Thought insertion

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.

Abstract: Ordinarily, if you say something like "I see a comet," you might make a mistake about whether it is a comet that you see, but you could not be right about whether it is a comet but wrong about who is seeing it. There cannot be an "error of identification" in this case. In making a judgement like, "I see a comet," there are not two steps, finding out who is seeing the thing and finding out what it is that is being seen, so that you could go wrong at either step. The only place to go wrong is in your de scription of what is being seen. We usually take it that the same point applies to present-tense ascriptions to oneself of psychological states in general. You can get it wrong about which psychological state you are in, but you cannot get it right about the psychological state but wrong about whose psychological state it is. In contrast, in a room full of people, I might hear a noise and conclude, "Bill sneezed," and in this case I could be wrong either about who it was that sneezed or about whether it was a sneeze, rather than say a death-rattle. This point seems to apply to knowledge of your own thoughts. If you say, "I am thinking about Vienna," we would ordinarily think that you cannot be right that someone is thinking about Vienna, but wrong about who it is that is doing that thinking. What is so striking about the phe nomenon of thought insertion as described by schizophrenic patients is that it seems to involve an error of identification. The patient might say, "Thoughts come into my head like 'Kill God'. It's just like my mind working, but it isn't. They come from this chap, Chris. They're his thoughts." (Frith 1992, 66). A patient who supposes that thoughts have been inserted into his mind by someone else is right about which thoughts

Abstract: The paper first introduces the concept of implicit and explicit temporality, referring to time as pre-reflectively lived vs. consciously experienced. Implicit time is based on the constitutive synthesis of inner time consciousness on the one hand, and on the conative–affective dynamics of life on the other hand. Explicit time results from an interruption or negation of implicit time and unfolds itself in the dimensions of present, past and future. It is further shown that temporality, embodiment and intersubjectivity are closely connected: While implicit temporality is characterised by tacit bodily functioning and by synchronisation with others, explicit temporality arises with states of desynchronisation, that is, of a retardation or acceleration of inner time in relation to external or social processes. These states often bring the body to awareness as an obstacle as well. On this basis, schizophrenia and melancholic depression are investigated as paradigm cases for a psychopathology of temporality. Major symptoms of schizophrenia such as thought disorder, thought insertion, hallucinations or passivity experiences may be regarded as manifesting a disturbance of the constitutive synthesis of time consciousness, closely connected with a weakening of the underlying pre-reflective self-awareness or ipseity. This results in a fragmentation of the intentional arc, a loss of self-coherence and the appearance of major self-disturbances. Depression, on the other hand, is mostly triggered by a desynchronisation from the social environment and further develops into an inhibition of the conative–affective dynamics of life. As will be shown, both mental illnesses bear witness of the close connection of temporality, embodiment and intersubjectivity.