What Is Ipseity Disturbance and Its Symptoms?
Learn about a disruption to the core sense of self that alters one's basic experience of their own thoughts, perceptions, and first-person perspective.
Ipseity is the sense of existing as a self. It is the pre-reflective awareness of being a unified individual who experiences life from a first-person point of view. This feeling of “I-ness” is the silent, constant background to all our thoughts and actions, the implicit knowledge that our experiences are our own. This sense of selfhood allows us to feel like the author of our thoughts and the agent of our actions. It provides a stable center from which we engage with the world, creating a seamless stream of consciousness we recognize as our own life.
Defining Ipseity Disturbance
When the sense of self becomes unstable, it results in ipseity disturbance. This is not a loss of identity in the conventional sense, but a fracture in the structure of self-experience. The disturbance consists of two interconnected components that alter a person’s relationship with their own consciousness.
One component is hyperreflexivity, an intense self-consciousness directed at processes that are normally automatic. For instance, if you suddenly become aware of the mechanics of walking, the effortless act becomes clumsy and unnatural. This excessive focus makes it difficult to simply “be.”
The other component is a diminished self-presence, a weakened sense of inhabiting one’s own life. Individuals may feel like a detached spectator to their own experiences, thoughts, and emotions, as if watching a film of their life. This creates a sense of distance where the feeling of being the subject of one’s own awareness fades.
Manifestations in Thought and Perception
Ipseity disturbance manifests in tangible ways, altering a person’s thoughts, bodily feelings, and perception of reality.
Bodily sensations can become a source of confusion through a state called “disembodiment.” This is not a literal out-of-body experience, but a subjective distance where the body feels more like an object. For example, a person might report that their own hand feels foreign or that they must consciously direct movements that were once spontaneous.
Disturbances in thought are also common, where the feeling of “mineness” is lost. Thoughts may seem to lack a personal origin, taking on an autonomous quality within the mind. A person might report a gap between their sense of self and the thoughts in their head, which can progress to feeling as if thoughts are being inserted.
The boundary between the self and the outside world can also become indistinct. This change makes it difficult to distinguish internal experiences from external events. The clear demarcation that separates “me” from “not-me” becomes permeable and uncertain.
Connection to Schizophrenia Spectrum Disorders
Ipseity disturbance is considered a core feature of schizophrenia spectrum disorders. The more widely recognized symptoms of schizophrenia, like hallucinations and delusions, are viewed as consequences of this disruption in the sense of self. The instability of the core self is believed to create a state from which these other symptoms emerge.
A person with a weakened self-presence may struggle to differentiate their own thoughts from external voices, potentially leading to auditory hallucinations. As the world and self lose their stable structure, the person may develop delusional beliefs to make sense of their altered reality.
Because these disruptions to the sense of self can appear in childhood or adolescence before overt psychosis, they are viewed as a potential early marker for schizophrenia risk. Identifying ipseity disturbance is therefore important for early intervention, shifting the focus to the core subjective changes that precede the disorder.
Distinguishing from Similar Experiences
While ipseity disturbance involves a sense of unreality, it is distinct from other dissociative experiences. The distinction lies in whether the disturbance affects the structure of selfhood or other aspects of experience.
Depersonalization is characterized by a feeling of being detached from oneself, as if one is an outside observer of their own thoughts, feelings, or body. However, in depersonalization, the basic sense of being a self—an “I” who is having this strange experience—remains intact. In contrast, ipseity disturbance strikes at this foundation, shaking the certainty of being a coherent subject.
Derealization involves the feeling that the external world is strange or unreal. People, objects, and surroundings may seem foggy, artificial, or dreamlike. The focus of the disturbance is on the perception of the outside world, not the internal sense of self. Ipseity disturbance, conversely, is primarily a disruption of the inner experience.
General identity confusion relates to the content of one’s identity rather than its fundamental structure. Questions like “Who am I?” or “What are my values?” reflect uncertainty about one’s personal narrative and social role. Ipseity disturbance is a deeper problem concerning the feeling of that I am—the basic awareness of being a conscious subject.