How the self is altered in psychiatric disorders: A neurophenomenal approach: Re-Visioning Psychiatry

You watch a movie. You find it boring, or rather, the experience is marked by a sense of boredom. Who experiences this boredom? You. Not only are you the subject of the experience, without a "you" there is no experience. More formally, an experiencing subject (the "self") is a prerequisite not only for the possible constitution of experience, but for consciousness itself. Clearly, much is at stake when it comes to characterizing or defining the concept of self, as well as understanding its alterations for persons living with psychiatric disorders. In order to elucidate the experience of psychiatric symptoms, I will focus on how to directly link subjective experience to neuronal mechanisms underlying the brain’s resting-state activity. Methodologically, this amounts to what I describe as a neurophenomenal approach, as distinguished from other approaches that also seek to explore the links between neurophysiology and experience, including neurophenomenological and neurocognitive research. In the first section of this chapter, I describe some alterations of selfexperience in major depression and schizophrenia. I then outline the main features of the neurophenomenal approach. Rather than going into much conceptual detail about the self (Northoff, 2011, 2013a, 2013b), I next summarize recent neuroscientific findings that suggest an overlap between the neural activity involved in what has been called "the resting state" and self-specific experience, especially in the anterior cortical midline regions. In the final section of the chapter, I relate the phenomenological features of alterations of the self to findings on resting activity in depression and schizophrenia. Space constraints prevent me from providing a more general overview on the psychopathology of the self in other psychiatric disorders like addiction (see, for example, de Greck et al., 2010; de Greck et al., 2009) and personality disorders (see, for example, Doering et al., 2013). But this same approach can be applied to a wide variety of psychiatric conditions, allowing us to link neural processing to complex behavioral and experiential manifestations of psychopathology. © Cambridge University Press 2015.