Skip to main content Accessibility help
×
Home
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 14
  • Print publication year: 2003
  • Online publication date: December 2009

16 - Self-narrative in schizophrenia

from Part III - Disturbances of the self: the case of schizophrenia

Summary

Abstract

Proper structures of self-narrative depend on at least four capacities in the narrator: (1) a capacity for temporal integration of information; (2) a capacity for minimal self-reference; (3) a capacity for encoding and retrieving autobiographical memories; (4) a capacity for engaging in reflective metacognition. This chapter explicates the cognitive, phenomenological, narratological and neurological details of these four capacities and their dysfunction in schizophrenia, as evidenced by schizophrenic self-narrative.

Introduction

The concept of the narrative self involves a diachronic and complex structure that depends on reflective experience and on factors that are conceptual, emotional and socially embedded. According to a narrative approach, persons constitute their own identity by formulating autobiographical narratives – life stories (Schechtman, 1996). In this chapter I want to explore issues pertaining to the generation and structure of the narrative self in schizophrenia. Normal generation of a narrative self depends on the proper functioning of a variety of cognitive capacities, including capacities for short-term temporal processing (working memory), self-awareness, episodic memory and reflective metacognition. Neuropsychological research suggests that in schizophrenia the mechanisms responsible for each of these elements are frequently disrupted. It should not be surprising that, as a result, schizophrenic narratives, and the self that is constituted through them, are problematic, both in structure and content. (Problems with narrative self-identity begin at the prodromal stage for preschizophrenic subjects at school age (Hartmann et al., 1984).

