The approach to mental health and well‐being taken here illustrates the complementary perspectives approach and assumes that there are useful and intersecting contributions from science (including medicine) and from religion and spirituality. What counts as poor mental well‐being depends on the interaction of relatively objective criteria with culturally contingent value judgments. I then discuss theological perspectives on depression, including a consideration of sources of hope and tolerance of dysphoria, and argue that depression can be part of a spiritual journey. I (...) then look at the relationship between psychosis and religion, including the work of Isabel Clarke, arguing that a spiritual approach to psychosis can complement a medical approach. Finally, I present a pastoral case study illustrating the interface between neurological and spiritual aspects of the sense of presence. A religious perspective can challenge and complement current assumptions about mental health in a potentially fruitful way. (shrink)

RESUMEN Desde 1980, C. D. Frith investiga la esquizofrenia, y explica sus síntomas centrales como las alucinaciones, con miras a aclarar cuál es el déficit originario de este trastorno mental. Frith propone una hipótesis centrada en el concepto de conciencia, que ha elaborado como parte del desarrollo científico contemporáneo. En primer lugar, como parte de la aplicación de modelos neurocognitivos de control motor, según los cuales el déficit se atribuye al concepto de copia eferente y su función. En segundo lugar, (...) la actualiza y complementa con evidencia de imagen cerebral de la atenuación de la actividad cortical parietal, como efecto derivado de la copia eferente. En tercer lugar, adiciona el concepto de sentido de agencia, y el componente de cognición social, intentando integrar la experiencia del paciente y la relevancia del ámbito intersubjetivo a su propuesta. Este artículo hace una revisión crítica de la hipótesis de Frith y se divide en cuatro partes: primero, se presenta una síntesis de la evolución de la hipótesis; segundo, se sintetiza su argumentación; tercero, se presentan los principales puntos críticos y, por último, se derivan unas conclusiones generales. ABSTRACT Since 1980, C. D. Frith has been working on schizophrenia, and explaining central symptoms such as hallucinations, in an attempt to clarify the basic deficits of this mental disorder. Frith has put forth a hypothesis based on the concept of consciousness, and has been adjusting it alongside contemporary scientific developments. In first place, it begins with the use of neurocognitive models of motor control, according to which the deficit is attributable to the concept of efferent copy and its function. In second place, he updated the model by including neuroimaging evidence of attenuation in parietal activity, as a consequence of the efferent copy. In third place, he added the concept of sense of agency, and the social cognition component, trying to integrate to his proposal the patient's experience and the relevance of the inter-subjective aspect. The current paper, which critically reviews Frith's hypothesis, it's divided in four parts: First, the hypothesis' evolution is synthesized; second, the main arguments are summarized; third, the main critical points are presented; and, finally, some general conclusions are drawn. (shrink)

Cerebral energy supply is insufficient to support continuous neuronal processing of the plethora of time-constant objects that we are aware of. As a result, the brain is forced to limit processing resources to cases of change. The neuronally generated world is thus temporally discontinuous. This parallels the fact that, in all relevant microscopic fundamental equations of nature, temporal change plays a dominant role. When a scientist calculates a “solution” to such an equation, integration over time is an essential step. The (...) present Hypothesis expresses that the step from neuronal activity to phenomenal content of consciousness is reflective of a “solution:” the main source of the incomprehensibility of consciousness is proposed to result from the introduction of phenomenal time-constant entities. These are “filled-in” via integration, even though neuronal data only exists for changes to these entities. In this way, a temporally continuous picture of the world phenomenally appears. Qualia are “initial conditions,” which are required for integration and cannot be deduced from present data. Phenomenal “identity” is related to qualia. Inattentive visual perception, which is only rarely investigated, offers insights into these relationships. Introspectively, unattended vision appears rich because percepts are cumulated over long time spans, whereas attentive perception relies purely on present neuronal signals. The present Hypothesis is that a brief neuronal activity can signify long-lasting and constant phenomenal content of consciousness. Experimental support is presented that comes from discrepancies between neuronal activity and perception: transient neuronal responses to sustained stimuli, “filling-in,” change blindness, identity vs. close resemblance. (shrink)

Decades ago, several authors have proposed that disorders in automatic processing lead to intrusive symptoms or abnormal contents in the consciousness of people with schizophrenia. However, since then, studies have mainly highlighted difficulties in patients’ conscious experiencing and processing but rarely explored how unconscious and conscious mechanisms may interact in producing this experience. We report three lines of research, focusing on the processing of spatial frequencies, unpleasant information, and time-event structure that suggest that impairments occur at both the unconscious and (...) conscious level.We argue that focusing on unconscious, physiological and automatic processing of information in patients, while contrasting that processing with conscious processing, is a first required step before understanding how distortions or other impairments emerge at the conscious level. We then indicate that the phenomenological tradition of psychiatry supports a similar claim and provides a theoretical framework helping to understand the relationship between the impairments and clinical symptoms. We base our argument on the presence of disorders in the minimal self in patients with schizophrenia. The minimal self is tacit and non-verbal and refers to the sense of bodily presence. We argue this sense is shaped by unconscious processes, whose alteration may thus affect the feeling of being a unique individual. This justifies a focus on unconscious mechanisms and a distinction from those associated with consciousness. (shrink)

