Mysticism and schizophrenia: A phenomenological exploration of the structure of consciousness in the schizophrenia spectrum disorders

Mysticism and schizophrenia are different categories of human existence and experience. Nonetheless, they exhibit important phenomenological affinities, which, however, remain largely unaddressed. In this study, we explore structural analogies between key features of mysticism and major clinical-phenomenological aspects of the schizophrenia spectrum disorders—i.e. attitudes, the nature of experience, and the ‘other’, mystical or psychotic reality. Not only do these features gravitate around the issue of the basic dimensions of consciousness, they crucially seem to implicate and presuppose a specific alteration of the very structure of consciousness. This finding has bearings for the understanding of consciousness and its psychopathological distortions.     

How to integrate dreaming into a general theory of consciousness--a critical review of existing positions and suggestions for future research

In this paper, we address the different ways in which dream research can contribute to interdisciplinary consciousness research. As a second global state of consciousness aside from wakefulness, dreaming is an important contrast condition for theories of waking consciousness. However, programmatic suggestions for integrating dreaming into broader theories of consciousness, for instance by regarding dreams as a model system of standard or pathological wake states, have not yielded straightforward results. We review existing proposals for using dreaming as a model system, taking into account concerns about the concept of modeling and the adequacy and practical feasibility of dreaming as a model system. We conclude that existing modeling approaches are premature and rely on controversial background assumptions. Instead, we suggest that contrastive analysis of dreaming and wakefulness presents a more promising strategy for integrating dreaming into a broader research context and solving many of the problems involved in the modeling approach.     

The neurophenomenology of early psychosis: An integrative empirical study

BackgroundThe integration of various domains or levels of analysis (clinical, neurobiological, genetic, etc.) has been a challenge in schizophrenia research. A promising approach is to use the core phenomenological features of the disorder as an organising principle for other levels of analysis. Minimal self-disturbance (fragility in implicit first-person perspective, presence and agency) is emerging as a strong candidate to play this role. This approach was adopted in a previously described theoretical neurophenomenological model that proposed that source monitoring deficits and aberrant salience may be neurocognitive/neurobiological processes that correlate with minimal self-disturbance on the phenomenological level, together playing an aetiological role in the onset of schizophrenia spectrum disorders. The current paper presents full cross-sectional data from the first empirical test of this model.MethodsFifty ultra-high risk for psychosis patients, 39 first episode psychosis patients and 34 healthy controls were assessed with a variety of clinical measures, including the Examination of Anomalous Self-Experience (EASE), and neurocognitive and neurophysiological (EEG) measures of source monitoring deficits and aberrant salience.ResultsLinear regression indicated that source monitoring (composite score across neurocognitive and neurophysiological measures), with study group as an interaction term, explained 39.8% of the variance in EASE scores (R² = 0.41, F(3,85) = 14.78, p < 0.001), whereas aberrant salience (composite score) explained only 6% of the variance in EASE scores (R² = 0.06, F(3,85) = 1.44, p = 0.93). Aberrant salience measures were more strongly related to general psychopathology measures, particularly to positive psychotic symptoms, than to EASE scores.DiscussionA neurophenomenological model of minimal self-disturbance in schizophrenia spectrum disorders may need to be expanded from source monitoring deficits to encompass other relevant constructs such as temporal processing, intermodal/multisensory integration, and hierarchical predictive processing. The cross-sectional data reported here will be expanded with longitudinal analysis in subsequent reports. These data and other related recent research show an emerging picture of neuro-features of core phenomenological aspects of schizophrenia spectrum disorders beyond surface-level psychotic symptoms.     

Attributional style, dreaming and depression

The relationship between attributional style, depression and dreaming was explored by analysing dream reports from 80 subjects for evidence of attributional style using the Content Analysis of Verbatim Material (CAVE) technique. These scores were then compared with a waking measure of attributional style—the Expanded Attributional Style Questionnaire (EASQ) and with levels of depression as measured by the BDI. Contrary to expectations, dream attributional style did not correlate with waking attributional style, nor was there a significant correlation between internal, global and stable attributional style in dreams and level of depression. Results did support previous research that an internal, stable and global waking attributional style correlates with depression.     