REFERENCES
Andreasen, N. C., O'Leary, D. S., Cizadlo, T. et al. (1996). Schizophrenia and cognitive dysmetria: a positron-emission tomography study of dysfunctional prefrontal-thalamic-cerebellar circuitry. Proceedings of the National Academy of Sciences of the United States of America, 93, 9985–90
Andreasen, N. C., Paradiso, S. & O'Leary, D. S. (1998). ‘Cognitive dysmetria’ as an integrative theory of schizophrenia: a dysfunction in cortical–subcortical–cerebellar circuitry. Schizophrenia Bulletin, 24, 203–18
Barclay, C. R. & DeCooke, P. A. (1988). Ordinary memories: some of the things of which selves are made. In Remembering Reconsidered: Ecological and Traditional Approaches to the Study of Memory, ed. U. Neisser & E. Winograd, pp. 91–125. Cambridge: Cambridge University Press
Bermúdez, J. (1996). The moral significance of birth. Ethics, 106, 378–403
Bermúdez, J. (1998). The Paradox of Self-Consciousness. Cambridge: MIT Press
Bernal, A. L. (2001). Concordancias Discordantes: Caracterización del Relato Autobiográfico de Pacientes con Diagnóstico de Esquizofrenia. Dissertation. Universidad del Valle, Escuela de Psicología, Santiago de Cali, Colombia
Bovet, P. & Parnas, J. (1993). Schizophrenic delusions: a phenomenological approach. Schizophrenia Bulletin, 19, 579–97
Bruner, J. & Kalmar, D. A. (1998). Narrative and metanarrative in the construction of self. In Self-Awareness: Its Nature and Development, ed. M. Ferrari & R. J. Sternberg, pp. 308–31. New York: Guilford Press
Campbell, J. (1999). Schizophrenia, the space of reasons and thinking as a motor process. The Monist, 82, 609–25
Carter, C. S., Perlstein, P., Ganguli, R. et al. (1998). Functional hypofrontality and working memory dysfunction in schizophrenia. American Journal of Psychiatry, 155, 1285–7
Chen, Y., Palafox, G. P., Nakayama, K. et al. (1999). Motion perception in schizophrenia. Archives of General Psychiatry, 56, 149–54
Cohen, J. D., Barch, D. M, Carter, C. S. & Servan-Schreiber, D. (1999). Schizophrenic deficits in the processing of context: converging evidence from three theoretically motivated cognitive tasks. Journal of Abnormal Psychology, 108, 120–133
Cutting, J. (1998). Psychopathology and Modern Philosophy. London: Forest
Andreasen, N. C., Rizzo, L. & Bruant, A. (1999). Functional mechanisms underlying impaired recognition memory and conscious awareness in patients with schizophrenia. Archives of General Psychiatry, 56, 639–44
Daprati, E., Franck, N., Georgieff, N. et al. (1997). Looking for the agent: an investigation into consciousness of action and self-consciousness in schizophrenic patients. Cognition, 65, 71–96
Gelder, B., Parnas, J., Bovet, P. et al. (1997). Impaired integration of audition and vision in schizophrenics. Experimental Brain Research, 117, 23
Gelder, B., Vroomen, J., Annen, J., Matsdhof, E. & Andreasen, N. C. Hodiamont, P. (in press). Audiovisual integration in schizophrenia. Schizophrenia Research, 1628
Dennett, D. (1988). Why everyone is a novelist. Times Literary Supplement, 4459, 1016, 1028–9
Dennett, D. (1991). Consciousness Explained. Boston: Little, Brown
DePue, R. A., Andreasen, N. C. & McCarthy, T. (1975). Differential recovery of intellectual, associational, and psychophysiological functioning in withdrawal and active schizophrenics. Journal of Abnormal Psychology, 84, 325–30
Vignemont, F. (2000). When the ‘I think’ does not accompany my thoughts. Consciousness and Cognition, 9, 543
Dilling, C. & Rabin, A. (1967). Temporal experience in depressive states and schizophrenia. Journal of Consulting Psychology, 31, 604–8
Dolan, R. J. & Fletcher, P. C. (1997). Dissociating prefrontal and hippocampal function in episodic memory encoding. Nature, 388, 582–5
Dreher, J.-C., Banquet, J.-P., Allilaire, J.-F. et al. (2001). Temporal order and spatial memory in schizophrenia: a parametric study. Schizophrenia Research, 51, 137–47
Fink, G. R., Markowitsch, H. J., Reinkemeier, M. et al. (1996). Cerebral representation of one's own past: neural networks involved in autobiographical memory. Journal of Neuroscience, 16, 4275–82
Fleming, K., Goldberg, T. E., Binks, S. et al. (1997). Visuospatial working memory in patients with schizophrenia. Biological Psychiatry, 41, 43–9
Fletcher, P. C., Frith, C. D. & Rugg, M. D. (1997). The functional neuroanatomy of episodic memory. Trends in Neuroscience, 20, 213–18
Fourneret, P. & Jeannerod, M. (1998). Limited conscious monitoring of motor performance in normal subjects. Neuropsychologia, 36, 1133–40
Franck, N., Farrer, C., Georgieff, N. et al. (2001). Defective recognition of one's own actions in patients with schizophrenia. American Journal of Psychiatry, 158, 454–9
Frith, C. D. (1992). The Cognitive Neuropsychology of Schizophrenia. Hillsdale, NJ: Lawrence Erlbaum
Frith, C. D. & Done, D. J. (1988). Towards a neuropsychology of schizophrenia. British Journal of Psychiatry, 153, 437–43
