Somatoparaphrenia is a pathology of self characterized by the sense of alienaton from parts of one’s body. It is usually construed as a kind of delusional disorder caused by extensive right hemisphere lesions. Lesions in the temporoparietal junction are common in somatoparaphrenia but deep cortical regions (for example, the posterior insula) and subcortical regions (for example, the basal ganglia) are also sometimes implicated (Valler and Ronschi 2009). Patients are often described as feeling that a limb belongs to another (...) person and thus attribute ownership of the limb and bodily sensation to someone else. There is also some question as to whether or not the higher-order thought (HOT) theory of consciousness can plausibly account for the depersonalization psychopathology of somatoparaphrenia (Liang and Lane 2009, Rosenthal 2010, Lane and Liang 2010). Liang and Lane argue that it cannot. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that it is the target of a HOT to the effect that “I am in mental state M” (Rosenthal 2005, Gennaro 2012). When the HOT is itself is unconscious, the conscious state is still outer-directed. When the HOT is conscious, we have introspection and so the conscious thought is directed at the mental state. In section I, I briefly review the previous exchange between Lane and Liang and David Rosenthal. In section II, I further explore somatoparaphrenia and the nature of delusion while offering a number of additional replies to Lane and Liang. In section III, I examine the central notions of “mental state ownership” and “self-concepts” in an effort to account especially for the depersonalization aspect of somatoparaphrenia against the background of HOT theory. In section IV, I argue that to the extent that somatoparaphrenia casts doubt on the notion that some thoughts are “immune to error through misidentification” (IEM), the most fundamental aspect of IEM is still consistent with HOT theory. Overall, I argue that HOT theory is left unscathed by the pheneomenon of somatoparaphrenia and can even help to explain what happens in these cases. (shrink)

Sydney Shoemaker argues that a certain class of self-ascriptions is immune to error through misidentification relative to the first-person pronouns. In their “Self-Consciousness and Immunity,” Timothy Lane and Caleb Liang question Shoemaker’s view. Lang and Liang present a clinical case and an experiment and argue that they are counterexamples to Shoemaker’s view. This paper is a response to Lane and Liang’s challenge. I identify the desiderata that a counterexample to Shoemaker’s view must meet and show that somatoparaphrenia and the (...) Body Swap Illusion fail to meet those desiderata. Thus, despite being puzzling phenomena, somatoparaphrenia and the Body Swap Illusion are not counterexamples to Shoemaker’s view. (shrink)

According to Rosenthal’s Higher-Order Thought (HOT) theory of consciousness, first-order mental states become conscious only when they are targeted by HOTs that necessarily represent the states as belonging to self. On this view a state represented as belonging to someone distinct from self could not be a conscious state. Rosenthal develops this view in terms of what he calls the ‘thin immunity principle’ (TIP). According to TIP, when I experience a conscious state, I cannot be wrong about whether it is (...) I who I think is in that state. We first suggest that TIP is a direct consequence of the HOT theory. Next we argue that somatoparaphrenia—a pathology in which sensations are sometimes represented as belonging to other people—shows that TIP can be violated. This violation of TIP in turn shows that the HOT theory’s claim that conscious states are necessarily represented as belonging to self is in error. Rosenthal’s attempt to account for pathological cases is found to be inadequate when applied to somatoparaphrenia, and other possible defenses are also shown to be incapable of preserving TIP. We further conclude by suggesting that the HOT theory’s failing in this regard is not a failing that is peculiar to this theory of consciousness. (shrink)

Mental ownership concerns who experiences a mental state. According to David Rosenthal (2005: 342), the proper way to characterize mental ownership is: ‘being conscious of a state as present is being conscious of it as belonging to somebody. And being conscious of a state as belonging to somebody other than oneself would plainly not make it a conscious state’. In other words, if a mental state is consciously present to a subject in virtue of a higher-order thought (HOT), then the (...) HOT necessarily representsthe subject as the owner of the state. But, we contend, one of the lessons to be learned from pathological states like somatoparaphrenia is that conscious awareness of a mental state does not guarantee first-person ownership. That is to say, conscious presence does not imply mental ownership. (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)

