This article provides an overview and analysis of recent work on the extended self, demonstrating that the boundaries of selves are fluid, shifting across biological, artifactual, and sociocultural structures. First, it distinguishes the notions of minimal self, person, and narrative self. Second, it surveys how philosophers, psychologists, and cognitive scientists argue that embodiment, cognition, emotion, consciousness, and moral character traits can be extended and what that implies for the boundaries of selves. It also reviews and responds to various criticisms and (...) counterarguments against the extended self. The main focus is on the link between the extended mind and extended self, which has received the most attention in recent literature. But accounts of the extended self developed independently of the extended mind are also briefly discussed. This article ends by drawing out some of the conceptual, methodological, and normative implications of the extended self and suggesting some directions for future research. (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)

This paper details the ways that gender structures our senses of agency on an enactive framework. While it is common to discuss how gender influences higher, narrative levels of cognition, as with the formulation of goals and in considerations about our identities, it is less clear how gender structures our more immediate, embodied processes, such as the minimal sense of agency. While enactivists often acknowledge that gender and other aspects of our socio-cultural situatedness shape our cognitive processes, there is little (...) work on how this shaping takes place. In order to provide such an account, I will first look at the minimal and narrative senses of agency (Gallagher 2012), a distinction that draws from work on minimal and narrative selves (Zahavi 2010). Next I will explain the influence of the narrative sense of agency on the minimal sense of agency through work on intention-formation (Pacherie 2007). After a discussion of the role of gender in the narrative sense of agency, I’ll expand on work by Haslanger (2012) and Young (1980) to offer three ways in which gender influences the minimal sense of agency, showing the effect that gender has on how we perceive our possibilities for interaction in a phenomenologically immediate, pre-reflective manner. (shrink)

This article investigates the relationship between for-me-ness and sociality. I start by pointing out some ambiguities in claims pursued by critics that have recently pressed on the relationship between the two notions. I next articulate a question concerning for-me-ness and sociality that builds on the idea that, occasionally at least, there is something it is like ‘for us’ to have an experience. This idea has been explored in recent literature on shared experiences and collective intentionality, and it gestures towards the (...) question of the extent to which some social interactions make a difference in the phenomenal character of their participants’ experiences. Finally, I present a construal of for-us-ness that complements the received understanding of for-me-ness, by drawing on Alfred Schutz’ concept of the we-relationship, and on the idea of second-personal awareness, i.e. awareness of a ‘you’. The current proposal provides a suitable account of some basic forms of phenomenally manifest social connectedness, in a way that is cognitively undemanding and without incurring the costs of a sui generis plural pre-reflective self-awareness. (shrink)

There is converging evidence that high doses of hallucinogenic drugs can produce significant alterations of self-experience, described as the dissolution of the sense of self and the loss of boundaries between self and world. This article discusses the relevance of this phenomenon, known as “drug-induced ego dissolution (DIED)”, for cognitive neuroscience, psychology and philosophy of mind. Data from self-report questionnaires suggest that three neuropharmacological classes of drugs can induce ego dissolution: classical psychedelics, dissociative anesthetics and agonists of the kappa opioid (...) receptor (KOR). While these substances act on different neurotransmitter receptors, they all produce strong subjective effects that can be compared to the symptoms of acute psychosis, including ego dissolution. It has been suggested that neuroimaging of DIED can indirectly shed light on the neural correlates of the self. While this line of inquiry is promising, its results must be interpreted with caution. First, neural correlates of ego dissolution might reveal the necessary neurophysiological conditions for the maintenance of the sense of self, but it is more doubtful that this method can reveal its minimally sufficient conditions. Second, it is necessary to define the relevant notion of self at play in the phenomenon of DIED. This article suggests that DIED consists in the disruption of subpersonal processes underlying the “minimal” or “embodied” self, i.e., the basic experience of being a self rooted in multimodal integration of self-related stimuli. This hypothesis is consistent with Bayesian models of phenomenal selfhood, according to which the subjective structure of conscious experience ultimately results from the optimization of predictions in perception and action. Finally, it is argued that DIED is also of particular interest for philosophy of mind. On the one hand, it challenges theories according to which consciousness always involves self-awareness. On the other hand, it suggests that ordinary conscious experience might involve a minimal kind of self-awareness rooted in multisensory processing, which is what appears to fade away during DIED. (shrink)

