Self-experience in Dementia

Dementia impairs narrative self-understanding, but more basic levels of self-experience—pre-reflective self-awareness and an episodic sense of self—are preserved until the final stages of the illness. The paper distinguishes three layers of selfhood: the minimal or pre-reflective self, the episodic self, and the narrative self. Against the view that dementia reduces the self to a bare minimal self, the authors argue that forms of self-reference and episodic self-awareness remain intact even when narrative identity is disrupted. This analysis clarifies conceptual confusion in dementia research about self and person.

Study at a glance

Abstract

This paper develops a phenomenological analysis of the disturbances of self-experience in dementia. After considering the lack of conceptual clarity regarding the notions of self and person in current research on dementia, we develop a phenomenological theory of the structure of self-experience in the first section. Within this complex structure, we distinguish between the basic level of pre-reflective self-awareness, the episodic sense of self, and the narrative constitution of the self. In the second section, we focus on dementia and argue that, despite the impairment of narrative self-understanding, more basic moments of self-experience are preserved. In accordance with the theory developed in the first part, we argue that, at least until the final stages of the illness, these self-experience in dementia goes beyond the pure minimal self, and rather entail forms of self-reference and an episodic sense of self.