Schizophrenia, dissociation, and consciousness

Current thinking suggests that dissociation could be a significant comorbid diagnosis in a proportion of schizophrenic patients with a history of trauma. This potentially may explain the term “schizophrenia” in its original definition by Bleuler, as influenced by his clinical experience and personal view. Additionally, recent findings suggest a partial overlap between dissociative symptoms and the positive symptoms of schizophrenia, which could be explained by inhibitory deficits. In this context, the process of dissociation could serve as an important conceptual framework for understanding schizophrenia, which is supported by current neuroimaging studies and research of corollary discharges. These data indicate that the original conception of “split mind” may be relevant in an updated context. Finally, recent data suggest that the phenomenal aspects of dissociation and conscious disintegration could be related to underlying disruptions of connectivity patterns and neural integration.     

Phenomenal consciousness in dreams and in mind wandering

Dreaming can be explained as the product of an interaction among memory processes, elaborative processes, and phenomenal awareness. A feedback circuit is activated by this interaction according to the associative links and the requirements of the dream scene. Recently, it has been hypothesized that a partial similarity exists between dreaming and mind wandering and that these two processes may involve the same neural default network. This commentary discusses the differences and similarities between phenomenal consciousness during dreaming and phenomenal consciousness during mind wandering from the perspective of the “continuity” of engagement of cognitive systems. The greatest difference consists in the lack of reality testing during dreaming. Dream imagery is hallucinatory by nature. Consequently, the simulated world in dreams makes dream imagery more akin to perception. In contrast, the imagery of mind wandering is more similar to imagination. The level of meta-awareness is preserved more frequently and to a greater degree in mind wandering.     

Artificial consciousness and the consciousness-attention dissociation

Artificial Intelligence is at a turning point, with a substantial increase in projects aiming to implement sophisticated forms of human intelligence in machines. This research attempts to model specific forms of intelligence through brute-force search heuristics and also reproduce features of human perception and cognition, including emotions. Such goals have implications for artificial consciousness, with some arguing that it will be achievable once we overcome short-term engineering challenges. We believe, however, that phenomenal consciousness cannot be implemented in machines. This becomes clear when considering emotions and examining the dissociation between consciousness and attention in humans. While we may be able to program ethical behavior based on rules and machine learning, we will never be able to reproduce emotions or empathy by programming such control systems—these will be merely simulations. Arguments in favor of this claim include considerations about evolution, the neuropsychological aspects of emotions, and the dissociation between attention and consciousness found in humans. Ultimately, we are far from achieving artificial consciousness.     

Auditory Verbal Experience and Agency in Waking,Sleep Onset,REM, and Non‐REM Sleep

We present one of the first quantitative studies on auditory verbal experiences (“hearing voices”) and auditory verbal agency (inner speech, and specifically “talking to (imaginary) voices or characters”) in healthy participants across states of consciousness. Tools of quantitative linguistic analysis were used to measure participants’ implicit knowledge of auditory verbal experiences (VE) and auditory verbal agencies (VA), displayed in mentation reports from four different states. Analysis was conducted on a total of 569 mentation reports from rapid eye movement (REM) sleep, non‐REM sleep, sleep onset, and waking. Physiology was controlled with the nightcap sleep–wake mentation monitoring system. Sleep‐onset hallucinations, traditionally at the focus of scientific attention on auditory verbal hallucinations, showed the lowest degree of VE and VA, whereas REM sleep showed the highest degrees. Degrees of different linguistic‐pragmatic aspects of VE and VA likewise depend on the physiological states. The quantity and pragmatics of VE and VA are a function of the physiologically distinct state of consciousness in which they are conceived.     

A critical review of the physicalistic approaches of the mind and consciousness

The aim of this paper is to construct a critical evaluation of the advantages and disadvantages of the physicalistic theory concerning mental phenomena and consciousness. Physicalism can, better than other theories, explain mental phenomena, such as intentionality and reasonability of human beings and other biological organisms. Modern neuroscience corroborates the conviction that the brain is a physical mind capable of giving meaning to, evaluating and further cognitively and behaviorally transforming complex aspects of the world. On the other hand, the emergence of consciousness from brain states seems to be a paradoxical, intransparent, physical coincidence hardly explained by the mental function of the brain at the physical level. Moreover, the intentionality and reasonability of psychic phenomena per se cannot be explained as a repercussion of the same attributes characterizing the brain function. In conclusion, the old debate between physicalism and other philosophical theories remains open. It can be expected that the progress of sciences will inspire novel approaches to the problem of the relations between matter, mind and consciousness.     

