Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-14T15:36:31.519Z Has data issue: false hasContentIssue false

17 - Phenomenology of a Disordered Self in Schizophrenia: Example of an Integrative Level for Psychiatric Research

from Section 6

Published online by Cambridge University Press:  02 April 2020

By
Josef Parnas  and
Maja Zandersen
Edited by
Kenneth S. Kendler ,
Josef Parnas  and
Peter Zachar
Kenneth S. Kendler
Affiliation:
Virginia Commonwealth University
Josef Parnas
Affiliation:
University of Copenhagen
Peter Zachar
Affiliation:
Auburn University, Montgomery
Get access

Summary

Psychiatric diagnostic systems contain approximately 400 mainly descriptively defined categories with incomprehensible overlaps and comorbidity. Empirical research has demonstrated a multitude of biological, psychological, and social risk factors, which are, however, not integrated in any conceptually coherent pathogenetic model. We argue that over and above a purely superficial symptomatic description we should address the level of mental structures underlying the symptoms. We emphasize the basic ontological structures, which are conditions for human experience and existence: intentionality, selfhood, intersubjectivity, temporality, and embodiment. A structural level may serve the purposes of classification and provide an integrative bridge between biological and psychological phenomena. We concentrate upon the level of selfhood where we distinguish the structural features (the so-called core self) and the more personal language and history involving level (the ‘narrative self’). Through a review of literature and presentation of two clinical cases, we demonstrate the value of the concept in studying schizophrenia.

