World psychiatry : official journal of the World Psychiatric Association (WPA)
June 1, 2022
Paolo Fusar-Poli, Andrés Estradé, Giovanni Stanghellini et al.
225 citations
Psychosis unfolds through distinct stages, each with its own core existential experiences. Early phases (premorbid and prodromal) involve loss of common sense, perplexity, lack of immersion in the world, heightened salience, a feeling that something important is about to happen, perturbation of the sense of self, and a need to hide inner turmoil. The first episode brings transitory relief from delusions, intense self-referentiality, permeated self-world boundaries, internal noise, and dissolution of self with social withdrawal. Later stages (relapsing and chronic) involve grieving losses, feeling split, and struggling to accept inner chaos, a new self, diagnosis, and uncertain future. Treatment experiences include both positive and negative aspects, with recovery understood as reconstructing personhood and re-establishing bonds toward meaningful goals.
Psychopathology
January 1, 2017
Luís Madeira, Sergio Carmenates, Cristina Costa et al.
31 citations
People with panic disorder report anomalous self-experiences—disturbances in the sense of self—at levels comparable to those seen in schizophrenia, though the specific patterns differ. In a study of 47 panic disorder patients and 47 healthy controls, patients scored much higher on the Examination of Anomalous Self Experiences (average 17.94 vs. 1.00 in controls). These experiences included common forms of derealization and depersonalization, which may reflect defensive psychological processes rather than a fundamental disturbance of the minimal self. The findings support the idea that basic-self-disturbance is specific to schizophrenia, while panic disorder involves a different, less profound type of self-alteration that can resemble schizophrenia-like phenomena but requires careful differentiation.
Psychopathology
January 1, 2024
Milena Mancini, Cecilia Maria Esposito, Andrés Estradé et al.
6 citations
Abnormal self-experiences are common in major depression but are not included in current diagnostic manuals, which limits understanding and treatment. Through qualitative interviews analyzed with the Consensual Qualitative Research method, three categories of abnormal self-experience emerged: an inability to project oneself forward, not recognizing one's self, and losing control over one's self. The core of depressive experience appears to be an inability to recognize otherness as part of oneself, leading to specific symptoms of depersonalization that differ from those in schizophrenia. Narrative identity is central to the development and maintenance of depression.
Early intervention in psychiatry
November 1, 2024
Massimo Ballerini, Eleonora Rossi, Emanuele Cassioli et al.
4 citations
People with anorexia nervosa or bulimia nervosa report anomalous self-experiences (ASEs) at levels comparable to those seen in schizophrenia. In a study of 90 individuals with anorexia, 41 with bulimia, and 92 general-population controls, ASEs were strongly correlated with feeling extraneous from one's own body, body uneasiness, and eating-disorder symptoms. Statistical modeling showed that ASEs influence eating-disorder symptoms indirectly, through disturbances in embodiment, identity, and body image. The findings suggest that anomalous interoceptive processes may initiate a maladaptive cascade that impairs embodiment and selfhood in feeding and eating disorders, and that assessing ASEs could help identify an early shared vulnerability across severe disorders involving altered embodiment.
Eating and weight disorders : EWD
July 8, 2025
Giovanni Stanghellini
1 citation
Transgressive eroticism, particularly the phenomenon of 'Overlove,' can both construct and dissolve embodied selfhood. Hyper-intense erotic practices are not merely psychopathological symptoms but existential strategies that disrupt normative consciousness and enable new forms of self-other relations. Drawing on Georges Bataille's writings, clinical literature, and literary case studies, the analysis shows that transgressive eroticism acts as an 'anti-moral' force dismantling subject-object binaries, revealing an elemental layer of being. It dissolves self-boundaries through dissipation and ecstatic union with others, operating as existential praxis. This reframing challenges entrenched psychiatric binaries and advocates for a clinical ethos attentive to both hazards and generative potential, uncovering utopian possibilities for new collective intimacies.
Psychopathology
February 2, 2026
Riccardo Poggioli, Giovanni Stanghellini
A critical expansion of phenomenological psychopathology from the individual to the collective dimension is proposed. To describe collective life and its link to individual psychology, the paper shifts focus from society to culture—a transversal symbolic system extending beyond social groups—and introduces "cultural existentials" (time, space, body, etc.) as a priori conditions of experience. These are integrated into a Dialectical Experiential Matrix (DEM) that frames the patient's experience as a dynamic interplay between individual freedom and cultural influence. An analysis of the convergence between pornographic culture and the homo œconomicus type demonstrates how cultural existentials provide a model for narcissistic vulnerabilities and dysregulations of alterity, offering a diagnostic device for clinicians.
Psychopathology
January 1, 2025
Matteo Ballabio, Giovanni Stanghellini
Adolescents with severe mental health problems that do not clearly fit any single diagnosis often receive labels such as borderline personality disorder, affective disorders, or ADHD based on behavioral symptoms like social withdrawal, aggression, or self-harm. These diagnoses miss the inner experience of suffering. Using a phenomenological approach, this paper presents two case studies of transitional age youth and additional clinical material. Concepts of self-disorders and anomalies of common sense—originally developed to characterize schizophrenia, especially non-delusional forms—are applied to complement standard diagnostic assessments. The authors propose that these constructs help clarify the psychopathological core of severe cases in transitional age youth and offer tentative criteria to distinguish such phenomena from schizophrenia.
Drug Science Policy and Law
January 1, 2023
Antonio Metastasio, Silvio Mignogna, Riccardo Paci et al.
LSD, when used under therapeutic guidance, enhanced the filmmaking creativity of Federico Fellini by altering his perception of time, space, body, and self. Time in his films flows irregularly with disorienting flashbacks; colors become supernaturally brilliant and detached from objects; sounds emerge independently from visible sources; and human bodies appear deformed, grotesque, and caricatural. The boundaries between dream and reality collapse. These changes made his films so distinctive that the adjective 'felliniesque' was coined.