Schizophrenia = Shattered Personality Structure

[spiritual_emergency]

I came across the following in some of my more recent wanderings and thought I'd share it in this space...

Myth #8: People with Schizophrenia Have Multiple Personalities

A prevalent misconception is that schizophrenia is the same thing as "split personality" or "multiple personality disorder." A popular bumper sticker, for example, reads: "I was schizophrenic once, but we're better now." The schizophrenia-multiple personality misconception is widespread. In one survey, 77% of introductory psychology students agreed that "a schizophrenic is someone with a split personality." The 2000 comedy film, Me, Myself, and Irene, starring Jim Carrey, features a man supposedly suffering from schizophrenia. Yet he actually suffers from a split personality, with one personality who's mellow and another who's aggressive.

In fact, schizophrenia differs sharply from the diagnosis of dissociative identity disorder (DID), once called multiple personality disorder. Unlike people with schizophrenia, people with DID supposedly harbor two or more distinct "alters"--personalities or personality states--within them at the same time. Robert Louis Stevenson's 1886 novel, The Strange Case of Dr. Jekyll and Mr. Hyde, is probably the best known illustration of multiple personality in popular literature. ...

The schizophrenia-DID myth probably stems in part from confusion in terminology. Swiss psychiatrist Eugen Bleuler coined the term "schizophrenia" meaning "split mind," in the early 20th century, and many writers soon misinterpreted Bleuler's definition. By schizophrenia, Bleuler meant that people suffer from a "splitting" within and between their psychological functions, especially emotion and thinking. For most of us, what we feel and think at one moment corresponds to what we feel and think at the next. Yet in the severe psychotic disorder of schizophrenia, these linkages are ruptured. As Bleuler observed, people with schizophrenia don't harbor more than one co-existing personality; they possess a single personality that's been shattered...

Source: The Top 10 Myths of Popular Psychology

My preferred terms for my own experience is "ego collapse" or "a fragmentation crisis". I think maybe I'll share some additional information I've gathered over the years as related to the psychological aspects of ego function and the experience known as schizophrenia in this culture...

[spiritual_emergency]

I came across the following several years ago when I was earnestly seeking to understand my own experience. The original page (link) is no longer available so I've sourced it back to my blog. I've also edited the layout slightly to make it easer to read...

Q: Can you tell me what a psychotic break is? I can't seem to find any information about it.

A: There are, at least to my way of thinking, several states of mind:

- normal, meaning consistent over time and situations;

- disorganized, meaning a little scattered, unfocused, fragmented;

- disturbed, meaning a state of mind leading to behavior that is socially unacceptable and potentially harmful to self and others;

- disordered, meaning a display of clinically definable and diagnosable symptoms that are clustered under one primary heading (Depression, Borderline, Kleptomania, etc.); and

- dissociated, meaning a collapse of the "ego integrity", a state of mind where the person is unsure of who they are, where they are, what they are doing and how they should be behaving - a pervasive and overall loss of "identity" and "sense-of-self".

The last, "dissociation" is generally considered a "psychotic break". In other words, a person is so overwhelmed by either internal or external turmoil that what we generally think of [as] their "ego" just plain collapses.

Source: Psychosis & Ego Collapse

[spiritual_emergency]

Here's another one...

Ego-Fragmentation in Schizophrenia: A severe dissociation of self-experience

In this chapter, I will propose that schizophrenic syndromes represent a unique type of 'ego' or 'self-pathology', an ego fragmentation that in extreme forms could be considered an annihilation of the "ego/self". I consider this fragmentation or splitting of the ego to be a special form of dissociation, striking the ego/self along the five basic dimensions of vitality, activity, coherence/consistency, demarcation and identity.

From this perspective, the schizophrenic syndromes can be thought of as lying on a continuum with other disorders, such as dissociative identity disorder (DID) and borderline personality disorder (BPD) all of which can be characterized as "non-cohesive" disorders. However, the perculiar rigidity and fragility of the schizophrenic ego which predisposes it to fragmentation contrasts with the fluid ego-states observed in DID and BPD. This 'ego-fluidity' may protect those with DID or BPD from the extreme fragmentation and deterioration seen in the schizophrenic syndromes....