Frith, C. D., Friston, K. J., Herold, S. et al. (1995). Regional brain activity in chronic schizophrenic patients during the performance of a verbal fluency task. British Journal of Psychiatry, 167, 343–9
Frith, C. D., Blakemore, S.-J. & Walpert, D. M. (2000). Explaining the symptoms of schizophrenia: abnormalities in the awareness of action. Brain Research Reviews, 31, 357–63
Fuster, J. M. (1997). Network memory. Trends in Neuroscience, 20, 451–58
Fuster, J. M. (1999). Commentary on ‘The human self construct and prefrontal cortex in schizophrenia (Vogeley et al.). Association for the Scientific Study of Consciousness: electronic seminar. Available online at: http://www.phil.vt.edu/assc/esem.html
Fuster, J. M., Bodner, M. & Kroger, J. K. (2000). Cross-modal and cross-temporal association in neurons of frontal cortex. Nature, 405, 347–51
Gallagher, S. (1996). The moral significance of primitive self-consciousness. Ethics, 107, 129–40
Gallagher, S. (1998). The Inordinance of Time. Evanston: Northwestern University Press
Gallagher, S. (2000a). Philosophical conceptions of the self: Implications for cognitive science. Trends in Cognitive Science, 4, 14–21
Gallagher, S. (2000b). Self-reference and schizophrenia: a cognitive model of immunity to error through misidentification. In Exploring the Self: Philosophical and Psychopathological Perspectives on Self-experience, ed. D. Zahavi, pp. 203–39. Amsterdam: John Benjamins
Gallagher, S. & Marcel, A. J. (1999). The self in contextualized action. Journal of Consciousness Studies, 6, 4–30
Gallagher, S. & Meltzoff, A. (1996). The earliest sense of self and others: Merleau-Ponty and recent developmental studies. Philosophical Psychology, 9, 213–36
Gazzaniga, M. (1995). Consciousness and the cerebral hemispheres. In The Cognitive Neurosciences, ed. M. Gazzaniga, pp. 1391–400. Cambridge, MA: MIT Press
Gazzaniga, M. (1998). The Mind's Past. New York: Basic Books
Gazzaniga, M. & Gallagher, S. (1998). The neuronal Platonist. Journal of Consciousness Studies, 5, 706–17
Georgieff, N. & Jeannerod, M. (1998). Beyond consciousness of external events: a ‘who’ system for consciousness of action and self-consciousness. Consciousness and Cognition, 7, 465–77
Georgieff, N. & Jeannerod, M. (1999). Deconstruction of Self-consciousness in Schizophrenia. Discussion of the human self construct and prefrontal cortex in schizophrenia. ASSC Electronic Seminar. Available online at: http://www.phil.vt.edu/assc/esem.html
Gold, J. M., Carpenter, C., Randolph, C., Goldberg, T. E. & Weinberger, D. R. (1997). Auditory working memory and Wisconsin Card Sorting Test performance in schizophrenia. Archives of General Psychiatry, 54, 159–65
Goldberg, T. E. & Weinberger, D. R. (1996). Effects of neuroleptic medication on the cognition of patients with schizophrenia: a review of recent studies. Journal of Clinical Psychiatry, 57 (suppl. 9), 62–5
Goldman-Rakic, P. S., (1994). Working memory dysfunction in schizophrenia. Journal of Neuropsychiatry and Clinical Neuroscience, 6, 348–57
Goldman-Rakic, P. S. (1995). Anatomical and functional circuits in prefrontal cortex of nonhuman primates: relevance to epilepsy. Advances in Neurology, 66, 51–63
Goldman-Rakic, P. S. & Selemon, L. D., (1997). Functional and anatomical aspects of prefrontal pathology in schizophrenia. Schizophrenia Bulletin, 23, 437–58
Graybiel, A. M., (1997). The basal ganglia and cognitive pattern generators. Schizophrenia Bulletin, 23, 459–69
Haggard, P., & Eimer, M., (1999). On the relation between brain potentials and the awareness of voluntary movements. Experimental Brain Research, 126, 128
Haggard, P., & Magno, E., (1999). Localising awareness of action with transcranial magnetic stimulation. Experimental Brain Research, 127, 102
Hartmann, E., Milofsky, E., Vaillant, G., et al. (1984). Vulnerability to schizophrenia. Prediction of adult schizophrenia using childhood information. Archives of General Psychiatry, 41, 1050–6
Heckers, S., Rauch, S., Goff, D., et al. (1998). Impaired recruitment of the hippocampus during conscious recollection in schizophrenia. Nature Neuroscience, 1, 318–23
Henke, K., Buck, A., Weber, B., & Wieser, H. G., (1997). Human hippocampus establishes associations in memory. Hippocampus, 7, 249–56
Hume, D. (1975). A Treatise of Human Nature. Oxford: Clarendon Press
Keefe, R. S., Lees-Roitman, S. E., & Dupre, R. L., (1997). Performance of patients with schizophrenia on a pen and paper visuospatial working memory task with short delay. Schizophrenia Research, 26, 9–14
Levin, S. (1984). Frontal lobe dysfunction in schizophrenia – eye movement impairments. Journal of Psychiatric Research, 18, 27–55
Locke, J. (1959). An Essay Concerning Human Understanding. New York: Dover
Maguire, E. A., Frith, C. D., & Morris, R. G., (1999). The functional neuroanatomy of comprehension and memory: the importance of prior knowledge. Brain, 122, 1839–50
