Somatoparaphrenia is a pathology of self characterized by the sense of alienaton from parts of one’s body. It is usually construed as a kind of delusional disorder caused by extensive right hemisphere lesions. Lesions in the temporoparietal junction are common in somatoparaphrenia but deep cortical regions (for example, the posterior insula) and subcortical regions (for example, the basal ganglia) are also sometimes implicated (Valler and Ronschi 2009). Patients are often described as feeling that a limb belongs to another (...) person and thus attribute ownership of the limb and bodily sensation to someone else. There is also some question as to whether or not the higher-order thought (HOT) theory of consciousness can plausibly account for the depersonalization psychopathology of somatoparaphrenia (Liang and Lane 2009, Rosenthal 2010, Lane and Liang 2010). Liang and Lane argue that it cannot. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that it is the target of a HOT to the effect that “I am in mental state M” (Rosenthal 2005, Gennaro 2012). When the HOT is itself is unconscious, the conscious state is still outer-directed. When the HOT is conscious, we have introspection and so the conscious thought is directed at the mental state. In section I, I briefly review the previous exchange between Lane and Liang and David Rosenthal. In section II, I further explore somatoparaphrenia and the nature of delusion while offering a number of additional replies to Lane and Liang. In section III, I examine the central notions of “mental state ownership” and “self-concepts” in an effort to account especially for the depersonalization aspect of somatoparaphrenia against the background of HOT theory. In section IV, I argue that to the extent that somatoparaphrenia casts doubt on the notion that some thoughts are “immune to error through misidentification” (IEM), the most fundamental aspect of IEM is still consistent with HOT theory. Overall, I argue that HOT theory is left unscathed by the pheneomenon of somatoparaphrenia and can even help to explain what happens in these cases. (shrink)

Sydney Shoemaker argues that a certain class of self-ascriptions is immune to error through misidentification relative to the first-person pronouns. In their “Self-Consciousness and Immunity,” Timothy Lane and Caleb Liang question Shoemaker’s view. Lang and Liang present a clinical case and an experiment and argue that they are counterexamples to Shoemaker’s view. This paper is a response to Lane and Liang’s challenge. I identify the desiderata that a counterexample to Shoemaker’s view must meet and show that somatoparaphrenia and the (...) Body Swap Illusion fail to meet those desiderata. Thus, despite being puzzling phenomena, somatoparaphrenia and the Body Swap Illusion are not counterexamples to Shoemaker’s view. (shrink)

According to Rosenthal’s Higher-Order Thought (HOT) theory of consciousness, first-order mental states become conscious only when they are targeted by HOTs that necessarily represent the states as belonging to self. On this view a state represented as belonging to someone distinct from self could not be a conscious state. Rosenthal develops this view in terms of what he calls the ‘thin immunity principle’ (TIP). According to TIP, when I experience a conscious state, I cannot be wrong about whether it is (...) I who I think is in that state. We first suggest that TIP is a direct consequence of the HOT theory. Next we argue that somatoparaphrenia—a pathology in which sensations are sometimes represented as belonging to other people—shows that TIP can be violated. This violation of TIP in turn shows that the HOT theory’s claim that conscious states are necessarily represented as belonging to self is in error. Rosenthal’s attempt to account for pathological cases is found to be inadequate when applied to somatoparaphrenia, and other possible defenses are also shown to be incapable of preserving TIP. We further conclude by suggesting that the HOT theory’s failing in this regard is not a failing that is peculiar to this theory of consciousness. (shrink)

Mental ownership concerns who experiences a mental state. According to David Rosenthal (2005: 342), the proper way to characterize mental ownership is: ‘being conscious of a state as present is being conscious of it as belonging to somebody. And being conscious of a state as belonging to somebody other than oneself would plainly not make it a conscious state’. In other words, if a mental state is consciously present to a subject in virtue of a higher-order thought (HOT), then the (...) HOT necessarily representsthe subject as the owner of the state. But, we contend, one of the lessons to be learned from pathological states like somatoparaphrenia is that conscious awareness of a mental state does not guarantee first-person ownership. That is to say, conscious presence does not imply mental ownership. (shrink)

