Psychopathology
January 1, 2014
Vittorio Gallese, Francesca Ferri
53 citations
This review examines recent evidence on the neurobiological basis of the bodily self—a minimal sense of self tied to the body and its motor capabilities. The authors show how the body and its potential for movement relate to this minimal self, and argue that this perspective can illuminate self-disturbances and social deficits in schizophrenia. They compare their approach with other views on the neural correlates of self-disturbances in schizophrenia and propose that cognitive neuroscience can now address classic psychopathological topics by linking first-person experiential aspects of psychiatric diseases to their neurobiological foundations.
Psychopathology
January 1, 2021
Julie Nordgaard, Mads Gram Henriksen, Lennart Jansson et al.
52 citations
The concept of disordered selfhood in schizophrenia reemerged around the year 2000. In 2005, the Examination of Anomalous Self-Experience (EASE) was published as a psychometric tool. This article traces the historical background of the EASE, explains the idea of a disorder of the basic or minimal self using phenomenological philosophy, and describes the clinical signs the EASE targets. The authors share their own experience using and teaching the EASE and review the empirical evidence gathered so far. They argue that basic self-disorder is a key phenotype of schizophrenia spectrum disorders, offering a path for empirical research into causes and for psychotherapeutic treatment.
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, 2014
V.v. Vodušek, J. Parnas, M. Tomori et al.
30 citations
Anxiety is reported as the basic emotion that buffers, transforms, and sometimes supplants all others in schizophrenia spectrum disorders. Emotions are experienced as foreign, unstable, and perturbing, contributing to feelings of ambivalence, perplexity, and an unstable sense of self. These emotion experiences may underlie a wide range of psychopathological phenomena in cognitive and social functioning. The results, based on interviews with 20 participants at admission and six months later, may not be generalizable to all schizophrenia patients due to the small sample size and selection from psychotherapeutic units.
Psychopathology
January 1, 2008
Barnaby Nelson, Louis A. Sass
24 citations
The relationship between substance use and psychosis is usually studied as a cause-and-effect question, but the subjective experiences of both are often overlooked. This paper compares the phenomenology of psychosis onset, based on Sass's four components (Unreality, Fragmentation, Mere Being, Apophany), with the experience of hallucinogenic intoxication as described by Huxley. The analysis finds significant parallels, including a breakdown of the sign-referent relationship and disconnection from the practical world. However, in psychosis this breakdown feels like alienation from self and world, while in hallucinogenic states it is experienced as mystical union and revelation. The authors suggest a shared factor—psychotic-like experience—and propose further research on other drugs like cannabis.
Psychopathology
January 1, 2015
Andreas Rosén Rasmussen, Josef Parnas
22 citations
In schizophrenia spectrum disorders, mental imagery can become unusually vivid and take on quasi-perceptual qualities—acquiring spatialization, constancy, and autonomy—while the normal sense of unreality is weakened. This perceptualized imagery often triggers strong emotional responses. The authors argue that these anomalies stem from a core disturbance in the minimal self (unstable first-person perspective) and propose that such pathology of imagination is key for early and differential diagnosis, distinguishing schizophrenia from other disorders where similar phenomena like obsessions occur.
Psychopathology
January 1, 2024
Pietro Sarasso, Martina Billeci, Irene Ronga et al.
18 citations
Dissociative experiences from ketamine, often seen as undesirable side effects, may be essential for its antidepressant action in certain depression subtypes. The 'relaxed prior hypothesis' proposes that ketamine enhances sensitivity to bodily signals by blocking glutamate, improving short-term plasticity. Two patients with 'depersonalized depression' (Entfremdungsdepression) in a six-month esketamine program showed that induced dissociation, particularly disembodiment, could suspend ingrained patterns of feeling and behavior. This creates a window of psychological plasticity, allowing the body to regain responsiveness to emotional cues. The findings suggest esketamine's dissociative effects may be especially beneficial for those with compromised interoceptive awareness and interaffectivity.
Psychopathology
January 1, 2017
Tudi Gozé, Till Grohmann, Jean Naudin et al.
14 citations
Schizophrenia involves a radical incomprehensibility of patients' experience, yet clinicians often sense its presence through a 'praecox feeling.' This paper proposes that affectivity—the way emotions and feelings connect body, self, world, and others—can explain this paradox. Drawing on Marc Richir's phenomenology, the authors argue that affectivity has a twofold bodily constitution that grounds embodied affective resonance, enabling empathic understanding. This model links affectivity to minimal self-disturbance in schizophrenia and highlights its intersubjective dimension, offering a coherent theoretical framework for the clinician's paradoxical comprehension.
Psychopathology
January 1, 2023
Cherise Rosen, Sohee Park, Tatiana Baxter et al.
