(2013). Does consciousness entail subjectivity? The puzzle of thought insertion. Philosophical Psychology: Vol. 26, No. 2, pp. 291-314. doi: 10.1080/09515089.2011.625117.

The notion of intersubjectivity has achieved a primary status in contemporary psychoanalytic debate, stimulating new theoretical proposals as well as controversies. This paper presents an overview of the main contributions on inter-subjectivity in the field of neurosciences. In humans as well as—probably—in other species, the ability for emotional resonance is guaranteed early in development. Based on this capacity, a primary sense of connectedness is established that can be defined inter-subjective in that it entails sharing affective states and intentions with caregivers. (...) We propose to define such a form of inter-subjectivity ascontingent, since the infant’s early abilities for resonance do not imply the more generalized capacity to permanently conceive of the relationship outside the realm of current interactions and the infant-caregiver’s mutual correspondence of internal states. This form of connection, hence, results in a self-referential, bodily, and affectively codified, context- and time dependent, like-me experience of interactions. The gradual maturation of brain structures and processes as well as interactive experiences allow proper intersubjectivity exchanges, grounded on new intentional and representational capacities, to evolve. In this more mature form of intersubjectivity, the individual is allowed to conceive of her own psychic space both as distinct and as possibly connected with the other’s contents and experience, even in the absence of current behavioral indicators of such correspondence. This multi-layered model of intersubjectivity, which is embraced by current neuroscience research, seems to allow for new interpretations of psychoanalytic models of human relatedness based upon classic clinical observations. (shrink)

This paper explores the question concerning the relationship between basic and higher layers of experience and self-experience. The latter distinction implicitly presupposes the idea of a univocal foundation. After explaining the formal ontological law of foundation, an attempt is made to clarify how the idea of foundation may be suitable to understand the relationship among moments, or layers, of self-experience. To this aim, the phenomenological descriptions of self- and world-experience in dementia and schizophrenia are compared. The comparison between these two, (...) in many ways radically different, pathologies allows us to highlight both the potentialities and the limits of resorting to the foundational relationship for the description of lived experience. Taking the challenges coming from the description of dementia and schizophrenia into serious consideration, the meaning of the “stratified” account of self-experience will be eventually reassessed, and a way to complement the idea of foundation among layers will be proposed. (shrink)

This paper argues that intuition plays a role in the diagnosis of schizophrenia and presents its phenomenological rationale. A discussion of self-assessment questionnaires and empirical studies in the clinical setting provides evidence that despite the prevalence of operational diagnosis, the intuitive judgment of schizophrenia continues to take place. Two related notions of intuitive diagnosis are presented: Minkowski’s diagnostic by penetration and Rümke’s praecox feeling. Further on, the paper explores and clarifies the phenomenology behind the praecox feeling. First, it is argued, (...) intuitive diagnosis is neither a feeling nor an experience, but a typification operating at an implicit level. Second, it is not simply subjective as spatially it takes place in the in-between of the clinical interaction. Finally, it is not just momentary, but temporally extended, and, hence, partly reflective. The paper suggests that intuitive diagnosis requires critical testing on the side of the psychiatrist to either confirm or falsify it through reflective operations. In conclusion, the merits and shortcomings of intuitive vs. operational diagnosis are presented. (shrink)

In two recent papers, I introduced the idea of embodied Rilkean movement knowledge and perception into the current philosophical debate on sports knowledge. In this paper, I offer a new analysis of how embodied movement knowledge and perception help us to identify and define movement consciousness. I develop a phenomenological account of embodied movement consciousness and show how it is closely linked to self-consciousness by generating anticipations and affordances that implicate pre-reflective self-awareness. I also expand Rowlands’ Rilkean memory notion to (...) include affective phenomenological properties that rely on the constitutive fault-lines between bodily material sensations and the ingrained recollections they are based on. From this perspective, embodied movement consciousness comprises empirical sensations that phenomenologically unfold as physical acts grounded in materiality. (shrink)

