Being Interrupted: The Self and Schizophrenia

A theory of the self seeks a comprehensive account of the elements whose interactions constitute a human being and the principles that govern those interactions. It must reckon with a vast array of phenomena, from perception and self-awareness to an infant's journey into adulthood; from language and labor to emotion, conscience, and mental illness. And it must do so in a way that recognizes that human beings are not simply instantiations of an eidos but unique, developing loci of life and activity. No two of us are alike. No one perceives, understands, or desires for another.

In this paper we want to explore what we regard as a fundamental facet of a human being: it engages in, even lives, as an ensemble of dialogues. Said otherwise, the locus of life and activity that we are is dialogical, and in the first place. We relate to others and ourselves, we plan, imagine, remember, and lust only on the basis of dialogical relations. Each of us is thus more than an atomistic entity. In elusive but crucial ways, our being is bound to and in some sense involves the presence of others, and our lives unfold as movements within ourselves and among others.

Even at the outset, it is crucial to note that our claim is not simply that selves employ narratives that synthesize their lives and that these narratives involve dialogues among various facets of a life. No doubt this happens, and we shall try to explain, at least in part, why and how. But our claim runs further than this. At base, that is, the very self whose life one might gather up and redirect through a narrative—that being is dialogical. To repeat, on our view, the self is dialogical in the first place, and thus a multiple phenomenon in and of itself, not simply in its self-representations.

Now, this is not to say that what follows provides a comprehensive account of the self. We have little to say about perception, memory, neurophysiology, self-conscious and prereflective awareness of bodily states, and so forth. Nor are we claiming that one might develop a comprehensive account using only the elements that we employ, nor even that these elements are irreducible to other phenomena. Falliblists through and through, we have little interest in dictating what any account simply must say at the end of inquiry.

In order to demonstrate the power of a dialogical theory of the self, we will use it to interpret the phenomenon of schizophrenia, and in a way that preserves the participants' perspective, addressing what it is like to suffer from schizophrenia and what it means when persons with schizophrenia tell us that their sense of self has been fundamentally damaged or disrupted. More specifically, we will interpret the disruptions in sense of self that characterize schizophrenia as well as the persistence of various symptoms associated with schizophrenia, particularly: (a) hallucinations (or having sensory perceptions that others do not share); (b) delusions (or having beliefs that others deem idiosyncratic and grossly implausible); and finally (c) the diminishment of will and desire. This will show, we think, that a dialogical approach to philosophical anthropology, clinical and experimental psychological research, and psychotherapy promises to pay rich dividends.

Let's begin with something of an intellectual history of dialogical theory. The outlines of a dialogical conception of the self can be found in diverse places. Among a distinguished group, we find Bakhtin's reading of Dostoyevsky, Nietzsche's reflections on subjectivity, and Dewey's and Mead's social psychology particularly helpful. Interpreting the poetics of Dostoyevsky, Bakhtin (1985) asserts that humans are best described as polyphonic beings, products of an ongoing series of dialogues among distinct voices. Rather than revolving around singular, conclusive perspectives, Bakhtin holds that our sense of self emerges through conversations among functionally independent elements within persons. As an illustration, consider Dostoyevsky's description of Roskolnikov in Crime and Punishment: "sullen, gloomy, arrogant, proud ... insecure ...magnanimous and kind ... cold and callous ... always in a hurry, always too busy and yet he lies there doing nothing" (Dostoyevsky 1993, 215). The point...