This study examined psychopathological correlates of implicit and explicit shame and guilt in 30 clinical and 129 non-clinical youths aged 8–17 years. Shame and guilt were measured explicitly via two self-reports and a parent report, and implicitly by means of an Implicit Association Test (IAT), while a wide range of psychopathological symptoms were assessed with questionnaires completed by children, parents, and teachers. The results showed no differences of implicit and explicit shame and guilt between the clinical and non-clinical group, (...) implying that dysregulation of these self-conscious emotions is not per definition associated with psychopathology. Correlational analyses indicated that self-reported explicit shame was positively associated with a broad range of internalizing psychopathology, while self-reported explicit guilt was associated with higher levels of anxiety and to some extent lower levels of externalizing psychopathology. Correlations with parent-rated shame and guilt revealed the same pattern of results but were in general weaker. Furthermore, implicit shame and guilt did not show significant correlations with the various measures of psychopathology. It can be concluded that the link between shame and guilt and psychopathology is complex, and partly dependent on the disorder under study and context-related factors defining the maladaptive nature of these self-conscious emotions. (shrink)

Gil R, Arroyo-Anllo EM, Ingrand P, Gil M, Neau JP, Ornon C, Bonnaud V. Self-consciousness and Alzheimer’s disease. Acta Neurol Scand 2001: 104: 296–300. # Munksgaard 2001. Objectives – To propose a neuropsychological study of the various aspects of self-consciousness (SC) in Alzheimer’s disease. Methods – Forty-five patients with probable mild or moderate AD were included in the study. Severity of their dementia was assessed by the Mini Mental State (MMS). Fourteen questions were prepared to evaluate (...) SC. Results – No significant correlations were found between SC score and educational level, age, and duration of disease. A significant correlation was found between SC score and the severity of dementia, whereas frontal disturbances were just short of the significance threshold. The various aspects of SC were not impaired to the same degree. The most disturbed ones were awareness of cognitive deficiencies, moral judgements and prospective memory. The least disturbed aspects were awareness of identity and of mental representation of the body. Items relating to anosognosia and moral judgements were significantly correlated with the MMS score, whereas affective state, body representation disorders, prospective memory, and capacities for introspection were not related to the severity of the dementia. Consciousness of identity was sound, regardless of MMS score. Conclusions – AD clearly induces an heterogeneous impairment of SC. SC requires a convergence of many neural networks. In AD, neuronal alterations involve many cortical areas and information sent to the associative frontal cortex from memory, language and visuospatial areas is lacking or disturbed. Thus, the sequential order of successive stimuli cannot be maintained by the heteromodal associative cortex (dorsal convexity of the prefrontal cortex), and the supramodal associative cortex (located rostrally in the frontal lobes) is unable to provide reliable monitoring and assessment of simultaneous neural cognitive networks carrying insufficient and inadequate input. The core deficiency in AD patients might be impaired SC equated with the disability to maintain sequential and simultaneous ‘‘attention to life’’. The Self-Consciousness Questionnaire, a clinical scale providing multidimensional measurement, indicates that different aspects of consciousness are not correlated with overall cognitive deficiency as determined by the MMSE. (shrink)

Empirical approaches on topics such as consciousness, self-awareness, or introspective perspective, need a conceptual framework so that the emerging, still unconnected findings can be integrated and put into perspective. We introduce a model of self-consciousness derived from phenomenology, philosophy, the cognitive, and neurosciences. We will then give an overview of research data on one particular aspect of our model, self-agency, trying to link findings from cognitive psychology and neuroscience. Finally, we will expand on pathological aspects (...) of self-agency, and in particular on psychosis in schizophrenia. We show, that a deficient self-monitoring system underlies, in part, hallucinations and formal thought (language) disorder in schizophrenia. We argue, that self-consciousness is a valid construct and can be studied with the instruments of cognitive and neuroscience. (shrink)

The clinical and para-clinical examination of residual self-consciousness in non-communicative severely brain damaged patients remains exceptionally challenging. Passive presentation of the patient’s own name and own face are known to be effective attention-grabbing stimuli when clinically assessing consciousness at the patient’s bedside. Event-related potential and functional neuroimaging studies using such self-referential stimuli are currently being used to disentangle the cognitive hierarchy of self-processing. We here review neuropsychological, neuropathological, electrophysiological and neuroimaging studies using the own name (...) and own face paradigm obtained in conscious waking, sleep, pharmacological coma, pathological coma and related disorders of consciousness. Based on these results we discuss what we currently do and do not know about the functional significance of the neural network involved in “automatic” and “conscious” self-referential processing. (shrink)

