Self and schizophrenia: a phenomenological perspective

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Abstract
The greatest hazard of all, losing one's self, can occur very quietly in the world, as if it was nothing at all. No other loss can occur so quietly; any other loss – an arm, a leg, five dollars, a wife etc. – is sure to be noticed (Søren Kirkegaard). Abstract The purpose of this chapter is to present in clinical detail phenomenology of the disorders of self-experience that are observable in the schizophrenia spectrum conditions. Schizophrenia was considered by the founders of its concept as an instance of a severe affliction of the self, and psychiatric literature, especially of the phenomenological tradition, contains descriptions and analyses of the self-disorders. Recent empirical, phenomenologically informed research conducted in Denmark, Germany and Norway has provided empirical data demonstrating that not-yet-psychotic anomalies of self-experience occur frequently in the beginning stages of schizophrenia and in the schizotypal conditions. The most fundamental level of selfhood that appears to be affected in early schizophrenia is the automatic, prereflective articulation of the first-person perspective. It is suggested that these subtle phenotypes may be of potential value as target phenomena for pathogenetic research (especially for research in the neurodevelopmental antecedents) and also of crucial importance for early differential diagnosis. Introduction Typically, psychiatric, cognitive and philosophical studies of anomalous experience and belief in schizophrenia focus on the well-crystallized psychotic stages, dominated by the so-called Schneiderian first-rank symptoms (Frith, 1992; Campbell, 1999).