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Cited by 1,324Mental Health and PsychiatrySchizophrenia research and treatmentPhilosophy and Theoretical Science

Schizophrenia, consciousness, and the self

Sass, L. A., Parnas, J.·2003·Schizophrenia Bulletin
DOI 10.1093/oxfordjournals.schbul.a007017
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Abstract

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 (ipse is Latin for "self" or "itself") 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.

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Crossref · 10.1093/oxfordjournals.schbul.a007017

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  • Disturbances in the minimal self are well-established and possibly core symptoms of schizophrenia.

    “These disturbances in the minimal self are well-established features and perhaps even core symptoms of schizophrenia (de Vries et al., 2013; Henriksen & Parnas, 2012; Hur et al., 2014; B. Nelson, Whitford, et al., 2014; B. Nelson, Parnas, et al., 2014; Parnas & Handest, 2003; Sass & Parnas, 2003).”

    From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Sass & Parnas, 2003

  • People with schizophrenia show marked disturbances in the minimal self, including diminished self-affection and hyper-reflexivity.

    “Phenomenologically, individuals with schizophrenia experience dramatic disturbances in the minimal self. The minimal self loses its vitality and stability as a subject of awareness (diminished self-affection) while at the same time aspects of self-experience may seem external or alien (hyper-reflexivity) (Sass & Parnas, 2003).”

    From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Sass & Parnas, 2003

  • Self-disturbance in schizophrenia extends from basic senses of agency and ownership to lifelong struggles with personal identity and meaning.

    “This self-disturbance is profound, reaching from basic senses of agency and ownership over experience (de Vries et al., 2013; Henriksen & Parnas, 2012; Hur et al., 2014; B. Nelson, Parnas, et al., 2014; Sass & Parnas, 2003) to lifelong struggles to build personal identity and find meaning amid lost roles, relationships, and internalized stigma (Andresen et al., 2003; Ben-David & Kealy, 2019; Conne”

    From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Sass & Parnas, 2003

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Authors
Sass, L. A., & Parnas, J.
Affiliations
  • Rutgers, The State University of New Jersey (US)
  • University of Copenhagen (DK)
Corresponding author
Parnas, J.
ORCID
Parnas, J.
Venue
Schizophrenia Bulletin
Publisher
Oxford University Press (OUP)
Published
2003-01-01
Volume
29
Issue
3
Pages
427-444
ISSN
  • 0586-7614 (ISSN-L)
  • 1745-1701
DOI
10.1093/oxfordjournals.schbul.a007017
OpenAlex
W2159675987
Cited by
1,324
References
139
Citations by year
2026: 90 · 2025: 76 · 2024: 90 · 2023: 87 · 2022: 91 · 2021: 80 · 2020: 93 · 2019: 86 · 2018: 72 · 2017: 69 · 2016: 74 · 2015: 77 · 2014: 56 · 2013: 80 · 2012: 51
FWCI
65.19
Type
journal article
Language
en
Open access
closed
Locations
  • Schizophrenia Bulletin (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Philosophy and Theoretical Science
Keywords
schizophrenia, consciousness
MeSH terms
Affect, Consciousness, Humans, Schizophrenia, Schizophrenic Psychology, Self Concept

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