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 subjective experience of time is a fundamental constituent of human consciousness and can be disturbed under conditions of mental disorders such as schizophrenia or affective disorders. Besides the scientific domain of psychiatry, time consciousness is a topic that has been extensively studied both by theoretical philosophy and cognitive neuroscience. It can be shown that both approaches exemplified by the philosophical analysis of time consciousness and the neuroscientific theory of cross-temporal contingencies as the neurophysiological basis of human consciousness implemented in (...) the prefrontal cortex converge in 2 respects. Firstly, a tripartite conception of consciousness divides human cognition in 3 different temporal domains comprising retention, presentation, and protention and the past, the present, and the future corresponding to working memory, interference control, and preparatory set. Secondly, both concepts refer to the present as an extended duration that integrates information from the recent past and the future. We propose that the integration of phenomenological and neuroscientific approaches can stimulate the development of enriched pathophysiological concepts of mental disorders. This approach appears to be particularly fruitful with respect to schizophrenia that is interpreted as a structural disturbance of time consciousness. (shrink)