Self-relatedness and psychopathology

1. Self-relatedness and psychopathology Gerrit Glas g.glas@dimence.nl Autumn School Heidelberg 24-28 October 2011

2. 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 Selfrelatedness and psychopathology

3. Background – concept of emotion • Tensionbetweenclinical (psychotherapeutic) and scientificapproaches • Scientificapproach to emotion • Emotion as state with ‘components’ (physiological, motor, verbal output) • Emotion as ‘cognitive’ interpretation (schema theory) • Emotion as actiontendency (dispositionalapproach) • Clinicalapproach • Emotion ‘means’ somethingabout the person in a particularsituation • Theysay as muchabout the situation as about the person • Angerafteran insult (nastiness of the otherpersonorexpression of somethingelsethat is goingon in me orboth to a certainextent?) Selfrelatedness and psychopathology

4. 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! Selfrelatedness and psychopathology

5. Two questions Does psychopathology have the same double (reflexive) structure? And, if not, is there still room for a self-relational perspective? Selfrelatedness and psychopathology

6. Two answers 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 Selfrelatedness and psychopathology

7. ‘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…. Selfrelatedness and psychopathology

8. ‘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’ Selfrelatedness and psychopathology

9. Three layers • Level 1: Being in a certain state Selfrelatedness and psychopathology

10. ‘I’ am in a certain state I Selfrelatedness and psychopathology

11. Three layers • Level 1: Being in a certain state • Level 2: Relating to that state Selfrelatedness and psychopathology

12. ‘I’ relate to that state I Selfrelatedness and psychopathology

13. 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 Selfrelatedness and psychopathology

14. By relating to that state I reveal something about myself… I ‘The’ self Selfrelatedness and psychopathology

15. …in time… I ‘The’ self Selfrelatedness and psychopathology

16. .. in relation with others and the world I - others • - the world • existence as such • transcendent reality ‘The’ self I – self relatedness Functions/modes Selfrelatedness and psychopathology

17. 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 Selfrelatedness and psychopathology

18. Levels of understanding psychopathology Level 3 Level 1 I ‘The’ self Level 2 Selfrelatedness and psychopathology

19. 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 Selfrelatedness and psychopathology

20. What does this have to do with self-relatedness? (is the concept of ‘relatedness’ not sufficient?) How does self-relatedness relate to psychopathology? Selfrelatedness and psychopathology

21. 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’ Selfrelatedness and psychopathology

22. The self - dimensions • Temporal: • character traits ; dispositions • short lasting states • Active – receptive (passive) • Agency • Basic self-awareness • Experiential • Body memory • Basic moods • Affective dispositions Selfrelatedness and psychopathology

23. The self - dimensions • Second order capacities • Self-regulation • Integration • ‘Reflexive mediation’ (Ricoeur) Selfrelatedness and psychopathology

24. 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 Layers in self-regulation (Murphy 2006) Selfrelatedness and psychopathology

25. Selfrelatedness – functional perspective 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 ‘I - self’ Selfrelatedness and psychopathology

26. Selfrelatedeness – dimensions; modes • 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) Functions/modes Physical Biotic Psychic Cognitive Social Legal Aesthetic Pistic ‘I - self’ Receptive/active Selfrelatedness and psychopathology

27. What does this have to do with self-relatedness? (is the concept of ‘relatedness’ not sufficient?) • Answer: • Psychopathological states influence the way we relate to ourselves (our states included) (concept of disease not confined to level 1 constructs!) • There are many selves and, therefore, many forms of psychopathologically self-relating Selfrelatedness and psychopathology

28. 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) Selfrelatedness and psychopathology

29. How does selfrelatedness relate to psychopathology? Selfrelatedness and psychopathology

30. Selfrelatedeness – dimensions; modes • 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) Functions/modes Physical Biotic Psychic Cognitive Social Legal Aesthetic Pistic ‘I - self’ Receptive/active Selfrelatedness and psychopathology

31. Psychopathology and the self

32. The functional perspective and psychopathology

33. Thank you for your attention E-mail: glasg@xs4all.nl Selfrelatedness and psychopathology

34. Selfrelatedness and psychopathology

35. Applications - the concept of disorder • Environmental effects • Biological • Emotional • Educational • Social • Compensating effects • Intellectual • Social • Comorbidity Genetic abnormalities ◄ ► Neurocognitive defects ◄ ► Social and cognitive impairments ◄ ► Clinical phenotype Concept of disorder could in principle refer to each of these levels Selfrelatedness and psychopathology

36. 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

37. 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

38. Empathy – the common view Object; the person that is perceived Subject, perceiver Inference with respect to the other based on body-mind assocation in oneself • Resemblance • Bodily posture • Emotional expression Self-relatedness and psychopathology

39. Empathy – the enactive view Object; the person that is perceived Subject, perceiver We know others by acquaintance and by sharing practices Self-relatedness and psychopathology

40. Selfrelatedness – functional modes Functions/modes Physical Biotic Affective Cognitive Social Legal Aesthetic Pistic • Primacy of • - the world • others • spiritual realities Calling ‘I - self’ Response

41. Self-relatedness – conceptual framework I - others • - the world • existence as such • transcendent reality ‘The’ self I – self relatedness Functions/modes

42. 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)

43. 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

44. Selfrelatedness and psychopathology Self-relatedness and psychopathology

45. Selfrelatedness and psychopathology Self-relatedness and psychopathology

46. Selfrelatedness and psychopathology Self-relatedness and psychopathology