REAL
From content to form: Identity versus self
We all have thoughts about ourselves. But there is a difference between what we think and how we experience those thoughts. When you experience your thoughts, you usually do not have to ask if they are your own. Ideally, we never have to think about it because it is simply self-evident.
In phenomenology (a discipline of philosophy), we distinguish between identity and the basic self. Identity is something we can think about and describe, like telling a story about ourselves. The basic self, on the other hand, is our immediate sense of “me” in our experiences, something we do not usually think about.
For some people, this basic sense of self is disturbed. People with schizophrenia spectrum disorders often experience some thoughts as strange, not really belonging to themselves. Such subtle changes in how people perceive themselves and reality can occur long before someone is diagnosed with a schizophrenia spectrum disorder. Over time, people with psychosis often lose touch with their sense of self, no longer feeling like they are participating in the life around them. Sometimes, even the world around them may seem fake or like a theater.
We still don’t know much about how these disturbances develop or if certain changes can predict psychosis. We also do not know whether these changes occur in specific contexts. We also wish to explore this. Current treatments mainly focus on symptoms like hallucinations and delusions, largely ignoring these more subtle changes in the experienced self of people with psychosis. We think that there is need to explore the first-person perspective of people who have experienced alterations in their sense of self and reality.
If we can understand how changes in the basic self develop over time, we may be able to help people earlier.
The REAL-Study: Reflection on Experiences of Alteration of Lived Self and Reality
In the REAL study, we explore moment-to-moment changes in the sense of self and reality. We involve people with lived experience at every level to create a self-report tool to study these changes over time. After that, we will use this instrument to track changes in the sense of self and reality in people at ultra-high risk of developing psychosis.