Two approaches studying first-person experience in psychosis—philosophical phenomenology and the recovery movement—offer different but potentially complementary insights. Phenomenology describes how lived experience in psychosis deviates from health, proposing the ipseity disturbance model, while recovery writings focus on experiences of moving toward well-being. These differences make integration for treatment challenging. The authors examine major tenets of each literature and suggest future directions for reconciling their contributions.
Disturbances in first-person experience are a broadly noted feature of schizophrenia that cannot be reduced to the expression of psychopathology, yet they are often ignored by most contemporary treatment models. This paper presents a model suggesting that deficits in metacognition and their later resolution parsimoniously explain the development of self-disturbance and clarify how persons can later recover. Metacognition is defined as processes integral to the availability of a sense of self and others within the flow of life. The paper describes Metacognitive Reflection and Insight Therapy (MERIT), an integrative form of psychotherapy designed to target metacognition and enhance recovery of healthy self-experience, with eight measurable core elements. Research provides evidence of MERIT's feasibility, acceptability, and effectiveness across a broad range of patients.