Keywords

diagnostic categoriesrisk factorsstructural levelsintegrationselfhoodschizophrenia spectrum
Type
Chapter
Information
Levels of Analysis in Psychopathology
Cross-Disciplinary Perspectives
 , pp. 207 - 227
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (1980) Diagnostic and statistical manual of mental disorders, 3rd ed. Washington: American Psychiatric Association.Google Scholar
American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders, 5th ed. Arlington: American Psychiatric Association.Google Scholar
Andreasen, N. C. (2007) “DSM and the death of phenomenology in America: An example of unintended consequences.” Schizophrenia Bulletin, 33(1), 108–112.Google Scholar
Bleuler, E. (1950) Dementia praecox or the group of schizophrenias (trans. J. Zinkin). New York: International Universities Press.Google Scholar
Conrad, K. (1959) Die Beginnende Schizophrenie. Stuttgart: Thieme.Google Scholar
Deutsch, H. (1942) “Some forms of emotional disturbance and their relationship to schizophrenia.” The Psychoanalytic Quarterly, 11(3), 301–321.Google Scholar
Erikson, E. H. (1956) “The problem of ego identity.” Journal of the American Psychoanalytic Association, 4(1), 56–121.CrossRefGoogle ScholarPubMed
Ey, H. (1973) Traité des Hallucinations. Paris: Masson.Google Scholar
Fuchs, T. (2018) The ecology of the brain: The phenomenology and biology of the embodied mind. Oxford: Oxford University Press.Google Scholar
Fuchs, T. (2001) “Melancholia as a desynchronization: Towards a psychopathology of interpersonal time.” Psychopathology, 34(4), 179–186.Google Scholar
Fuchs, T. (2013) “Temporality and psychopathology.” Phenomenology and the Cognitive Sciences, 12(1), 75–104.CrossRefGoogle Scholar
Ghaemi, N. S. (2009) The rise and fall of the biopsychosocial model: Reconciling art and science in psychiatry. Baltimore: Johns Hopkins University Press.Google Scholar
Gruhle, H. W. (1929) Psychologie der Schizophrenie. Berlin: Springer.CrossRefGoogle Scholar
Hart, J. (2009) Who one is. Meontology of the “I”: A transcendental phenomenology. Berlin: Springer.Google Scholar
Hartmann, H. (1950) “Comments on the psychoanalytic theory of the ego.” The Psychoanalytic Study of the Child, 5(1), 74–96.Google Scholar
Haug, E., Lien, L., Raballo, A., Bratlien, U., Øie, M., Andreassen, O. A., … Møller, P. (2012) “Selective aggregation of self-disorders in first-treatment DSM-IV schizophrenia spectrum disorders.” The Journal of Nervous and Mental Disease, 200(7), 632–636.CrossRefGoogle ScholarPubMed
Hoch, P. H., & Cattell, J. P. (1959) “The diagnosis of pseudoneurotic schizophrenia.” Psychiatric Quarterly, 33(1), 17–43.CrossRefGoogle ScholarPubMed
Hoch, P., & Polatin, P. (1949) “Pseudoneurotic forms of schizophrenia.” Psychiatric Quarterly, 23(2), 248–276.Google Scholar
Jablensky, A. (2018) “The dialectic of quantity and quality in psychopathology.” World Psychiatry, 17(3), 300–301.Google Scholar
Jacobson, E. (1964) The self and the object world. New York: International Universities Press.Google Scholar
Jaspers, K. (1997) General psychopathology (trans. J. Hoenig & M. W. Hamilton). London: John Hopkins.Google Scholar
Kendler, K. S. (2018) “Classification of psychopathology: Conceptual and historical background.” World Psychiatry, 17(3), 241–242.CrossRefGoogle ScholarPubMed
Kernberg, O. F. (1985) Borderline conditions and pathological narcissism. Northvale: Jason Aronson.Google Scholar
Kernberg, O. (1967) “Borderline personality organization.” Journal of the American Psychoanalytic Association, 15(3), 641–685.CrossRefGoogle ScholarPubMed
Kernberg, O. F. (2016) “What is personality?” Journal of Personality Disorders, 30(2), 145–156.CrossRefGoogle ScholarPubMed
Klein, M. (1946) “Notes on some schizoid mechanisms.” International Journal of Psycho-Analysis, 27, 99–110.Google ScholarPubMed
Kohut, H. (1977) The restoration of the self. Chicago: The University of Chicago Press.Google Scholar
Koren, D. (in press) “Basic self-disturbance in adolescence predicts schizophrenia-spectrum disorders in young adulthood: A 7-year follow-up study among non-psychotic treatment-seeking adolescents.” Schizophrenia. https://doi.org/10.1016/j.schres.2019.12.022Google Scholar
Kraepelin, E. (1899) Psychiatrie: Ein Lehrbuch für Studirende und Aerzte, 6. Auflage. Leipzig: Johann Ambrosius Barth.Google Scholar
Krauss, A. (1999) “The significance of intuition for the diagnosis of schizophrenia.” In Maj, M. & Sartorius, N. (Eds.), Schizophrenia (pp. 47–49). Chichester: John Wiley & Sons.Google Scholar
Krueger, R. F., Kotov, R., Watson, D., Forbes, M. K., Eaton, N. R., Ruggero, C. J., … Bagby, R. M. (2018) “Progress in achieving quantitative classification of psychopathology.” World Psychiatry, 17(3), 282–293.CrossRefGoogle ScholarPubMed
Laing, R. D. (1960) The divided self: An existential study in sanity and madness. London: Penguin Books.Google Scholar