Autism provides a model for exploring the nature of self‐consciousness: self‐consciousness requires the ability to reflect on mental states, and autism is a disorder with a specific impairment in the neurocognitive mechanism underlying this ability. Experimental studies of normal and abnormal development suggest that the abilities to attribute mental states to self and to others are closely related. Thus inability to pass standard ‘theory of mind’ tests, which refer to others’ false beliefs, may imply lack (...) of self‐consciousness. Individuals who persistently fail these tests may, in the extreme, be unable to reflect on their intentions or to anticipate their own actions. In contrast, individuals with high‐functioning autism or Asperger syndrome often possess a late‐acquired, explicit theory of mind, which appears to be the result of effortful learning. An experimental study with three people with Asperger syndrome suggested that level of performance on standard theory of mind tasks was strongly related to the ability to engage in introspection. Qualitative differences in the introspections of high‐functioning people with autism are also reflected in autobiographical accounts which may give a glimpse of what it is like to be autistic. (shrink)

This chapter is about susceptibility to one type of division within our selves that can occur within self‐conscious experience and is present in certain mental disorders. This is the separation between experiencing oneself as subject and as agent. The chapter considers some disorders of self‐consciousness and examines the role that this particular division may play in those disorders. Companion to consciousness studies is not completed without attention to the philosophical psychopathology of self‐ (...) class='Hi'>consciousness. The chapter also examines the case of verbal auditory hallucinations. Investigators often say that hallucinations involve “loss of ego boundaries” or “internal/external confusion”. The chapter presents a case of alienated self‐consciousness, and explores the phenomenon of thought insertion. According to the standard or traditional account of thought insertion, the patient is aware of her own thoughts, but denies that they are hers and attributes them to someone else. So, thought insertion certainly seems to constitute alienated awareness of one's own thoughts. (shrink)

The chapter explores some aspects of the relationship between self-consciousness and consciousness of others, by looking in particular at the phenomenology of social anxiety disorder. More specifically, drawing on the phenomenological distinction between pre-reflective and reflective self-consciousness, and its application to the study of schizophrenia spectrum disorders, I suggest that the disturbances of social experience characteristic of social anxiety disorder are rooted in certain alterations of self-experience, and I endeavour to provide an account (...) of the latter. More specifically, I claim that a) pathological social anxiety involves a heightening of the subject’s reflective self-consciousness, and b) that this, at least partly, originates in the experience of a low sense of self-worth, which I refer to as low “self-esteem”, and conceive of as a particular kind of background affective orientation. (shrink)

Stephens and Grahamset themselves an apparently modest task, to understand why people who experience alien voices and inserted thoughts do not believe that they themselves are the source of these experiences. However, it soon becomes clear that there are many connected issues here. In eight short chapters, they address the phenomenology and ontology of consciousness, the phenomenology of alien voices, inserted thoughts, obsessive-compulsive thoughts and feelings, and other cases of unusual experience often associated with psychopathology, including brief discussion of (...) multiple personality disorder. They survey some of the main empirical explanations of the phenomenology, set out the shortcomings of these theories, and end by proposing their own schematic account. (shrink)

Stephens and Grahamset themselves an apparently modest task, to understand why people who experience alien voices and inserted thoughts do not believe that they themselves are the source of these experiences. However, it soon becomes clear that there are many connected issues here. In eight short chapters, they address the phenomenology and ontology of consciousness, the phenomenology of alien voices, inserted thoughts, obsessive-compulsive thoughts and feelings, and other cases of unusual experience often associated with psychopathology, including brief discussion of (...) multiple personality disorder. They survey some of the main empirical explanations of the phenomenology, set out the shortcomings of these theories, and end by proposing their own schematic account. (shrink)

This paper offers a framework for consciousness of internal reality. Recent PET experiments are reviewed, showing partial overlap of cortical activation during self-produced actions and actions observed from other people. This overlap suggests that representations for actions may be shared by several individuals, a situation which creates a potential problem for correctly attributing an action to its agent. The neural conditions for correct agency judgments are thus assigned a key role in self/other distinction and self-consciousness. (...) A series of behavioral experiments that demonstrate, in normal subjects, the poor monitoring of action-related signals and the difficulty in recognizing self-produced actions are described. In patients presenting delusions, this difficulty dramatically increases and actions become systematically misattributed. These results point to schizophrenia and related disorders as a paradigmatic alteration of a ''Who?'' system for self-consciousness. (shrink)

A theory of pre-reflective self-consciousness (TOPS) can be made fruitful if pre-reflectivity is understood as a bodily trait. This approach helps to overcome certain blurry definitions of pre-reflective self-consciousness (PrSCs) from the past, and can aid to a philosophical explanation of self-consciousness, which also goes in line with many psychological and cognitive neuro-scientific find­ings. Especially it can help to understand certain pathologies like neurodegenerative, affective or psychotic disorders from a different angle and thus (...) might help to bring new insights into these fields. (shrink)

