Phenomenology and the Role of Selfhood Disorders

Review Article

Abstract

Schizophrenia remains challenging to fully comprehend due to insufficient attention to its characteristic overall pattern, or "Gestalt," which defines its psychopathological structure. Schizophrenia is a chronic psychiatric condition influenced by diverse genetic and neurobiological factors impacting early brain development. It manifests through psychotic symptoms including hallucinations, delusions, disorganization, and cognitive impairments. Although gross brain pathology is absent, subtle pathological changes occur in specific neural cell populations and their communication. Neuroimaging reveals functional abnormalities in information processing among both first-episode and chronic patients. While pharmacological treatments can alleviate psychotic symptoms, they often do not significantly enhance social, cognitive, or occupational functioning. Psychosocial interventions such as cognitive-behavioral therapy, cognitive remediation, and supported education and employment programs offer value but are inconsistently applied. Early identification and preventive strategies are crucial due to the disorder's early onset and varying prevalence influenced by urbanization and immigration patterns. This article argues that disorders of selfhood are pivotal in shaping this Gestalt. Initially, it provides a phenomenological exploration of the self, followed by an examination of common complaints in schizophrenia that reflect disturbances in self-perception, often tracing back to childhood experiences. The characteristic features of schizophrenic psychosis, such as "double bookkeeping," hallucinations, and delusions, are then discussed in relation to their association with instability in self-representation. The article briefly recounts an encounter with a schizophrenia patient, highlighting the diagnostic significance of self-disorders