Alexander A. Fingelkurts

In this conceptual review, we explore how alterations in the configuration and expression of the three core aspects of experiential Selfhood—‘Self,’ ‘Me’, and ‘I’—both reflect and shape an individual’s susceptibility to neuropsychopathology. Drawing on empirical neurophenomenological evidence and theoretical insights, we examine a range of psychiatric and neurological disorders through the lens of the Selfhood triumvirate. Our findings indicate that, despite variations in the expression of Selfhood aspects across different pathologies, their proportional configuration remains remarkably stable in most conditions, with the ‘Self’ aspect consistently dominant, followed by the ‘Me’ aspect, and finally the ‘I’ aspect. This stability suggests a fundamental neurophenomenological hierarchy in Selfhood organization, which seems to be disrupted only in extreme cases such as vegetative (unresponsive) states and also schizophrenia. Ultimately, we propose that all neuropsychopathologies are best understood as disorders of Selfhood, where disruptions in the dynamic balance and configuration of the ‘Self’, ‘Me’, and ‘I’ aspects accompany neurophenomenological manifestations in distinct dysfunctions and pathologies.

Unprecedented advancements in the diagnosis and treatment of patients with disorders of consciousness (DoC) have given rise to ethical questions about how to recognize and respect autonomy and a sense of agency of the personhood when those capacities are themselves disordered, as they typically are in patients with DoC. At the intersection of these questions rests the distinction between consciousness and unconsciousness. Indeed, evaluations of consciousness levels and capacity for recovery have a significant impact on decisions regarding whether to discontinue or prolong life-sustaining therapy for DoC patients. However, in the unconsciousness domain, there is the confusing array of terms that are regularly used interchangeably, making it quite challenging to comprehend what unconsciousness is and how it might be empirically grounded. In this opinion paper, we will provide a brief overview of the state of the field of unconsciousness and show how a rapidly evolving electroencephalogram (EEG) neuroimaging technique may offer empirical, theoretical, and practical tools to approach unconsciousness and to improve our ability to distinguish consciousness from unconsciousness and also nonconsciousness with greater precision, particularly in cases that are borderline (as is typical in patients with DoC). Furthermore, we will provide a clear description of three distant notions of (un)consciousness (unconsciousness, nonconsciousness, and subconsciousness) and discuss how they relate to the experiential selfhood which is essential for comprehending the moral significance of what makes life worth living.

Background: There is a growing consensus that chronological age (CA) is not an accurate indicator of the aging process and that biological age (BA) instead is a better measure of an individual’s risk of age-related outcomes and a more accurate predictor of mortality than actual CA. In this context, BA measures the “true” age, which is an integrated result of an individual’s level of damage accumulation across all levels of biological organization, along with preserved resources. The BA is plastic and depends upon epigenetics. Brain state is an important factor contributing to health- and lifespan. Methods and Objective: Quantitative electroencephalography (qEEG)-derived brain BA (BBA) is a suitable and promising measure of brain aging. In the present study, we aimed to show that BBA can be decelerated or even reversed in humans (N = 89) by using customized programs of nutraceutical compounds or lifestyle changes (mean duration = 13 months). Results: We observed that BBA was younger than CA in both groups at the end of the intervention. Furthermore, the BBA of the participants in the nutraceuticals group was 2.83 years younger at the endpoint of the intervention compared with their BBA score at the beginning of the intervention, while the BBA of the participants in the lifestyle group was only 0.02 years younger at the end of the intervention. These results were accompanied by improvements in mental–physical health comorbidities in both groups. The pre-intervention BBA score and the sex of the participants were considered confounding factors and analyzed separately. Conclusions: Overall, the obtained results support the feasibility of the goal of this study and also provide the first robust evidence that halting and reversal of brain aging are possible in humans within a reasonable (practical) timeframe of approximately one year.

Medical well-regarded policy recommendations for patients with disorders of consciousness (DoC) are almost exclusively relied on behavioural examination and evaluation of higher-order cognition, and largely disregard the patients’ self. This is so because practically establishing the presence of self-awareness or Selfhood is even more challenging than evaluating the presence of consciousness. At the same time, establishing the potential (actual physical possibility) of Selfhood in DoC patients is crucialy important from clinical, ethical, and moral standpoints because Selfhood is the most central and private evidence of being an independent and free agent that unites intention, embodiment, executive functions, attention, general intelligence, emotions and other components within the intra-subjective frame (first-person givenness). The importance of Selfhood is supported further by the observation that rebooting of self-awareness is the first step to recovery after brain damage. It seems that complex experiential Selfhood can be plausibly conceptualized within the Operational Architectonics (OA) of brain-mind functioning and reliably measured by quantitative electroencephalogram (qEEG) operational synchrony.

Many practicing clinicians are time-poor and are unaware of the accumulated neuroscience developments. Additionally, given the conservative nature of their field, key insights and findings trickle through into the mainstream clinical zeitgeist rather slowly. Over many decades, clinical, systemic, and cognitive neuroscience have produced a large and diverse body of evidence for the potential utility of brain activity (measured by electroencephalogram—EEG) for neurology and psychiatry. Unfortunately, these data are enormous and essential information often gets buried, leaving many researchers stuck with outdated paradigms. Additionally, the lack of a conceptual and unifying theoretical framework, which can bind diverse facts and relate them in a meaningful way, makes the whole situation even more complex. To contribute to the systematization of essential data (from the authors’ point of view), we present an overview of important findings in the fields of electrophysiology and clinical, systemic, and cognitive neuroscience and provide a general theoretical–conceptual framework that is important for any application of EEG signal analysis in neuropsychopathology. In this context, we intentionally omit detailed descriptions of EEG characteristics associated with neuropsychopathology as irrelevant to this theoretical–conceptual review.

This study investigates eight case reports of spontaneously emerging, brief episodes of vivid altered states of Selfhood (ASoSs) that occurred during mental exercise in six long-term meditators by using a neurophenomenological electroencephalography (EEG) approach. In agreement with the neurophenomenological methodology, first-person reports were used to identify such spontaneous ASoSs and to guide the neural analysis, which involved the estimation of three operational modules of the brain self-referential network (measured by EEG operational synchrony). The result of such analysis demonstrated that the documented ASoSs had unique neurophenomenological profiles, where several aspects or components of Selfhood (measured neurophysiologically and phenomenologically) are affected and expressed differently, but still in agreement with the neurophysiological three-dimensional construct model of the complex experiential Selfhood proposed in our earlier work (Fingelkurts et al. in Conscious Cogn 86:103031. https://doi.org/10.1016/j.concog.2020.103031, 2020).