This paper takes a new look at an old question: what is the human self? It offers a proposal for theorizing the self from an enactive perspective as an autonomous system that is constituted through interpersonal relations. It addresses a prevalent issue in the philosophy of cognitive science: the body-social problem. Embodied and social approaches to cognitive identity are in mutual tension. On the one hand, embodied cognitive science risks a new form of methodological individualism, implying a dichotomy not between (...) the outside world of objects and the brain-bound individual but rather between body-bound individuals and the outside social world. On the other hand, approaches that emphasize the constitutive relevance of social interaction processes for cognitive identity run the risk of losing the individual in the interaction dynamics and of downplaying the role of embodiment. This paper adopts a middle way and outlines an enactive approach to individuation that is neither individualistic nor disembodied but integrates both approaches. Elaborating on Jonas’ notion of needful freedom it outlines an enactive proposal to understanding the self as co-generated in interactions and relations with others. I argue that the human self is a social existence that is organized in terms of a back and forth between social distinction and participation processes. On this view, the body, rather than being identical with the social self, becomes its mediator. (shrink)

Contemporary perspectives on delusions offer valuable neuropsychiatric, psychoanalytic, and philosophical explanations of the formation and persistence of delusional phenomena. However, two problems arise. Firstly, these different perspectives offer us an explanation “from the outside”. They pay little attention to the actual personal experiences, and implicitly assume their incomprehensibility. This implicates a questionable validity. Secondly, these perspectives fail to account for two complex phenomena that are inherent to certain delusions, namely double book-keeping and the primary delusional experience. The purpose of this (...) article is to address both problems, by offering an understanding “from the inside”. Our phenomenological approach is a form of “radical empathy”, and crosses the Jaspersian limits of understanding. It compares delusional experiences with variations of reality experience in everyday life, and makes use of the structure of imagination. Six factors influencing the experience of reality are discussed and illustrated by clinical and non-clinical examples. These factors are: continuity, materiality and resistance, multiplicity of sensations and perceptions, intensity, the sense of authorship, and the complex role of intersubjectivity. I suggest that experiences of hypo- and hyperreality are not restricted to pathology, but have their place in everyday life as well. Delusional phenomena can be better understood by investigating the interplay of these six factors. With this framework, the two complex phenomena consequently prove to be better understandable to us. Our approach remains within the phenomenal experience and might thereby contribute to the validity of psychopathology. (shrink)