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” (Rosenthal 2005, Gennaro 2012). In a previous (...) publication (Gennaro 2015), I argued that a HOT theorist can adequately respond to this concern with respect to somatoparaphrenia. Somatoparaphrenia is a “depersonalization disorder” which is characterized by the sense of alienation from parts of one’s body. It is a bizarre type of body delusion where one denies ownership of a limb or an entire side of one’s body. My focus in the chapter, however, is on “inserted thoughts” which is a common symptom of schizophrenia, although it will also be useful to contrast it with somatoparaphrenia. Schizophrenia is a mental disorder which most commonly manifests itself through auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking. Thought insertion is the delusion that some thoughts are not “one’s own” in some sense or are somehow being inserted into one’s mind by someone else. Graham and Stephens (2000), for example, have suggested that thought insertion should be understood as alienated self-consciousness or meta-representation. I argue that HOT theory has nothing to fear from this phenomenon either and can consistently explain what happens in this admittedly unusual case. (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)

Subjectivity theories of consciousness take self-reference, somehow construed, as essential to having conscious experience. These theories differ with respect to how many levels they posit and to whether self-reference is conscious or not. But all treat self-referencing as a process that transpires at the personal level, rather than at the subpersonal level, the level of mechanism. -/- Working with conceptual resources afforded by pre-existing theories of consciousness that take self-reference to be essential, several attempts have been made to explain seemingly (...) anomalous cases, especially instances of alien experience. These experiences are distinctive precisely because self-referencing is explicitly denied by the only person able to report them: those who experience them deny that certain actions, mental states, or body parts belong to self. The relevant actions, mental states, or body parts are sometimes attributed to someone or something other than self, and sometimes they are just described as not belonging to self. But all are referred away from self. -/- The cases under discussion here include somatoparaphrenia, schizophrenia, depersonalization, anarchic hand syndrome, and utilization behavior; the theories employed, Higher-Order Thought, Wide Intrinsicality, and Self-Representational. Below I argue that each of these attempts at explaining or explaining away the anomalies fails. Along the way, since each of these theories seeks at least compatibility with science, I sketch experimental approaches that could be used to adduce support for my position, or indeed for the positions of theorists with whom I disagree. -/- In a concluding section I first identify two presuppositions shared by all of the theorists considered here, and argue that both are either erroneous or misleading. Second, I call attention to divergent paths adopted when attempting to explain alienation experiences: some theorists choose to add a mental ingredient, while others prefer to subtract one. I argue that alienation from experience, action, or body parts could result from either addition or subtraction, and that the two can be incorporated within a comprehensive explanatory framework. Finally, I suggest that this comprehensive framework would require self-referencing of a sort, but self-referencing that occurs solely on the level of mechanism, or the subpersonal level. In adumbrating some features of this “subpersonal self,” I suggest that there might be one respect in which it is prior to conscious experience. (shrink)

According to what we will call subjectivity theories of consciousness, there is a constitutive connection between phenomenal consciousness and subjectivity: there is something it is like for a subject to have mental state M only if M is characterized by a certain mine-ness or for-me-ness. Such theories appear to face certain psychopathological counterexamples: patients appear to report conscious experiences that lack this subjective element. A subsidiary goal of this chapter is to articulate with greater precision both subjectivity theories and the (...) psychopathological challenge they face. The chapter’s central goal is to present two new approaches to defending subjectivity theories in the face of this challenge. What distinguishes these two approaches is that they go to great lengths to interpret patients’ reports at face value – greater length, at any rate, than more widespread approaches in the extant literature. (shrink)

In recent years, a debate has emerged on whether bodily sensations are typically accompanied by a sense of body ownership, namely a distinctive experience of one's body or body part as one's own. Realists about the sense of body ownership heavily rely on evidence from experimentally-induced bodily illusions (e.g., the rubber hand illusion) and pathological disownership syndromes (e.g. somatoparaphrenia). In this chapter, I will introduce novel evidence regarding body disownership syndromes induced by psychoactive drugs rather than pathological conditions, and (...) discuss its relevance to the debate on the sense of body ownership. (shrink)

Philosophical and empirical research on bodily awareness has mostly focused so far on bodily disorders – such as anorexia nervosa, somatoparaphrenia, or xenomelia (body integrity dysphoria) – and bodily illusions induced in an experimental setting – such as the rubber hand illusion, or the thermal grid illusion. Studying these conditions can be illuminating to investigate a broad range of issues about the nature, function, and etiology of bodily experience. However, a number of psychoactive compounds can also induce a remarkably (...) wide variety of bodily effects that have received little attention despite their relevance to these issues. Some of these effects are similar to those associated with bodily disorders or experimental bodily illusions, while others appear to be unique. The purpose of this chapter is to provide an overview of these lesser known bodily effects of psychoactive compounds, and outline some ways in which they can bear on recent debates regarding bodily awareness and bodily ownership. (shrink)