Auditory verbal hallucinations (AVHs) are a highly complex and rich phenomena, and this has a number of important clinical, theoretical and methodological implications. However, until recently, this fact has not always been incorporated into the experimental designs and theoretical paradigms used by researchers within the cognitive sciences. In this paper, we will briefly outline two recent examples of phenomenologically informed approaches to the study of AVHs taken from a cognitive science perspective. In the first example, based on Larøi and Woodward (...) (Harv Rev Psychiatry 15:109–117, 2007 ), it is argued that reality monitoring studies examining the cognitive underpinnings of hallucinations have not reflected the phenomenological complexity of AVHs in their experimental designs and theoretical framework. The second example, based on Jones (Schizophr Bull, in press, 2010 ), involves a critical examination of the phenomenology of AVHs in the context of two other prominent cognitive models: inner speech and intrusions from memory. It will be shown that, for both examples, the integration of a phenomenological analysis provides important improvements both on a methodological, theoretical and clinical level. This will be followed by insights and critiques from philosophy and clinical psychiatry—both of which offer a phenomenological alternative to the empiricist–rationalist conceptualisation of AVHs inherent to the cognitive sciences approach. Finally, the paper will conclude with ideas as to how the cognitive sciences may integrate these latter perspectives into their methodological and theoretical programmes. (shrink)

Schizophrenia as a pathology of self-awareness has attracted much attention from philosophical theorists and empirical scientists alike. I view schizophrenia as a basic self-disturbance leading to a lifeworld of solipsism adopted by the sufferer and explain how this adoption takes place, which then manifests in ways such as first-rank psychotic symptoms. I then discuss the relationships between these symptoms, not as isolated mental events, but as end-products of a loss of agency and ownership, and argue that symptoms like thought insertion (...) and other ego-boundary disorders are by nature a multitude of paradoxes created by a fragmented awareness. I argue that such fragmentation does not always require or lead to a delusional elaboration as the definitive feature of its phenomenology, and present reasons for the role of the first-person pronoun as a mere metaphor used to represent the patient’s bizarre experiences where sensory perception and thinking processes converge. Further, I discuss the initi... (shrink)

Patients with psychotic disorders experience a range of reality distortions. These often include auditory-verbal hallucinations, and thought insertion to a lesser degree; however, their mechanisms and relationships between each other remain largely elusive. Here we attempt to establish a integrative model drawing from the phenomenology of both AVHs and TI and argue that they in fact can be seen as ‘spectra’ of experiences with varying degrees of agency and ownership, with ‘silent and internal own thoughts’ on one extreme and ‘fully (...) external and clearly audible voices’ in the absence of a speaker on the other. We believe a spectral model will add emphasis to the continuity of experience and help to better understand how one type of psychotic symptom may interact with another, and put forward the argument that the experience of TI itself is not sufficient to classify as a delusion. In addition we aim to discuss some of the conceptual issues surrounding AVHs and TI with first-person accounts and current philosophical and neuropsychological theories in mind. We propose that the mechanisms behind AVHs and TI are more complex than source-monitoring deficits; indeed, to understand such phenomena one must appreciate that their very ‘existence’ and ‘reality’ as experienced by the individual have much deeper implications and meaning, both philosophically and clinically. (shrink)

In keeping with recent views of consciousness of self as represented in the body in action, empirical studies are reviewed that demonstrate a bottlenose dolphin’s conscious awareness of its own body and body parts, implying a representational “body image” system. Additional work reviewed demonstrates an advanced capability of dolphins for motor imitation of self-produced behaviors and of behaviors of others, including imitation of human actions, supporting hypotheses that dolphins have a sense of agency and ownership of their actions and may (...) implicitly attribute those levels of self-awareness to others. Possibly, a mirror-neuron system, or its functional equivalent to that described in monkeys and humans, may mediate both self-awareness and awareness of others. (shrink)

Schizophrenia spectrum has been associated with a disruption of the basic sense of self, which pertains, among others, the representation of one’s own body. We investigated the impact of either implicit or explicit access to the representation of one’s own body-effectors on bodily self-awareness, in first-episode schizophrenia patients and healthy controls . We contrasted their performance in an implicit self-recognition task and in an explicit self/other discrimination task. Both tasks employed participant’s own and others’ body-effectors. Concerning the implicit task, HCs (...) were more accurate with their own than with others’ body-effectors, whereas patients did not show such self-advantage. Regarding the explicit task, both groups did not exhibit a self-advantage, and patients showed a higher percentage of self-misattribution errors. Neither self/other nor implicit/explicit effects were found in both groups when processing inanimate-objects. We propose that FES patients suffer of a disturbed implicit sense of bodily self. (shrink)

