Nagai highlights a certain form of “excess of introspection” as a prominent feature of schizophrenia (Nagai 1991). According to Nagai, the tradition of phenomenological psychopathology has neglected paying sufficient attention to the phenomenon of (excessive) introspection in schizophrenia. This neglect must in part be seen as the result of the view held by for example Blankenburg, who regarded reflectivity as a compensatory mechanism for deficient pre-reflective attunement to the world (lack of common sense or natural evidence) (Blankenburg 1971). In this understanding, the increased reflectivity is not abnormal in itself but rather a secondary act or response to primary pathological changes. Furthermore, Nagai regards the neglect as the result of a common view among psychiatrists, namely, that introspection is a good thing in itself equating it to insight into one’s mental condition or in psychiatric terminology “insight into illness”.Footnote 4 On the contrary, Nagai suggests that reflection or introspection in itself can be part of the problem.Footnote 5
To understand this phenomenon, it is crucial that Nagai distinguishes between two types of introspection, namely “simultaneous introspection” and “post facto introspection” (Nagai 1990). In short, post facto introspection designates what we would normally call “reflection” or “self-reflection,” and it is this type of introspection that she regards as compensatory. According to Nagai, the ordinary sort of introspection always occurs “post facto,” meaning that it is a “retrospective gaze that is turned on the past self” (Nagai 1991). An example of this is when a person has erred and afterwards reflects on what he or she did wrong. It is not uncommon to find an increase of this type of introspection among schizophrenic patients. In clinical terms, patients may scrutinize what happened during the day to grasp what the meaning was, or anticipate future events or situations in analytic detail due to the insecure sense of self and due to problems with common sense.
When Nagai speaks of “post facto” introspection, it at first glance appears to designate attending to a past experience as opposed to attending to an ongoing experience. More precisely, however, it implies that in reflection one always grasps oneself in a delayed manner. In Husserlian terms self-reflection is always grasping the retentional moments of the stream of consciousness (Husserl 1973). Differently put, the reflecting moment is always elusive since it cannot grasp itself. Ryle articulates this elusiveness with the analogy of someone trying to jump up to the head of their own shadow, being always just one step behind (Ryle 1949). This implies a differentiation between a “reflecting” and “reflected” moment, that is, between the moment that is the object of the introspection, and the moment that performs the introspection akin to Husserl’s notions of “objective subjectivity” and “functioning (operative) subjectivity” (Husserl 1973, 431). In ordinary self-reflection, these moments are merely implied or potential, but hidden in the unity of experience.
According to Nagai, there is an “established relationship” between the two moments in reflection and it is precisely this established relationship that becomes insecure in “simultaneous introspection,” which we will now turn to.
Simultaneous introspection signifies a ceaseless and involuntary self-observation or self-monitoring that occurs even when one is occupied with worldly matters. As Nagai puts it “even in simple, everyday experiences wherein ordinarily, one would ‘forget oneself,’ our patients never quite forget themselves” (Nagai 1991). With the notion of “simultaneous introspection,” Nagai tried to capture a specific form of excessive reflection being itself problematic, in making it very difficult for the patient to become fully engaged or immersed. We have already quoted one of Nagai’s patients who suffered from this ceaseless self-observation, and it is also vividly illustrated in the following quote from another patient:
I’m too self-conscious. I’m constantly watching, staring at myself. Because I’m staring at myself so intensely, when I watch TV, it doesn’t get inside my head. Even while talking with someone, all I do is watch myself. So I can’t really get what the other person is talking about… I don’t feel at ease when I’m in a place where there are many people. I constantly feel that I’m being watched. (Nagai 1991)
It is important to emphasize that not all schizophrenia patients have that degree of introspective access to or awareness of “the inner workings” of the pathological changes they experience, and may therefore be unable to verbalize these disturbing experiences as clearly as in the vignettes presented in this paper. Nonetheless, these vignettes seem to point to essential features of the illness. The difficulty in articulating these experiences may also stem from the fact that it is much easier to express the content of an introspection than the fact that one is introspecting.
As opposed to post facto introspection, where the reflecting moment is elusive, simultaneous introspection seems to be this very impossible movement where the reflecting moment, as Nagai puts it, is trying to grasp itself as it “appears at this very moment” (Nagai 1991). This simultaneity however, is by no means tantamount to a convergence of the reflecting and reflected moment. Instead of experiencing an unproblematic self-coincidence the vignettes above manifest experiences of a gap or distance and a sense of self-fragmentation.
