Self affection

reflection_pic.jpgThe Times has just published an article by neuropsychologist Paul Broks on the concept of the self and how it becomes distorted when affected by mental illness or brain injury.

The self has a fascinating history in mind and brain science as the concept has changed considerably over the years.

In the first chapter of the book The Self in Neuroscience and Psychiatry Berrios and Markov√° track how our modern-day idea of the self shows only traces in the thinking of the early Greek philosophers. It wasn’t until St Augustine that the self was defined as a ‘private inner space’.

17th century philosopher John Locke doubted the self was anything more than the ability of memory to give the illusion of continuity, when in reality, the mind was being bombarded with constantly changing thoughts and perceptions.

The ‘self’ has become a key concept in psychiatry where psychosis, and particularly schizophrenia, were first defined by many influential psychiatrists as a breakdown in the integration of the self.

Perhaps for this reason, schizophrenia is often confused with ‘multiple personality disorder’, although the two are considered distinct by psychiatrists.

Nevertheless, people who ‘hear voices‘ – an experience that also occurs in people who aren’t considered mentally ill – often experience them as having distinct personalities. In effect, these are distinct and autonomous selves within an individual’s self-consciousness.

On the more mundane level, phrases like “I’m not feeling myself today” suggest that we hold multiple ideas of who and what our self is, and that we can experience other forms of self-hood.

Broks’ article deals with some of the ways the self has been explained by notable neuroscientists and psychologists, and how this abstract notion can arise from the seemingly mechanical function of the biological brain.

Link to Broks’ article on the self.
Link to excerpt from The Self in Neuroscience and Psychiatry.

3 thoughts on “Self affection”

  1. There’s a great historical review by Roy Baumeister called “How the self became a problem” which discusses how modern society creates the circumstances for the self to be *something*. In a society that had, for example, no concept of privacy and no time was spent alone except for necessity (ie ours a few hundred years ago) “the self” looks like a very different thing. Would our current notions of individuality even make sense in that world?
    Baumeister, R. (1987). How the self became a problem: A psychological review of historical research. Journal of Personality and Social Psychology, 52, 163-176.

  2. You take the schizophrenic experience of voices to mean that, “(i)n effect, these are distinct and autonomous selves within an individual’s self-consciousness.”
    As a psychiatrist in clinical practice with patients with both schizophrenic illness and dissociative disorders such as multiple personality disorder (we refer to it as DID, dissociative identity disorder), I don’t agree with your inference. You rightly disavow the confusion between schizophrenia and MPD/DID and then go on to muddy the waters.
    The schizophrenic split should be understood as not a lateral one, into distinct autonomous selves (or even fragments of selves) but as a split between inner and outer, as best described in R.D. Laing’s The Divided Self, the best phenomenological description of the experience of schizophrenia. In essence, the boundaries of what the schizophrenic considers his/her self progressively contract to include less and less of him/herself, and more and more of the patient’s mental content are experienced as Other, not Self, the boundary between the two no longer coinciding with the surface of the skin as we conventionally conceive.
    There are voices in dissociative disorders as well, which arise from laterally split-off portions of the self having more autonomous self-like coincident existences. In modern psychiatry in which the time is not taken to talk to patients and get to know them, in which all symptoms are considered targets for medication treatment, the distinction is not understood, and antipsychotics are thrown at anyone who has “auditory hallucinations.” In careful clinical practice in which the caregiver gets some familiarity with the interior landscape of the patient (even if one is psychopharmacologically oriented), it is possible — one might even say easy — to recognize the difference between a patient with schizophrenic voices and one with dissociative voices. And by the way, the question trainees are typically taught to ask to distinguish — namely, “Do the voices seem to come from inside or outside your head?” is virtually useless for making the clinically crucial distinction I am drawing here. But it is an important distinction both because understanding the phenomenology of the patient’s experience is crucial to the talking cure, and because, more concretely, antipsychotic medications have little or no efficacy in dissociative phenomena, both in my clinical experience and as per the body of literature.
    Thanks for hearing me out on this one…

  3. egelwan, I really want to understand what you are saying. However, I am only in High School. I don’t know those big words! Please clarify. I want to major in Psychology and maybe get my doctrate. I’m still debating that. You seem to be intelligent enough to even use little words for those of use who are still stupid in the area of Big medical terminology. Thanx.

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