Patients suffering from schizophrenia have an impaired meta-representation also known as Theory of Mind . Moreover, the presence of delusions or other positive symptoms of schizophrenia has been correlated to poor ToM performances. Lack of insight is a common symptom of schizophrenia and can be considered a critical manifestation of impaired ToM abilities. In particular, the present study addresses the role of perspective ToM ability in schizophrenic patients. Thirty severely delusional schizophrenic patients completely lack insight when interviewed about their delusions. (...) Seven subsequently gain insight about their mental state when perspective is shifted from the first person to third person. These data suggest that in some delusional schizophrenic patients, it may be possible to gain access to and modify their mental states. (shrink)

This essay, the last in a series, focuses on the relationship between Nietzsche’s mental illness and his philosophical art. It is predicated upon my original diagnosis of his mental condition as bipolar affective disorder, which began in early adulthood and continued throughout his creative life. The kaleidoscopic mood shifts allowed him to see things from different perspectives and may have imbued his writings with passion rarely encountered in philosophical texts. At times hovering on the verge of psychosis, Nietzsche was able (...) to gain access to unconscious images and the music of language, usually inhibited by the conscious mind. He reached many of his linguistic, psychological and philosophical insights by willing suspension of the rational. None of these, however, could have been communicated had he not tamed the subterranean psychic forces with his impressive discipline and hard work. (shrink)

Wegner and colleagues have offered an explanation of the sense of agency over one’s bodily actions. If the orthodox view is correct and there is a sense of agency deficit associated with delusions of alien control, then Wegner and colleagues’ model ought to extend to an explanation of this deficit. Data from intentional binding studies opens up the possibility that an abnormality in representing the timing of mental events leads to a violation of the principle of priority in those suffering (...) from delusions of alien control. However, the model ultimately fails as it is unable to accommodate action monitoring deficits associated with delusions of alien control, in particular the theory of mind deficiencies predicted by such accounts have not materialised. There are theory of mind problems associated with schizophrenia but they are not associated with delusions of alien control. Such accounts thereby fail to adequately explain delusions of alien control. (shrink)

Current thinking suggests that dissociation could be a significant comorbid diagnosis in a proportion of schizophrenic patients with a history of trauma. This potentially may explain the term “schizophrenia” in its original definition by Bleuler, as influenced by his clinical experience and personal view. Additionally, recent findings suggest a partial overlap between dissociative symptoms and the positive symptoms of schizophrenia, which could be explained by inhibitory deficits. In this context, the process of dissociation could serve as an important conceptual framework (...) for understanding schizophrenia, which is supported by current neuroimaging studies and research of corollary discharges. These data indicate that the original conception of “split mind” may be relevant in an updated context. Finally, recent data suggest that the phenomenal aspects of dissociation and conscious disintegration could be related to underlying disruptions of connectivity patterns and neural integration. (shrink)

The phenomenon of consciousness has received through the centuries a profusion of interpretations, engaging researchers across many disciplines. Nevertheless, consensus still floats at large. The aim of the present work is therefore twofold. Through the review of a selected number of existing proposals, it will first be considered the extents of their reciprocal compatibility, tentatively shaping an integrated, theoretical profile of consciousness. A new theory, the Endogenous Feedback Network will consequently be introduced which, besides being able to accommodate the main (...) tenets of the reviewed theories, appears able to compensate for the explanatory gaps they leave behind. The EFN proposes consciousness as the phenomenon emerging from a distinct neural network broadcasting the changes associated to mental activations across the brain. It additionally argues for the need to include a 5th element to Ned Block’s taxonomy that is, non-cognitive consciousness. (shrink)

This is a bibliography of books and articles on consciousness in philosophy, cognitive science, and neuroscience over the last 30 years. There are three main sections, devoted to monographs, edited collections of papers, and articles. The first two of these sections are each divided into three subsections containing books in each of the main areas of research. The third section is divided into 12 subsections, with 10 subject headings for philosophical articles along with two additional subsections for articles in cognitive (...) science and neuroscience. Of course the division is somewhat arbitrary, but I hope that it makes the bibliography easier to use. This bibliography has first been compiled by Thomas Metzinger and David Chalmers to appear in print in two philosophical anthologies on conscious experience . From 1995 onwards it has been continuously updated by Thomas Metzinger, and now is freely available as a PDF-, RTF-, or HTML-file. This bibliography mainly attempts to cover the Anglo-Saxon and German debates, in a non-annotated, fully formatted way that makes it easy to "cut and paste" from the original file. To a certain degree this bibliography also contains items in other languages than English and German - all submissions in other languages are welcome. Last update of current version: July 13th, 2001. (shrink)