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Schizophrenia, Consciousness, and the Self
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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“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
In the citing paper
“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
In the citing paper
“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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EASE: Examination of Anomalous Self-Experience
Parnas, J., Møller, P., Kircher, T., Thalbitzer, J., Jansson, L., Handest, P., & Zahavi, D. (2005) · Psychopathology · doi:10.1159/000088441 · Cited by 905
Self-citationPsychosis and autism as diametrical disorders of the social brain
Crespi, B. J., & Badcock, C. R. (2008) · Behavioral and Brain Sciences · doi:10.1017/s0140525x08004214 · Cited by 635
Ego-dissolution and psychedelics: validation of the ego-dissolution inventory (EDI).
Nour, M. M., Evans, L., Nutt, D., & Carhart-Harris, R. L. (2016) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2016.00269 · Cited by 470
Convergence of biological and psychological perspectives on cognitive coordination in schizophrenia
Phillips, W. A., & Silverstein, S. M. (2003) · Behavioral and Brain Sciences · doi:10.1017/s0140525x03000025 · Cited by 445
Embodiment and psychopathology: a phenomenological perspective
Fuchs, T. A. E., & Schlimme, J. E. (2009) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e3283318e5c · Cited by 405
Metadata
- 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
- 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 › Arts and Humanities › Philosophy › Philosophy and Theoretical Science
- Keywords
- schizophrenia, consciousness
- MeSH terms
- Affect, Consciousness, Humans, Schizophrenia, Schizophrenic Psychology, Self Concept
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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