Ego Disturbances in the Sense of Kurt Schneider: Historical and Phenomenological Aspects

Bürgy, M.

doi:10.1159/000325059

Cited by 9 publications

(8 citation statements)

References 75 publications

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“…The presence of the core dimensions of BSD in both cases, including disturbances in the sense of mineness of experience, challenges the view that such disturbances are restricted to the schizophrenia spectrum, as asserted by Bürgy [39]. However, these results are in line with both historical and contemporary phenomenological analysis of chronic depersonalization and DPD.…”

Section: Discussionsupporting

confidence: 51%

“…In line with this conceptualization, and referring to Sass and Parnas’ BSD model, Bürgy [39] asserts that disturbances in the sense of mineness of experience constitute a core syndrome in the schizophrenia spectrum not present in DPD. A categorical distinction between DPD and SSD is reflected in current diagnostic manuals [32, 41, 42].…”

Section: Introductionmentioning

confidence: 99%

“…However, the description of prototypical symptoms in DPD does include several aspects of disturbances in the sense of mineness of experience, as described with respect to feelings of disembodiment, although not including frank first-rank symptoms [37, 38]. Such similarities seem to question a clear distinction between SSD and other mental disorders, including DPD, as made by Schneider [40], Klosterkötter [16], Bürgy [39], and proponents of the BSD model [30]. …”

Section: Introductionmentioning

confidence: 99%

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Anomalous Self-Experiences: Markers of Schizophrenia Vulnerability or Symptoms of Depersonalization Disorder? A Phenomenological Investigation of Two Cases

2018

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Background: Basic self-disturbance (BSD) is proposed to constitute the clinical core of schizophrenia spectrum disorders, including prodromal states and schizotypy. Anomalous self-experiences (ASEs) are suggested as phenotypic variants of BSD, representing markers of schizophrenia vulnerability. However, ASEs are not restricted to the schizophrenia spectrum, but may also occur in non-psychotic states like depersonalization disorder (DPD). It is unclear to what extent the prevalence and nature of ASEs are differing between the two conditions. The main aim of this paper is to assess and compare ASEs in both conditions, based on literature and two illustrating cases. This might expand the understanding of these phenomena, and strengthen the basis for clinical differentiation. Methods: One patient with schizotypal personality disorder (SPD) and one with DPD were selected from an ongoing clinical high-risk (CHR) for psychosis study. ASEs were assessed with the Examination of Anomalous Self-Experience (EASE) and analyzed according to the two central dimensions of BSD: diminished self-affection and hyperreflexivity, as well as according to prototypical aspects of depersonalization. The cases were also analyzed and compared with respect to chronology, other symptomatology, and psychopathological pathways. Results: Both cases revealed ASEs reflecting the central dimensions of BSD as well as prototypical aspects of depersonalization. Only the SPD case however, linked ASEs to psychotic-like ideas of external influence and control. The symptoms had an insidious early childhood onset with no obvious triggers in the SPD case, and an abrupt adolescence onset triggered by second-time cannabis use and panic anxiety in the DPD case. Conclusions: The similarities and differences in ASEs, symptomatology and developmental pathways of the two cases might be accounted for by an updated model of self-disorders. The model proposes that schizophrenia manifests as a result of a combination of early “primary”-onset ASEs, reflecting disturbances in early neurodevelopment, and later occurring, “secondary” ASEs of a more defensive-protective character. In line with this, the DPD case may be characterized only by secondary ASEs and thus better protected against psychotic decompensation than the SPD case, tentatively affected by a combination of primary and secondary ASEs.

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Section: Discussionsupporting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anomalous Self-Experiences: Markers of Schizophrenia Vulnerability or Symptoms of Depersonalization Disorder? A Phenomenological Investigation of Two Cases

2018

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“…This has also been supported by in silico simulations demonstrating that disruption of parahippocampal cortex from other MTL regions results in memory deficits that mimic those seen in schizophrenia [Talamini et al, ]. Finally, depersonalization (a state of altered self‐awareness at the psychotic level equivalent to ego‐disturbances [Burgy, ; Sass et al, ]) has been linked to abnormal function of the MTL regions [Lambert et al, ; Lemche et al, ].…”

