Psychiatric Disorders and the Self

The last blog discussed recent findings about the temporal structure in the brain’s spontaneous activity and how they are related to our sense of self, specifically, self-consciousness. This is not only important to understand our self and its nature in general, but also why and how the self can be altered in psychiatric disorders like schizophrenia and depression.
Schizophrenic patients show severe changes in their sense of self. They have the feeling that other people can read their thoughts and determine and put them into their mind. Even worse, schizophrenic patients can experience themselves as a completely different person when taking on the identity and self of another person. Often they take on the identity of a famous or religious person like being Nofretete, the former Egyptian queen, or of Mao the chairman of china in former years, or religious leaders like Jesus or Buddha. That is rather bizarre and strange. How is that possible? This remains one of the mysteries of the mind.
Depression too shows abnormalities in the sense of self. Here the opposite seems to be the case. Depressed patients focus too much on their own self. All their thoughts, emotions, etc. are focused almost exclusively on their own self. “My self is insufficient”, “my self is guilty”, “my self is not worth to be treated” , etc. We described that as an “increased self-focus” where everything revolves around the own self.
Where and how are the abnormalities in the sense of self generated? We can now recall our previous blog. There I discussed that the self or better self-consciousness was related to the temporal structure in the brain’s spontaneous activity as indexed by the power law exponent. The relationship in the power between slower and higher frequency ranges signifies the power law exponent and thus the temporal structure in especially the anterior midline regions of the brain and that in turn predicted the degree of self-consciousness: the more temporal structure in the brain’s spontaneous activity, the higher your degree of self-consciousness.
What does that imply for psychiatric patients? Schizophrenic patients show decreased self-focus where the focus on the self is replaced by the focus on another person’s self, the self-consciousness thus decreases or recedes and vanishes completely. Based on our data in healthy subjects, one would now expect that schizophrenic patients show decreased temporal structure in their spontaneous activity: the decreased self-consciousness should be traced to lower degrees of temporal structure and thus lower levels of the power law exponent. The opposite should be the case in depression. Here patients show an abnormally high degree of self-focus and thus increased self-consciousness. One would consequently expect increased temporal structure with higher levels in the power law exponent in the medial prefrontal cortex.
We can thus make clear predictions from the healthy subjects for the expected abnormalities in psychiatric patients based on the symptoms they present. We are currently testing the hypotheses put forward and I will get back to that later. If true, this carries major therapeutic implications. One may then want to interfere with the temporal structure in the spontaneous activity by for instance stimulating certain frequency ranges in an individually specific way. And thereby directly target the altered sense of self or self-consciousness in our therapy. That in turn should remedy the associated affective, cognitive, and social symptoms in these patients since they all can be traced to an altered sense of self. Accordingly, such “spatiotemporal psychopathology” opens the door for novel and hopefully more effective forms of treatments.

References

Is the Sense of Agency in Schizophrenia Influenced by Resting-State Variation in Self-Referential Regions of the Brain?
Robinson JD, Wagner NF, Northoff G.
Schizophr Bull. 2016 Mar;42(2):270-6. doi: 10.1093/schbul/sbv102. Epub 2015 Jul 28.

Is schizophrenia a spatiotemporal disorder of the brain's resting state?
Northoff G.
World Psychiatry. 2015 Feb;14(1):34-5. doi: 10.1002/wps.20177.

Resting state activity and the "stream of consciousness" in schizophrenia--neurophenomenal hypotheses.
Northoff G.
Schizophr Bull. 2015 Jan;41(1):280-90. doi: 10.1093/schbul/sbu116. Epub 2014 Aug 23.

How is our self altered in psychiatric disorders? A neurophenomenal approach to psychopathological symptoms.
Northoff G.
Psychopathology. 2014;47(6):365-76. doi: 10.1159/000363351. Epub 2014 Oct 3.

Spatiotemporal psychopathology I: No rest for the brain's resting state activity in depression? Spatiotemporal psychopathology of depressive symptoms.
Northoff G.
J Affect Disord. 2016 Jan 15;190:854-66. doi: 10.1016/j.jad.2015.05.007. Epub 2015 May 14. Review.