Panpsychism, the view that consciousness is present everywhere at the fundamental level of reality, has established itself as an increasingly popular option in the philosophy of mind. Situated between substance dualism and reductive physicalism, panpsychism aims to capture the intuitions behind both, integrating consciousness into the physical world without explaining it in terms of purely physical facts. In this thesis, I offer a defence of panpsychism. -/- First, I examine influential arguments against physicalism, such as Thomas Nagel’s (1974, 1979) perspective-based (...) proposal, Frank Jackson’s (1982) knowledge argument, David Chalmers’ (1996, 2010) conceivability argument, as well as vagueness arguments (Antony 2006a; Tye 1996). I argue that none of them offers a knockdown case against physicalism, particularly because of the threat presented by the phenomenal concept strategy (Chalmers 2007; Papineau 2007a), though they suggest panpsychism as a promising alternative that avoids many common objections. -/- Second, I discuss independent arguments for panpsychism, including the Russellian monist view (Goff 2017; Russell 1927/1992), the intrinsic nature argument (Seager 2006; Strawson 2006), recent developments in the literature as presented by Hedda Hassel Mørch (2018, 2020) and Luca Dondoni (2022), Tye’s (2021b) representational panpsychism based on the vagueness argument, as well as cosmopsychism (Nagasawa & Wager 2016; Shani 2015) – an alternative to panpsychism that shares its aims whilst claiming to avoid its shortcomings. -/- Third, I address the most pressing objection to panpsychism: the combination problem or the question of how fundamental consciousness can combine to lead to complex consciousness (James 1890). Focusing especially on the subject-summing version of the combination problem or the issue of how small subjects can combine to form complex subjects, I go over various proposals for either solving or avoiding it, such as Philip Goff’s (2016) phenomenal bonding relation and William Seager’s (2010) combinatorial infusion proposal, arguing against both and agreeing at the end with Sam Coleman (2014), who advocates that subject-summing is demonstrably incoherent. -/- However, as I argue in the fourth and final chapter, the panpsychist still has an option that avoids the subject-summing problem, while also circumventing the objections faced by the alternative view of cosmopsychism. Inspired though not reliant on the philosophy of Gottfried Wilhelm Leibniz (1902/2005), I introduce what I call monadic panpsychism, the view that the phenomenal character of any given consciousness-bearing physical ultimate is determined by its relations to other such ultimates featuring in the relevant causal structure. -/- The theory consists of two key claims. The first is that phenomenal qualities are relational rather than intrinsic. This view has precedent in literature on the philosophy of mind, such as in Rudolf Carnap (1928), Gottlob Frege (1956), Moritz Schlick (1959), as well as more recently in David Hilbert and Mark Kalderon (2000) and Austen Clark (2000), though not in the context of panpsychism. -/- The second claim is that physical ultimates only possess a very basic form of consciousness necessary for experiencing as such. There are many ways to conceptualise this basic consciousness: non-relational or intrinsic, rudimentary and non-specific, a point of view without experiences, the minimal subject, a mere conduit for experience, phenomenal space, etc. Russellian panpsychists offer a more detailed proposal in which every physical ultimate has an appropriate associated type of experience. For example, all quarks have the same quark-type of experience, assuming for the sake of discussion that quarks are ultimates. Still, arguing for a more minimal notion, as I do, requires making less claims and should not be controversial to any panpsychist. -/- So, what follows from these two claims? I propose that the relational constitution of phenomenal qualities has its endpoint at the fundamental level rather than at the level of a combined complex or emergent subject. Put simply, physical ultimates guarantee the basic consciousness or the point of view that I occupy, while the relational structure constitutes my rich and full human experience. So to speak, relationally constituted phenomenal qualities ‘anchor’ themselves in physical ultimates. As long as these relations result in a phenomenally unified experience, which is an uncontroversial thesis, then no matter where that process reaches the end of its causal chain, it will necessarily be experienced from a subjective point of view. -/- Since only qualities but not subjects need to combine, my proposal avoids the subject-summing version of the combination problem, which is arguably an insurmountable challenge to other forms of panpsychism. Because of this, I conclude that my theory contributes to the field, serving as a good starting point for further developments of neither combinatory nor emergent panpsychism with regard to subjects. (shrink)

Memories of our personal past are the building blocks of our narrative identity. So, when we depend on objects and other people to remember and construct our personal past, our narrative identity is distributed across our embodied brains and an ecology of environmental resources. This paper uses a cognitive niche construction approach to conceptualise how we engineer our memory ecology and construct our distributed narrative identities. It does so by identifying three types of niche construction processes that govern how we (...) interact with our memory ecology, namely creating, editing, and using resources in our memory ecology. It also conceptualises how identity-relevant information in objects and (family) stories is transmitted vertically, i.e., across different generations of people. Identifying these processes allows us to better understand the cultural information trajectories that constitute our memory ecologies. Thus, what I’ll argue is that our memory ecology distributes our narrative identity and that engineering our memory ecology is a form of narrative niche construction. (shrink)

The Abhidharma Buddhist revisionary metaphysics aims to provide an intellectually and morally preferred picture of the world that lacks a self. The first part of the paper claims that the Abhidharma ‘no-self’ view can be plausibly interpreted as a no-ownership view, according to which there is no locus or subject of experience and thus no owner of mental or bodily awarenesses. On this interpretation of the no-self view, the Abhidharma Buddhist metaphysicians are committed to denying the ownership of experiences, and (...) thereby apparently obliged to explain our purported experience of ownership. My experiences seemingly come with the sense that I am the one who is undergoing this experience. But is there a really an experience of ownership—namely, an experience of being a subject that underlies our sense of ownership? I argue that there is nothing that it is like to be an owner of experiences, in the sense that there is no experiential phenomenology associated with the ownership of experience. The second part of the paper argues that, since there is no experience of ownership, there is no onus on the Abhidharma philosopher to give an explanation of the sense of ownership. (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)