In recent years, there has been much focus on the apparent heterogeneity of schizophrenic symptoms. By contrast, this article proposes a unifying account emphasizing basic abnormalities of consciousness that underlie and also antecede a disparate assortment of signs and symptoms. Schizophrenia, we argue, is fundamentally a self-disorder or ipseity disturbance that is characterized by complementary distortions of the act of awareness: hyperreflexivity and diminished self-affection. Hyperreflexivity refers to forms of exaggerated self-consciousness in which aspects of (...) oneself are experienced as akin to external objects. Diminished self-affection or self-presence refers to a weakened sense of existing as a vital and self-coinciding source of awareness and action. This article integrates recent psychiatric research and European phenomenological psychiatry with some current work in cognitive science and phenomenological philosophy. After introducing the phenomenological approach along with a theoretical account of normal consciousness and self-awareness, we turn to a variety of schizophrenic syndromes. We examine positive, then negative, and finally disorganization symptoms—attempting in each case to illuminate shared distortions of consciousness and the sense of self. We conclude by discussing the possible relevance of this approach for identifying early schizophrenic symptoms. (shrink)

The objective of analysis is new opportunities in the study of self-awareness, which became possible through the use of an interdisciplinary approach. This approach allows to solve number of conceptual and methodological problems in psychology and psychiatry. The general development of psychiatry in the 20th and early 21st centuries was to improve diagnosis and therapy based on objectively measured indicators. There is a very superficial development of the phenomenology of self-awareness disorders as a result. The interdisciplinary point (...) of view may be the beginning of new theoretical studies of self-awareness in philosophy, as well as provoke pragmatic conclusions for psychological and psychiatric science. Authors claim that the delimitation of the methodological tools of various sciences in the study of self-awareness is unnecessary in principle. interdisciplinary view should be formed by philosophers. The phenomenology of Karl Jaspers and his concept of self-awareness in this sense are heuristically attractive. The authors propose a working model of self-awareness, based on the phenomenological approach of Jaspers, on the ideas of his followers, and also abandoning the disciplinary view of the subject. In this model self-awareness is described through its specific functions. That may be pragmatically useful for mental health professionals: psychiatrists, psychologists and psychotherapists and it may be interesting to philosophers using phenomenological analysis. (shrink)

Neurological disorders of body representation have for a long time suggested the importance of multisensory processing of bodily signals for self-consciousness. One such group of disorders – illusory own body perceptions affecting the entire body – has been proposed to be especially relevant in this respect, based on neurological data as well as philosophical considerations. This has recently been tested experimentally in healthy subjects showing that integration of multisensory bodily signals from the entire body with respect (...) to the three aspects: self-location, first-person perspective, and self-location, is crucial for bodily self-consciousness. Here we present clinical and neuroanatomical data of two neurological patients with paroxysmal disorders of full body representation in whom only one of these aspects, self-identification, was abnormal. We distinguish such disorders of global body representation from related but distinct disorders and discuss their relevance for the neurobiology of bodily self-consciousness. (shrink)

Costandi explains the neuroscience behind how we view our selves and our bodies, drawing from neurological studies on our sense of agency and free will, the neural correlates of mental representations, mirror neurons, and how the brain perceives timing and sensory consequences. He explores case studies of amputees with phantom limb syndrome, people with Body Integrity Identity Disorder (who have a desire to amputate healthy limbs they feel don't belong to them) and post-op transsexuals.

Commentary on: Olaf Blanke, Thomas Metzinger, Full-body illusions and minimal phenomenal selfhood, Trends in Cognitive Sciences, Volume 13, Issue 1, January 2009, Pages 7-13, ISSN 1364-6613, DOI: 10.1016/j.tics.2008.10.003.

