Is Schizophrenia a Disorder of Consciousness? Experimental and Phenomenological Support for Anomalous Unconscious Processing.
Is Schizophrenia a Disorder of Consciousness? Experimental and Phenomenological Support for Anomalous Unconscious Processing.
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DOI：
10.3389/fpsyg.2017.01659
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发表时间：
2017
影响因子：
3.8
通讯作者：
Mishara AL
中科院分区：
文献类型：
--
作者：
Giersch A;Mishara AL
几十年前，几位作者提出，自动处理障碍会导致精神分裂症患者出现侵入性症状或意识内容异常。然而，从那时起，研究主要强调患者意识体验和处理的困难，但很少探讨无意识和意识机制在产生这种体验时如何相互作用。我们报告了三方面的研究，重点关注空间频率、令人不快的信息和时间事件结构的处理，这些研究表明损伤发生在无意识和意识层面。我们认为，在了解扭曲或其他损伤如何在意识层面出现之前，首先需要关注患者对信息的无意识、生理和自动处理，同时将这种处理与有意识的处理进行对比。然后我们指出，精神病学的现象学传统支持类似的主张，并提供了一个理论框架，有助于理解损伤与临床症状之间的关系。我们的论点基于精神分裂症患者的最小自我存在障碍。最小自我是默示的、非语言的，指的是身体存在的感觉。我们认为这种感觉是由无意识过程塑造的，因此无意识过程的改变可能会影响作为一个独特个体的感觉。这证明了对无意识机制的关注以及与意识相关机制的区别是合理的。
Decades ago, several authors have proposed that disorders in automatic processing lead to intrusive symptoms or abnormal contents in the consciousness of people with schizophrenia. However, since then, studies have mainly highlighted difficulties in patients’ conscious experiencing and processing but rarely explored how unconscious and conscious mechanisms may interact in producing this experience. We report three lines of research, focusing on the processing of spatial frequencies, unpleasant information, and time-event structure that suggest that impairments occur at both the unconscious and conscious level. We argue that focusing on unconscious, physiological and automatic processing of information in patients, while contrasting that processing with conscious processing, is a first required step before understanding how distortions or other impairments emerge at the conscious level. We then indicate that the phenomenological tradition of psychiatry supports a similar claim and provides a theoretical framework helping to understand the relationship between the impairments and clinical symptoms. We base our argument on the presence of disorders in the minimal self in patients with schizophrenia. The minimal self is tacit and non-verbal and refers to the sense of bodily presence. We argue this sense is shaped by unconscious processes, whose alteration may thus affect the feeling of being a unique individual. This justifies a focus on unconscious mechanisms and a distinction from those associated with consciousness.
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