... I assume that a highly unstable and fluctuating ego-self is less disposed to ego-fragmentation -- the most severe form of dissociation. It is even possible that is it the very instability or fluctuating nature of the ego-self in dissociative identity disorder that protects it from ego-fragmentation. This would mean that the precondition for a schizophrenic dissociative ego-disorder would be a more rigid ego, predisposed for fragmentation, rather than fluctuation. One can imagine schizophrenic symptoms as glass and dissociative identity disorder as quicksilver: the rigid glass fragments split apart and do not reassemble easily, whereas the quicksilver glides smoothly apart into globes -- little wholes -- but quickly unites without splitting apart.

Source: Psychosis, Trauma and Dissociation: Emerging Perspectives on Severe Psychopathology

[spiritual_emergency]

One more. This one is from an article related to spirituality and trauma...

... Certain experiences, such as peak, near death, and mystical experiences often project individuals into another realm of consciousness that is often referred to as transpersonal or spiritual. At these times the ego is displaced or cracked open. This enables transpersonal dimensions of consciousness to emerge. Many of these experiences, despite their beauty and sublime character, are unnerving and terrifying.

Trauma, in addition to its ability to deconstruct reality horizontally in terms of belief systems and frames of reference, also initiates a vertical deconstruction. It either displaces or obliterates the ego. Victims are thrust into the realm of the Deeper Self without warning and preparation. This brutal exposure illuminates the fact that the ego is a mosaic held together by personal narration, continual feedback from others, and internalised object relations.

Trauma, in spite of its brutality and destructiveness, has the power to open victims to issues of profound existential and spiritual significance. The displacement of the ego forces confrontations with deeper levels of self and reality. Trauma throws victims onto a path that mystics, shamans, mythic heroes, and spiritual seekers have been walking for thousands of years. The difference is that victims of trauma must work this territory or be overcome by it. Non-traumatised seekers have the luxury of getting off the path at will; for theirs is not a life or death struggle.

Source: Spirituality & Trauma

[spiritual_emergency]

Here is an article excerpt that talks about what an ego actually is...

The first thing to be understood is what ego is. A child is born. A child is born without any knowledge, any consciousness of his own self. And when a child is born the first thing he becomes aware of is not himself; the first thing he becomes aware of is the other. It is natural, because the eyes open outwards, the hands touch others, the ears listen to others, the tongue tastes food and the nose smells the outside. All these senses open outwards.

That is what birth means. Birth means coming into this world, the world of the outside. So when a child is born, he is born into this world. He opens his eyes, sees others. 'Other' means the thou. He becomes aware of the mother first. Then, by and by, he becomes aware of his own body. That too is the other, that too belongs to the world. He is hungry and he feels the body; his need is satisfied, he forgets the body.

This is how a child grows. First he becomes aware of you, thou, other, and then by and by, in contrast to you, thou, he becomes aware of himself.

This awareness is a reflected awareness. He is not aware of who he is. He is simply aware of the mother and what she thinks about him. If she smiles, if she appreciates the child, if she says, "You are beautiful," if she hugs and kisses him, the child feels good about himself. Now an ego is born.

Through appreciation, love, care, he feels he is good, he feels he is valuable, he feels he has some significance.

A center is born...

Source: Ego - The False Center

If we understand how an ego is constructed that can help us understand how to rebuild one. Typically, an ego is rooted in relationship. One of the most important relationships you will ever have is the one with yourself. It can be worth paying attention to how you "talk to yourself". Do you have a healthy relationship with yourself?

Other people are also of critical importance in forging an ego -- parents, siblings, partners, children, employers, co-workers. All these relationships help build your sense of self-identity (your ego). This is why it can be counter-productive for people to be hospitalized or isolated from their social networks.

When you are first trying to rebuild your sense of self-identity, you should expect you might not be all that good at it. With practice, people can get better at it.

In rebuilding your ego, you also end up rebuilding your "outer skin". This can make it a bit easier to interact with others without feeling so open and vulnerable all the time.

Music of the Hour:

[Luna-]

Thanks for the continuing education ...

