Depersonalization/derealization disorder is classified as a dissociative disorder in the DSM5. It is noteworthy that the symptoms of depersonalization and derealization are commonly found in many other psychological disorders, including schizophrenia spectrum disorders, while phenomenological features of schizophrenia are commonly found in DPDR. The current study attempts to clarify these apparent similarities via highly detailed phenomenological interviews with four persons diagnosed with DPDR. The data revealed four interrelated facets: 1, Loss of resonance, 2, Detachment from experience, 3, Loss of self, (...) and 4, Commitment to reality. These facets point to a felt loss of immediate and familiar engagement in experience as a basic organizing Gestalt which permeates the various symptoms and signs of our participants with DPDR. Close consideration of this disruption allows their experiences to be more easily distinguished from those of schizophrenia-spectrum disorders. (shrink)

In this paper, I explore scientific attempts to articulate a unified theory of the serotonin system and to explain the effects of psychedelic substances. I consider how certain accounts of psychedelic action have focused primarily on cognitive states, and I propose some phenomenological insights to supplement these models and inform work on psychedelics as therapeutic agents. Specifically, I argue that considering “psychological transformation” to be a core desideratum of psychedelic therapy should lead us to investigate the role of affect in (...) guiding significant psychological change. The phenomenological tradition offers resources for describing the relationship between knowledge and affect, and I argue that epistemically significant affective states such as fascination and revelation are more central to psychedelic experience than is commonly acknowledged. I propose that understanding the role of affect in psychedelic experiences is critical to developing a plausible account of the potential for using these substances therapeutically. (shrink)

Depersonalization/Derealization Disorder (DPD) is a psychopathological condition in which subjects suffer from a massive alienation from themselves and the world around them. In recent years, several philosophers have proposed accounts that explain DPD in terms of an alteration in global features of normal consciousness, such as ‘mineness’. This article criticizes such accounts and develops an alternative approach, based on the observation that many mental states relate to the subject because of the kind of state they belong to. I argue that (...) most symptoms of DPD can be understood as impairments in such forms of self-relation. (shrink)

The initial cause of Cotard delusion is pervasive dyshomeostasis (dysregulation of basic bodily function).This explanation draws on interoceptive active inference account of self‐representation. In this framework, the self is an hierarchical predictive model made by the brain to facilitate homeostatic regulation. The account I provide is an alternative to two factor accounts of the Cotard delusion that treat depersonalisation experience as the first factor in genesis of the Cotard delusion. I argue that depersonalisation experience and the Cotard delusion are produced (...) by different breakdowns in the process of self‐modelling. (shrink)

In his paper “Whatever next? Predictive brains, situated agents, and the future of cognitive science,” Andy Clark seminally proposed that the brain's job is to predict whatever information is coming “next” on the basis of prior inputs and experiences. Perception fundamentally subserves survival and self-preservation in biological agents, such as humans. Survival however crucially depends on rapid and accurate information processing of what is happening in the here and now. Hence, the term “next” in Clark's seminal formulation must include not (...) only the temporal dimension (i.e., what is perceivednow) but also the spatial dimension (i.e., what is perceivedhereor next-to-my-body). In this paper, we propose to focus on perceptual experiences that happen “next,” i.e., close-to-my-body. This is because perceptual processing of proximal sensory inputs has a key impact on the organism's survival. Specifically, we focus on tactile experiences mediated by the skin and what we will call the “extended skin” or “second skin,” that is, immediate objects/materials that envelop closely to our skin, namely, clothes. We propose that the skin and tactile experiences are not a mere border separating the self and world. Rather, they simultaneously and inherently distinguishandconnect the bodily self to its environment. Hence, these proximal and pervasive tactile experiences can be viewed as a “transparent bridge” intrinsically relating and facilitating exchanges between the self and the physical and social world. We conclude with potential implications of this observation for the case of Depersonalization Disorder, a condition that makes people feel estranged and detached from their self, body, and the world. (shrink)

In this paper, we argue that there are reasons to believe that an implicit bias for normalcy influences what are considered medically necessary treatments in psychiatry. First, we outline two prima facie reasons to suspect that this is the case. A bias for ‘the normal’ is already documented in disability studies; it is reasonable to suspect that it affects psychiatry too, since psychiatric patients, like disabled people, are often perceived as ‘weird’ by others. Secondly, psychiatry's explicitly endorsed values of well-being (...) and function are hard to measure directly, which is why we see simpler box-ticking conceptions of recovery used in large research studies. This need not be problematic, but might lead to researchers and clinicians focusing too much on treatments that promote easy-to-measure proxies for recovery, instead of what actually matters to psychiatric patients themselves. Next, we provide examples of treatments and treatment decisions within two areas – self-injury and psychosis – which are hard to explain unless we assume that an implicit and harmful normalcy bias is at work. We conclude with some suggestions for clinicians and future research. (shrink)

The label Body Integrity Dysphoria (BID) refers to a heterogeneous class of conditions whose sufferers desire a particular type of physical impairment. Variants of the desire for disability share the experiential “friction” elicited by the mismatch between the physical body and the subjective body. Perceived from childhood, body integrity dysphoria intensifies progressively throughout life, often leading sufferers to simulate disability and attempt to engage in self-injury. The contemporary scientific community agrees on the assumption that BID is a complex phenomenon that (...) involves biological, social, and psychological dimensions. The present work aims to provide a preliminary qualitative overview of the desire for permanent visual impairment through novel descriptions from a recent narrative interview we conducted. The desire for blindness appears to be extremely rare. To date, there have been very few studies investigating this phenomenon. Despite these limitations, this paper aims to describe the subjective aspect of visual dysphoria, considering its similarities and differences with other variants grouped under the label of BID. (shrink)

Alienation has been recently revived as a central theme in critical theory. Current debates, however, tend to focus on normative rather than on explanatory issues. In this paper, I confront the latter and advance an account of alienation that bears on the mechanisms that bring it about in order to locate alienation as a distinctive social and psychological fact. In particular, I argue that alienation can be explained as a disruption induced by social factors in the sense of mental ownership (...) that comes with the first personal awareness of being a subject of attitudes, emotions, and actions, and outline how social factors can play a structuring causal role in the process that brings it about. In the first section, I introduce the theme and explain why it is important to focus on the mechanisms that underlie alienation. In the second section, I maintain that understanding how alienation works is crucial to make sense of false consciousness. In the third section, I consider the relevance of mental ownership to explaining alienation and discuss existing evidence about whether and how it can fail. In the final section, I argue that disturbances in the simulation routines that support social cognition might underpin alienation, and outline how social factors might play a structuring causal role in this connection. (shrink)