The borderlands of waking: Quantifying the transition from reflective thought to hallucination in sleep onset

We lose waking consciousness spontaneously and regularly over the circadian cycle. It seems that every time we fall asleep, reflective thinking gradually gives way to our interactions with an imaginary, hallucinatory world that brings multimodal experiences in the absence of adequate external stimuli. The present study investigates this transition, proposing a new measure of hallucinatory states. Reflective thinking and motor imagery were quantified in 150 mentation reports provided by 16 participants after forced awakenings from different physiology-monitored time intervals after sleep onset. Cognitive agency analysis and motor agency analysis – which are objective (grammatical–semantic) tools derived from linguistic theories – show (i) a decrease in reflective thinking which sleepers would need to acknowledge the hallucinatory quality of their state, and (ii) an increase in motor imagery, indicating interactions with a hallucinatory world. By mapping these spontaneous changes in human consciousness onto physiology, we can in the long run explore the conditions of its decline, and possibilities for treatment.     

Attachment theory: a framework for understanding symptoms and interpersonal relationships in psychosis

We investigated associations between adult attachment, symptoms and interpersonal functioning, including therapeutic relationships in 96 patients with psychosis. Using a prospective design, we also assessed changes in attachment in both psychiatrically unstable and stable groups. We measured attachment using the Psychosis Attachment Measure (PAM) and interpersonal problems and therapeutic relationships were assessed from both psychiatric staff and patient perspectives. Avoidant attachment was associated with positive symptoms, negative symptoms and paranoia. Attachment ratings were relatively stable over time, although changes in attachment anxiety were positively correlated with changes in symptoms. Predicted associations between high levels of attachment anxiety and avoidance and interpersonal problems were supported, and attachment avoidance was associated with difficulties in therapeutic relationships. Findings suggest that adult attachment style is a meaningful individual difference variable in people with psychosis and may be an important predictor of symptoms, interpersonal problems and difficulties in therapeutic relationships over and above severity of illness.     

The relationship between consciousness,understanding, and rationality

The purpose of the present article is to explore the relationship between consciousness and understanding. To do so, I first briefly review recent work on the nature of both understanding and consciousness within philosophy and psychology. Building off of this work, I then defend the thesis that if one is conscious of a given content then one also understands that content. I argue that this conclusion can be drawn from (1) the fact that understanding is associated with rational intention formation and (2) the fact that conscious access appears to involve the selective routing/broadcasting of representational content to neural systems that integrate information in order to select cognitive/behavioral intentions in conjunction with goals. Based on these premises I illustrate how a disruption to the rationality of a representation’s influence on intention formation (when it becomes consciously accessible) would also remove any evidence that a person was conscious of the content of that representation. I therefore suggest that conscious content (and associated phenomenology) may be determined by the rational, content-appropriate influences an accessed representation has on intention formation (i.e., the influences associated with understanding). I conclude by offering replies to several potential objections to this thesis.     

Consciousness,self-consciousness,and meditation

Many spiritual traditions employ certain mental techniques (meditation) which consist in inhibiting mental activity whilst nonetheless remaining fully conscious, which is supposed to lead to a realisation of one’s own true nature prior to habitual self-substantialisation. In this paper I propose that this practice can be understood as a special means of becoming aware of consciousness itself as such. To explain this claim I conduct some phenomenologically oriented considerations about the nature of consciousness qua presence and the problem of self-presence of this presence.

Memory specificity as a risk factor for suicidality in non-affective psychosis: The ability to recall specific autobiographical memories is related to greater suicidality

A difficulty in recalling specific autobiographical memories has been noted as a risk factor for suicidal behaviour. However, the relationship between memory specificity and suicide has not previously been investigated in those with non-affective psychosis. It was predicted that in this group, more specific memory recall would be associated with an increased risk of suicide. This is because such specific memories are likely to be associated with greater levels of distress and negative affect than less specific memories. This prediction contradicts the prevailing belief that lower memory specificity is associated with greater suicidality. Sixty participants with schizophrenia spectrum disorders were recruited, 40 of whom reported past suicide attempts. Analyses showed suicide attempters recalled a greater proportion of specific memories, whilst controlling for trait anxiety and depressive symptoms. These results supported the main hypothesis, and suggest non-specific memory may have adaptive qualities in individuals with psychosis.     