[spiritual_emergency]

Namaste Luna. This is surely as much my own continuing education as anyone else's. I have been learning since this all started close to a decade ago. I'd like to be learning faster, to be honest.

Meantime, I do think it's helpful to talk about the ego/personality structure -- elsewhere, the talk is predominated by neurochemistry and medications that will affect them. However experiences like depression, mania and psychosis happen to people and when we examine those experiences we can see fluctuations in the ego states of those individuals. This tells me that the ego state is just as important as the neurochemical state and maybe even more so, since the ego state may dictate the neurochemical response.

[lagrima]

-----------------------------

[spiritual_emergency]

Hello lagrima,

I believe the author is suggesting that yes, there can be "normal" ego-states that are less stable/more flexible, and that individuals who operate from this stance might be more vulnerable to develop dissociative identity disorder whereas someone with a more stable ego might be more prone to the shattering aspect I've shared via the posts above.

The ego (self-identity) is intimately tied to having a body and living in a social network. We develop an ego as a means of protecting and taking care of our bodies and also as a means of finding acceptance and approval within our social circles. Here's a bit more info from one of the articles above...

... A center is born.

But this center is a reflected center. It is not his real being. He does not know who he is; he simply knows what others think about him. And this is the ego: the reflection, what others think. If nobody thinks that he is of any use, nobody appreciates him, nobody smiles, then too an ego is born: an ill ego; sad, rejected, like a wound; feeling inferior, worthless. This too is the ego. This too is a reflection.

First the mother - and mother means the world in the beginning. Then others will join the mother, and the world goes on growing. And the more the world grows, the more complex the ego becomes, because many others' opinions are reflected.

The ego is an accumulated phenomenon, a by-product of living with others...

Ego is a need; it is a social need, it is a social by-product. The society means all that is around you - not you, but all that is around you. All, minus you, is the society. And everybody reflects. You will go to school and the teacher will reflect who you are. You will be in friendship with other children and they will reflect who you are. By and by, everybody is adding to your ego, and everybody is trying to modify it in such a way that you don't become a problem to the society.

Source: Ego - The False Center

Ironically, that article is related to moving beyond the concept of ego to a different kind of self-identification but it serves a very useful purpose of detailing how the self-identity (ego) is created. People can then attempt to model that for themselves when they are in the process of rebuilding their own ego.

This is part of the reason it's very important to be in healthy relationships with other people because of that "reflection" quality. That inner relationship that you have with your self will also be important because it will either accept or reject the ideas of others. If it accepts them, sadness and worthlessness will become a reality. The person can come to believe what others think. If it rejects them, anger is the result. Anger can productively serve as a protective measure and can actually help people to build (or re-build) a reasonably healthy ego.

As yet another example, I got angry when people told me I could not recover. That anger served a productive purpose because it allowed me to push away the conceptions of others to sculpt out my own recovery for myself. I'm very much opposed to telling people they can never get better or that there is "no cure". When I was told that, a part of me said, "F--- you. I'll do it my own way!" That often meant I had to go it alone but it also contributed greatly to my recovery.

The so called ego is but a billions of neural connections inside the

brain ; What do we know of them ?

I'm not going to be able to provide you much in the way of information in that area because I've never accepted that people are nothing more than their neurochemistry. I do believe however that people can go through life experiences that will produce a corresponding neurochemical response; war would be a good example -- being in a war zone can be highly distressing. But if we can change those life conditions, the neurochemical response will also change.

To put it another way, if you have a truck parked on your foot, it's going to produce pain and physical damage. If you can get the truck off your foot however, the pain will end and you can begin to heal.

[spiritual_emergency]

An article from my recent wanderings that I thought fit in well with this collection. One aspect I quite liked about the article was the final excerpt I share which suggests simple techniques that could be adopted as a means of self-soothing.

... Kraepelin was aware of his somewhat rigorous nosopoietic construction and looked for a common characteristic of his polymorphous group. He conceived it in the following feature: “a particular destruction of the inner coherence of the psychic personality”

... The concept of dissociation which led E. Bleuler to the name was widespread at that time. Hysteria, hypnotic phenomena and multiple personalities were the main sources for the interpretation by the concept of dissociation.This meant the separation of conscious from unconscious events, but also of certain mental functions from its normally interrelated and connected context.