For years, phenomenological psychiatry has proposed that distortions of the temporal structure of consciousness contribute to the abnormal experiences described before schizophrenia emerges, and may relate to basic disturbances in consciousness of the self. However, considering that temporality refers mainly to an implicit aspect of our relationship with the world, disturbances in the temporal structure of consciousness remain difficult to access. Nonetheless, previous studies have shown a correlation between self disorders and the automatic ability (...) to expect an event in time, suggesting timing is a key issue for the psychopathology of schizophrenia. Timing disorders may represent a target for cognitive remediation, but this requires that disorders can be demonstrated at an individual level. Since cognitive impairments in patients with schizophrenia are discrete, and there is no standardized timing exploration, we focused on timing impairments suggested to be related to self disorders. We present the case report of AF, a 22 year old man suffering from schizophrenia, with no antipsychotic intake. Although AF shows few positive and negative symptoms and has a normal neurocognitive assessment, he shows a high level of disturbance of Minimal Self Disorders (SDs) (assessed with the EASE scale). Moreover, AF has a rare ability to describe his self and time difficulties. An objective assessment of timing ability (variable foreperiod task) confirmed that AF had temporal impairments similar to those previously described in patients, i.e., a preserved ability to distinguish time intervals, but a difficulty to benefit from the passage of time to expect a visual stimulus. He presents additional difficulties in benefitting from temporal cues and adapting to changes in time delays. The impairments were ample enough to yield significant effects with analyses at the individual level. Although causal relationships between subjective and objective impairments cannot be established, the results show that exploring timing deficits at the individual level is possible in patients with schizophrenia. Besides, the results are consistent with hypotheses relating minimal self disorders (SDs) to timing difficulties. They suggest that both subjective and objective timing investigations should be developed further so that their use at an individual level can be generalized in clinical practice. (shrink)

Self-reflection plays a key role in healthy human adaptation. Self-reflection might involve different capacities which may be impaired to different degrees relatively independently of one another. Variation in abilities for different forms of self-reflection are commonly seen as key aspects of many adult mental disorders. Yet little has been written about whether there are different kinds of deficits in self-reflection found in mental illness, how those deficits should be distinguished from one another and how to (...) characterize the extent to which they are interrelated. We review clinical and experimental literature and suggest four different forms of deficits in self-reflection: sense of ownership of one’s own thoughts and actions, emotional awareness, distinction between fantasy and reality and the integration of a range of different views of oneself and others. We propose how these different impairments in self-reflection are linked with one another. (shrink)

Understanding alterations of selfhood (termed self-disorders or self-disturbances) that are considered typical of the schizophrenia-spectrum is a central focus of phenomenological research. The currently most influential way of phenomenologically conceiving self-disorders in schizophrenia is as disorders of the so-called most basic or “minimal self”. In this paper, we first highlight some challenges for the minimal self-view of self-disorders, focusing on (1) problems arising from the supposedly “essential” or “universal” nature of (...) minimal self with respect to phenomenal awareness and (2) the critical implications of alterations of self-experience in schizophrenia that involve heightened or exaggerated sense of self. In the second part, we tentatively explore how a (non-egological) transparency-view of consciousness may offer an alternative way of understanding the experiential abnormalities involved in self-disorders in schizophrenia. We discuss how such a transparency-view (1) may account for loss-of-self experiences; (2) is compatible with the key notion of “hyper-reflexivity”; and (3) can help explain instances of self-disorder involving increased sense of self. In conclusion, we consider some possible advantages of this alternative view for research on self-disorders and clinical approaches. (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)

Kafka's writings are frequently interpreted as representing the historical period of modernism in which he was writing. Little attention has been paid, however, to the possibility that his writings may reflect neural mechanisms in the processing of self during hypnagogic (i.e., between waking and sleep) states. Kafka suffered from dream-like, hypnagogic hallucinations during a sleep-deprived state while writing. This paper discusses reasons (phenomenological and neurobiological) why the self projects an imaginary double (autoscopy) in its spontaneous hallucinations and how (...) Kafka's writings help to elucidate the underlying cognitive and neural mechanisms. I further discuss how the proposed mechanisms may be relevant to understanding paranoid delusions in schizophrenia. Literature documents and records cognitive and neural processes of self with an intimacy that may be otherwise unavailable to neuroscience. To elucidate this approach, I contrast it with the apparently popularizing view that the symptoms of schizophrenia result from what has been called an operative (i.e., pre-reflective) hyper-reflexivity. The latter approach claims that pre-reflective self-awareness (diminished in schizophrenia) pervades all conscious experience (however, in a manner that remains unverifiable for both phenomenological and experimental methods). This contribution argues the opposite: the. (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)

Impairment of self-control is often said to be a defining feature of addiction. Yet many addicts display what appears to be a considerable amount of control over their drug-oriented actions. Not only are their actions clearly intentional and frequently carried out in a conscious and deliberate manner, there is evidence that many addicts are responsive to a wide range of ordinary incentives and counter-incentives. Moreover, addicts have a wide variety of reasons for using drugs, reasons which often seem to (...) go a long way towards explaining their drug-oriented behavior. Many use drugs, for example, to cope with stressful or traumatic experiences. In this article I argue that some standard philosophical explanations of addicts’ impairment of self-control are inadequate, and propose an alternative. (shrink)