The self-alienation in question concerns a characteristic self-fragmentation or self-redoubling, with Nagai’s words, involving a “formation of two quasi-subjects” (ibid.). The “formation of two quasi-subjects” signifies the experience of being at the same time someone who is engaged in actual situations, and someone who is, so to speak, watching the scene from behind. Most importantly, there is an experience of non-coincidence between the two quasi-subjects. It is important to note that the reason we call them “quasi” is that none of them can be considered as autonomous, true subjects.
In the second vignette, the alienation involved in the experience of self-redoubling is perhaps even more conspicuous, because the constant self-observation has developed into a feeling of actually being watched by others, and not merely by oneself. Here, the aspects of the patient’s self have become externalized, and he grasps himself as an ‘other’ in a concrete manner. This experience is exactly what the notion of “alterization” refers to, which we will return to in the below.
It should be remarked, that it is of course not completely unordinary to observe oneself while at the same time interacting with the world. Especially in disquieting situations (exams, networking events etc.) one may become painfully self-conscious hindering one’s natural performance or engagement. In such cases of self-observation we witness a disturbing self-reflection, which nonetheless follows the structure of normal reflection where the reflecting ego remains phenomenally elusive. It is therefore not the simultaneousness of a self-observation alone that makes it characteristic for schizophrenia, and therefore we suggest to replace the notion of “simultaneous introspection” with “involuntary self-witnessing.” The term “introspection” is replaced because the term “self-witnessing” captures the involuntary and passive character of the experience.
To elucidate the experience of involuntary self-witnessing, it is helpful, as Nagai proposes, to introduce an externalized visual analogy: namely, that of looking at oneself in the mirror. Following this analogy, on the one hand, one is “looking at oneself in the mirror”, and on the other hand, one is “being looked at by oneself in the mirror” (Nagai 1991). We can add that most people can relate to having alienating experiences when looking at themselves in the mirror, but the sense of alienation remains extremely transient. In schizophrenia this experience of “looking at oneself in the mirror” is alienating in a much more radical manner. When we look in the mirror, the two moments of “looking at” and “being looked at” might present themselves as two distinct moments, but crucially they remain parts of one and the same experience. In schizophrenia, however, these two moments come to the fore as separate and the very link between them has become insecure.Footnote 6 This sometimes even evolves into a sense of not knowing on which side of the mirror one is located metaphorically speaking.
Returning to experiences of self-redoubling in schizophrenia, we propose that the formation of two quasi-subjects may be a reification of a more basic level of differentiation implicit and potential in all subjectivity. One of our patients gave a very articulate account that suggests such a process:
I think it’s strange that you can experience something that you then at the same time register, as if you have.. as if there is a difference between the one who experiences something, and the one who experiences that one experiences something… I feel like that about my own thoughts… It is as if there is a true inner me who knows what I think, feel, and ought to do, but is hidden. Who I am and act according to is the ‘outside person’ who interacts with others and… It’s difficult to explain. I’m sometimes in contact with the true me, actually every day, but it is only because of distrust in the ‘outside person’… There is a tension between the two… I don’t feel I’m any of them. Actually, I am afraid that if the ‘outside person’ were peeled off, then there would be nothing.
Just as in the two previous vignettes, the patient expresses a continuous observation of his self involving self-fragmentation. What is important to note here, is the fact that he furthermore articulates some sort of gap or distance implicit within experience itself, that is, the separation allowing for a distinction between the experience of something itself, and the experience that you experience something. As Grøn puts it with a reference to Hegel, consciousness does not relate to itself as an object, but rather it “experience itself in experiencing the world.” (Grøn 2010, 84; our italics). Ultimately, it is a congealing of this differentiation that leads to a sense of duplication or redoubling of the self in schizophrenia.
In schizophrenia, this normal but only potentially present gap between the two moments of reflection becomes reified and appears in the patients’ awareness as a sense of self-duplication. We find an indication of such a dynamism, when the patient explains that his “inner self” is not “available to him,” and that he is only in touch with the “true inner me” when it suddenly interrupts the “outside person” saying:” you don’t really think that” and the like. The reflection has so to speak come to the fore as only a reflection, and not merely as a constitutive part of the lived experience. This does indeed seem to clarify the signification of him explaining that it is only because of “distrust” in the outside person that he is in contact with the “true me.” It is for this very reason that he did not like to speak to psychiatrists and psychologists, because he had no idea if what he was telling them about himself was true. He said that everything he felt and thought was “unreliable.”