Abstract: What grounds the experience of our body as our own? Can we rationally doubt that this is our own body when we feel sensations in it? This article shows how recent empirical evidence can shed light on issues on the body and the self, such as the grounds of the sense of body ownership and the immunity to error through misidentification of bodily self-ascriptions. In particular, it discusses how bodily illusions (e.g., the Rubber Hand Illusion), bodily disruptions (e.g., (...) class='Hi'>somatoparaphrenia), and the multimodal nature of bodily self-knowledge challenge a classic view of ownership and immunity that puts bodily sensations at its core. (shrink)

In Disturbed Consciousness, philosophers and other scholars examine various psychopathologies in light of specific philosophical theories of consciousness. The contributing authors—some of them discussing or defending their own theoretical work—consider not only how a theory of consciousness can account for a specific psychopathological condition but also how the characteristics of a psychopathology might challenge such a theory. Thus one essay defends the higher-order thought (HOT) theory of consciousness against the charge that it cannot account for somatoparaphrenia (a delusion in (...) which one denies ownership of a limb). Another essay argues that various attempts to explain away such anomalies within subjective theories of consciousness fail. -/- Other essays consider such topics as the application of a model of unified consciousness to cases of brain bisection and dissociative identity disorder; prefrontal and parietal underconnectivity in autism and other psychopathologies; self-deception and the self-model theory of subjectivity; schizophrenia and the vehicle theory of consciousness; and a shift in emphasis away from an internal (or brainbound) approach to psychopathology to an interactive one. Each essay offers a distinctive perspective from the intersection of philosophy, consciousness research, and psychiatry. -/- Contributors Alexandre Billon, Andrew Brook, Paula Droege, Rocco J. Gennaro, Philip Gerrans, William Hirstein, Jakob Hohwy, Uriah Kriegel, Timothy Lane, Thomas Metzinger, Erik Myin, Inez Myin-Germeys, Myrto Mylopoulos, Gerard O’Brien, Jon Opie, J. Kevin O’Regan, Iuliia Pliushch, Robert Van Gulick . (shrink)

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M.” I have argued in previous work that (...) a HOT theorist can adequately respond to this concern with respect to somatoparaphrenia and thought insertion. There is also Cotard syndrome which is a rare neuropsychiatric disorder in which people hold the delusional belief that they are dead, do not exist, or have lost their blood or internal organs. In this paper, I argue that HOT theory has nothing to fear from it either and can consistently account for what happens in such unusual cases. I analyze Cotard syndrome in light of my previous discussion of somatoparaphrenia and thought insertion, and argue that HOT theory can provide a somewhat analogous account without the worry of inconsistency. It is crucial to recognize that there are multiple “self-concepts” and levels of HOTs which can help to provide a more nuanced explanation. With regard to the connection between consciousness and self-consciousness, it is proposed that Cotard patients are indeed capable of having some “I-thoughts” about their bodies and mental states. (shrink)

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M” (Rosenthal 2005, Gennaro 2012). In a previous (...) publication (Gennaro 2015), I argued that a HOT theorist can adequately respond to this concern with respect to somatoparaphrenia. Somatoparaphrenia is a “depersonalization disorder” which is characterized by the sense of alienation from parts of one’s body. It is a bizarre type of body delusion where one denies ownership of a limb or an entire side of one’s body. My focus in the chapter, however, is on “inserted thoughts” which is a common symptom of schizophrenia, although it will also be useful to contrast it with somatoparaphrenia. Schizophrenia is a mental disorder which most commonly manifests itself through auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking. Thought insertion is the delusion that some thoughts are not “one’s own” in some sense or are somehow being inserted into one’s mind by someone else. Graham and Stephens (2000), for example, have suggested that thought insertion should be understood as alienated self-consciousness or meta-representation. I argue that HOT theory has nothing to fear from this phenomenon either and can consistently explain what happens in this admittedly unusual case. (shrink)

