Disturbed time experience during and after psychosis

Abstract

Disturbances in time experience have been argued to play a significant, if not causative role in the clinical presentation of schizophrenia. Phenomenological considerations suggest a fragmented or dis-articulated time experience causing both primary symptoms such as hallucinations, delusions, and self-disorders, as well as an intersubjective desynchronization. We employed content analysis on material collected from patients diagnosed with schizophrenia using the Time Questionnaire to generate hypotheses on possible disturbances of time experience in schizophrenia. As a key result we find evidence for the distinction between acute psychotic and post-psychotic syndromes. Acute psychosis is predominantly a disturbance of the passage of time, whereas the remission from psychosis is primarily defined by changes in the experience of the explicit structure of time integrating past, present, and future. We discuss our findings with regards to previous insights and observations on time experience and time perception. We suggest our findings hold significance for the diagnostic and therapeutic understanding of schizophrenia as well as for future integrative research on time experience in general.

The Temporality of Situated Cognition

“…For future consideration, we propose that these changes of the temporal experience in altered mental states can be much better understood in terms of an altered enduring situatedness. Similar approaches may exist for other disorders and mental states for which temporality has been proposed as a defining constituent (e.g., Zukauskas et al, 2009 ; Hohwy et al, 2016 ; Vogel D. et al, 2019 ; Vogel D. H. V. et al, 2019 ; Vogel et al, 2020 ).…”

“…Relating this phenomenological view to current hypotheses from neuroscience, the cause for temporal fragmentation is hypothesized to lie in a faulty evaluation of predictions by the brain, caused by dysregulated dopamine release ( Fletcher and Frith, 2009 ; Vogel D. H. V. et al, 2019 ). These inadequate predictions need to be explained by a dominant involvement of top-down processes that correlate to the development of delusional believes.…”

“…From a phenomenological point of view, it has primarily been argued that this fragmentation is due to an alteration of the future directed protention on the microlayer of time ( Kupke, 2009 , pp. 53–62; Fuchs, 2013 ; Stanghellini et al, 2016 ; Vogel D. H. V. et al, 2019 ; Vogel D. et al, 2019 ). In this context, protention is understood as analogous to an anticipatory process ( Fuchs, 2013 ), which graduates future perceptions along a spectrum of probability.…”

“…In both exemplary cases, these alterations in temporal experience have been described as hypothetically linked to changes in predictive processing (e.g., Kent et al, 2019 ; Vogel D. et al, 2019 ; Vogel D. H. V. et al, 2019 ; Vogel et al, 2020 ) just as temporality and predictive processing more generally have been ( Grush, 2006 ; Hohwy et al, 2016 ; Wiese, 2017 ). Although these two approaches may not coincide in all respects [e.g., the debate between (neo-)neo-Kantian representationalism and Husserlian transcendental idealism ( Zahavi, 2018 ), or see Grush, 2006 for an overview of difficulties and weaknesses of some integrative approaches mentioned or referred to herein], they converge on the intrinsic unfolding of temporality on what we have now called the microlayer of time.…”

Predictive processing as a systematic basis for identifying the neural correlates of consciousness

“…As a final example, the sense of the present as temporally extended may be explained by PP-like internal simulation (Grush 2006); the sense of temporal flow of conscious experience -how one moment passes seamlessly into the next even when nothing much happens in the environment -may be explained by the dynamics of hierarchical Bayes that encode expected change in the environment (Hohwy, Paton et al 2016, Vogel, Falter-Wagner et al 2018, Vogel, Beeker et al 2019, Sherman, Fountas et al 2020; this process may in turn relate to the alternation of percepts in binocular rivalry, as discussed above.…”