13 citations
Sensed presence—the feeling that someone or something is there despite no one being present—is a common experience that can occur in many contexts, from isolation to psychosis. This online survey of adults found three distinct clusters of people based on their levels of sensed presence, attenuated psychosis symptoms, and transliminality (a trait involving absorption, fantasy proneness, and heightened sensitivity). One cluster had few sensed presence experiences, low psychosis symptoms, and low transliminality. A second cluster had moderate sensed presence, low psychosis symptoms, and moderate transliminality, along with increased closeness to God.
Psychopathology
January 1, 2023
Cassandre Bois, István Fazakas, Juliette Salles et al.
12 citations
Borderline personality disorder involves a fragmentation of narrative identity, a widely shared view that has been challenged by alternative perspectives emphasizing agency. This article contributes to that debate using a phenomenological approach. It reviews the narrative interpretation, justifies a stratified model of the self based on phenomenology, and draws on László Tengelyi's three layers of self—self-institution, self-formation, and minimal self—to integrate competing concepts from Fuchs, Schmidt, Gold, Kyratsous, and Zahavi. The final section reconfigures the identity-related experiences and manifestations of BPD through this layered phenomenological lens.
Psychopathology
January 1, 2020
Tudi Gozé, Istvan Fazakas
12 citations
Anomalies of imagination are common and disabling in schizophrenia spectrum disorders but have been neglected in psychopathology due to the lack of a conceptual framework. Recently, the link between minimal self disorders and pathology of imagination has been emphasized. This article discusses that initiative by drawing on the recent imaginary turn in phenomenological research, which is active in philosophy but rarely applied in psychopathology or cognitive sciences. The authors examine psychopathological literature on anomalous fantasy and imagination, provide an overview of the phenomenological imaginary turn, and explore how fantasy and imagination are involved in embodiment and identity. They also consider implications for psychotherapy and recovery.
Psychopathology
January 1, 2024
Valerio Ricci, Giuseppe Maina, Giovanni Martinotti
11 citations
Dissociation in addiction involves a fragmented sense of self that extends beyond momentary experiences, creating a persistent discontinuity of identity. This process compresses an individual's vital space and freezes their perception of time, impairing emotion, sensation, and comprehension. The authors construct a framework through historical analysis and phenomenological perspective, exploring trauma and temporality to understand dissociative experiences in addiction.
Psychopathology
January 1, 2024
Valerio Ricci, Giuseppe Maina, Giovanni Martinotti
8 citations
The twilight state of consciousness involves a narrowed yet expanded awareness, marked by perceptual shifts in time and space. New psychoactive substances can induce this state by deconstructing core components of consciousness, potentially triggering exogenous psychosis. This paper uses a phenomenological approach to explore how these substances alter spatial and temporal perception during the twilight phase, highlighting an overlooked aspect of psychopathology.
Psychopathology
June 30, 2025
Stephan Lechner, Karl Erik Sandsten, Dusan Hirjak et al.
7 citations
Altered experiences of time and space are linked to general symptoms and basic self-disorders in people with schizophrenia spectrum disorder. Self-disturbance acts as a key mediator through which fundamental time-space disruptions influence perceptual changes as well as negative, positive, and general symptoms. Data were collected at three medical expert centers using semi-structured phenomenological interviews and analyzed with network and mediation methods.
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.
Psychopathology
January 1, 2022
Constanze Hausteiner-Wiehle, Peter Henningsen
6 citations
Medicine and psychotherapy typically treat the body as a biological machine or ignore it entirely, focusing on genes, brain scans, or personality and cognition. However, the intersection where being a person and having a body—the bodily self—is crucial for illness, health, and recovery. This paper briefly summarizes embodiment and enactivism, then suggests practical approaches for clinical diagnostics that integrate the bodily self.
Psychopathology
January 1, 2024
Helene Stephensen, Annick Urfer-Parnas, Josef Parnas
4 citations
Feeling fundamentally different from others (Anderssein) is a core but underexplored experience in schizophrenia spectrum disorders. Based on interviews with 25 patients, most reported having felt this way since childhood, often describing it as existing outside shared reality. Intersubjective reality felt unreal or inauthentic, while their inner world was invaded by alien thoughts, emotions, or social rules. The onset of psychosis involved a gradual extension of these altered structures of subjectivity. The authors conceptualize Anderssein as a halted dynamic movement between particularity and intersubjectivity, with critical implications for understanding schizophrenia's onset.
Psychopathology
January 1, 2023
Joanna Szczotka, Michał Wierzchoń
4 citations
Heautoscopy is a rare experience where a person sees a double of their own body while feeling uncertain about where their self is located and sensing that the illusory body belongs to them. It occurs in diverse conditions like schizophrenia, brain tumors, migraine, epilepsy, and depression. A review of over 140 case studies found only 9 that met strict criteria for heautoscopy, distinguishing it from similar phenomena such as autoscopy and out-of-body experiences, which are often mislabeled. From the patient's perspective, heautoscopy feels like a bodily illusion rather than a false belief. The sense of being in two places at once arises from shifting self-location and expanded body ownership, not from having two viewpoints. The phenomenon offers insight into how the brain constructs bodily boundaries and spatial perspective.
