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)

Philosophical and scientific investigations of the proprietary aspects of self—mineness or mental ownership—often presuppose that searching for unique constituents is a productive strategy. But there seem not to be any unique constituents. Here, it is argued that the “self-specificity” paradigm, which emphasizes subjective perspective, fails. Previously, it was argued that mode of access also fails to explain mineness. Fortunately, these failures, when leavened by other findings (those that exhibit varieties and vagaries of mineness), intimate an approach better suited to searching (...) for an explanation. Having an alternative in hand, one that shows promise of achieving explanatory adequacy, provides an additional reason to suspend the search for unique constituents. In short, a negative and a positive thesis are developed: we should cease looking for unique constituents and should seek to explain mineness in accord with the model developed here. This model rejects attempts to explain the phenomenon in terms of either a narrative or a minimal sense of self; it seeks to explain at a “molecular” level, one that appeals to multiple, interacting dimensions. The molecular-level model allows for the possibility that subjective perspective is distinct from a stark perspective (one that does not imply mineness). It proposes that the confounding of tacit expectations plays an important role in explaining mental ownership and its complement, disownership. But the confounding of tacit expectations is not sufficient. Because we are able to be aware of the existence of mental states that do not belong to self, we require a mechanism for determining degree of self-relatedness. One such mechanism is proposed here, and it is shown how this mechanism can be integrated into a general model of mental ownership. In the spirit of suggesting how this model might be able to help resolve outstanding problems, the question as to whether inserted thoughts belong to the patient who reports them is also considered. (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)

A subset of people with severe mental health conditions feels they are on the verge of losing control, even in the absence of external threats or triggers. Some go to extreme ends to avoid affective arousal and associated expectations of a possible, impending catastrophe. We have learned about such phenomenological, emotional challenges in a group of individuals with severe, composite mental health problems and psychosocial disabilities. These individuals have had long treatment histories in the mental health care system. They have (...) been encountered at a specialized inpatient ward offering exposure-based therapy that aims at restoring self-regulation and recovery. We describe the phenomenology of anxiety and fear presented by these service users, a fear we have coined existential catastrophe anxiety. We also suggest a set of underlying, interacting, psychological mechanisms that may give rise to ECa, before comparing ECa with three other constructs previously described in the literature—annihilation anxiety, ontological insecurity, and affect phobia. These comparisons show several similarities, but also unique qualities with ECa and its suggested underlying mechanisms. The conceptualization of ECa may aid clinicians in addressing extreme experiential turmoil and engage service users in empowering therapeutic projects. (shrink)

A flood of new multidisciplinary work on the causes of depersonalization disorder provides a new way to think about the feeling that experiences “belong” to the self. In this paper I argue that this feeling, baptized “mineness” or “subjective presence” : 565–573, 2013) emerges from a multilevel interaction between emotional, affective and cognitive processing. The “self” to which experience is attributed is a predictive model made by the mind to explain the modulation of affect as the organism progresses through the (...) world. When the world no longer produces predicted affect the organism needs to explain this unpredicted absence of feeling. It is important to this account that cognition and perception are otherwise intact. Consequently the mind’s representation of the world and its emotionally salient properties are unchanged, leading the mind to predict a characteristic affective response. When that prediction is not fulfilled the organisms feels as if she is no longer present in experience. This is reported at the as feeling of depersonalization. (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)

Patient RB has a peculiar memory impairment wherein he experiences his memories in rich contextual detail, but claims to not own them. His memories do not feel as if they happened to him. In this paper, I provide an explanatory model of RB’s phenomenology, the self-attentional model. I draw upon recent work in neuroscience on self-attentional processing and global workspace models of conscious recollection to show that RB has a self-attentional deficit that inhibits self-bias processes in broadcasting the contents of (...) episodic memories to the global workspace. Typically, self-related contents enjoy a higher salience level than other-related contents. Elimination of bias toward self-related contents diminishes the salience of those contents to the level of other-related contents. Because the typical high salience of self-related content is necessary for the feeling of ownership, RB lacks the feeling of ownership. I also discuss potential applications of the self-attentional model to other psychopathological cases. (shrink)

Depersonalization and derealization refer to states of dissociation in which one feels a sense of alienation in relation to one’s self and environment, respectively. Whilst transient episodes often diminish without treatment, chronic experiences of DP and DR may last for years, with common treatments lacking a strong evidence base for their efficacy. We propose a theoretical explanation of DP and DR based on interoceptive predictive coding, and discuss how transient experiences of DP and DR may be induced in the non-clinical (...) population using virtual reality. Further, we review the use of heartbeat evoked potentials in detecting the neural correlates of DP and DR allowing for an objective measure of these experiences in the non-clinical population. Finally, we discuss how the induction and detection of transient experiences of DP and DR in the non-clinical population could shed light on how the brain constructs one’s sense of self and reality. (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)