Los pacientes con somatoparafrenia reportan que una extremidad no les pertenece. En filosofía, esta psicopatología motiva la discusión sobre el autopercatamiento, entendido como el sentido de propiedad que acompaña nuestras experiencias mentales. También motiva reflexiones sobre el autopercatamiento corporal; es decir, sobre la experiencia de un miembro como parte del propio cuerpo. Propongo que la somatoparafrenia involucra una dimensión intercorporal anómala. A diferencia de otras patologías de la espacialidad del cuerpo, en la somatoparafrenia se gana alteridad dentro de los límites (...) del cuerpo orgánico: el miembro pertenece a otro. Desarrollo mi propuesta en dos partes: en la primera, retomo discusiones de la filosofía sobre la autopercatamiento corporal usando la somatoparafrenia como ejemplo. En la segunda parte, planteo algunas reflexiones para entender el problema de la alteridad en la somatoparafrenia, y por qué este trastorno puede ubicarse dentro de las discusiones actuales sobre las vivencias intercorporales. (shrink)

Depersonalization is a pathological condition consisting in a deep modification of the way things appear to a subject, leading him to feel estranged from his body, his actions, his thoughts, his mind and even from himself. In this article, I argue that the study of depersonalization raises three challenges for recent theories of the sense of bodily ownership. These challenges—which I call the centrality challenge, the dissociation challenge and the grounding challenge— thwart most of these theories and suggest that the (...) sense of bodily ownership hinges on a phenomenal mark of mineness that can not be accounted for in terms of our sensory, interoceptive, agentive, cognitive or affective dispositions and that is psychologically primitive. In short: that mineness is first. (shrink)

Subjectivity theories of consciousness take self-reference, somehow construed, as essential to having conscious experience. These theories differ with respect to how many levels they posit and to whether self-reference is conscious or not. But all treat self-referencing as a process that transpires at the personal level, rather than at the subpersonal level, the level of mechanism. -/- Working with conceptual resources afforded by pre-existing theories of consciousness that take self-reference to be essential, several attempts have been made to explain seemingly (...) anomalous cases, especially instances of alien experience. These experiences are distinctive precisely because self-referencing is explicitly denied by the only person able to report them: those who experience them deny that certain actions, mental states, or body parts belong to self. The relevant actions, mental states, or body parts are sometimes attributed to someone or something other than self, and sometimes they are just described as not belonging to self. But all are referred away from self. -/- The cases under discussion here include somatoparaphrenia, schizophrenia, depersonalization, anarchic hand syndrome, and utilization behavior; the theories employed, Higher-Order Thought, Wide Intrinsicality, and Self-Representational. Below I argue that each of these attempts at explaining or explaining away the anomalies fails. Along the way, since each of these theories seeks at least compatibility with science, I sketch experimental approaches that could be used to adduce support for my position, or indeed for the positions of theorists with whom I disagree. -/- In a concluding section I first identify two presuppositions shared by all of the theorists considered here, and argue that both are either erroneous or misleading. Second, I call attention to divergent paths adopted when attempting to explain alienation experiences: some theorists choose to add a mental ingredient, while others prefer to subtract one. I argue that alienation from experience, action, or body parts could result from either addition or subtraction, and that the two can be incorporated within a comprehensive explanatory framework. Finally, I suggest that this comprehensive framework would require self-referencing of a sort, but self-referencing that occurs solely on the level of mechanism, or the subpersonal level. In adumbrating some features of this “subpersonal self,” I suggest that there might be one respect in which it is prior to conscious experience. (shrink)

In certain startling neurological and psychiatric conditions, what is ordinarily most intimate and familiar to us—our own body—can feel alien. For instance, in cases of somatoparaphrenia subjects misattribute their body parts to others, while in cases of depersonalization subjects feel estranged from their bodies. These ownership disorders thus appear to consist in a loss of any feeling of bodily ownership, the felt sense we have of our bodies as our own. Against this interpretation of ownership disorders, I defend Sufficiency, (...) the thesis that every experience of bodily awareness suffices for a feeling of bodily ownership. Since Sufficiency conflicts with a face‐value interpretation of these ownership disorders, the burden is on me to explain away the apparent tension. To do so, I identify and correct what I believe to be the fundamental mistake in the extant literature on the feeling of bodily ownership, namely the tendency to treat the notion of a feeling of bodily ownership as a single psychological construct. Instead, I distinguish the feeling of minimal ownership, the first‐personal character of bodily awareness, from the feeling of affective ownership, the distinctive type of felt concern we have for our bodies. I motivate this distinction by raising the disownership puzzle, the fact that subjects suffering from ownership disorders display an ambiguous set of symptoms, arguing the distinction I draw between minimal and affective ownership is just what is required to resolve the puzzle. (shrink)