What altered states of consciousness—the dissolution of feelings of time and self—can tell us about the mystery of consciousness. During extraordinary moments of consciousness—shock, meditative states and sudden mystical revelations, out-of-body experiences, or drug intoxication—our senses of time and self are altered; we may even feel time and self dissolving. These experiences have long been ignored by mainstream science, or considered crazy fantasies. Recent research, however, has located the neural underpinnings of these altered states (...) of mind. In this book, neuropsychologist Marc Wittmann shows how experiences that disturb or widen our everyday understanding of the self can help solve the mystery of consciousness. Wittmann explains that the relationship between consciousness of time and consciousness of self is close; in extreme circumstances, the experiences of space and self intensify and weaken together. He considers the emergence of the self in waking life and dreams; how our sense of time is distorted by extreme situations ranging from terror to mystical enlightenment; the experience of the moment; and the loss of time and self in such disorders as depression, schizophrenia, and epilepsy. Dostoyevsky reported godly bliss during epileptic seizures; neurologists are now investigating the phenomenon of the epileptic aura. Wittmann describes new studies of psychedelics that show how the brain builds consciousness of self and time, and discusses pilot programs that use hallucinogens to treat severe depression, anxiety, and addiction. If we want to understand our consciousness, our subjectivity, Wittmann argues, we must not be afraid to break new ground. Studying altered states of consciousness leads us directly to the heart of the matter: time and self, the foundations of consciousness. (shrink)

Memory is a general attribute of living species, whose diversification reflects both evolutionary and developmental processes. Episodic-autobiographical memory is regarded as the highest human ontogenetic achievement and as probably being uniquely human. EAM, autonoetic consciousness and the self are intimately linked, grounding, supporting and enriching each other’s development and cohesiveness. Their development is influenced by the socio-cultural–linguistic environment in which an individual grows up or lives. On the other hand, through language, textualization and social exchange, all three elements (...) leak into the world and participate to the dynamic shaping and re-shaping of the cultural scaffolding of the self, mental time traveling and EAM formation. Deficits in self-related processing, autonetic consciousness, emotional processing and mental time traveling can all lead to or co-occur with EAM disturbances, as we illustrate by findings from EAM impairments associated with neurological or psychiatric disorders. (shrink)

Disorders of consciousness and the self are at the forefront of schizophrenia symptomatology. Patients are impaired in feeling themselves as the authors of their thoughts and actions. In addition, their flow of consciousness is disrupted, and thought fragmentation has been suggested to be involved in the patients’ difficulties in feeling as being one unique, unchanging self across time. Both impairments are related to self disorders, and both have been investigated at the experimental level. (...) Here we review evidence that both mechanisms of motor control and the temporal structure of signal processing are impaired in schizophrenia patients. Based on this review, we propose that the sequencing of action and perception plays a key role in the patients’ impairments. Furthermore, the millisecond time scale of the disorders, as well as the impaired sequencing, highlights the cooperation between brain networks including the cerebellum, as proposed by Andreasen (1999). We examine this possibility in the light of recent knowledge on the anatomical and physiological properties of the cerebellum, its role in timing, and its involvement in known physiological impairments in patients with schizophrenia, e.g., resting states and brain dynamics. A disruption in communication between networks involving the cerebellum, related to known impairments in dopamine, glutamate and GABA transmission, may help to better explain why patients experience reduced attunement with the external world and possibly with themselves. (shrink)

Disorders of the self figure prominently in psychotic experiences. Subjects de­scribe that “alien” thoughts are inserted in their mind by foreign powers, can sometimes hear their thoughts aloud or describe complex voices interacting with each other. Such experiences can be conceptualized in the framework of a Philosophical Anthropology, which suggests that human experience is characterized by centric and excentric positionality: subjects experience their environment centered around their enlived body and at the same time can reflect upon their place (...) in a shared lifeworld from an excentric point of view. Pre-reflective self awareness has been suggested to ensure that subjects can identify their own thoughts or actions as belonging to themselves, even when they reflect upon them from an excentric point of view. This pre-reflective self awareness appears to be impaired during psychotic experiences, when subjects no longer identify thoughts in their own stream of consciousness as belonging to themselves and instead attribute them to an outside agent. Among several potential causes, it is suggested that such impairments can be due to discrimi­natory or traumatic experiences, which affect the enlived (centric) position of a person and make her feel encircled and deeply threatened by aversive powers. As a consequence, the afflicted individual may fundamentally distance herself from her current centric position in a hostile environment, at the price of experiencing her own thoughts or actions as alien. Philosophical Anthropology may thus help to explain how social exclusion, discrimination and traumatization can promote psychotic experiences and why social support is of primary importance for any treatment of psychosis. (shrink)