This paper proposes a qualitative study exploring anomalous self and world-experiences in individuals with high levels of depersonalization experiences. Depersonalization (DP) is a condition characterized by distressing feelings of being a detached, neutral and disembodied onlooker of one’s mental and bodily processes. Our findings indicate the presence of a wide range of anomalous experiences traditionally understood to be core features of DP, such as disembodiment and disrupted self-awareness. However, our results also indicate experiential features that are less highlighted in previous (...) work, such as faster time perception and blurriness of the self/other boundaries which may play a key role in altering one’s sense of self and sense of presence in the world. Our qualitative study provides an in-depth examination of self-reported disturbances of one’s relatedness to one’s self and the world, thereby shedding further light on the nature of altered subjective experiences in DP. In doing so, this paper draws attention to key aspects yet overlooked that may prove valuable for shedding further light into the phenomenon of depersonalization. We conclude by highlighting limitations of this study and a number of open questions that further work needs to address in the future. (shrink)

Descartes was certain that he was thinking and he was accordingly certain that he existed. Like Descartes, we seem to be more certain of our thoughts and our existence than of anything else. What is less clear is the reason why we are thus certain. Philosophers throughout history have provided different interpretations of the cogito, disagreeing both on the kind of thoughts it characterizes and on the reasons for its cogency. According to what we may call the empiricist interpretation of (...) the cogito, I can only claim to be certain of having experiences, and this certainty, as well as that of my own existence, stems from their phenomenal and subjective character. According to rationalist interpretations, on the other hand, I am certain of having some self-reflexive propositional attitudes, and this certainty derives from their rational features. Psychiatric patients suffering from acute forms of depersonalization or of the Cotard syndrome often doubt that they think and exist, and might even believe that they don't. I argue that their study allows us to favor the empiricist interpretation of the cogito. (shrink)

Patients suffering from the Cotard syndrome can deny being alive, having guts, thinking or even existing. They can also complain that the world or time have ceased to exist. In this article, I argue that even though the leading neurocognitive accounts have difficulties meeting that task, we should, and we can, make sense of these bizarre delusions. To that effect, I draw on the close connection between the Cotard syndrome and a more common condition known as depersonalisation. Even though they (...) are not delusional, depersonalised patients seem to have experiences that are quite similar to those of Cotard patients. I argue that these experiences are essentially characterised by a lack of subjective character and of two other structural features of experience, which I call ‘the present character’ and ‘the actual character’. Cotard's nihilistic delusions simply consist in taking these anomalous experiences at face value. (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)

If I see, hear, or touch a sparrow, the sparrow seems real to me. Unlike Bigfoot or Santa Claus, it seems to exist; I will therefore judge that it does indeed exist. The “sense of existence” refers to the kind of awareness that typically grounds such ordinary judgments of existence or “reality.” The sense of existence has been invoked by Humeans, Kantians, Ideologists, and the phenomenological tradition to make substantial philosophical claims. However, it is extremely controversial; its very existence has (...) been called into question. This paper aims to clarify the nature and reality of the sense of existence by studying a psychiatric condition in which the sense appears to be disrupted: depersonalization disorder (DPD). (shrink)

Many philosophers regard the persistence of philosophical disputes as symptomatic of overly ambitious, ill-founded intellectual projects. There are indeed strong reasons to believe that persistent disputes in philosophy (and more generally in the discourse at large) are pointless. We call this the pessimistic view of the nature of philosophical disputes. In order to respond to the pessimistic view, we articulate the supporting reasons and provide a precise formulation in terms of the idea that the best explanation of persistent disputes entails (...) that they are pointless. We then show how to answer the pessimistic argument. Taking a well-known mathematical controversy as our paradigm example, we argue that some persistent disputes reflect substantive disagreements at the “meta-analytic” level, i.e., disagreements about the best way, among quite different candidates, to understand the topic at issue, and the best associated cluster of analytic truths one should accept concerning it. Moreover, our concrete example shows that such meta-analytic disagreements can in principle be settled and yield a genuine theoretical (as opposed to merely pragmatic) breakthrough. We conclude optimistically that persistent disputes can be an important means of fostering epistemic progress. (shrink)