Thus, it was suggestive to apply this model of dissociation (which was rather loosely defined at that time as it is nowadays) also to the psychoses which seemed to be characterized mainly by a disorganization, dissolution, split, fragmentation of the most central instance of the conscious person, his ego, self.

... In this process of establishing schizophrenia as a valid nosological category and entity, the concept of dissociation was almost but not fully lost.

... But schizophrenias are kept separate in spite of the fact that schizophrenias were named by authors who followed the concept of dissociation. There are valid arguments for reintroducing schizophrenias as the most severe manifestation of dissociative disorders, namely a fragmentation, even destruction of the ego/self.

‎... Long before the nosopoietic construction and naming of schizophrenias, psychiatrists had observed patients with a “destruction of their I-ness” (Heinroth), with a loss of their certainty of being an egoized unity (Esquirol), a coherent being, even of being alive (Kahlbaum), of maintaining the former identity.

... “I feel myself dead ... I feel directed by alien forces ... I am split apart, my body dissolved ... I am no longer aware of any boundary of myself ... The shape of my face has changed ... I am some-

one else than I appeared to be before ...”

... The empirical studies of the ego disorders in schizophrenics (n = 552) revealed that about 25% of the patients reported bodily symptoms, as an expression of their disordered body ego:

Reported symptoms in 552 schizophrenics.

- my body or parts of it changed: 23.4%

- parts of my body didn’t match anymore: 11.9%

- my body was torn to pieces or dissolving: 12.7%

- parts of my body lay outside me: 7.5%

- my body or parts of it died: 20.8%

- I had to hurt myself: 13.8%

- I had to see my blood: 5.1%

- I had to rub my skin: 16.7%

- my sexuality changed: 22.1%

- I had to breathe heavily: 27.3%

From the three ego pathology syndromes resulting from the study one is called the dismembered and mortified body ego:

The dismembered and mortified body ego

- I felt myself dying. (19)

- My body or parts of it changed. (30)

- I often had to look in the mirror. (2)

- I felt myself dead (like a mummy). (20)

- My body or parts of it died. (34)

- I had to rub my skin. (37)

- My body was torn to pieces or dissolving. (32)

- I was made up of several beings. (29)

- Parts of my body did not match anymore. (31)

- My sex changed. (4)

- Parts of my body lay outside me. (33)

- I had to see my blood. (36)

This is the section with some potentially helpful suggestions...

Put into a system, this statements can be presented in five basic ego dimensions:

- ego vitality: being present as a living being

- ego activity: functioning as a self-directing unity, governing the integration of afferent (e. g. perceptive), cognitive (e. g. thinking), cognitive-affective (relation of thoughts and emotions/affects) and

efferent (e. g. speaking, movements, reactions and actions)

functions

- ego consistency and coherence: being mentally and bodily a united consistent and coherent being

- ego demarcation: being distinct from other things and beings, aware of the boundary between ego/self and non-ego

- ego identity: certainty of one’s own personal self-sameness concerning morphology, physiognomy, gender, genealogical origin, social function and biographical (lifetime) continuity...

Body-including treatment as suggested by ego psychopathology.

- VITALITY: breathing, pulsation of blood in fingers, face, abdominal aorta, centre the body in abdominal-pelvic region, sensory awareness (Gindler, Selver) in griping, keeping (patient himself)

- ACTIVITY: activity, intentional movements (fingers), reassuring self-directedness, self-determination

- CONSISTENCE: focussing on centre of the body, breathing, becoming aware of continuous flow throughout the whole body, close the arms around the own trunk, hedgehog-, turtle-position

- DEMARCATION: to mark the own territor y (mat, circle made by chalk, ring) patient determines distance and closeness himself

(instrumental, verbal)

- IDENTITY: focussing on face and palms (together) (feeling the warmth, pulsation, calming), mirror.

Source:

Schizophrenic ego disorders – argument for body-including therapy

[finding my way]

This discussion of ego function, and now including the body, is so very interesting, SE Thank you.