Malenka, R. C., Angel, R. W., Hampton, B., & Berger, P. A., (1982). Impaired central errorcorrecting behaviour in schizophrenia. Archives of Geneneral Psychiatry, 39, 101–7
Marcel, A. J. (in press). The sense of agency: awareness and ownership of actions and intentions. In Agency and Self-Awareness, ed. J. Roessler & N. Eilan. Oxford: Oxford University Press
Melges, F. T. (1982). Time and the Inner Future: A Temporal Approach to Psychiatric Disorders. New York: Wiley
Melges, F. T., & Freeman, A. M., (1977). Temporal disorganization and inner–outer confusion in acute mental illness. American Journal of Psychiatry, 134, 874–7
Meltzoff, A. & Moore, M. K. (1977). Imitation of facial and manual gestures by human neonates. Science, 198, 75–8
Milner, B. (1974). Hemispheric specialization: scope and limits. In The Neurosciences: Third Study Program, ed. F. O. Schmitt & F. G. Worden, pp. 75–89. Cambridge: MIT Press
Minkowski, E. (1970). Lived Time: Phenomenological and Psychological Studies. Translated by N. Metzel. Evanston: Northwestern University Press
Mlakar, J., Jensterle, J. & Frith, C. D. (1994). Central monitoring deficiency and schizophrenic symptoms. Psychological Medicine, 24, 557–64
Park, S. & Holzman, P. S. (1992). Schizophrenics show spatial working memory deficits. Archives of General Psychiatry, 49, 975–82
Parnas, J., Bovet, P. & Keefe, R. S. (1996). Schizophrenic trait features, binding, and cortico-cortical connectivity: a neurodevelopmental pathogenetic hypothesis. Neurology, Psychiatry and Brain Research, 4, 185–96
Pöppel, E. (1978). Time perception. Handbook of Sensory Physiology, 8, 713–29
Pöppel, E. (1997). A hierarchical model of temporal perception. Trends in Cognitive Sciences, 1, 56–61
Pöppel, E. (1994). Temporal mechanisms in perception. International Review of Neurobiology, 37, 185–202
Pöppel, E. & Schwender, D. (1993). Temporal mechanisms of consciousness. International Anesthesiology Clinics, 31, 27–38
Ricoeur, P. (1992). Oneself as Another. Translated by K. Blamey. Chicago: University of Chicago Press
Rubin, P., Holm, S. M., Madsen, P. L. et al. (1994). Regional cerebral blood flow distribution in newly diagnosed schizophrenia and schizophreniform disorder. Psychiatry Research, 53, 57–75
Sartre, J.-P. (1936). La Transcendance de l'Ego. Paris: Vrin
Sass, L. (1992). Madness and Modernism: Insanity in the Light of Modern Art, Literature, and Thought. New York: Basic Books
Sass, L. (1998). Schizophrenia, self-consciousness and the modern mind. Journal of Consciousness Studies, 5, 543–65
Sass, L. (2000). Furtive abductions: schizophrenia, the lived-body, and dispossession of the self. Arobase: Journal des Lettres et Sciences Humaines, 4, 63–73
Schacter, D. L., Alpert, N. M., Savage, C. R., Rauch, S. L. & Albert, M. S. (1996). Conscious recollection and the human hippocampal formation: evidence from positron emission tomography. Proceedings of the National Academy of Science of the USA, 93, 321–25
Schectman, M. (1996). The Constitution of Selves. Ithaca: Cornell University Press
Schwartz, B. D., Maron, B. A., Evans, W. J. & Winstead, D. K. (1999). High velocity transient visual processing deficits diminish ability of patients with schizophrenia to recognize objects. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 12, 170–7
Shoemaker, S. (1968). Self-reference and self-awareness. Journal of Philosophy, 65, 555–67
Singh, J. R., Knight, T., Rosenlicht, N. et al. (1992). Abnormal premovement brain potentials in schizophrenia. Schizophrenia Research, 8, 31–41
Spence, S. A., Brooks, D. J., Hirsch, S. R. et al. (1997). A PET study of voluntary movement in schizophrenic patients experiencing passivity phenomena (delusions of alien control). Brain, 120, 1997–2011
Stephens, G. L. & Graham, G. (1994). Self-consciousness, mental agency, and the clinical psychopathology of thought insertion. Philosophy, Psychiatry, and Psychology, 1, 1–12
Strawson, P. F. (1994). The first person and others. In Self-Knowledge, ed. Q. Cassam, pp. 210–15. Oxford: Oxford University Press
Strous, R. D., Cowan, N., Ritter, W., & Javitt, D., (1995). Auditory sensory (‘echoic’) memory dysfunction in schizophrenia. American Journal of Psychiatry, 152, 1517–19
Tauscher-Wisniewski, S., (1999). Cognitive processing speed slows before schizophrenia. Poster session, Society of Biological Psychiatry. Reported by Moon, M. A. Clinical Psychiatry News, 27, 1
von Steinbüchel, N., Wittman, M. & Pöppel, E. (1996). Timing in perceptual and motor tasks after disturbances to the brain. In Time, Internal Clocks, and Movement, ed. M. A. Pastor & J. Artieda, pp. 281–303. London: Elsevier
Wexler, B. E., Stevens, A. A., Bowers, A. A., Sernyak, M. J. & Goldman-Rakic, P. S. (1998). Word and tone working memory deficts in schizophrenia. Archives of General Psychiatry, 55, 1093–6
Wittgenstein, L. (1958). The Blue and Brown Books. Oxford: Basil Blackwell