Disturbance of Minimal Self (Ipseity) in Schizophrenia: Clarification and Current Status
Nelson, Parnas, Sass
Schizophrenia Bulletin vol. 40 no. 3 pp. 479–482, 2014
doi:10.1093/schbul/sbu034 Advance Access publication March 11, 2014
Insights from phenomenological psychiatry and philosophy, focused on disturbed subjectivity, indicate that disturbed self-experience or selfhood may underlie and generate many “surface-level” psychotic symptoms.
There are many different meanings and controversies surrounding the notion of the “self.” These controversies mainly concern its ontology or ultimate reality status, e.g., as a kind of “substance,” object, or process. The experiential, subjective notion of the self (the sense of self) is, however, widely acknowledged, both in the analytic philosophy of mind and in phenomenology. Two levels of the experiential self are typically proposed:
1. “Minimal” self, also referred to as “basic” or “core” self or as “ipseity.” This is a prereflective, tacit level of selfhood. It refers to the implicit first-person quality of consciousness, ie, the implicit awareness that all experience articulates itself in first person perspective as “my” experience. In other words, all conscious acts are intrinsically self-conscious, a feature sometimes designated as “self-affection.” “Minimal” or “core” self constitutes the foundational level of selfhood on which other levels of selfhood are built.
2. “Narrative” or social self. This refers to characteristics such as social identity, personality, habits, style, personal history, etc. Psychological concepts such as “self-esteem” or “self-image” refer to this level of selfhood. This level is widely understood to presuppose the sense of existing as a subject of experience (“minimal self”) and often involves reflective, metacognitive processes, in which one’s self is largely an object of awareness.
The ipseity-disturbance model (IDM), developed by Sass and Parnas, presents distortion/instability of the minimal self as consisting of complementary aspects: hyperreflexivity and diminished self-affection. The IDM posits that disturbance in the structure of experience, normally permeated by stable first person perspective, characterizes schizophrenia spectrum disorders. This instability manifests itself in a range of anomalous subjective experiences, typically already present in childhood or early adolescence, including forms of depersonalisation, diminished sense of existing as a bodily subject, distortions of first-person perspective with weakened sense of “fineness” of the field of awareness (thoughts, sensations, etc.), diminished sense of coherence and consistency in fundamental features of self (eg, sense of anonymity, identity confusion, etc.), and disturbed self-other/self-world boundaries.
Being self-present and present in the world of others and objects (the self-world structure) exist as 2 sides of the same coin. Accordingly, minimal self-disturbance involves diminished attunement and immersion in the world, inadequate spontaneous grasp of self-evident meanings (perplexity, diminished “common sense”), and hyperreflectivity.
Both research and theory in cognitive neuroscience, phenomenology, and the philosophy of mind suggest, as well, that disruptions of ipseity will affect narrative self and metacognition far more than the reverse.