Elsevier

Consciousness and Cognition

Volume 14, Issue 4, December 2005, Pages 752-770
Consciousness and Cognition

The self in action: Lessons from delusions of control

https://doi.org/10.1016/j.concog.2005.04.002Get rights and content

Abstract

Patients with delusions of control are abnormally aware of the sensory consequences of their actions and have difficulty with on-line corrections of movement. As a result they do not feel in control of their movements. At the same time they are strongly aware of the action being intentional. This leads them to believe that their actions are being controlled by an external agent. In contrast, the normal mark of the self in action is that we have very little experience of it. Most of the time we are not aware of the sensory consequences of our actions or of the various subtle corrections that we make during the course of goal-directed actions. We know that we are agents and that we are successfully causing the world to change. But as actors we move through the world like shadows glimpsed only occasional from the corner of an eye.

Section snippets

How do we understand disorders of the self in schizophrenia?

The diagnosis of schizophrenia is largely based on what patients report about their experiences and beliefs. These experiences and beliefs are typically labelled hallucinations and delusions and are considered to be abnormal because they are false. The experiences are false in the sense that they do not correspond to the sensory input. The beliefs are false in that they are not justified by the evidence. Since misperceptions and false beliefs in this sense are rather common in the general

Disordered experiences of the self in schizophrenia

Hearing voices (auditory hallucinations) are a characteristic symptom of schizophrenia (Slade & Bentall, 1988). In some cases there is evidence that ‘the voice’ is overtly generated by the patient since the content of sub-vocal muttering can be shown to correspond to the content of ‘the voice’ reported by the patient (Gould, 1949, Green and Preston, 1981).

The patient whispers, ‘The only voice I hear is hers. She knows everything. She knows all about aviation.’ At this point the patient states

The feeling of being in control

Hohwy and Frith (2004) have proposed that the feeling of being in control is a case where neuroscience has informed our understanding of one aspect of consciousness. We suggest that the feeling of being in control has two core components: a mechanism for prediction and attenuating sensations associated with movements, and a mechanism for the on-line adjustment of movements without awareness. Both mechanisms are necessary for our feeling of being in control of our actions. If one could make

Awareness of action initiation

So far I have discussed how prediction modifies our experience during the course of an action; what the movement will feel like and its course and timing. However, we are also aware of the moment of initiating an action. The well-known paradigm developed by Libet (Libet, Gleason, Wright, & Pearl, 1983) reveals two aspects of actions that we are aware of before any sensory feedback occurs. The first is the time at which we first have the ‘urge’ to perform an act and the second is the time at

The feeling of agency

Agency is all about causality. There are two aspects of agency in action. At the lower level there is the perception that my act has caused some effect. For example, by pressing this button I have caused a sound to occur. At a more abstract level there is the perception that my intention to press the button has caused my act of pressing the button.

Where does our feeling of agency come from? Wegner and Wheatley (1999) have shown that simple contingency can be sufficient. If the intention to act

Awareness of agency in others

This binding effect (and the associated perception of agency) also occurs when we observe other peoples’ actions. If we watch someone else doing the button pressing task, then the time at which the button is pressed and the time at which the tone occurs appear to be closer together than they really are. However, this intentional binding does not occur when the button is pressed by a mechanical device (Wohlschläger, Haggard, Gesierich, & Prinz, 2003). At first sight the intentional binding that

Conclusions

Since the original proposal that delusions of control in schizophrenia might be explained by a defect in self-monitoring there has been a dramatic increase in studies of the awareness of action in normal volunteers and in various patient groups. In the normal case the experience of action is indeed transparent. Our perception of the sensations caused by our actions is attenuated and we are not aware of the minor corrections made on the course of goal directed movements. These effects derive

Acknowledgments

This work was supported by the Wellcome Trust. I grateful to George Graham, Daniel Wegner, and the editors for their insightful comments on earlier drafts of this paper.

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