A new framework for self-disorders: anxiety as a case study

Current conceptions of anxiety disorders often neglect the lived experience of individuals, resulting in an incomplete account of how anxiety alters both self- and world-experience. Taking first-person reports seriously and applying a phenomenological lens, this dissertation argues that anxiety disorders involve disruptions to the experiential core-self—the pre-reflective sense of being a bodily agent embedded in and capable of navigating the world. Specifically, I propose that anxiety disorders should be considered instances of self-disorders due to alterations in what I call the Felt-Reality System, a bodily-affective system responsible for conferring a sense of reality to objects and structuring one’s embedded agency. The Felt-Reality System not only underpins how individuals experience objects as real and co-spatial (here and now), but also plays a crucial role in constituting the pre-reflective sense of self—specifically, the embodied agential self embedded in a behaviorally-negotiable world. In cases of anxiety, this system undergoes breakdowns, producing an overwhelming sense that a threat is present here and now, disrupting the individual’s capacity to orient herself as an agent in behaviorally-negotiable world. Chapter 1 introduces the topic by reviewing existing research on anxiety, including its prevalence, treatment efficacy, and dominant explanatory models. In Chapter 2, I argue that Felt-Reality is a phenomenological feature of experience that implicitly shapes perception and action at the proto-noetic level. In Chapter 3, I consider ways the Felt-Reality System can breakdown and propose a novel conceptualization of anxiety as the Felt-Reality of threat, characterized by an overwhelming sense that a threat is present—even when it is neither here nor now—and a corresponding sense of the self as threatened. In Chapter 4, I argue that anxiety disorders include disruptions to an individual’s experiential core-self, the pre-reflective sense of being an agent in the world. On this view, anxiety disorders are instances of self-disorders, given the disruptions in the Felt-Reality System. This approach not only refines our understanding of anxiety disorders but also suggests novel therapeutic interventions. In Chapter 5, I conclude by advocating for phenomenological psychopathology that prioritizes lived experience, enabling more precise classifications and interventions in mental health.