisation. In his examination of these abnormal experiences, Ratcliffe concludes that both Capgras and Cotard syndromes cannot be regarded as delusions, meaning false beliefs, in an ordinary sense. In other words, individuals who exhibit these phenomena are not taking a propositional attitude when they assert that they are dead or that impostors have replaced their relatives. Although many philosophers share this view, it merely shows how complex delusions are to be reasoned about. The final word on the nature of delusions is yet to be written. But it is the neglect of the robust and consistent findings of impaired face processing and other cognitive neuropsychological abnormalities in Capgras syndrome in particular that undermines Ratcliffe's account.

Ratcliffe's approach is interesting and novel, an example of interdisciplinary scholarship. There are original insights and illuminating descriptions of what anomalous or morbid existential feeling may be like. This is really Ratcliffe's main contribution, an insistence on a phenomenology of existential feelings and a re-emphasis of the importance of this approach for clinical psychopathology.