The Buddhists philosophers put forward a revisionary metaphysics which lacks a “self” in order to provide an intellectually and morally preferred picture of the world. The first task in the paper is to answer the question: what is the “self” that the Buddhists are denying? To answer this question, I look at the Abhidharma arguments for the No-Self doctrine and then work back to an interpretation of the self that is the target of such a doctrine. I argue that Buddhists (...) are not just denying the diachronically unified, extended, narrative self but also minimal selfhood insofar as it associated with sense of ownership and sense of agency. The view is deeply counterintuitive and the Buddhists are acutely aware of this fact. Accordingly, the Abhidharma-Buddhist writings are replete with attempts to explain the phenomenology of experience in a no-self world. The second part of the paper reconstructs the Buddhist explanation using resources from contemporary discussions about the sense of agency. (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)

In the contemporary phenomenological literature it has been argued that it is possible to distinguish between two forms of selfhood: the “minimal” and “narrative” self. This paper discusses a claim which is central to this account, namely that the minimal and narrative self complement each other but are fundamentally distinct dimensions. In particular, I challenge the idea that while the presence of a minimal self is a condition of possibility for the emergence of a narrative self, the dynamics which characterise (...) narrative selfhood do not have a structuring effect on minimal self-experience. I do so by drawing on both classical and contemporary phenomenological literature to show that at least certain forms of affective experience are complex phenomena in which minimal and narrative forms of selfhood are deeply entwined. More specifically, I claim that, due to their evaluative character, intentional and non-intentional affective states convey a pre-reflective experience of constitutive aspects of the narrative self. This enables me to argue that minimal and narrative selfhood are phenomenologically inextricable. (shrink)

In this study I explore from a phenomenological perspective the relationship between affectivity and narrative self-understanding in depression. Phenomenological accounts often conceive of the disorder as involving disturbances of the narrative self and suggest that these disturbances are related to the alterations of emotions and moods typical of the illness. In this paper I expand these accounts by advancing two sets of claims. In the first place, I suggest that, due to the loss of feeling characteristic of the illness, the (...) narratives with which the patients identified prior to the onset of depression are altered in various ways, thus leading to the weakening or abandonment of the narratives themselves. I then move to show that these autobiographical narratives are replaced by new stories which possess a distinctive structure and I argue that this is dependent upon specific configurations of affective experience, such as existential feelings of guilt, hopelessness, and isolation, and particular forms of temporal and spatial experience. (shrink)

ABSTRACTThe distinction between minimal self and narrative self has gained ground in recent discussions of selfhood. In this article, this distinction is reassessed by analysing Zahavi and Gallagher’s account of selfhood and supplementing it with Husserl’s concept of person. I argue that Zahavi and Gallagher offer two compatible and complementary notions of self. Nevertheless, the relationship between minimal self and narrative self requires further clarification. Especially the embeddedness of self, the interplay between passivity and activity, and the problems of uniqueness (...) and persistence are better understood with Husserl’s analysis of person and its central concepts of position-taking, habitualities, and overall style. The embeddedness of self is elucidated by outlining how person is related to its environment, to other people, and to its past. This relational notion of self is both passively constituted and actively shaped: person mediates between minimal self characterized by perspectival ownership... (shrink)

