E-Mail karger@karger.com Psychopathology DOI: 10.1159/000431291 Anomalies of Imagination and Disordered Self in Schizophrenia Spectrum Disorders Andreas Rosén Rasmussen   a Josef Parnas   a, b a  Psychiatric Center Hvidovre, Faculty of Health and Medical Sciences, University of Copenhagen, Brøndby, and b  Center for Subjectivity Research, Faculty of Humanities, University of Copenhagen, Copenhagen, Denmark the underlying generative disorder of schizophrenia, name- ly the disorder of minimal self (unstable ipseity or first-person perspective). We propose that pathology of imagination is an important psychopathological aspect of the schizophre- nia spectrum, with significant relevance for early diagnosis and differential diagnosis. © 2015 S. Karger AG, Basel Introduction Imagination is a specific modality of intentionality (i.e. a specific mode of consciousness), often epitomizing the very notion of the so-called ‘inner life’. Imagination is re- lated to other intentional modes such as perceiving, thinking, remembering and feeling. Psychiatry, especially with its contemporary operational-polythetic (logical- empiricist) orientation, lacks the conceptual and descrip- tive resources to grasp and articulate such subjective dis- tinctions [1]. Here, a psychiatrist has at his disposal only a common sense, lay understanding of mental terms, and very likely he would find it hard to account for the expe- riential distinctiveness of, e.g., the acts of imagination, perception or recollection. However, many patients with various disorders, e.g. affective, anxiety and schizophre- Key Words Imagination · Self-disorders · Schizophrenia spectrum disorders · Mental imagery · Obsessions · Pseudohallucination · Schizophrenia Abstract Vivid mental imagery occurs frequently in schizophrenia spectrum disorders (SSDs). Overlapping phenomena, such as obsessions or ruminations, are also frequent in other psy- chiatric disorders, raising significant diagnostic challenges. Unfortunately, contemporary operational psychopathology lacks the epistemological and phenomenological frame- work to address such questions. Using the resources of phe- nomenology and philosophy of mind, we articulate the structure of imagination and describe its distinctive modifi- cations in the SSDs. Drawing on pilot data with patients’ self- descriptions, we present the notion of perceptualized imag- ery. The anomalous imagery acquires spatialization, spatio- temporal constancy, explorability, autonomy and a sense of experiential distance between the subject and the image. As a quasi-perceptual, stable object, such imagery often evokes an intense affective response, whereas the normal sense of ‘irreality’ of the fantasy may become compromised. We ar- ticulate these anomalies of imagination as being entailed by Received: February 23, 2015 Accepted after revision: May 8, 2015 Published online: September 10, 2015 Andreas Rosén Rasmussen, MD Psychiatric Center Hvidovre, Faculty of Health and Medical Sciences University of Copenhagen, Brøndbyøstervej 160 DK–2605 Brøndby (Denmark) E-Mail Arr  @  dadlnet.dk © 2015 S. Karger AG, Basel 0254–4962/15/0000–0000$39.50/0 www.karger.com/psp Downloaded by: Copenhagen University Library 198.143.54.65 - 9/10/2015 8:13:22 PM