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SELF-RELATEDNESS AND PSYCHOPATHOLOGY Gerrit Glas [email protected] Autumn School Heidelberg 24-28 October 2011
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Self-relatedness and psychopathology

Feb 23, 2016

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Self-relatedness and psychopathology. Gerrit Glas [email protected]. Autumn School Heidelberg 24-28 October 2011. Outline. Background Research on the concept of emotion (esp. anxiety) The concept of selfrelatedness Terminology: not selfreferentiality - PowerPoint PPT Presentation
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Page 1: Self-relatedness and psychopathology

SELF-RELATEDNESS AND

PSYCHOPATHOLOGY

Gerrit [email protected]

Autumn School Heidelberg 24-28 October 2011

Page 2: Self-relatedness and psychopathology

Outline Background

Research on the concept of emotion (esp. anxiety) The concept of selfrelatedness

Terminology: not selfreferentiality Three layers in the conceptualization of psychopathology

Selfrelatedness and psychopathology The perspective of selfregulation The functional perspective

Applications Concept of disorder Neuroscience Psychopathology

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Selfrelatedness and psychopathology

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Background – concept of emotion Tension between clinical (psychotherapeutic) and

scientific approaches Scientific approach to emotion

Emotion as state with ‘components’ (physiological, motor, verbal output)

Emotion as ‘cognitive’ interpretation (schema theory) Emotion as action tendency (dispositional approach)

Clinical approach Emotion ‘means’ something about the person in a

particular situation They say as much about the situation as about the

person Anger after an insult (nastiness of the other person or

expression of something else that is going on in me or both to a certain extent?)

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Selfrelatedness and psychopathology

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Background – concept of emotion Emotions have a ‘self-referential’ structure:

Emotions neither output of a machine, nor just events in a private inner world

Emotions refer not only to an outer situation or to an inner process; by ‘saying’ something about the situation they also and at the same time ‘reveal’ something about the person who has the emotion

Understanding emotion requires understanding of the situation and of the particular way this person relates to that situation: double structure

Compare gestures: similar ‘double’ structure but element of referring back to the person less prominent and more emphasis on the activity instead of receptivity Affectivity: we are affected and the way we are affected does express

something about us (something we sometimes don’t like) Magical transformation of the world (Sartre)

However: self-referentiality is not self-reflexivity!

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Selfrelatedness and psychopathology

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Does psychopathology have the same double (reflexive) structure?

And, if not, is there still room for a self-relational perspective?

Two questions5

Selfrelatedness and psychopathology

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Does psychopathology have the same double (reflexive) structure?

Answer: no, many forms don’t have

And, if not, is there still room for a self-relational perspective?

Answer: yes

Two answers6

Selfrelatedness and psychopathology

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‘Relative independence’ Many forms of psychopathology have a

‘relative independence’ (cf: liver function) Thought confusion (formal) Clouding of consciousness (metabolic,

toxic) Panic attacks (‘typical’ attacks) Some forms of ‘endogenous’ depression End stages of addiction Repetitive behaviour in severe OCD Stress reactions (arousal, heightened

sensory awareness) And so on….

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Selfrelatedness and psychopathology

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‘Relative independence’ The confusion (panic, depression, et cetera) does

not in itself say something about the person

The confusion (panic, depression, et cetera) does say something about the person in a trivial sense, i.e., that he/she is in a certain state

However, in dealing with the confusion (panic, depression et cetera) the person does say a lot about him or herself.

In this ‘dealing with’ there is again ‘self-referentiality’

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Selfrelatedness and psychopathology

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Three layers Level 1: Being in a certain state

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Selfrelatedness and psychopathology

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‘I’ am in a certain state

I

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Selfrelatedness and psychopathology

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Three layers Level 1: Being in a certain state

Level 2: Relating to that state

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Selfrelatedness and psychopathology

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‘I’ relate to that state

I

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Selfrelatedness and psychopathology

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Three layers Level 1: Being in a certain state

Level 2: Relating to that state

Level 3: By relating to that state revealing

something about oneself

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Selfrelatedness and psychopathology

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By relating to that state I reveal something about myself…

I

‘The’ self

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Selfrelatedness and psychopathology

