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Philosophy, Psychiatry, & Psychology 8.4 (2001) 339-341
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Schizophrenia and Self-Awareness
In his paper, "Cogito and I: A Bio-Logical Approach," Kimura Bin raises a number of intriguing issues. Let me in the following address a few of them. Kimura Bin's point of departure is the idea that schizophrenia is basically to be understood as a disorder of self and self-experience. Thus, fundamental alterations in the sense of possession and control of one's own thoughts, actions, sensations, or emotions figure among the most prominent symptoms in its advanced stages. But even in the absence of overt symptoms, the schizophrenic may feel uncertain about her selfhood, and it is often in an attempt to restore or at least sustain her precarious self-identity that the patient engages in characteristic obsessive self-reflections that frequently simply exacerbate the problem.
1. One way to illustrate what is peculiar about the self-disorder in schizophrenia is by contrasting it with the symptoms found in senile dementia. Whereas the demented patient might lack any knowledge about the features that characterize him from a third-person perspective, i.e., age, nationality, profession, location, etc., he is usually in possession of an intact first-person perspective: He is still aware of the I-Here-Now. In schizophrenia, the problem is typically exactly the reverse (Tatossian 1997, 26). This contrast makes it tempting to argue, as Kimura Bin in fact does, that we need to distinguish two different dimensions of selfhood: the self as subject and the self as object. Of course, by making that distinction, we are immediately partaking in a classical philosophical discussion. Thus, at least since Kant, it has been customary to distinguish between the transcendental subject and the empirical or mundane subject. This distinction can be cashed out as a distinction between two different ways of being aware of oneself, one external, the other internal. On the one hand, I can think of myself from a third-person perspective, that is, I can refer to an object by way of a proper name, a demonstrative, or a definite description, and occasionally this object happens to be myself. When I refer to myself in this way, I am referring to myself in exactly the same way that I can refer to Others, and Others can refer to me (the only difference being that I am the one doing it, thus making the reference into a kind of self-reference). Apart from being external and contingent, this kind of self-reference is also non-thematic, since it can occur without my knowledge of it, that is, I can refer to myself from the third-person perspective without realizing that I myself am the referent. In contrast, the self-reference available from the first-person perspective—the one expressed in the subject-use of "I"—is of an internal kind. Not only is it impossible to refer to anybody and anything apart from oneself in the first-person way, but it also belongs to the proper use of "I" that one knows that one is referring to oneself. That is, apart from being internal and necessary, the self-reference in question is also of a thematic nature. In [End Page 339] more traditional terms: One can be conscious of oneself as an empirical object with mental properties, and one can be conscious of oneself as the subject of intentionality. Or again, one can be aware of oneself as a causally determined known object, as a part of the world, and one can be aware of oneself as a knowing subject, as—to paraphrase Wittgenstein—the limit of the world. In short, the difference between the empirical subject and the transcendental subject is closely linked to the difference between being aware of oneself as an object in the world and being aware of oneself as a subject for the world.
Utilizing this distinction, it can be said that schizophrenia involves a disturbance on the transcendental level (this way of speaking would, by the way, be anathema to a classical Kantian transcendental philosophy but more acceptable to the...