As pointed out by Searle (1987), sub-jectivity and intentionality have alwaysbeen defined as basic characteristics ofconsciousness. Both of them are alsoneeded in order to determine whethera person is a (self-)murderer or not: alegal report of the consciousness stateshould verify whether at that particularmoment a person was subjectively andintentionally able to decide on his/herown actions. Despite the relevance of thisassessment, at the moment the scien-tific community is not providing a uni-fied definition of consciousness (Velmans,2009). This lack is particularly relevantfor psychopathology, since consciousnessproblems have been connected to sev-eral clinical pathologies. In the past, veryscarce attention has been paid to theclinical assessment of consciousness, andresearch was mainly devoted to disordersof consciousness. However, assessment ofconsciousness has been acknowledged asbeing extremely relevant for psychiatricpathologies too, as a way of prevent-ing self-harming and suicidal behavior.Several pathologies could result in suici-dal behavior, such as schizophrenia (Boband Mashour, 2011), substance-relateddisorders (Bortelote et al., 2004), post-traumatic stress disorder (O’Brien andNutt, 1998), eating disorders (Favaro andSantonastaso,1995),andothers.Literaturehas usually divided people linked toself-harm into two branches: those whocommitted suicidal actions with a specificintention (intentional suicides, ISP), andthose who died as a consequence of a riskybehavior,withoutaclearsuicidalintention(risky behavior people, RBP).The ISP sample is mainly composedby people who are/were suffering fromeither major or mixed depressive episodes(Schneider, 2003; Bortelote et al., 2004).These patients usually focus attention onsingle aspects of their perception, con-cerning inner experiences (Ringel, 1953)or circumstances (i.e., confrontation withlifeortraumaticeventsaswellasdevel-opmental tasks: Tschiesner et al., 2012).Patients of this group perceive and elab-orate only specific contents according totheir symptoms, and this may be viewedalso as a restriction of consciousness(Ringel, 1953; Poldinger, 1968). The con-tent of their phenomenal consciousnessconsists, on the one hand, mainly of emo-tional experiences in many cases ratedmore intense as normal, and, on the otherhand, of a constriction in perceiving alter-native ways of behavior or reaction indifficult situations. Therefore, a dyspho-ric mood characterizes consciousness andtriggers intentions of the same conno-tation, forcing people to direct aggres-sion toward themselves (Ringel, 1953).Rottenberg et al. (2006) have shown thiscongruency between mood and behaviorin depressive patients, a fact that, in turn,wouldexplain whyitissodifficult todefertheir attention from their negative emo-tional status, which could lead them tocarry out suicidal actions. Self-harmingbehavioristhereforeoneoftheaimsofISP,and consistent with, and caused by, theirconstricted consciousness.The RBP category includes people thatare for example looking for thrills doingextreme sports or putting themselvesin dangerous situations, or doing theirofficial jobs like policemen, paramedics,soldiers,orfirefighters(Goma-i-Freixanet,1995; Tschiesner, 2012). The drive forsituations characterized by novelty andintensity has been described in theSensations Seeking sub-construct “thrilland adventure seeking” (Zuckerman,2007). Sensation-seekers are described asshowingalowlevelofarousal,andtheytryto increase it, in an unconscious way, bydoing extreme sports, consuming drugs,attending religious rituals and so on.This way of controlling arousal throughintense and novel stimuli (Arnett, 1995;Zuckerman, 2007) has been indicated asthe main indirect cause for assuming risksand provoking accidents. Accordingly,Schneider and Rheinberg (2003) arguedthat the aim of risky behavior—by doingrisky activities–is not the danger in itself,but the ability to keep control in dan-gerous situations. Keeping control in adesperate situation like climbing a wallwithout a rope is linked with pleasure(Balint, 1959). Rephrasing, we may saythat RBP seek to manage themselves inextreme situations, in which normal peo-plewouldn’tbeabletodoso.Thisway,RBP are intentionally targeting on theperformance but not the correlated risks,the latter being part of the whole situa-tion,butexcludedfromconsciousanalysis.The access to consciousness is influenced
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Jun 7, 2024
Justine Vily-Petit + 9
Open Access