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…in time…

I

‘The’ self

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Selfrelatedness and psychopathology

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I – self relatednes

s

‘The’ self I - others - the world- existence as such- transcendent

reality

Functions/modes

.. in relation with others and the world

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Selfrelatedness and psychopathology

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Understanding psychopathology Level 1: signs and symptoms

Level 2: interpretation of these signs and symptoms by the patient and his/her environment

Level 3: life historical perspective; ‘holistic’;

dynamical; existential

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Selfrelatedness and psychopathology

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Levels of understanding psychopathology

I

‘The’ self

Level 1

Level 3

Level 2

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Selfrelatedness and psychopathology

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The adapted framework

Person Disorder

A B

A = influence of personality on relatedness of the patient to the disorder – example: dependence; narcissistic vulnerability

B = influence of disorder on relatedness of the patient to the disorder – example: hopelessness in depression

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Selfrelatedness and psychopathology

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What does this have to do with self-relatedness? (is the concept of ‘relatedness’ not sufficient?)

How does self-relatedness relate to psychopathology?

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Selfrelatedness and psychopathology

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Selfrelatedness - concepts The ‘I’ = the person who speaks,

experiences and acts Holistic concept Primitive (P.F. Strawson) Concept at the level of everyday language

‘The’ self The part of oneself the person is (implicitly

or explicitly) referring to by speaking, acting, experiencing

There are many ‘selves’

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Selfrelatedness and psychopathology

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The self - dimensions Temporal:

character traits ; dispositions short lasting states

Active – receptive (passive) Agency Basic self-awareness

Experiential Body memory Basic moods Affective dispositions

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Selfrelatedness and psychopathology

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The self - dimensions

Second order capacities Self-regulation Integration ‘Reflexive mediation’ (Ricoeur)

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Selfrelatedness and psychopathology

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Layers in self-regulation (Murphy 2006) Selfregulation with a fixed goal

Selfregulation by ‘re-setting’ of targets Being able to form images of targets and scenario’s Being able to (mentally) represent abstract goals

Evaluating one’s own evaluation

Homeostasis

Frustration tolerance

Long term change prevails over short term executive functioning

Altruism

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Selfrelatedness and psychopathology

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Selfrelatedness – functional perspective

‘I - self’

Functions/modes

Physical - spatiotemporal positioning

Biotic - homeostasis over time

Affective - emotional attunement; attachment

Cognitive - planning, selection, flexibility

Social - positioning oneself in a social universe

Legal - larger responsibilities (institutional) Aesthetic - imaginative play in a social context

Pistic - dedicatedness; ultimate concerns

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Selfrelatedness and psychopathology

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Selfrelatedeness – dimensions; modes

‘I - self’

Functions/modes

Physical

Biotic

Psychic

Cognitive

Social

Legal Aesthetic

Pistic

The self (receptive side; attunement; regulation)- Core sense of self, including basic self-awareness- Sense of agency- Experiences that form the basis of

- body memory (Damasio)

- basic mood - affective dispositions

- Second order capacities:- self-regulation- integration - ‘reflexive mediation’

(Ricoeur)

Receptive/active

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Selfrelatedness and psychopathology

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What does this have to do with self-relatedness? (is the concept of ‘relatedness’ not sufficient?)

Answer: 1.Psychopathological states influence the

way we relate to ourselves (our states included) (concept of disease not confined to level 1 constructs!)

2.There are many selves and, therefore, many forms of psychopathologically self-relating

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Selfrelatedness and psychopathology

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Further consequences Ad 1 (concept of disease not confined to

level 1): Being depressed in a depressed way Example: demoralization

Ad 2 (many selves to relate to): Situation-bound anxieties (social phobia)

can be related to a situational (=social) ‘self’, to character (the way one deals with the phobia; avoidant personality); and to existential concerns (the person exists as ‘disappearing’ subject)

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Selfrelatedness and psychopathology

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How does selfrelatedness relate to psychopathology?