Summary Apotemnophilia, or body integrity image disorder (BIID), is characterised by a feeling of mismatch between the internal feeling of how one’s body should be and the physical reality of how it actually is. Patients with this condition have an often overwhelming desire for an amputation- of a specific limb at a specific level. Such patients are not psychotic or delusional, however, they do express an inexplicable emotional abhorrence to the limb they wish removed. It is also known that such (...) patients show a left-sided preponderance for their desired amputation. Often they take drastic action to be rid of the offending limb. Given the left-sided bias, emotional rejection and specificity of desired amputation, we suggest that there are clear similarities to be drawn between BIID and somatoparaphrenia. In this rare condition, which follows a right parietal stroke, the patient rejects (usually) his left arm as ‘‘alien’’. We go on to hypothesis that a dysfunction of the right parietal lobe is also the cause of BIID. We suggest that this leads to an uncoupling of the construct of one’s body image in the right parietal lobe from how one’s body physically is. This hypothesis would be amenable to testing by response to cold-water vestibular caloric stimulation, which is known to temporarily treat somatoparaphrenia. It could also be investigated using functional brain imaging and skin conductance response. If correct our hypothesis not only suggests why BIID arises, but also, in caloric stimulation a therapeutic avenue for this chronic and essentially untreatable condition. (shrink)

In Disturbed Consciousness, philosophers and other scholars examine various psychopathologies in light of specific philosophical theories of consciousness. The contributing authors—some of them discussing or defending their own theoretical work—consider not only how a theory of consciousness can account for a specific psychopathological condition but also how the characteristics of a psychopathology might challenge such a theory. Thus one essay defends the higher-order thought (HOT) theory of consciousness against the charge that it cannot account for somatoparaphrenia (a delusion in (...) which one denies ownership of a limb). Another essay argues that various attempts to explain away such anomalies within subjective theories of consciousness fail. Other essays consider such topics as the application of a model of unified consciousness to cases of brain bisection and dissociative identity disorder; prefrontal and parietal underconnectivity in autism and other psychopathologies; self-deception and the self-model theory of subjectivity; schizophrenia and the vehicle theory of consciousness; and a shift in emphasis away from an internal (or brainbound) approach to psychopathology to an interactive one. Each essay offers a distinctive perspective from the intersection of philosophy, consciousness research, and psychiatry. (shrink)

Are bodily self-ascriptions immune to error through misidentification? According to the Inside mode view, one cannot be mistaken about whose body part it is when experiencing them from the inside. Here I shall consider two possible objections to bodily immunity. On the one hand, I shall briefly envisage two cases of misidentification: somatoparaphrenia and the Rubber Hand illusion. I shall show that none of them challenges the immunity principle. On the other hand, I shall highlight a more serious issue (...) for bodily immunity, namely, the multimodal nature of bodily self-knowledge. Very few bodily self-ascriptions are based on grounds that are purely or exclusively from the inside. I shall evaluate the consequences of multimodality for bodily immunity. (shrink)

