PSYCH 029: Neuropsychiatry of Self

The sense of self feels immediate and unquestionable - yet it is a construction. This chapter explores the neuropsychiatry of self, examining how brain systems generate the experience of being a coherent, continuous individual.In this episode, we examine how networks such as the default mode network contribute to self-referential processing - enabling reflection, autobiographical memory, and the sense of continuity across time. The self is not located in a single region, but emerges from coordinated activity across distributed systems.We explore different dimensions of selfhood: the minimal self (immediate experience), the narrative self (identity over time), and the social self (how we relate to others). These layers interact to produce the experience of “I”.Disruptions in these systems can lead to profound alterations in experience - from depersonalisation and dissociation to the fragmentation seen in psychosis. These are not simply cognitive disturbances, but shifts in the very structure of subjective experience.This chapter challenges assumptions. The self is not fixed - it is dynamic, constructed, and dependent on underlying neural processes. Understanding this opens new ways of thinking about both normal experience and psychiatric disorder.Key Takeaways* The sense of self is constructed through distributed brain networks.* The default mode network plays a key role in self-referential processing.* Selfhood includes minimal, narrative, and social dimensions.* Continuity of identity emerges from integration across time and memory.* Disruptions can lead to depersonalisation, dissociation, and psychosis.* The self is dynamic, not fixed.* Psychiatry must engage with subjective experience as well as biology. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe