Disturbances of the Self

The Fragile Architecture of Selfhood

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This post was inspired by a wonderful discussion I had recently, which centred on the confusion in perceptual boundaries between self and other, in the context of psychosis.

This confusion refers to moments when the usual sense of distinction between what is me and what is not me becomes blurred. For example, when one's thoughts might feel as if they come from someone else, internal sensations might seem to originate from outside, or even one’s own voice or actions can feel unfamiliar.

Essentially, when the boundary between self and world (usually so stable we take it for granted), becomes porous and uncertain.

What do we mean by the self?

Before we can talk about what it means to feel estranged from oneself, we need to understand what the self is in the first place.

In neuroscience the self is understood as a construction, or a model generated by the brain which allows us to feel that our thoughts, sensations, and actions belong to us [1]. This is, in some contexts, referred to as the minimal self, a term that captures the most basic sense of being a subject of experience [2]. That is, the sense of : “I”, “me”, “my”, “mine.”

We usually don’t notice this level of selfhood because it functions in the background. But this is simply the silent sense that this is my body, my thought, my perception.

Unlike the reflective self, which involves thinking about ourselves as objects with a past and a personality, the minimal self is about the felt immediacy of experience. It is not about who we are, but that we are.

When the Minimal Self is Disturbed

In some mental states, for example in psychotic-spectrum conditions, this structure can become unstable. Phenomenological research in psychiatry, that is research focused on lived experience, refers to this instability as basic self-disturbance [2].

Basic self-disturbance refers to a range of disruptions in how the self is experienced, including changes in the sense of ownership over thoughts, disintegration of bodily awareness, and uncertainty about the boundary between self and other. This is when the experience of being becomes strange, effortful, or even fractured.

When the minimal self is disturbed, the continuity, coherence, and trust we usually place in our own experience can begin to break down. As Tom¹ put it to me a few weeks ago: “As someone with BPD² I have no real sense of ‘me’ or ‘I’, and when I look in the mirror I mostly don't recognise the person looking back at me.”

Phenomenology Meets Neuroscience

Self-disturbance is not just a philosophical idea. It has a neural footprint.

One of the clearest explanations is what neuroscience calls self-monitoring [3], the brain’s ability to distinguish between internally generated and externally generated experiences. For example, when we initiate a thought or movement, the brain issues a predictive signal, referred to as a corollary discharge, to let sensory systems know, “This came from me [3].”

However, if this signal is disrupted or not registered properly, inner speech might feel like it’s coming from someone else, and a thought may seem intrusive or alien. In psychosis, this process can become unreliable, weakening the boundary between self and world.

The salience network is thought to guide switching between the default mode & executive networks. Image Source : CC BY

This predictive mechanism involves communication across multiple brain regions, including the prefrontal cortex, temporal parietal junction, and supplementary motor areas. It also relies on broader networks such as the Default Mode Network, involved in self-referential thought, and the Salience Network, which tags what is relevant and worthy of attention. When coordination among these systems falters, the basic sense of selfhood can begin to unravel [4].

So, while phenomenology gives language to what experiencing self-disturbance feels like, neuroscience helps us understand how it might happen. But neither alone tell us what it means to live with an unreliable sense of self.

The Self We Depend On

Even if the self is, as some argue, a neurological illusion, it remains a necessary one—a construct that enables coherence, moral responsibility, and healing.

j.e. moyer, LPC

Now I’ll turn to Buddhism, because its idea of letting go of the self stands in tension with what happens when the self fades away.

See, there’s a concept in Buddhist philosophy that has always fascinated me: anattā, or non-self. This is the view that the self is not essential or permanent, that’s rather a fabrication of the mind, and that loosening our grip on it can bring clarity [5].

But, as we’ve been discussing, in conditions such as psychosis and borderline states, when the self loosens, it does not dissolve into insight.

It fragments into instability and confusion.

So, if the self is a construction, a fabrication, or even an illusion, and yet its disruption is disturbing, we are forced to ask what makes it so essential.

We often rely on things that aren’t ultimately real in an objective sense, but that are functionally real in experience. The self, may not exist as a real entity, as both Buddhism and neuroscience suggest, but it still organises our internal world.

It gives continuity to memory, a stable point for perspective, and a sense of agency over action. When that coherence collapses ( i.e. in psychosis) we feel unmoored. So, we don’t rely on the self because it’s real in any ultimate sense. We rely on it because without it, we don’t know how to move through the world.

A Final Reflection

The key then, lies in the difference between letting go of the self and losing it.

In Buddhist practice, the letting go is deliberate, gradual, and held by attention and insight. But when the self slips away in psychosis, it happens without consent. It unravels, leaving confusion and fear in its place.

I speculate that the difference may come down entirely to one thing: agency. For, letting go is a gesture of choice. While losing the self is what happens when choice is not available.

So, what is left for those who have no choice, for those whose sense of self slips away on its own?

To my mind, part of what’s left must come from the rest of us.

That means acknowledging the confusion, respecting the experience as it is, and crucially, appreciating the fragility of the reality we share.

If you're interested in learning how to support someone living with a psychosis diagnosis, I recommend reading this post by

Leon Macfayden

.

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If you’re new here, welcome! I post a new article every Wednesday at 4.30 pm (UK time) & share notes every day. I’m so glad you’re here :)

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Reference List:

[1] Metzinger, T. (2009). The ego tunnel: The science of the mind and the myth of the self. Basic Books.

[2] Parnas, J., & Handest, P. (2003). Phenomenology of anomalous self-experience in early schizophrenia. Comprehensive Psychiatry, 44(2), 121–134. https://doi.org/10.1053/comp.2003.50017

[3] Ford, J. M., & Mathalon, D. H. (2005). Corollary discharge dysfunction in schizophrenia: Can it explain auditory hallucinations? International Journal of Psychophysiology, 58(2–3), 179–189. https://doi.org/10.1016/j.ijpsycho.2005.01.014

[4] Potvin, S., Gamache, L., & Lungu, O. (2019). A functional neuroimaging meta-analysis of self-related processing in schizophrenia. Frontiers in Neurology, 10, 990. https://doi.org/10.3389/fneur.2019.00990:contentReference[oaicite:3]{index=3}

[5] Wright, R. (2017). Why Buddhism is true: The science and philosophy of meditation and enlightenment. Simon & Schuster.

1. The name has been changed to preserve this person’s privacy.

2. Borderline Personality Disorder (BPD) is a mental health condition marked by instability in self-image, emotions, and relationships. It often involves intense emotional experiences, a fluctuating sense of identity, and difficulty maintaining boundaries between self and others.