: Self-consciousness is considered in a framework comprising four dimensions which are theoretically defined and supported by clinical neuropsychological evidence. Self-monitoring is defined as the ability to reflect on one’s own behaviour, with supporting evidence for deficits in this capacity noted in anosognosia syndrome. Self-feeling is defined as the capacity to feel all sensations related to one’s own body, with supporting evidence from deficiencies occurring in alexithymia, psychosomatic states and Cotard’s delusion. Identity refers to the capacity to recognize an object (...) as identical to oneself, based on autobiographic memory; pathological conditions related to this dimension include delusions of identity and the Zelig syndrome. Ownership is the capacity to perceive the status of ones’ own body, and is clinically altered in somatoparaphrenia. All four dimensions are related to specific brain networks. Keywords: Self-Monitoring; Self-Feeling; Identity; Ownership; Neurocognitive Dimensions Le dimensioni neurocognitive dell’autocoscienza Riassunto: L’autocoscienza viene inquadrata in base a quattro dimensioni, determinate in via teorica e supportate da evidenze cliniche di carattere neuropsicologico. L’automonitoraggio è definito quale capacità di riflettere sul proprio comportamento ed è sostenuto da evidenze che derivano da quella sindrome denominata anosognosia. Il sentire il proprio sé è la capacità di avvertire tutte le sensazioni del corpo proprio ; questa dimensione è supportata da evidenze derivanti da condizioni cliniche quali l’alessitimia, le affezioni psicosomatiche e il delirio di Cotard. L’identità si riferisce alla capacità di riconoscere come identico a se stesso un oggetto, fondata sulla memoria autobiografica; le condizioni patologiche legate a questa dimensione sono il delirio di identità e la sindrome di Zelig. Il possesso di sé è la capacità di percepire lo stato del proprio corpo, condizione che risulta alterata nella somatoparafrenia. Tutte queste quattro dimensioni sono collegate a specifici network cerebrali. Parole chiave: Automonitoraggio; Sentimento di sé; Identità; Padronanza di sé; Dimensioni neurocognitive. (shrink)

David Rosenthal’s higher-order thought theory says that for a mental state to be conscious, it must be accompanied by a higher-order thought about that state. One objection to Rosenthal’s account is that HOTs do not secure what Sydney Shoemaker has called ‘immunity to error through misidentification’. I will argue that Rosenthal’s discussion of dissociative identity order fails to salvage his account from this objection and that his thin immunity principle is in tension with cases of somatoparaphrenia. Rather than showing (...) that self-awareness consists in identification, an examination of the delusions of disownership found in dissociative identity disorder and somatoparaphrenia lends support to IEM and highlights an important distinction between perspectival ownership and personal ownership. (shrink)

Self-knowledge (SK) is a natural ability of the human cognitive system and is defined as a complex re-representation of knowledge subject has about her own internal states. It is composed of two basic representations: the representation of I and the representation of the experienced state. SK has a propositional (i.e. language-like) form and can be expressed in the form of self-reports like “I believe that I believe that p”. It has then the form of a second-order belief which, as a (...) re-representation, generates the following problem concerning false representations: if the first-order representations of the I or of experienced states can be false like in cases of self-illusions or disorders like somatoparaphrenia, then how can error in self-cognition inherited by the re-representation (i.e. by SK) be avoided? I claim that the re-representational model of SK is a useful but artificial tool for the description of the components of SK; however, it is misleading to think of it as capturing the truth about SK. I propose here a representational model of SK which reduces those beliefs constituting SK to first-order beliefs which are sufficient as constituents of SK. (shrink)

Anosognosia for hemiplegia is the denial of neurologically-caused paralysis, and it often co-occurs with a number of distortions of belief and emotion such as somatoparaphrenia and an exaggeration of negative affect towards minor health complaints. The salience of these latter symptoms led early investigators to propose explanations of AHP which construed it as a process of motivated self-deception against the overwhelming anxiety and depression that knowledge of deficit would otherwise cause, and which was observed in hemiplegic patients without the (...) anosognosia. Since some influential critiques of this approach, however, theories of this kind have largely been rejected on the grounds that they are inappropriately “psychogenic.” What has replaced them are a class of theories which explain the lack of awareness in terms of neurocognitive deficit, with the deficit in question variously described by researchers as involving spatial awareness, motor control, and other capacities. In this paper I argue – contra claims in the literature – that the patterns of explanation which are characteristic of the psychodynamic theory are not incompatible in principle with the notion that the illness involves neurocognitive deficit. That means that these patterns of explanation can be preserved where they make good sense of the obscure attitudinal and emotional symptoms that occur in AHP – symptoms that are otherwise difficult to explain. I suggest some ways in which this fact could be accommodated by deficit theories of the illness which are based on motor deficit. (shrink)

