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.
A review compares three research fields—metacognition, social cognition, and mentalizing—to determine whether metacognitive research offers unique insight into psychosis. The authors argue that metacognition, as defined by the integrated model, can quantify activities whose impairment may cause subjective disturbances in psychosis. They distinguish metacognition from the other fields in experimental procedures, theoretical advances, and clinical applications. Metacognitive research uniquely describes an architecture that, when compromised in psychosis, leads to loss of purpose, possibilities, place in the world, and self-coherence. Repairing this architecture may promote recovery of a coherent sense of self and others, with implications for recovery-oriented treatment.
Metacognition—the ability to know, monitor, and adjust one's own beliefs, memories, and behaviors—is often studied as an individual cognitive process. This review argues that metacognition is also fundamentally intersubjective: people know and reflect upon themselves and others through connections with other people. Reviewing research on metacognition in schizophrenia using an integrative model that assesses metacognition within personal narratives, the authors discuss how disturbances in intersubjective experience and metacognitive capacity mutually influence one another. Disruptions in metacognition may be more deeply understood as disruptions in relatedness with others. The paper explores how metacognition and intersubjectivity each affect mental health and discusses implications for treatments targeting metacognition.