Self-Disturbances, Perceptual Anomalies, and Physicality

Thought insertion (TI) is regarded as one of the most complex and severe symptoms of psychosis. Current approaches to TI often make the focus of their analysis specific terms such as the sense of ownership and the sense of agency. This chapter suggests that such models are insufficient in explaining TI’s complexity as they neglect the multimodal view of psychotic experience first introduced by the Early Heidelberg School. On this view, TI involves a disruption to the inner connectedness of thoughts and experiences by a ‘becoming sensory’ of these thoughts experienced as inserted. This includes how thinking is anticipated moment-to-moment as continuous. The application of phenomenological analysis to the experience of TI reveals a ‘physicality’ of the body as an object for the individual; his/her own ‘thoughts’ are experienced as material objects (devoid of inner subjectivity) but preserved in these catastrophic conditions in a ‘paralysis of the I’. After clarifying some of the main elements of our proposal, we explore the way in which predictive coding and Bayesian inference may provide a framework able to link the neurobiology of psychosis with its clinical phenomenology.