Mahler, M. S. (1971) “A study of the separation-individuation process: And its possible application to borderline phenomena in the psychoanalytic situation.” The Psychoanalytic Study of the Child, 26(1), 403–424.CrossRefGoogle ScholarPubMed
Marcia, J. E. (2006) “Ego identity and personality disorders.” Journal of Personality Disorders, 20(6), 577–596.Google Scholar
Motobayashi, Y., Parnas, J., Motobayashi, Y., Kimura, B., & Toda, D. L. (2016) “The ‘schizophrenic’ in the self-consciousness of schizophrenic patients”, by Mari Nagai (1990). History of Psychiatry, 27(4), 493–503.Google Scholar
Møller, P., & Husby, R. (2000) “The initial prodrome in schizophrenia: Searching for naturalistic core dimensions of experience and behavior.” Schizophrenia Bulletin, 26(1), 217–232.CrossRefGoogle ScholarPubMed
Nelson, B., Lavoie, S., Gaweda, L., Li, E., Sass, L. A., Koren, D., … Allott, K. (2019) “Testing a neurophenomenological model of basic self disturbance in early psychosis.” World Psychiatry, 18(1), 104–105.Google Scholar
Nelson, B., Thompson, A., & Yung, A. R. (2012) “Basic self-disturbance predicts psychosis onset in the ultra high risk for psychosis ‘prodromal’ population.” Schizophrenia Bulletin, 38(6), 1277–1287.CrossRefGoogle ScholarPubMed
Nilsson, M., Arnfred, S., Carlsson, J., Nylander, L., Pedersen, L., Mortensen, E. L., Handest, P. (2019) “Self-disorders in Asperger syndrome compared to schizotypal disorder: A clinical study.” Schizophrenia Bulletin. https://doi.org/10.1093/schbul/sbz036CrossRefGoogle Scholar
Nordgaard, J., Handest, P., Vollmer-Larsen, A., Sæbye, D., Pedersen, J. T., & Parnas, J. (2017) “Temporal persistence of anomalous self-experience: A 5 years follow-up.” Schizophrenia Research, 179, 36–40.CrossRefGoogle Scholar
Nordgaard, J., Jessen, K., Sæbye, D., & Parnas, J. (2016) “Variability in clinical diagnoses during the ICD-8 and ICD-10 era.” Social Psychiatry and Psychiatric Epidemiology, 51(9), 1293–1299.CrossRefGoogle ScholarPubMed
Nordgaard, J., Nilsson, L. S., Sæbye, D., & Parnas, J. (2018) “Self-disorders in schizophrenia-spectrum disorders: A 5-year follow-up study.” European Archives of Psychiatry and Clinical Neuroscience, 268(7), 713–718.CrossRefGoogle ScholarPubMed
Nordgaard, J., & Parnas, J. (2014) “Self-disorders and the schizophrenia spectrum: A study of 100 first hospital admissions.” Schizophrenia Bulletin, 40(6), 1300–1307.Google Scholar
Nordgaard, J., Sass, L. A., & Parnas, J. (2013) “The psychiatric interview: Validity, structure, and subjectivity.” European Archives of Psychiatry and Clinical Neuroscience, 263, 353–364.CrossRefGoogle ScholarPubMed
Parnas, J. (2004) “Belief and pathology of self-awareness a phenomenological contribution to the classification of delusions.” Journal of Consciousness Studies, 11(10–11), 148–161.Google Scholar
Parnas, J. (2011) “A disappearing heritage: The clinical core of schizophrenia.” Schizophrenia Bulletin, 37(6), 1121–1130.Google Scholar
Parnas, J. (2012) “DSM-IV and the founding prototype of schizophrenia: Are we regressing to a pre-Kraepelinian nosology?” In Kendler, K. S. & Parnas, J. (Eds.), Philosophical issues in psychiatry II: Nosology (pp. 237–259). Oxford: Oxford University Press.CrossRefGoogle Scholar
Parnas, J., & Bovet, P. (2015) “Psychiatry made easy: Operation(al)ism and some of its consequences.” In Kendler, K. S. & Parnas, J. (Eds.), Philosophical issues in psychiatry III: The nature and sources of historical change (pp. 190–212). Oxford: Oxford University Press.Google Scholar
Parnas, J., Bovet, P., & Innocenti, G. M. (1996) “Schizophrenic trait features, binding, and cortico-cortical connectivity: A neurodevelopmental pathogenetic hypothesis.” Neurology, Psychiatry and Brain Research, 4(4), 185–196.Google Scholar
Parnas, J., Handest, P., Jansson, L., & Sæbye, D. (2005) “Anomalous subjective experience among first-admitted schizophrenia spectrum patients: Empirical investigation.” Psychopathology, 38(5), 259–267.Google Scholar
Parnas, J., Handest, P., Sæbye, D., & Jansson, L. (2003) “Anomalies of subjective experience in schizophrenia and psychotic bipolar illness.” Acta Psychiatrica Scandinavica, 108(2), 126–133.CrossRefGoogle ScholarPubMed
Parnas, J., & Henriksen, M. G. (2016) “Mysticism and schizophrenia: A phenomenological exploration of the structure of consciousness in the schizophrenia spectrum disorders.” Consciousness and Cognition, 43, 75–88.Google Scholar
Parnas, J., Jansson, L., Sass, L. A., & Handest, P. (1998) “Self-experience in the prodromal phases of schizophrenia: A pilot study of first-admissions.” Neurology Psychiatry and Brain Research, 6(2), 97–106.Google Scholar
Parnas, J., Møller, P., Kircher, T., Thalbitzer, J., Jansson, L., Handest, P., & Zahavi, D. (2005) “EASE: Examination of anomalous self-experience.” Psychopathology, 38(5), 236–258.Google Scholar