Section: Introductionmentioning

confidence: 93%

Finding the self by losing the self: Neural correlates of ego-dissolution under psilocybin

et al. 2015

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Ego-disturbances have been a topic in schizophrenia research since the earliest clinical descriptions of the disorder. Manifesting as a feeling that one's "self," "ego," or "I" is disintegrating or that the border between one's self and the external world is dissolving, "ego-disintegration" or "dissolution" is also an important feature of the psychedelic experience, such as is produced by psilocybin (a compound found in "magic mushrooms"). Fifteen healthy subjects took part in this placebo-controlled study. Twelve-minute functional MRI scans were acquired on two occasions: subjects received an intravenous infusion of saline on one occasion (placebo) and 2 mg psilocybin on the other. Twenty-two visual analogue scale ratings were completed soon after scanning and the first principal component of these, dominated by items referring to "ego-dissolution", was used as a primary measure of interest in subsequent analyses. Employing methods of connectivity analysis and graph theory, an association was found between psilocybin-induced ego-dissolution and decreased functional connectivity between the medial temporal lobe and high-level cortical regions. Ego-dissolution was also associated with a "disintegration" of the salience network and reduced interhemispheric communication. Addressing baseline brain dynamics as a predictor of drug-response, individuals with lower diversity of executive network nodes were more likely to experience ego-dissolution under psilocybin. These results implicate MTL-cortical decoupling, decreased salience network integrity, and reduced inter-hemispheric communication in psilocybin-induced ego disturbance and suggest that the maintenance of "self"or "ego," as a perceptual phenomenon, may rest on the normal functioning of these systems.

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“…Several authors also described these effects as “self-disturbances” ( Ichstörungen ), a term introduced by Hans Gruhle (a colleague of Karl Jaspers in Heidelberg) to characterize passivity experiences in schizophrenia (Gruhle, 1915; see Mishara et al, 2016). The notion of “self-disturbance” was later systematized by Kurt Schneider, who included it among first-rank symptoms of schizophrenia, as “alterations of the sense of “I”, “me” or “mine” [ Meinhaftigkeit ]” linked to passivity symptoms (Schneider, 1959; see Bürgy, 2011; Mishara et al, 2014). …”

Section: The Phenomenology Of Diedmentioning

confidence: 99%

Looking for the Self: Phenomenology, Neurophysiology and Philosophical Significance of Drug-induced Ego Dissolution

Millière

2017

Front. Hum. Neurosci.

148

155

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There is converging evidence that high doses of hallucinogenic drugs can produce significant alterations of self-experience, described as the dissolution of the sense of self and the loss of boundaries between self and world. This article discusses the relevance of this phenomenon, known as “drug-induced ego dissolution (DIED)”, for cognitive neuroscience, psychology and philosophy of mind. Data from self-report questionnaires suggest that three neuropharmacological classes of drugs can induce ego dissolution: classical psychedelics, dissociative anesthetics and agonists of the kappa opioid receptor (KOR). While these substances act on different neurotransmitter receptors, they all produce strong subjective effects that can be compared to the symptoms of acute psychosis, including ego dissolution. It has been suggested that neuroimaging of DIED can indirectly shed light on the neural correlates of the self. While this line of inquiry is promising, its results must be interpreted with caution. First, neural correlates of ego dissolution might reveal the necessary neurophysiological conditions for the maintenance of the sense of self, but it is more doubtful that this method can reveal its minimally sufficient conditions. Second, it is necessary to define the relevant notion of self at play in the phenomenon of DIED. This article suggests that DIED consists in the disruption of subpersonal processes underlying the “minimal” or “embodied” self, i.e., the basic experience of being a self rooted in multimodal integration of self-related stimuli. This hypothesis is consistent with Bayesian models of phenomenal selfhood, according to which the subjective structure of conscious experience ultimately results from the optimization of predictions in perception and action. Finally, it is argued that DIED is also of particular interest for philosophy of mind. On the one hand, it challenges theories according to which consciousness always involves self-awareness. On the other hand, it suggests that ordinary conscious experience might involve a minimal kind of self-awareness rooted in multisensory processing, which is what appears to fade away during DIED.

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Ego Disturbances in the Sense of Kurt Schneider: Historical and Phenomenological Aspects

Cited by 9 publications

References 75 publications

Anomalous Self-Experiences: Markers of Schizophrenia Vulnerability or Symptoms of Depersonalization Disorder? A Phenomenological Investigation of Two Cases

Anomalous Self-Experiences: Markers of Schizophrenia Vulnerability or Symptoms of Depersonalization Disorder? A Phenomenological Investigation of Two Cases

Finding the self by losing the self: Neural correlates of ego-dissolution under psilocybin

Looking for the Self: Phenomenology, Neurophysiology and Philosophical Significance of Drug-induced Ego Dissolution

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