Theories of personality and personality disorders need, from time to time, to be revised and updated according to new empirical and conceptual developments. Such development has taken place in the realms of affective neuroscience, evolution and social cognition. In this article we outline a new personality theory which claims that phenomena we usually ascribe to the concept personality are best understood by postulating a web consisting of three major constituents: Temperament (mainly primary emotions), attachment and self-consciousness (mentalizing). (...) We describe these constituents, their neurobiological underpinnings, the subjective experiences they evoke and their behavioral implications. We discuss the relevance of the espoused theory for the field of personality disorders with references to borderline, narcissistic and avoidant personality disorders as well as the DSM-5 Alternative Model. Implications for social psychology, psychotherapy and common-sense self-understanding are outlined. The theory aims to bridge previous contradictions between natural sciences and hermeneutics by its propositions of the evolution of self-consciousness. (shrink)

Abstract The view that mirror self-recognition (MSR) is a definitive demonstration of self-awareness is far from universally accepted, and those who do support the view need a more robust argument than the mere assumption that self-recognition implies a self-concept (e.g. Gallup in Socioecology and Psychology of Primates, Mouton, Hague, 1975 ; Gallup and Suarez in Psychological Perspectives on the Self, vol 3, Erlbaum, Hillsdale, 1986 ). In this paper I offer a new argument in favour (...) of the view that MSR shows self-awareness by examining the nature of the mirror image itself. I argue, using the results of ‘symbol-mindedness’ experiments by Deloache (Trends Cogn Sci 8(2):66–70, 2004) , that where self-recognition exists, the mirror image must be functioning as a symbol from the perspective of the subject and the subject must therefore be ‘symbol-minded’ and hence concept possessing. Further to this, according to the Concept Possession Hypothesis of Self-Consciousness (Savanah in Conscious Cogn 2011 ), concept possession alone is sufficient to demonstrate the existence of self-awareness. Thus MSR as a demonstration of symbol-mindedness implies the existence of self-awareness. I begin by defending the ‘mark test’ protocol as a robust methodology for determining self-recognition. Then follows a critical examination of the extreme views both for and against the interpretation of MSR as an indication of self-awareness: although the non-mentalistic interpretation of MSR is unconvincing, the argument presented by Gallup is also inadequate. I then present the symbol-mindedness argument to fill in the gaps in the Gallup approach. Content Type Journal Article Pages 1-17 DOI 10.1007/s10539-012-9318-2 Authors Stephane Savanah, ARC Centre of Excellence in Cognition and its Disorders (CCD), Macquarie University, Sydney, NSW 2109, Australia Journal Biology and Philosophy Online ISSN 1572-8404 Print ISSN 0169-3867. (shrink)

Disorders of consciousness (DOC) raise profound scientific, clinical, ethical, and philosophical issues. Growing knowledge on fundamental principles of brain organization in healthy individuals offers new opportunities for a better understanding of residual brain function in DOCs. We here discuss new perspectives derived from a recently proposed scheme of brain organization underlying consciousness in healthy individuals. In this scheme, thalamo-cortical networks can be divided into two, often antagonistic, global systems: (i) a system of externally oriented, sensory-motor networks (the (...) ‘‘extrinsic’’ system); and (ii) a system of inward-oriented networks (the ‘‘intrinsic’’ or default system). According to this framework, four distinct mental states would be possible that could be relevant for understanding DOCs. In normal healthy volunteers and locked-in syndrome patients, a state of high functionality of both the extrinsic and intrinsic or default systems is expected — associated with full awareness of environment and self. In this case, mental imagery tasks combined with fMRI can be used to detect covert awareness in patients that are unable to communicate. According to the framework, two complementary states of system imbalance are also possible, in which one system is in a hyperfunctional state, while the other is hypoactive. Extrinsic system hyperfunction is expected to lead to a state of total sensory-motor ‘‘absorption’’ or ‘‘lost self.’’ In contrast, intrinsic or default system hyperfunction is expected to lead to a state of complete detachment from the external world. A state where both extrinsic and intrinsic systems are hypofunctional is predicted to lead to markedly impaired consciousness as seen in DOCs. Finally, we review the potential use of ultra-slow fluctuations in BOLD signal as a tool for assessing the functional integrity of extrinsic and intrinsic systems during ‘‘resting state’’ fMRI acquisitions.. (shrink)

The notion of minimal, basic, pre-reflective or core self is currently debated in the philosophy of mind, cognitive sciences and developmental psychology. However, it is not clear which experiential features such a self is believed to possess. Studying the schizophrenic experience may help exploring the following aspects of the minimal self: the notion of perspective and first person perspective, the ‘mineness’ of the phenomenal field, the questions of transparency, embodiment of point of view, and the issues of (...) agency and ownership, considered as different and less fundamental than the feeling of mineness. Two clinical vignettes of patients with the diagnosis of schizophrenia will be presented: the first one, illustrating early illness stages, and the second case, of chronic schizophrenia, symptomatically marked by persistent hallucinations. Through their analysis, we will discuss the experiential dimensions of minimal self. (shrink)