Parnas, J., Raballo, A., Handest, P., Jansson, L., Vollmer-Larsen, A., & Sæbye, D. (2011) “Self‐experience in the early phases of schizophrenia: Five‐year follow‐up of the Copenhagen Prodromal Study.” World Psychiatry, 10(3), 200–204.Google Scholar
Parnas, J., & Sass, L. A. (2008) “Varieties of ‘phenomenology’: On description, understanding, and explanation in psychiatry.” In Kendler, K. S. & Parnas, J. (Eds.), Philosophical issues in psychiatry: Explanation, phenomenology, and nosology (pp. 239–278). Baltimore: John Hopkins University Press.Google Scholar
Parnas, J., Sass, L. A., & Zahavi, D. (2013) “Rediscovering psychopathology: The epistemology and phenomenology of the psychiatric object.” Schizophrenia Bulletin, 39(2), 270–277.Google Scholar
Parnas, J., & Urfer-Parnas, A. (2017) “The ontology and epistemology of symptoms: The case of auditory verbal hallucinations in schizophrenia.” In Kendler, K. S. & Parnas, J. (Eds.), Philosophical issues in psychiatry IV: Classification of psychiatric illness (pp. 201–216). Oxford: Oxford University Press.Google Scholar
Pick, A. (1903) “Zur Pathologie des Ich-Bewusstseins.” European Archives of Psychiatry and Clinical Neuroscience, 38(1), 22–33.Google Scholar
Raballo, A., Pappagallo, E., Dell’Erba, A., Lo Cascio, N., Patane’, M., Gebhardt, E., … & Girardi, P. (2016) “Self-disorders and clinical high risk for psychosis: An empirical study in help-seeking youth attending community mental health facilities.” Schizophrenia Bulletin, 42(4), 926–932.CrossRefGoogle ScholarPubMed
Raballo, A., & Parnas, J. (2012) “Examination of anomalous self-experience: Initial study of the structure of self-disorders in schizophrenia spectrum.” The Journal of Nervous and Mental Disease, 200(7), 577–583.Google Scholar
Raballo, A., & Parnas, J. (2010) “The silent side of the spectrum: Schizotypy and the schizotaxic self.” Schizophrenia Bulletin, 37(5), 1017–1026.Google Scholar
Raballo, A., Sæbye, D., & Parnas, J. (2009) “Looking at the schizophrenia spectrum through the prism of self-disorders: An empirical study.” Schizophrenia Bulletin, 37(2), 344–351.Google Scholar
Rasmussen, A. R., Nordgaard, J., & Parnas, J. (2019) “Schizophrenia-spectrum psychopathology in obsessive-compulsive disorder: An empirical study.” European Archives of Psychiatry and Clinical Neuroscience. https://doi.org/10.1007/s00406-019-01022-zGoogle Scholar
Roy, J-M., Petitot, J., Pachoud, B., & Varela, F. J. (1999) “Beyond the gap: An introduction to naturalizing phenomenology.” In Roy, J-M., Petitot, J., Pachoud, B., & Varela, F. J. (Eds.), Naturalizing phenomenology: Issues in contemporary phenomenology and cognitive science (pp. 1–80). Stanford: Stanford University Press.Google Scholar
Ricoeur, P. (1992) Oneself as another. Chicago: The University of Chicago Press.Google Scholar
Rümke, H. C. (1958) “Die klinische Differenzierung innerhalb der Gruppe der Schizophrenien.” Der Nervenarzt, 29, 40–53.Google Scholar
Sass, L. A., & Parnas, J. (2003) “Schizophrenia, consciousness, and the self.” Schizophrenia Bulletin, 29(3), 427–444.Google Scholar
Schneider, K. (1950) Klinische Psychopathologie (3. Vermehrte Auflage der Beiträge zur Psychiatrie ed.). Stuttgart: Thieme.Google Scholar
Stephensen, H., & Parnas, J. (2018) “What can self-disorders in schizophrenia tell us about the nature of subjectivity? A psychopathological investigation.” Phenomenology and the Cognitive Sciences, 17(4), 629–642.CrossRefGoogle Scholar
Stern, D. N. (1985) The interpersonal world of the infant: A view from psychoanalysis and developmental psychology. New York: Basic Books.Google Scholar
World Health Organization (WHO). (1974) Glossary of mental disorders and guide to their classification: For use in conjunction with the International Classification of Diseases, 8th Revision. Geneva: WHO.Google Scholar
Winnicott, D. W. (1965) The maturational processes and the facilitating environment. London: Hogarth Press.Google Scholar
Wyrsch, J. (1946) “Über die Intuition bei der Erkennung der Schizophrenen.” Schweizerische Med Wochenschrift, 46, 1173–1176.Google Scholar
Zahavi, D. (2018a) “Consciousness, self-consciousness, selfhood: A reply to some critics.” Review of Philosophy and Psychology, 9(3), 703–718.CrossRefGoogle Scholar
Zahavi, D. (2018b) Phenomenology: The basics. London: Routledge.Google Scholar
Zandersen, M., Henriksen, M. G., & Parnas, J. (2019) “A recurrent question: What is borderline?” Journal of Personality Disorders, 33(3), 341–369.Google Scholar
Zandersen, M., & Parnas, J. (2019a) “Borderline personality disorder or a disorder within the schizophrenia spectrum? A psychopathological study.” World Psychiatry, 18(1), 109–110.CrossRefGoogle ScholarPubMed
Zandersen, M., & Parnas, J. (2019b) “Identity disturbance, feelings of emptiness, and the boundaries of the schizophrenia spectrum.” Schizophrenia Bulletin, 45(1), 106–113.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×