Borderline personality disorder (BPD) is characterized by severe disturbances in a subject’s sense of identity. Persons with BPD suffer from recurrent feelings of emptiness, a lack of self-feeling, and painful incoherence, especially regarding their own desires, how they see and feel about others, their life goals, or the roles to which they commit themselves. Over the past decade or so, clinical psychologists, psychotherapists, and psychiatrists have turned to philosophical conceptions of selfhood to better understand the borderline-specific ruptures in the sense (...) of identity, which are frequently associated with severe affective instability and turbulence in interpersonal relationships. Fuchs (2007) has suggested that these disturbances in self-experience can best be described and explained by using notions—widely discussed in philosophy and psychology—ofnarrativityandnarrative identity. On such a narrative view, key features of BPD present significant modifications of proto-narrative structures and inhibit the development of a narrative identity, resulting in a disturbed sense of identity. Although the role of narrativity in BPD has been acknowledged by many researchers, some have voiced dissatisfaction with what they take to be limitations of a narrativistic understanding of the disorders of identity characterizing BPD, and have proposed alternative, allegedly non-narrativistic, accounts. In this paper, we critically examine an example of the latter, viz. Gold and Kyratsous’ (2017) account ofthe person as an intrapersonal team reasoner. We defend a narrativistic understanding of BPD identity disorder against their objections. To this end, we propose a broader, and more finely-differentiated, concept of narrativity. On this account, four aspects of narrativity are distinguished, the disordering of which can affect those with BPD. As it turns out, our account implies that even Gold and Kyratsous—in order to ground their approach—must either make use of these aspects or propose an as-yet unarticulated alternative. This casts doubt upon whether their approach is non-narrativistic after all. (shrink)

The claim that selves are narratively constituted has attained considerable currency in both analytic and continental philosophy. However, a set of increasingly standard objections to narrative identity are also emerging. In this paper, I focus on metaphysically realist versions of narrative identity theory, showing how they both build on and differ from their neo-Lockean counterparts. But I also argue that narrative realism is implicitly committed to a four-dimensionalist, temporal-parts ontology of persons. That exposes narrative realism to the charge that the (...) narratively constituted self, on the one hand, and the self that is the object of much of our everyday self-reference and self-experience, on the other, can't be the same thing. This conclusion may well force narrativists to abandon metaphysical realism about narrative selves—which, in turn, may leave the invocation of ‘narrativity’ as identity-constituting somewhat under-motivated. (shrink)

Background Treatment of chronic inflammatory bowel disease (IBD) aims to improve patients’ quality of life and the extent of treatment success is measured via patient reported outcomes (PROs). However, questionnaires used to collect PROs often include scales that are not specific to IBDs. Improving these scales requires a deeper understanding of patients’ lived experience. With this study we give first insights and develop hypotheses on how patients with IBDs experience their body and self and how they adjust their life plans (...) in the context of precision medicine (PM). The guiding question is to understand what they need to achieve a good life, while facing their disease. Methods We developed a conception of the “good life” that draws on Philippa Foot’s “naturalized” approach and distinguishes six different dimensions that are relevant for a good life. This conception guided us as we conducted 10 qualitative interviews with patients suffering from IBD who were in precision medicine clinical research settings. The interviews aimed to gain insights for answering our research question: How do body experiences affect the good life of patients with IBD? We analyzed the interviews with interpretative phenomenological analysis (IPA). Results Five group experiential themes emerged: (i) Life options and plans, (ii) other people’s responses, (iii) strategies to deal with others’ responses, (iv) perception of the body and self, and (v) perception of life as good despite suffering. We report here on three of them (i, iv and v), which are primarily relevant for evaluating the outcomes of PM care. Whereas with “life options and plans (i),” our study predominantly confirmed previous research, with “perception of the body and self (iv),” we found that some of the patients changed their relationship to their body and themselves. They perceived the body or the disease as the “other” and their self appears divorced from their own body. Although this might be an avoidance strategy patients use to assign responsibility for their condition and its “disgusting” symptoms to the “other,” it is important to include it in patient reported outcome (PRO) assessments. Conclusions We conclude with the insight that the multi-dimensional approach based on Foot’s concept of a good life is well-suited as a basis for investigating the quality of life of people with IBD. Interviews based on this concept produced results that go beyond the understanding of health-related quality of life (HRQoL). Additionally, we offer some considerations about patients’ opportunities for achieving a good life and suggestions for further developing patient reported outcome scales. (shrink)