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Predicting the Self: Lessons from Schizophrenia

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Abstract

Newly developed Bayesian perspectives on schizophrenia hold out the promise that a common underlying mechanism can account for many, if not all, of the positive symptoms of schizophrenia. If this is the case, then understanding how schizophrenic minds go awry could shine light on how healthy minds maintain a sense of self. This article investigates this Bayesian promise by examining whether the approach can indeed account for the difficulties with self-awareness experienced in schizophrenia. While I conclude that it cannot, I nonetheless maintain that understanding how the self breaks down in schizophrenia tells us much about how and why the self functions in normal human circumstances. I proceed first by recounting in some detail a Bayesian interpretation of perception, schizophrenia, and self-awareness, as well as some of the empirical data supporting this interpretation, then by exploring aspects of schizophrenia that this approach leaves out. I conclude by discussing what the “left out” aspects tell us about self-awareness, thereby (I hope) convincing the reader that studying patients with schizophrenia is indeed a useful avenue for understanding awareness of self.

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Notes

  1. Some suggest that we should understand this concept as a “minimal” notion of self, a bare awareness of being embodied (e.g., Gallagher 2000, Blanke and Metzinger, 2009, Metzinger 2013; see also Blanke 2012 [I note that some disagree over whether Metzinger and others offer something a bit richer than a bare awareness of being embodied.]), upon which richer notions of self and consciousness could be built. However, for the purposes of this paper, I am taking self-awareness to be more than this minimal notion; self-awareness also includes reflexivity. It requires some sense that there is an “I” who is having the conscious states or engaging in actions. This would be closer to Tulving’s notion of the “autonoetic self” (Tulving 1985).

  2. I am not going to define here what the “I” is exactly, because my arguments should go through regardless of how one conceives of the self. Even if one considers the self a Humean illusion, it is still an illusion that we use in explaining our own thoughts and behaviors. I myself have previously argued for a narrative conception of self (Hardcastle 1999, 2003a, b; 2008; see also Damasio 1999, Dennett 1992, Flanagan 1996, Gallagher 2000, Hardcastle and Flanagan 1999, Ricoeur 1990/1992, Zahavi 2014) and have described how we can relate difficulties with self-narration to various mental disorders (Hardcastle, 2003a, b; Hardcastle and Flanagan 1999).

  3. These disturbances include depersonalization, diminished sense of existing as bodily subject, distortions of first-person perspective, identity confusion, reduced sense of coherence, and confused self-other/self-world boundaries (Parnas et al. 2005).

  4. I should note that, even though Bayesian approaches are of interest they are still rather controversial. See especially Firestone and Scholl 2016; though see also the 2016 special issue of Consciousness and Cognition on cognitive penetration and predictive coding, especially O’Callaghan et al. 2016, and other references following. And, of course, there is a multitude of different ways in which scientists use Bayesian ideas in their theorizing. I am not going to engage in the question of whether Bayesian approaches in general are correct, nor am I going to advocate for any particular version of Bayesianism, but instead I confine myself to the question of whether this type of approach could help us understand problems of self-awareness in schizophrenia.

  5. Bayes’s theorem states that:

    p(θ|x) = p(x|θ)p(θ)/p(x).

    Relative to perception, we can interpret Bayes’s theorem as: p(θ|x) is the probability that perception θ is true, given sensory input x; p(x|θ) is the probability of sensory input x given θ; and p(θ) is the prior probability of θ before the sensory evidence x has accrued.

  6. We see similar impairments in action sequencing in patients with schizophrenia (Delevoye-Turrell et al., 2007, 2012, Jorgens-Kosterman et al., 2001). Giersch et al. (2016) argues that the timing difficulties in both action and perception are likely due to a common mechanism.

  7. This model has been linked to abnormalities in the glutamate and GABA systems in patients with schizophrenia (Adams et al. 2013, Corlett et al. 2010, Giersch et al. 2016, Notredame et al. 2014, Seymour et al. 2013).

  8. This inability to use associated information in schizophrenia appears to start quite early in sensory processing. For example, Seymour et al. 2013 have shown that contextual modulation to visual orientation information in V1 (primary visual cortex) is significantly reduced in patients.

  9. In contrast, circular inference approaches would say that top-down expectations reverberate more than bottom-up stimuli, thereby leading to the inability of stimuli inputs to correct predictions about the world (Notredame et al. 2014). See also Schmack et al. 2016 for new imaging evidence in support of a predictive signaling approach to explaining for delusions.

  10. I note that not all Bayesian models take into account the mechanisms believed to be behind self-monitoring: efference copies of motor commands and corollary discharges from expected sensory. For example, Pickering and Clark’s (2014) Auxiliary Forward Model explicitly relies on these mechanisms to compute sensory consequences, while their Integral Forward Model does not. Wilkinson (2015) offers reasons to accept the IFM over the AFM, especially in explaining psychotic symptoms. Given the brain’s tendency toward functional redundancy, I do not see why it could not exploit both models in trying to predict its world.

  11. Langland-Hassan (2016) argues that we can fail to recognize speech as our own without needing the full Bayesian apparatus of comparing predicted stimuli to actual stimuli.

  12. In Bethany’s case, after receiving appropriate medication, her positive symptoms abated and her capacity for retrieving and cognitively manipulating memories returned.

  13. We can see the most extreme examples of this loss of self-narrative in patients with amnesia, especially those who have both retrospective and prospective memory loss. They feel as though they are just waking up for the first time, in the midst of a life, but without any experiences to anchor or give meaning to their present. (See discussion in Hardcastle 2008.)

  14. Many thanks are due to two anonymous referees whose detailed comments and thoughtful suggestions turned a mediocre essay into something better. I am truly grateful. An earlier version of this essay was presented at the Embodied Awareness conference sponsored by the Taft Humanities Center, University of Cincinnati. Audience comments made this a stronger work as well. This work was sponsored by a grant from the Templeton Foundation as part of the University of Cambridge New Directions in the Study of Mind project.

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  1. Philosophy, Psychology, and Psychiatry & Behavioral Neuroscience, Scholar-in-Residence, Weaver Institute for Law and Psychiatry, University of Cincinnati, Cincinnati, OH, USA

    Valerie Gray Hardcastle

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Hardcastle, V.G. Predicting the Self: Lessons from Schizophrenia. Rev.Phil.Psych. 10, 381–400 (2019). https://doi.org/10.1007/s13164-017-0335-6

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