Is Schizophrenia a Disorder of Consciousness? Experimental and Phenomenological Support for Anomalous Unconscious Processing

Abstract

Decades ago, several authors have proposed that disorders in automatic processing lead to intrusive symptoms or abnormal contents in the consciousness of people with schizophrenia. However, since then, studies have mainly highlighted difficulties in patients’ conscious experiencing and processing but rarely explored how unconscious and conscious mechanisms may interact in producing this experience. We report three lines of research, focusing on the processing of spatial frequencies, unpleasant information, and time-event structure that suggest that impairments occur at both the unconscious and conscious level. We argue that focusing on unconscious, physiological and automatic processing of information in patients, while contrasting that processing with conscious processing, is a first required step before understanding how distortions or other impairments emerge at the conscious level. We then indicate that the phenomenological tradition of psychiatry supports a similar claim and provides a theoretical framework helping to understand the relationship between the impairments and clinical symptoms. We base our argument on the presence of disorders in the minimal self in patients with schizophrenia. The minimal self is tacit and non-verbal and refers to the sense of bodily presence. We argue this sense is shaped by unconscious processes, whose alteration may thus affect the feeling of being a unique individual. This justifies a focus on unconscious mechanisms and a distinction from those associated with consciousness.

Minimal Self and Timing Disorders in Schizophrenia: A Case Report

“…Overall, AF's complaints about time were supported by objective exploration. The paucity of other symptoms and neuro-cognitive impairment makes it tempting to propose a relationship between objective and/or subjective timing difficulties and minimal SDs, consistent with previous hypotheses (Martin et al, 2014 , 2017 ; Giersch and Mishara, 2017a , b ). However, such a relationship cannot be proven, and more extensive exploration of timing might be useful, e.g.…”

“…We also report experimental results (“objective” timing) analyzed at the single case level in AF, focusing on temporal expectation in the seconds time-range. Complementary results on a simultaneity judgement task in the millisecond range (Martin et al, 2014 ; Giersch and Mishara, 2017a , b ), can be found in Supplementary Materials. We explored implicit timing, which is defined by the processing of information in time independently of any explicit temporal judgement (Coull and Nobre, 2008 ).…”

“…This type of timing is very close to the phenomenological description of human time in that it shapes conscious experience rather than representing the contents of time. We favor this approach because explicit duration judgements are characterized by variability rather than a clear over- or underestimation (Thoenes and Oberfeld, 2017 ), can be affected by attention or working memory impairments (e.g., Campbell and Davalos, 2015 ), and hence are difficult to interpret at an individual level (see Giersch and Mishara, 2017b , for a discussion on implicit vs. explicit measures in schizophrenia).…”

Where Scizophrenia and Consciousness Intersect: Disorders of Consciousness in Schizophrenia

“…In this context, 'the doors of perception' proposed by Aldous Huxley would make sense and the switches may be situated on those metaphorical doors. Such an assertion tallies with the suggestion that in SCZ, there is disconnection between the automatic unconscious thinking process and conscious mind (Giersch and Mishara, 2017).…”

Novel method to measure temporal windows based on eye movements during viewing of the Necker cube

“…These alternations are faster than alternations at the conscious level, confirming that alternations occur at different time scales. It remains to be checked whether the partial parallelism between ocular and manual windows indexes a temporal coupling between different mechanisms involved in perception [43], but some conclusions can already be tentatively derived. Sensory alternations are supposed to trigger conscious alternations in perception [44] and the fact that there are faster alternations in the case of ocular temporal windows is consistent with the idea that sensory alternations are primarily driving perceptual switches.…”