The Seven Selves of Dementia

Abstract

The self is a complex and multifaceted phenomenon, encompassing a variety of cognitive processes and psychosocial influences. Considering this, there is a multiplicity of "selves," the current review suggesting that seven fundamental self-processes can be identified that further our understanding of the experience of dementia. These include (1) an embodied self, manifest as corporeal awareness; (2) an agentic self, related to being an agent and influencing life circumstances; (3) an implicit self, linked to non-conscious self-processing; (4) a critical self, which defines the core of self-identity; (5) a surrogate self, based on third-person perspective information; (6) an extended self, including external objects or existences that are incorporated into the self; and, finally, (7) an emergent self, a property of the self-processes that give rise to the sense of a unified self. These are discussed in relation to self-awareness and their use in making sense of the experience of dementia.

Keywords: Alzheimer's disease; awareness; dementia; self; selfhood.

Figure 1

The Components of the Self Model (CoSM). The relationship between the seven forms of self-processes reviewed here is illustrated. Neurocognitive processes, such as the implicit, critical, and surrogate, interact with and are controlled by agentic processes. All these systems are embodied. Beyond an individual perspective, interaction between embodied and social processes leads to extended selfhood. The emergent self is the result of these multiple interactions, providing a unifying context for experience and allowing for some self-processes to compensate for impairments in others.