Self-disturbances in schizophrenia: history, phenomenology, and relevant findings from research on metacognition.
Aaron Mishara, Paul H Lysaker, Michael A Schwartz
Schizophrenia Bulletin January 2014 DOI: 10.1093/schbul/sbt169 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Measures | Metacognition Assessment Scale (MAS-A) |
| Topics | Philosophy of mind |
| Keywords | Ichstörung self-disturbance Embodied cognition Metacognition Narrative Phenomenological psychiatry Psychosis Quality of life Recovery |
| Key points | Argues that phenomenological psychiatrists such as Blankenburg, Binswanger, and Conrad interpreted self-disturbance (Ichstörung) as a disturbed relationship to self and others, challenging recent efforts to interpret self-disturbance as diminished pure passive self-affection that putatively explains schizophrenia. Also proposes that narrative is a reflective, embodied process requiring dynamic perspective shifting, and that the Metacognition Assessment Scale suggests persons with schizophrenia tend to produce narratives with reductions in the binding processes required for an integrated, embodied self within narrated life stories and interactive relationships. |
Abstract
With a tradition of examining self-disturbances (Ichstörungen) in schizophrenia, phenomenological psychiatry studies the person's subjective experience without imposing theoretical agenda on what is reported. Although this tradition offers promising interface with current neurobiological models of schizophrenia, both the concept of Ichstörung and its history are not well understood. In this article, we discuss the meaning of Ichstörung, the role it played in the development of the concept of schizophrenia, and recent research on metacognition that allows for the quantitative study of the link between self-disturbance and outcome in schizophrenia. Phenomenological psychiatrists such as Blankenburg, Binswanger, and Conrad interpreted the Ichstörung as disturbed relationship to self and others, thus challenging recent efforts to interpret self-disturbance as diminished pure passive self-affection, which putatively "explains" schizophrenia and its various symptoms. Narrative is a reflective, embodied process, which requires a dynamic shifting of perspectives which, when compromised, may reflect disrupted binding of the components of self-experience. The Metacognition Assessment Scale-abbreviated as MAS-A-suggests that persons with schizophrenia tend to produce narratives with reductions in the binding processes required to produce an integrated, embodied self within narrated life stories, and in interactive relationships with others.
Comparable studies
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| Study | Year | Design | Participants |
|---|---|---|---|
| Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. | 2003 | Theoretical or philosophical paper | |
| From dopamine to salience to psychosis--linking biology, pharmacology and phenomenology of psychosis. | 2005 | Theoretical or philosophical paper | |
| How do the brain's time and space mediate consciousness and its different dimensions? Temporo-spatial theory of consciousness (TTC). | 2017 | Theoretical or philosophical paper | |
| The phenomenology of deep brain stimulation-induced changes in OCD: an enactive affordance-based model. | 2013 | Theoretical or philosophical paper | |
| Looking for the Self: Phenomenology, Neurophysiology and Philosophical Significance of Drug-induced Ego Dissolution | 2017 | Theoretical or philosophical paper |
Citations in the library
Cited by 23
- Looking for the Self: Phenomenology, Neurophysiology and Philosophical Significance of Drug-induced Ego Dissolution Frontiers in Human Neuroscience May 23, 2017
- Hallucinations Beyond Voices: A Conceptual Review of the Phenomenology of Altered Perception in Psychosis. Schizophrenia Bulletin February 1, 2019
- Temporal structure of consciousness and minimal self in schizophrenia. Frontiers in Psychology 2014
- Thought insertion as a self-disturbance: An integration of predictive coding and phenomenological approaches Frontiers in Human Neuroscience December 22, 2016
- Is Schizophrenia a Disorder of Consciousness? Experimental and Phenomenological Support for Anomalous Unconscious Processing. Frontiers in Psychology 2017
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Cites 6
- The phenomenology and neurobiology of delusion formation during psychosis onset: Jaspers, Truman symptoms, and aberrant salience. Schizophrenia Bulletin March 2013
- Kafka, paranoic doubles and the brain: hypnagogic vs. hyper-reflexive models of disrupted self in neuropsychiatric disorders and anomalous conscious states. Philosophy, Ethics, and Humanities in Medicine August 20, 2010
- Klaus Conrad (1905-1961): delusional mood, psychosis, and beginning schizophrenia. Schizophrenia Bulletin December 4, 2009
- Brain Dynamics Underlying the Nonlinear Threshold for Access to Consciousness PLoS Biology September 25, 2007
- Is minimal self preserved in schizophrenia? A subcomponents view. Consciousness and Cognition September 1, 2007
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