Body Image and Self-Concept in Schizophrenia

Abstract

Disturbances of ego, self-concept and body-image have always been regarded as central in the psychopathology of schizophrenia. The passivity phenomena, automatisme superieur of the French authors, are indeed very common in this disease. There is a disturbance of the self which is shown in depersonalization and in feelings of influence and passivity. The boundaries of the self become loose or blurred and the patient may feel, for example, that parts of his body do not belong to him or that he is part of the plants, animals, clouds, other people or of the whole world and that they are part of him. He may feel at one with the whole of mankind. Self-concept is closely related to what has been termed “body image” or “perceived body”. Head (29, 30) has shown that what he called “body schema” is very important for motor co-ordination and performance of purposeful movements and also for orientation in space. Schilder (53) in his monograph has analysed the problem of body-image in great detail. He has found in the idea of the body image the basis for the body or physical ego. He follows Head in stating that the body image consists of the proprioceptions of the whole body and that it changes with the body's varying postures. Yet neither Head's body schema nor Schilder's body image are identical with the body ego. The body schema represents the constant mental knowledge of one's body; the body image is the changing presentation of the body in one's mind. Throughout the changes of the body image there is an awareness of continuity of one's body, a sense of basic identity and oneness. This constitutes the bodily or physical ego. The body ego in its turn is the basis of a wider “self” which can be called self-concept or selfhood. This self-concept or selfhood contains, in addition to the awareness of the continuity and the identity of one's own body in spite of its constant change, the awareness of the continuity of one's self as a person in spite of constantly changing relationship with the external world, and in spite of the playing and taking different “roles” in social interactions. According to Mead (38) and Coutu (16), selfhood is a social phenomenon and emerges only through interaction with other people, through “taking their roles” and viewing oneself from their point of view.