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Selfrelatedness and psychopathology

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Selfrelatedeness – dimensions; modes

‘I - self’

Functions/modes

Physical

Biotic

Psychic

Cognitive

Social

Legal Aesthetic

Pistic

The self (receptive side; attunement; regulation)- Core sense of self, including basic self-awareness- Sense of agency- Experiences that form the basis of

- body memory (Damasio)

- basic mood - affective dispositions

- Second order capacities:- self-regulation- integration - ‘reflexive mediation’

(Ricoeur)

Receptive/active

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Selfrelatedness and psychopathology

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Psychopathology and the self

The self PsychopathologyCore sense of selfbasic self-awarenessSense of agency Schizophrenia

Experiential basis of Body memory Disorders of body schema; anorexia nervosa?

Basic mood Dysthymia

Affective dispositions

Anxiety disorder incl PTSS

Second order capacities

Self-regulation Impulse control disturbances; addiction

Integration Personality disorder (cluster B)

Reflexive mediation Lack of insight

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The functional perspective and psychopathology

Functions/modes Psychopathology (executive functioning)

Physical spatiotemporal positioning

Neurological disorders (Parkinson; dizziness)

Biotic homeostasis Derailed HPA axis (depression)Affective

emotional attunement; attachment

Disorders of attachment; psychopathy; anxiety disorder

Cognitive

planning, selection, flexibility

Frontal lobe dysfunction in dementias, OCD and schizophrenia

Social positioning oneself in a social universe

Autism spectrum disorder, schizoid PD

Legal larger responsibilities (institutional

Behavioral disturbances

Aesthetic

(self-)expression in imagination

Hysteria; OCPD

Pistic orientation toward ‘transcendent’ reality

Lack of self-transcendence (Cloninger)

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Thank you for your attention

E-mail: [email protected]

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Selfrelatedness and psychopathology

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Selfrelatedness and psychopathology

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Applications - the concept of disorder

Genetic abnormalities

Neurocognitive defects

Clinical phenotype

Social and cognitive impairments

Environmental effects

- Biological- Emotional- Educational- Social

Compensating effects

- Intellectual- Social

Comorbidity

Concept of disorder could in principle refer to each of these levels

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Selfrelatedness and psychopathology

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Applications - neuroscience Moving away from a computationalist (modular)

approach toward a connectivist, ‘embodied cognition’ approach

Perception-action cycles Hierarchy of intersecting cycles that include the

environment (Fuster, Walter) Example: learning of contingencies in emotion

recognition vocal sound and lips facial expression and inflection of voice emotional value of these expressions ‘emerges’

over time in an adequate context

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Applications - enactive approach to psychopathology Knowing is not mirroring; it is not just respresenting

the world; it is a result of engagement with the world

The process of knowing (the ‘mind’) is an emergent phenomenon of complex interactions between the subject and the world

Therefore: meaning is contextual (example: chair) These interactions are primarily bodily (= shared

bodily practices) and acquire ‘emerging’ (=new and qualitatively distinct) properties in the course of a person’s development

Therefore: the mind is embodied; meaning is ‘in’ the body (gestures, actions, behaviour)

Self-relatedness and psychopathology

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Empathy – the common view

Resemblance- Bodily posture- Emotional expression

Inference with respect to the other

based on body-mind assocation in oneself

Subject, perceiverObject; the person that is perceived

Self-relatedness and psychopathology

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Empathy – the enactive view

We know others by acquaintance and by

sharing practices

Subject, perceiverObject; the person that is perceived

Self-relatedness and psychopathology

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Selfrelatedness – functional modes

Functions/modesPhysical

BioticAffectiveCognitive

SocialLegal

AestheticPistic

Primacy of - the world- others- spiritual

realities

Calling

Response

‘I - self’

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I – self relatednes

s

‘The’ self I - others - the world- existence as such- transcendent

reality

Functions/modes

Self-relatedness – conceptual framework

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Evan Thompson Enactivism: input and output are

interconnected (vs. sandwich model)

The ‘brainweb’ organizes itself and its interactions with the environment in parallel

Global processes “subsume their components so that they are no longer clearly separable as components”(423)

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Evan Thompson Causation nothing else than

an “organizational constraint of a system with respect to its components” (interconnectedness; relatedness among processes)

Relational holism instead of top-down causation

Isomorphism between the levels

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Self-relatedness and psychopathology

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Selfrelatedness and psychopathology

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Self-relatedness and psychopathology

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Self-relatedness and psychopathology

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Selfrelatedness and psychopathology