According to what we will call subjectivity theories of consciousness, there is a constitutive connection between phenomenal consciousness and subjectivity: there is something it is like for a subject to have mental state M only if M is characterized by a certain mine-ness or for-me-ness. Such theories appear to face certain psychopathological counterexamples: patients appear to report conscious experiences that lack this subjective element. A subsidiary goal of this chapter is to articulate with greater precision both subjectivity theories and the (...) psychopathological challenge they face. The chapter’s central goal is to present two new approaches to defending subjectivity theories in the face of this challenge. What distinguishes these two approaches is that they go to great lengths to interpret patients’ reports at face value – greater length, at any rate, than more widespread approaches in the extant literature. (shrink)

In recent years, a debate has emerged on whether bodily sensations are typically accompanied by a sense of body ownership, namely a distinctive experience of one's body or body part as one's own. Realists about the sense of body ownership heavily rely on evidence from experimentally-induced bodily illusions (e.g., the rubber hand illusion) and pathological disownership syndromes (e.g. somatoparaphrenia). In this chapter, I will introduce novel evidence regarding body disownership syndromes induced by psychoactive drugs rather than pathological conditions, and (...) discuss its relevance to the debate on the sense of body ownership. (shrink)

Philosophical and empirical research on bodily awareness has mostly focused so far on bodily disorders – such as anorexia nervosa, somatoparaphrenia, or xenomelia (body integrity dysphoria) – and bodily illusions induced in an experimental setting – such as the rubber hand illusion, or the thermal grid illusion. Studying these conditions can be illuminating to investigate a broad range of issues about the nature, function, and etiology of bodily experience. However, a number of psychoactive compounds can also induce a remarkably (...) wide variety of bodily effects that have received little attention despite their relevance to these issues. Some of these effects are similar to those associated with bodily disorders or experimental bodily illusions, while others appear to be unique. The purpose of this chapter is to provide an overview of these lesser known bodily effects of psychoactive compounds, and outline some ways in which they can bear on recent debates regarding bodily awareness and bodily ownership. (shrink)

This book proposes a novel and rigorous explanation of consciousness. It argues that the study of an aspect of our self-consciousness known as the ‘feeling of embodiment’ teaches us that there are two distinct phenomena to be targeted by an explanation of consciousness. First is an explanation of the phenomenal qualities – 'what it is like' – of the experience; and second is the subject's awareness of those qualities. Glenn Carruthers explores the phenomenal qualities of the feeling of embodiment using (...) the tools of quality spaces, as well as the subject's awareness of those qualities as a functionally emergent property of various kinds of processing of these spaces. Where much recent work on consciousness focuses on visual experience, this book rather draws evidence from the study of self-consciousness. Carruthers argues that in light of recent methodological discoveries, awareness must be explained in terms of the organization of multiple cognitive processes. The book offers an explanation of anomalous body representations and, from that, poses a more general theory of consciousness. Ultimately this book creates a hybrid account of consciousness that explains phenomenology and awareness using different tools. It will be of great interest to all scholars of psychology and philosophy as well as anyone interested in exploring the intricacies of how we experience our bodies, what we are and how we fit into the world. -/- . (shrink)

In this chapter, I first review and assess evidence regarding brain damage or neural abnormalities associated with some psychopathologies and cognitive deficits, such as hemispatial neglect, agnosias, amnesia, somatoparaphrenia, and others. It becomes clear just how closely normal mental functioning and consciousness depend upon normal brain functioning as well as how some very specific mental changes occur when, and only when, very specific brain damage occurs. I then explore the metaphysical implications of these results with respect to the nature (...) of mind and consciousness. In particular, I examine the plausibility of materialism, roughly the view that mental processes are brain processes, in light of the evidence discussed and in contrast to a dualist conception of the mind (whereby mental states are not physical in some sense). I also explore the prospects for a conscious afterlife based both on the brain damage evidence adduced and the metaphysical implications discussed. (shrink)