Self-Disturbance in Schizophrenia: A Phenomenological Approach to Better Understand Our Patients
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Article Abstract A phenomenological approach explains the apparently unintelligible experiences of patients with schizophrenia as a disruption of the normal self-perception. Patients with schizophrenia suffer from a decline of "me," the background core of their experiences. Normally tacit experiences intrude into the forefront of their attention, and the sense that inner-world experiences are private diminishes. These patients lose the sense that they are the origin of their thoughts and actions; their self-evident network of meanings and a solid foundation of life disintegrate. Subsequently, their experiential world is transformed, alienated, intruded, and fragmented. In this article, a phenomenological investigation of the self-experiences and actions of 4 patients with schizophrenia is presented. Prim Care Companion CNS Disord 2013;15(1):doi:10.4088/PCC.12m01382 © Copyright 2013 Physicians Postgraduate Press, Inc. Submitted: March 27, 2012; accepted October 3, 2012. Published online: January 17, 2013. Corresponding author: Henriette D. Heering, MSc, Department of Early Psychosis, Academic Medical Center, Melbergdreef 5, Amsterdam, Noord-Holland 1105 AZ, The Netherlands (h.d.heering@amc.uva.nl).
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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 de Vries et al., 2013
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 de Vries et al., 2013
In phenomenological psychiatry, psychosis and schizophrenia are not seen mainly as collections of hallucinations or delusions, but as changes in the person's relation to self and world.
“In phenomenological psychiatry, psychosis and schizophrenia are not seen mainly as collections of hallucinations or delusions, but as changes in the person’s relation to self and world [1].”
From Delusional Experiences Emerging From AI Chatbot Interactions or “AI Psychosis” (2025) · cites this paper as [1]
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Schizophrenia as a self-disorder due to perceptual incoherence
Postmes, L., Sno, H. N., Goedhart, S., van der Stel, J., Heering, H. D., & de Haan, L. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2013.07.027 · Cited by 183 · see citing works
“This results in diminished cohesion and an altered composition between background and foreground sensory information, which changes subjective experience in a profound and ‘ inexplicable ’ way (de Vries et al., 2013).”
Self-citationDelusional Experiences Emerging From AI Chatbot Interactions or “AI Psychosis”
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Understanding Identity Changes in Psychosis: A Systematic Review and Narrative Synthesis
Conneely, M., McNamee, P., Gupta, V., Richardson, J., Priebe, S., Jones, J. M., & Giacco, D. (2021) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa124 · Cited by 60 · see citing works
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“In schizophrenia and other forms of psychosis, patients often report the perception of seemingly real autonomous beings who communicate with them (de Vries et al., 2013).”
Rosen, C., Jones, N., Chase, K. A., Melbourne, J. K., Grossman, L. S., & Sharma, R. P. (2017) · Consciousness and Cognition · doi:10.1016/j.concog.2017.01.015 · Cited by 29 · see citing works
“Eventually, in synergistic combination with other factors and processes, such object-like thoughts may be asserted as autochthonous thoughts, “voices” or delusions of thought-control (Stanghellini, 2004; de Vries et al., 2013).”
BackgroundHeering, H. D., Goedhart, S., Bruggeman, R., Cahn, W., de Haan, L., Kahn, R. S., Meijer, C. J., Myin‐Germeys, I., van Os, J., & Wiersma, D. (2016) · Psychopathology · doi:10.1159/000441952 · Cited by 23 · see citing works
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A two-factor structure of first rank symptoms in patients with a psychotic disorder
Heering, H. D., van Haren, N. E. M., & Derks, E. M. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2013.04.032 · Cited by 16 · see citing works
Self-citationSchizophrenia Patient or Spiritually Advanced Personality? A Qualitative Case Analysis
Bhargav, H., Jagannathan, A., Nagarathna, R., et al. (2014) · Journal of Religion and Health · doi:10.1007/s10943-014-9994-0 · Cited by 13 · see citing works
“Increasing numbers of empirical studies show that disturbances in the ‘sense of self’ or selfexperience are characteristic of schizophrenia (Raballo 2012; Boulanger et al. 2013; de Vries et al. 2013).”
BackgroundSocial functioning in patients with a psychotic disorder and first rank symptoms
Heering, H. D., & van Haren, N. E. M. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.01.050 · Cited by 11 · see citing works
“…immerse herself in the world because an invisible barrier prevented her full presence ” (Cer-molacce et al., 2007)(p706) and of Ms D who “ struggled to regain her familiar rhythm of conversation and connection with herself and to be able to make contact with others again ” (de Vries et al., 2013).”
Self-citationTonna, M. (2024) · Culture Medicine and Psychiatry · doi:10.1007/s11013-024-09873-5 · Cited by 7 · see citing works
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“In their article ‘Self-Disturbance in Schizophrenia,’ Vries et al. (2013) argue that patients with schizophrenia experience ‘a disruption of the normal self-perception’ where ‘tacit experiences intrude into the forefront of their attention, and the sense that inner-world experiences are private…”
BackgroundEmbodied Cognition in the Clinic
Gallagher, S., & Hutto, D. D. (2024) · Springer eBooks · doi:10.1007/978-3-031-38391-5_8 · Cited by 3 · see citing works
Shahri, H. (2025) · The Clinical Journal of the International Institute for Bioenergetic Analysis · doi:10.30820/0743-4804-2025-35-89
Delcourt, F., Cowan, H. R., Sibéoni, J., Allé, M. C., Rasmussen, A. C. R., Ritunnano, R., Giersch, A., Monte, F. L., Englebert, J., & Pachoud, B. (2026) · Wiley Interdisciplinary Reviews Cognitive Science · doi:10.1002/wcs.70023
The autism-schizophrenia continuum : prosodic and conversational patterns as new endophenotypes
Lucarini, V. (2024) · theses.fr (ABES) · doi:10.70675/b674de0bz354ez4361zb6fez867240052631
Nakamura, D., Mizuno, M., Cicero, D. C., Arai, Y., Suzuki, H., Hirose, S., Kasai, T., Sugita, S., Nakamura, Y., Wood, S. J., et al. (2026) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.70099
Lopes, B., Jaspal, R., & Gifford, A. J. (2026) · Healthcare · doi:10.3390/healthcare14152376
“The experience of identity loss is associated with severe psychopathology, such as depersonalization, depression, substance misuse, psychosis, and suicidal ideation [44,46–48].”
- Authors
- de Vries, R., Heering, H. D., Postmes, L., Goedhart, S., Sno, H. N., & de Haan, L.
- Venue
- The Primary Care Companion For CNS Disorders
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2013-01-17
- Volume
- 15
- Issue
- 1
- ISSN
- 2155-7772 (ISSN-L)
- 2155-7780
- PMC
- PMC3661330
- OpenAlex
- W2033816134
- Cited by
- 19
- References
- 0
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2022: 2 · 2021: 1 · 2020: 2 · 2017: 1 · 2016: 2 · 2014: 1 · 2013: 2
- FWCI
- 12.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Primary Care Companion For CNS Disorders (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- 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 › Phenomenology and Existential Philosophy
- Keywords
- schizophrenia, self-disturbance, self-perception, phenomenology, self-experience, alienation, loss of self, early psychosis
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