Psychopathology
January 1, 2025
Stefan Jerotić, Janko Nešić, Vuk Vuković et al.
3 citations
Psychopharmacology is often reduced to treating biological symptoms while ignoring patients' subjective, embodied experience. This paper proposes an enactive and embodied framework that integrates phenomenology, neuroscience, and physiology to understand how psychotropic drugs affect the entire lived body—altering emotional processing, perception, existential feelings, and the embodied sense of self. Medications shape how patients engage with their environment, which in turn influences the embodied system. The clinician's role is to mediate these embodied changes, supporting patients through shifts in self-perception and relationality. The authors advocate for phenomenological drug profiles and patient-centered interventions that account for subjective and embodied changes alongside clinical efficacy.
Psychopathology
January 1, 2022
Andrea Patti, Gabriele Santarelli, Giulio D'Anna et al.
3 citations
Aberrant salience, an anomalous way of experiencing the world linked to psychosis proneness, was examined in 106 postgraduate university students. Cannabis users reported higher aberrant salience scores than nonusers. Among all participants, aberrant salience was associated with positive psychotic-like symptoms, personality traits (low self-directedness and high self-transcendence), and cannabis use. However, the relative importance of these factors differed: personality traits were more prominent among nonusers, while positive psychotic-like experiences played a larger role among cannabis users. The findings suggest that pre-reflexive anomalous experiences are intertwined with personality, subclinical symptoms, and cannabis use.
Psychopathology
January 1, 2021
Naomi Lyons, Detlef E Dietrich, Johannes Graser et al.
3 citations
A disturbed sense of self, particularly feeling disconnected from one's own body (disembodiment), may contribute to delusions in psychosis. In a randomized experiment, 73 patients with psychosis either performed a 10-minute guided self-massage to enhance bodily boundary awareness or massaged a fabric ring. Those who did the self-massage showed a reduced tendency to jump to conclusions (an average of 4.11 pieces of evidence before deciding versus 2.43 in the control group, a moderate effect). However, there was no significant difference in explicit paranoid beliefs. The findings suggest that improving the sense of bodily boundaries can reduce an implicit bias linked to delusional thinking, supporting the idea that disembodiment plays a role in psychotic symptoms.
Psychopathology
January 1, 2023
Sarah Troubé
2 citations
The article examines psychiatrist Henri Grivois's concept of nascent psychosis, which describes how the first moments of psychosis involve a breakdown in the tacit, prereflexive mechanisms of mimesis and interpersonal attunement. Grivois identifies experiences of concernment and centrality—a disruption in the embodied, gestural foundations of intersubjectivity. By comparing Grivois's approach with phenomenological accounts, the article argues that centrality challenges the limits of verbal descriptions of psychotic experience and suggests therapeutic methods that emphasize bodily anchoring and attunement between patient and therapist.
Psychopathology
January 1, 1978
Moises Lemlij
2 citations
Hallucinogenic drugs, particularly ayahuasca containing the active agent harmine, are used by witch doctors in the Peruvian jungle for therapeutic purposes. Treatment occurs in groups of about 10 to 12 patients, who meet weekly at dawn for an average of 5 hours in the open air. The healer makes a magical diagnosis and provides a potion drunk by the witch doctor, assistant, and patients. Patients attend sessions until they feel well enough to leave, then pay a voluntary fee. The study focused on describing these group processes, which had not previously been documented.
Psychopathology
March 27, 2026
Xiaoran Ding, Yaping Wu, Juan Yang et al.
1 citation
Ketamine is a rapid-acting antidepressant, especially for treatment-resistant depression, working through multiple targets in the glutamatergic system. It blocks NMDA receptors, which disinhibits dopamine reward pathways and increases BDNF expression via eEF2K suppression, activating the mTOR pathway and enhancing synaptic plasticity. Neuroimaging shows ketamine rapidly reshapes prefrontal-limbic connectivity and normalizes brain activity. It has a fast onset and broad therapeutic window, but enantiomers and metabolites differ in effects. Long-term safety, dependence risk, and cognitive effects require monitoring. Future work should explore synergistic treatments and safer ketamine derivatives for precision psychiatry.
Psychopathology
January 1, 2026
Valerio Ricci, Massimiliano Aragona, Giuseppe Maina et al.
1 citation
Hallucinations in schizophrenia, substance-induced psychosis (SIP), and substance-related persistent psychosis (PP) differ qualitatively. Schizophrenic hallucinations typically occur in clear consciousness with variable sensory vividness. SIP hallucinations arise in an oneiroid (dreamlike) state with increased vividness and multisensory integration. PP hallucinations occur in a twilight state of consciousness, often simpler but intrusive. These phenomenological differences provide a conceptual framework for more accurate diagnosis and treatment, especially in substance-related psychopathologies.