Varieties of self-experience: A comparative phenomenology of melancholia, mania, and schizophrenia, part I

This paper provides a critical survey of some subtle and often overlooked disturbances of self-experience that can occur in schizophrenia, melancholia, and mania. The goal is to better understand both similarities and differences between these conditions. We present classical and contemporary studies, mostly from the phenomenological tradition, and illustrate these with patient reports. Experiential changes in five domains of selfhood (following Parnas et al,2005) are considered: Cognition, Self-Awareness, Bodily Experiences, Demarcation/Transitivism, and Existential Reorientation. We discuss: I. major differences involving self-experience between schizophrenia and affective disorders; II. experiences in which these conditions nevertheless resemble each other; III. suggestions on how these experiences may still differ on a more subtle, phenomenological plane. While affective patients may undergo significant changes in self-experience, their underlying sense of basic or minimal selfhood ('ipseity') remains intact. In schizophrenia, basic self is disturbed, and this may help to account for many characteristic disturbances of this disorder.