The logic, intentionality, and phenomenology of emotion

My concern in this paper is with the intentionality of emotions. Desires and cognitions are the traditional paradigm cases of intentional attitudes, and one very direct approach to the question of the intentionality of emotions is to treat it as sui generis—as on a par with the intentionality of desires and cognitions but in no way reducible to it. A more common approach seeks to reduce the intentionality of emotions to the intentionality of familiar intentional attitudes like desires and cognitions. In this paper, I argue for the sui generis approach.

When hoarding is a symptom of OCD: A case series and implications for DSM-V

Hoarding, the excessive collection and failure to discard objects of apparently little value, can represent a serious psychiatric problem and pose a threat to public health. Hoarding has traditionally been considered a symptom (or symptom dimension) of Obsessive-Compulsive Disorder (OCD), but its nosological status has recently been debated. Mounting evidence suggests that, once other primary causes are ruled out, hoarding may be a discrete diagnostic entity, recently named Hoarding Disorder. However, hoarding can sometimes be a genuine OCD symptom. This can be confusing and clinicians may sometimes struggle making the differential diagnosis. To illustrate this, we describe 10 OCD patients with severe hoarding behavior that is better conceptualized as a symptom of OCD. We focus on the motivations for hoarding and the overlapping of hoarding with other obsessive-compulsive symptom dimensions. We estimate that this clinical presentation is relatively rare and accounts for a minority of severe hoarding cases. We discuss the unique characteristics of hoarding as a symptom of OCD and the implications for DSM-V.     

Computation, reduction, and teleology of consciousness

This paper aims to explore mechanistic and teleological explanations of consciousness. In terms of mechanistic explanations, it critiques various existing views, especially those embodied by existing computational cognitive models. In this regard, the paper argues in favor of the explanation based on the distinction between localist (symbolic) representation and distributed representation (as formulated in the connectionist literature), which reduces the phenomenological difference to a mechanistic difference. Furthermore, to establish a teleological explanation of consciousness, the paper discusses the issue of the functional role of consciousness on the basis of the aforementioned mechanistic explanation. A proposal based on synergistic interaction between the conscious and the unconscious is advanced that encompasses various existing views concerning the functional role of consciousness. This two-step deepening explanation has some empirical support, in the form of a cognitive model and various cognitive data that it captures.     

Self-consciousness, self-agency, and schizophrenia

Empirical approaches on topics such as consciousness, self-awareness, or introspective perspective, need a conceptual framework so that the emerging, still unconnected findings can be integrated and put into perspective. We introduce a model of self-consciousness derived from phenomenology, philosophy, the cognitive, and neurosciences. We will then give an overview of research data on one particular aspect of our model, self-agency, trying to link findings from cognitive psychology and neuroscience. Finally, we will expand on pathological aspects of self-agency, and in particular on psychosis in schizophrenia. We show, that a deficient self-monitoring system underlies, in part, hallucinations and formal thought (language) disorder in schizophrenia. We argue, that self-consciousness is a valid construct and can be studied with the instruments of cognitive and neuroscience.     

Where experiences are: Dualist, physicalist, enactive and reflexive accounts of phenomenal consciousness

Dualists believe that experiences have neither location nor extension, while reductive and ‘non-reductive’ physicalists (biological naturalists) believe that experiences are really in the brain, producing an apparent impasse in current theories of mind. Enactive and reflexive models of perception try to resolve this impasse with a form of “externalism” that challenges the assumption that experiences must either be nowhere or in the brain. However, they are externalist in very different ways. Insofar as they locate experiences anywhere, enactive models locate conscious phenomenology in the dynamic interaction of organisms with the external world, and in some versions, they reduce conscious phenomenology to such interactions, in the hope that this will resolve the hard problem of consciousness. The reflexive model accepts that experiences of the world result from dynamic organism–environment interactions, but argues that such interactions are preconscious. While the resulting phenomenal world is a consequence of such interactions, it cannot be reduced to them. The reflexive model is externalist in its claim that this external phenomenal world, which we normally think of as the “physical world,” is literally outside the brain. Furthermore, there are no added conscious experiences of the external world inside the brain. In the present paper I present the case for the enactive and reflexive alternatives to more classical views and evaluate their consequences. I argue that, in closing the gap between the phenomenal world and what we normally think of as the physical world, the reflexive model resolves one facet of the hard problem of consciousness. Conversely, while enactive models have useful things to say about percept formation and representation, they fail to address the hard problem of consciousness.