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)

Although philosophical approaches to the self are diverse, several of them are relevant to cognitive science. First, the notion of a 'minimal self', a self devoid of temporal extension, is clarified by distinguishing between a sense of agency and a sense of ownership for action. To the extent that these senses are subject to failure in pathologies like schizophrenia, a neuropsychological model of schizophrenia may help to clarify the nature of the minimal self and its neurological underpinnings. Second, there is (...) good evidence to suggest that although certain aspects of the minimal self are primitive and embodied, other aspects may be accessed only in reflective consciousness. Employing a modified concept of the minimal self, it may be possible to construct a robotic form of non-conscious self-reference that depends on an interaction between the robotic body and its environment. In contrast to the minimal self, the narrative self involves continuity over time and is directly relevant to discussions of memory and personal identity. There is growing consensus among philosophers and cognitive scientists about the importance of narrative and its relation to episodic memory and left-hemisphere functions. There are, however, at least two different views of how the narrative self is structured. On one model it is nothing more than an abstract point. On a more extended view, proposed here, the self is a rich amalgam of narratives that allows for the equivocations, contradictions, and self-deceptions of personal life. Even in this case, however, neurocognitive models contribute to our understanding of how narrative identity is structured. (shrink)

As a rule, mental illnesses are connected with increased self-observation, a narrowing of attention to one′s own person, and with the backward turn of thinking to what has already been done or has happened. These phenomena can be summed up in the concept of hyperreflexivity. In this paper, this concept is interpreted against the background of Plessner′s distinction between the lived and the objective body as implying always already a component of self-alienation. This will be illustrated in a number of (...) psychopathological conditions such as insomnia, obsessive-compulsive disorder, hypochondria and schizophrenia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 323-326 [Access article in PDF] The Tacit Dimension Thomas Fuchs Thirty years after its appearance, Blankenburg's "Psychopathology of common sense" has not lost its relevance. In my commentary I will try to illustrate the fruitfulness of his approach by pointing to some connections with the phenomenology of the body as well as with recent memory and infant research.As Blankenburg himself indicates, the notion (...) of common sense developed by a shift of meaning from the classical sensus communis and thus has its original basis in the sensual-bodily experience. By the koinè aísthesis, Aristoteles meant a central sense organ integrating all single modalities of sensation (which he localized in the heart). In German physiology and psychiatry of the nineteenth century, the sensus communis was still translated as "Gemeingefühl" ("common feeling") or "cenesthesia" (Fuchs 1995). This term denoted the inner, proprioceptive bodily sensations, but also an original unity of the senses, which has been rediscovered by recent infant research as intermodal sensory perception. The affection of the body was thus regarded as the common basis of all sensation.Looking on this track for a bodily basis of the common sense, we find it in the habitual structure of the lived-body as analysed by Merleau-Ponty (1945). The body is the primary "matter-of-course," namely, the tacitly functioning medium of our everyday being-in-the-world prior to any subject-object split. The body schema, in Merleau-Ponty's view, is not only a system of familiar units of movement or "kinetic melodies," it also incorporates the surrounding things, tools, and spaces that are familiar to us and that we "inhabit." Thus, the musician "does not only manipulate the instrument like a separate object, but lives in it like a limb and inhabits the expressive musical space it opens" (Behnke 1997). But for Merleau-Ponty, the body schema is also the basis of "intercorporeity," i.e., a prepersonal sphere of reciprocal comportment and understanding prior to any explicit consensus and symbolic communication. In this sphere of elementary contact, the "atmospheric" senses play a major role: The sense of smell (as shown, e.g., by the expression "to scent treason" or in German, "jemand nicht riechen können" [not be able to "smell" or stand someone]) as well as the sense of taste whose ambiguous meaning, mentioned by Blankenburg, points to the bodily basis of the feeling for what is suitable, decent, or aesthetically pleasing. Even the designation of homo sapiens that we give to ourselves is derived from the latin sapere (to taste/to know), and thus shows that the knowledge characteristic for man is not an explicit one, but an intuitive, implicit knowing or "feel" for his surroundings, or as Kant says, an "aesthetic rather than intellectual judgment" (cited by Blankenburg).Polanyi (1967) has analysed this knowledge at the roots of common sense as "tacit knowledge." It is based on processes of Gestalt formation that enable us to grasp unified wholes through their constituting elements without still being aware of the latter. Thus, we understand the facial expression of others immediately but cannot tell from which details. Or we know how [End Page 323] to waltz without knowing the single movements or being able to explain it. Tacit knowledge implies all the taken-for-granted that we have forgotten once it has become our second nature and part of our bodily habits. It is mainly based on the neuronal coupling of single sensori-motor units by repeated perception or action. This unconscious knowing has only recently come to be explored by psychology under the heading of "implicit" or "procedural memory" (Schacter 1987, 1996). It contains familiar styles or "melodies" of moving, perceiving, and being-with-others in which our whole bodily and emotional experience is engaged. There is an atmospheric, "felt" quality about them that cannot be analysed into single elements. Implicit knowledge may, therefore, never be wholly expressed by words—it is only realized in the concrete situation. It may only be circumscribed by expressions such as "how it feels...," "how it is...," e.g., how it is... (shrink)