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M.” I have argued in previous (...) work that a HOT theorist can adequately respond to this concern with respect to somatoparaphrenia and thought insertion. There is also Cotard syndrome which is a rare neuropsychiatric disorder in which people hold the delusional belief that they are dead, do not exist, or have lost their blood or internal organs. In this paper, I argue that HOT theory has nothing to fear from it either and can consistently account for what happens in such unusual cases. I analyze Cotard syndrome in light of my previous discussion of somatoparaphrenia and thought insertion, and argue that HOT theory can provide a somewhat analogous account without the worry of inconsistency. It is crucial to recognize that there are multiple “self-concepts” and levels of HOTs which can help to provide a more nuanced explanation. With regard to the connection between consciousness and self-consciousness, it is proposed that Cotard patients are indeed capable of having some “I-thoughts” about their bodies and mental states. (shrink)

Obsessive compulsive disorder is a debilitating psychiatric condition where people become obsessed by remotely possible harm, error, bad luck, and compulsively repeat mental or behavioural rituals to neutralize these possibilities. This tendency to draw inferences on the basis of remote rather than more likely possibilities is termed 'inferential confusion' and can lead to immersion in possible worlds accompanied by feelings of dissociation between: knowing and doing, imagination and reality, and authentic and inauthentic self. These dissociation experiences in OCD may (...) inform us on the relational 'possibilistic' nature of consciousness. In a relational model of consciousness, the boundaries of consciousness are located between the person and the world, and shift according to the 'aboutness' of self-world interaction. A key element of 'aboutness' is projecting into the future to what is 'about to be', so sense of reality is constructed through a consensus about what could be, operationalized as a personal possibility distribution. Experiences such as derealization and depersonalization occur in OCD when there is a clash between personally possible worlds and the person ends up living in simultaneously a possible and an impossible world. Recognizing this confusion may be a key to alleviating dissociative symptoms. (shrink)

BackgroundMedia have increasingly reported on the difficulties associated with end-of-life decision-making in patients with Disorders of Consciousness (DOC), contextualizing such dilemma in detailed accounts of the patient’s life. Two of the first stories debated in the scientific community were those related to the cases of two women, one American, the other Italian, who captured attention of millions of people in the first years of this third millennium.MethodsMuch has been written about the challenges of surrogate decision-making for patients in (...) DOC, but less has been written comparing these challenges across legal systems and cultures. In our paper, we propose a systematic analysis of the final legal documents written by the American and Italian Courts in relation to the two cases, developing our discussion around three areas: the level of certainty/reliability of diagnosis and prognosis, the reconstruction of self-expression, time of illness and time of care. They are examples of the typical issues discussed by legal authors and allow us to understand the link and the difference between the legal and ethical perspectives.ResultsThe legal approach to the two cases has some common elements: the need to be certain about the diagnosis and prognosis and the fact that the clinical criteria are necessary in determining the most appropriate treatments, although these criteria are not sufficient unless they are supplemented by the patient’s will. The issue of relations takes on importance both from a legal and an ethical point of view, but from two different perspectives. While ethics safeguards relationships by guaranteeing their differences and makes them reconcilable, law safeguards relationships by guaranteeing the cold forms of respect, equality, impartiality, symmetry, reciprocity, and irreversibility. In this perspective, the link between the time of care and the decision of the family members assumes importance.ConclusionsThe most interesting point that emerges from our analysis is the issue of relationships and how they affect decisions, both from a legal and ethical point of view. For this reason, during the patients’ hospitalization, it is necessary to identify ways in which they might give their opinion about the moral issues underlying their choices. (shrink)

In Disturbed Consciousness, philosophers and other scholars examine various psychopathologies in light of specific philosophical theories of consciousness. The contributing authors—some of them discussing or defending their own theoretical work—consider not only how a theory of consciousness can account for a specific psychopathological condition but also how the characteristics of a psychopathology might challenge such a theory. Thus one essay defends the higher-order thought (HOT) theory of consciousness against the charge that it cannot account for somatoparaphrenia (...) (a delusion in which one denies ownership of a limb). Another essay argues that various attempts to explain away such anomalies within subjective theories of consciousness fail. Other essays consider such topics as the application of a model of unified consciousness to cases of brain bisection and dissociative identity disorder; prefrontal and parietal underconnectivity in autism and other psychopathologies; self-deception and the self-model theory of subjectivity; schizophrenia and the vehicle theory of consciousness; and a shift in emphasis away from an internal (or brainbound) approach to psychopathology to an interactive one. Each essay offers a distinctive perspective from the intersection of philosophy, consciousness research, and psychiatry. (shrink)

