Kafka, paranoic doubles and the brain: hypnagogic vs. hyper-reflexive models of disrupted self in neuropsychiatric disorders and anomalous conscious states

Cognitive and clinical neuroscience face very real problems about the nature of the human self, how we define and study "self," and treat individuals when the mind, or brain, becomes so disordered that the experience of self becomes disrupted. "Cognitive neuroscience" contains the terms, "mind" and "brain," respectively. These terms remain imprecise due to a fundamental ambiguity that we are both minds, i.e., being a self (so-called first-person experience), and brains or bodies, i.e., having a self (third-person perspective). The experienced body (and implicated neural pathways) is comprised by both a motoric-body (proprioceptive body-schema), the "I" (as agent), and perceptual-body (exteroceptive body-image), the social "me," united provisionally and fragilely by an interoceptive body (the "mineness" of this relationship). "Mineness" is disrupted in hallucinations of a double or Doppelg？nger. The verbal descriptors "I," "me," and "mine," however, are only approximations of the underlying neural processes [1-3]. We are generally equipped with common-sense folk-psychological views about self and how we experience other selves, which help us get by in everyday situations. Nevertheless, the self has turned out to be exceptionally difficult to define, operationalize and study in neuroscience and related disciplines. Many researchers in the fields of cognitive science/neuroscience refer to the ability to recognize self in the mirror, or make judgments involving oneself as evidence of self, but this is one-sided. Much of the self-awareness literature confuses mediated self-reference of higher order cognition with being a self. It addresses the self as object (having a self), not self as subject (being a self). By overlooking this conceptual distinction, self-reference (representational content about self or self-awareness, self as object) is confused with "being a self" (e.g., Gusnard [4]). The current exclusive focus on self as object ("self-representation," rather than