What if everything you thought you knew about yourself—your memories, your body, even your sense of being—was not as solid as it seemed? Science writer Anil Ananthaswamy invites us to explore this provocative idea through the lens of “altered selves,” experiences shaped by conditions like schizophrenia, Alzheimer’s, foreign limb syndrome, and out-of-body phenomena. His exploration is both a scientific journey and a deeply human one, urging us to rethink our assumptions about identity and reality.
About a decade ago, Ananthaswamy met someone who had experienced schizophrenia. They described how their sense of self felt like it was shifting: the edges of their body became fuzzy, and their psychological boundaries porous. This wasn’t simply a symptom, it was a profound alteration in how they perceived being themselves. Over time, Ananthaswamy encountered many such individuals and came to a startling realization: what we call the self is not a given. It’s not as “real” or permanent as we assume. It is, instead, a complex construction that can be reshaped—and sometimes undone—by the workings of the brain.
Take the simple, yet profound, question: “Who am I?” Most of us would answer with a story—a personal narrative that stitches together the episodes of our lives. But what happens when the ability to weave that story starts to falter? Alzheimer’s disease provides a stark example. In its early stages, Alzheimer’s disrupts short-term memory, making it difficult for new experiences to be integrated into the long-term narrative we rely on to define ourselves. As the disease progresses, it begins to erode even established memories, leaving the person unable to maintain a coherent story. The result is not just memory loss; it is a fracturing of the narrative self. Yet, even in this disrupted state, there remains a person—a witness to this altered narrative, no matter how scrambled it becomes.
Our relationship with our bodies offers another clue to the constructed nature of selfhood. Most of us take for granted that our bodies—and their parts—belong to us. But conditions like xenomelia, or foreign limb syndrome, challenge this assumption. In xenomelia, individuals may feel that one of their own limbs doesn’t belong to them, despite it being perfectly healthy. This is not a whimsical delusion but a profound failure of the brain’s processes that create our sense of bodily ownership. Just as a phantom limb is a mental presence of an absent body part, xenomelia is the unsettling reality of having an embodied limb that feels alien. In some cases, this can lead people to seek the removal of a limb they cannot integrate into their sense of self.
Agency—the feeling that we are the authors of our actions—is another foundational component of the self. Yet this too can fracture. People with schizophrenia may perform actions without the accompanying sense of agency, feeling as though movements or thoughts are imposed upon them. This dissociation highlights that even the sense of willing our actions is a mental construction vulnerable to breakdown.
Then there are experiences that seem to transcend the body entirely. Around five percent of people report having out-of-body experiences (OBEs), in which they feel as if their consciousness is floating outside their physical form, often observing their own body from above. Laboratory experiments have even replicated milder forms of OBEs, confirming that these experiences stem from disrupted brain processes. If the experience of “being in” a body is itself subject to distortion, it suggests that our sense of embodiment is yet another layer of the constructed self.
What do these diverse altered states teach us? They reveal that the components of selfhood—our narratives, sense of body ownership, sense of agency, and sense of embodiment—are all built by the brain. They feel immediate and undeniable, but they are in fact malleable and fragile. Theologians and philosophers have long debated whether the self is an illusion. The insights from altered minds give weight to this idea. If every aspect of what we take to be “me” can be disrupted, what remains?
This leads to the deeper question of whether there is an enduring “I” that experiences all of this—a core witness to these changes. Even in the face of disrupted narratives and fragmented body perception, there often seems to be some experiencer left. But if every constituent part of the self is a construction, could this experiencing “I” be just another mental fabrication? The answer is still elusive, and the debate continues.
For Ananthaswamy, the implications of this understanding are both humbling and empowering. On one hand, it challenges the idea that we are fixed, unchanging entities. On the other, it opens the door to greater compassion and flexibility. Knowing that our stories are constructed might help us hold them more lightly. It might allow us to let go of rigid identities that cause suffering—for ourselves and others. And perhaps most importantly, it invites empathy toward those living with altered selves. Their experiences are not deficits to be pitied but different ways of being that can teach us about the profound complexity and vulnerability of the human mind.
From the ancient meditations of the Buddha to the explorations of modern neuroscientists, humanity has long sought to understand the nature of the self. The experiences of those with altered minds provide a crucial piece of this puzzle. They remind us that while the self may feel solid and permanent, it is in fact a delicate tapestry woven by the brain and body. Appreciating this can help us become not only wiser but also more compassionate toward ourselves and each other.
Credits: Based on a talk by Anil Ananthaswamy, science writer and author.
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