In Disturbed Consciousness, philosophers and other scholars examine various psychopathologies in light of specific philosophical theories of consciousness. The contributing authors—some of them discussing or defending their own theoretical work—consider not only how a theory of consciousness can account for a specific psychopathological condition but also how the characteristics of a psychopathology might challenge such a theory. Thus one essay defends the higher-order thought (HOT) theory of consciousness against the charge that it cannot account for somatoparaphrenia (...) (a delusion in which one denies ownership of a limb). Another essay argues that various attempts to explain away such anomalies within subjective theories of consciousness fail. -/- Other essays consider such topics as the application of a model of unified consciousness to cases of brain bisection and dissociative identity disorder; prefrontal and parietal underconnectivity in autism and other psychopathologies; self-deception and the self-model theory of subjectivity; schizophrenia and the vehicle theory of consciousness; and a shift in emphasis away from an internal (or brainbound) approach to psychopathology to an interactive one. Each essay offers a distinctive perspective from the intersection of philosophy, consciousness research, and psychiatry. -/- Contributors Alexandre Billon, Andrew Brook, Paula Droege, Rocco J. Gennaro, Philip Gerrans, William Hirstein, Jakob Hohwy, Uriah Kriegel, Timothy Lane, Thomas Metzinger, Erik Myin, Inez Myin-Germeys, Myrto Mylopoulos, Gerard O’Brien, Jon Opie, J. Kevin O’Regan, Iuliia Pliushch, Robert Van Gulick . (shrink)

Pre-reflective Consciousness: Sartre and Contemporary Philosophy of Minddelves into the relationship between the current analytical debates on consciousness and the debates that took place within continental philosophy in the twentieth century and in particular around the time of Sartre and within his seminal works. Examining the return of the problem of subjectivity in philosophy of mind and the idea that phenomenal consciousness could not be reduced to functional or cognitive properties, this volume includes twenty-two unique contributions from (...) leading scholars in the field. Asking questions such as: Why we should think that self-consciousness is non-reflective? Is subjectivity first-personal? Does consciousness necessitate self-awareness? Do we need pre-reflective self-consciousness? Are ego-disorders in psychosis a dysfunction of pre-reflective self-awareness? How does the Cartesian duality between body and mind fit into Sartre's conceptions of consciousness? (shrink)

Contemporary phenomenological psychopathology has raised questions concerning selfhood and its possible alterations in schizophrenia spectrum disorders. Although the notion of the self is central to several accounts of anomalies, it remains a question how exactly the radically minimal experiential features of selfhood can be altered. Indeed, the risk is to reduce the notion of selfhood so drastically, that it can no longer account for alterations of experience. Here we propose to give thickness to the minimal self. To (...) do this we first discuss Sartre’s phenomenological definition of coenesthesia as the translucent matter of consciousness articulating it with the notion of existential feelings. We then draw on the historical research on coenesthesia to dig deeper in this translucent materiality identified as the element of the body. We show that selfhood, even in its most minimal level, must be conceived of with a specific elemental thickness, corresponding to a phenomenological materiality of embodiment. We argue that a phenomenological reading of coenesthesia as the bodily element of ipseity can shed a new light on the anomalies of self-experience. (shrink)

A family of recent externalist approaches in philosophy of mind argues that our psychological capacities are synchronically and diachronically “scaffolded” by external resources. I consider how these “scaffolded” approaches might inform debates in phenomenological psychopathology. I first introduce the idea of “affective scaffolding” and make some taxonomic distinctions. Next, I use schizophrenia as a case study to argue—along with others in phenomenological psychopathology—that schizophrenia is fundamentally a self-disturbance. However, I offer a subtle reconfiguration of these approaches. I argue that (...) schizophrenia is not simply a disruption of ipseity or minimal self-consciousness but rather a disruption of the scaffolded self, established and regulated via its ongoing engagement with the world and others. I conclude by considering how this scaffolded framework indicates the need to consider new forms of intervention and treatment. (shrink)

While many theorists have argued that dissociative identity disorder is a case of multiple selves or persons in a single body, I maintain that DID instead should be understood as involving a single self who suffers from significant disruptions to self-consciousness. Evidence of overlapping abilities and memories, as well as the very logic of dissociation, supports the claim that DID results from internal conflict endured by a single self. Along these lines, I will maintain that alter-formation (...) should be understood as the result of extreme emotional ambivalence. While it is true that subjects with DID exhibit volitional conflict, as Frankfurt [1988. The Importance of What We Care About. New York: Cambridge University Press; 1999. Necessity, Volition, and Love. New York: Cambridge University Press] maintains, I argue that these incompatible volitions have a deeper source: conflicting desires and affective stances concerning basic emotional needs that are not easily abandoned. A single subject turns to... (shrink)