The mental representation of one’s own body does not necessarily correspond to the physical body. For instance, a dissociation between perceived and actual reach-ability has been shown, that is, individuals perceive that they can reach objects that are out of grasp. We presented participants with 3D pictures of objects located at four different distances, namely near-reaching space, actual-reaching space, perceived-reaching space and non-reaching space. Immediately after they were presented with function, manipulation, observation or pointing verbs and were required to judge (...) if the verb was compatible with the object.Participants were faster with function and manipulation verbs than with observation and pointing verbs. Strikingly, with both function and manipulation verbs participants were faster when objects were presented in actual than the perceived reaching space. These findings suggest that our knowledge of the world is implicitly built online through behaviour, and is not necessarily reflected in explicit estimates or conscious representations. (shrink)

In this paper we focus on what is referred to as the ‘mineness’ of experience, that is, the intimate familiarity we have with our own thoughts, perceptions, and emotions. Most accounts characterize mineness in terms of an experiential dimension, the first-person givenness of experience, that is subsumed under the notion of minimal self-consciousness or a ‘minimal self’. We argue that this account faces problems and develop an alternative account of mineness in terms of the coherence of experiences with what we (...) label an ‘embodied biography’. Building on a near consensus among consciousness researchers over the function of consciousness as integrating infor- mation, we argue that the phenomenology of mineness consists in the absence of any further thought on top of the experience itself. Finally we argue that this non-phenomenological account of mineness fits well with existing data on pathologies of mineness such as delusions of thought insertion. (shrink)

The article discusses the problem of whether the self, or the subject, is real. There are several realist and anti-realist solutions to this problem. The author interprets all possible positions concerning this issue as conceptions of a certain relationship between the phenomenal self and the ontological self. In line with what is called phenomenal, or experiential minimalism, the author concludes that the experiential dimension of the self is sufficient for it to be real without qualification. Providing an argument against anti-realism, (...) the author differentiates between strong and reductive realism and maintain that selves criticized by anti-realists like Metzinger are things of strong realism, while in fact selves might turn out to be the things of reductive realism. The author suggests a solution to another problem of the ontology of the self, namely the problem of characterization. By endorsing minimalism, the self is characterized as the experiential faculty. According to the suggested version of minimalism, having experience is a necessary and sufficient condition to be a self or a subject. All other properties ascribed to subjects in philosophical literature are contingent. Properties like these are of course attributes of subjects, but they are neither necessary nor sufficient for subjectivity. A subject who loses these properties does not cease to be a subject. On the contrary, a thing which has lost its experiential ability ceases to be a subject. In addition, there are non-human subjects who may lack all subjectivity-related features, except for the experiential faculty, and still be considered subjects. Phenomenal minimalism is a solution to the problem of the reality of selves. Subjects, or selves, are real as things with the experiential faculty. Finally, the author rejects pluralism and conventionalism. Instead, essentialist realism is endorsed. (shrink)

In this paper we focus on the psychiatric approach of Open Dialogue and seek to explain why the intersubjective process of dialogue, one of OD’s core clinical principles, is effective in schizophrenia treatment. We address this question from an interdisciplinary viewpoint, by linking the OD approach with a theoretical account of the self as endorsed by enactive cognitive science. The paper is structured as follows: first, we introduce the OD approach and focus in particular on the principles that are characteristic (...) of the dialogical therapeutic attitude. Second, we clarify our stance on the concept of schizophrenia by relying on insights from phenomenological psychiatry. Third, we introduce an enactive perspective on mental disorders, which elaborates on phenomenological psychiatry and conceives of the self as a self-organizing system, brought forth through interactional processes. Based on this enactive approach, we draw clinical implications for schizophrenia. In the fourth and final part, we propose conceptual bridges between the OD and the enactive approach by bringing to attention the intersubjective nature of the human self and the inherent vulnerability entailed in both the self’s maintenance and in the practice of dialogue. We then propose that the dialogical stance adopted by OD is effective in supporting the recovery of a balanced sense of self precisely because it provides an intersubjective space in which clients can safely experience and maintain the basic structures underlying the socially constituted self. Since our analysis touches upon fundamental structures of the therapeutic relationship, we hope that it will also be useful to inform general psychiatric practice and help advancing a more integrative understanding of psychotherapy for schizophrenia. (shrink)

This dissertation combines two scientific disciplines and research fields, namely philosophy and psychopathology. Within such a wide field of investigation, two precise perspectives are to be adopted in this inquiry: stemming from the first field, the phenomenological perspective on subjectivity and intersubjectivity; stemming from the second, the psychopathological perspective on schizophrenia. The combination of philosophy and psychopathology has often proven fruitful. Moreover, the main motivation for such combined approach is justified by the strong belief that, when critically used, phenomenology offers (...) a viable method of studying the first-personal perspective of experience, including the experiences of people with mental disorders. Philosophical analysis can thereby be used as a means to evaluate the meaning and adequacy of psychopathological concepts and ideas. As a result, phenomenological psychopathology may help understand what is often claimed to be incomprehensible. Particularly for the understanding of schizophrenia, this is taken to be a valuable contribution. For more than twenty years now, the phenomenological approach to schizophrenia has developed a strong and influential hypothesis on the basic alterations of this disorder. Schizophrenia, it is claimed, is a disorder of subjectivity, and more specifically, a disorder of the minimal self. Simultaneously, and often in conjunction, philosophical research on the self has vastly proliferated. The vivid interaction between these two fields makes the phenomenology of schizophrenia a good example of effective interdisciplinary work. Within the philosophical debate on subjectivity, intersubjectivity, or the relation between self and other, is currently a key topic. However, this has not significantly influenced the psychopathology of schizophrenia yet. The initial and fundamental claim of this dissertation is indeed that a renewed evaluation and inclusion of intersubjectivity, next to subjectivity, is to increase the validity of the phenomenological approach to schizophrenia. This would allow the previous hypothesis on schizophrenia as minimal self disorder to be challenged, criticized, or complemented, which would accordingly increase the significance and its clinical value. What I will attempt to do in this dissertation is then to thoroughly evaluate the role of intersubjectivity in schizophrenia. It will hence become clear what this role and its significance are. Consequently, I will finally argue that the basic alterations of schizophrenia concern both subjectivity and intersubjectivity. My argument is developed in four chapters. In the first, I introduce the topic of the self, including the distinction between the minimal and the extended self. This chapter equally introduces schizophrenia as a psychiatric concept, and three different clinical approaches are discussed, among which the phenomenological approach in most detail. After the topics of the self and schizophrenia, I introduce intersubjectivity, notably from a developmental-psychological perspective. By way of status quaestionis, I recapitulate the current research on intersubjectivity and schizophrenia. It will become clear that this research is relatively scarce. I then conclude the chapter with a full formulation of the two research questions informing this dissertation, namely Is schizophrenia an intersubjectivity-disorder? and Which self-concept is suited to define schizophrenia as a self and intersubjectivity disorder? The second chapter examines the phenomenology of intersubjectivity. The exact delineation of what is meant here by intersubjectivity will allow the reader to acknowledge its extent and variety. This chapter is aimed to provide the necessary philosophical tools to analyse schizophrenia in the light of intersubjectivity. In the third chapter I turn to psychopathology. In the first section, I analyse the work of seven major psychopathologists on schizophrenia. The goal of this section is to look for elements of intersubjectivity in their accounts of schizophrenia. Many of these psychopathologists have been influential for the development of the current self-disorder hypothesis, and the investigation intends to show how some crucial intersubjective elements in their work have been neglected. In the second section of this chapter, I focus on the symptoms, signs, and phenomena of schizophrenia that relate to intersubjectivity. This chapter finally offers all the material needed to positively answer the first research question. In the fourth chapter, I bring together psychopathology and philosophy, and I attempt to answer the two research questions. Since Chapter 3 allows me to affirmatively answer the first question, I examine whether the current self-disorder hypothesis is adequate to integrate intersubjectivity disturbances. It will appear that it is not, and the first section of this chapter consequently deals with the question why intersubjectivity and its disturbances have been neglected until now. In the second section it will become clear that no different self-concept is required, but that schizophrenia primarily concerns a particular capacity or orientation of subjectivity. I introduce the concept of open subjectivity and thereby answer the second research question. By describing schizophrenia as a disturbance of open subjectivity, I am finally able to integrate both self-disturbances and intersubjectivity-disturbances into a coherent and unified theory. To conclude this dissertation, I summarize and recapitulate its major issues, questions, and results in Chapter 5. Both clinical implications and possible future research are also discussed here. (shrink)