Contemplating my greater concentration of paranoid people on my current caseload, I am struck by how many of them cannot accept blame for even the smallest of infractions. I am not suggesting, not by a long shot, that character traits are driving schizophrenia. But I do wonder if we have misunderstood which part of the brain is broken. At present, we see the self-observation and considering-alternative-narrative areas of the cortex as the culprits. But those areas are also exactly the ones we use in mediating discomfort about taking responsibility. Accepting blame/consequences/responsibility means envisioning how we might have acted in a better way.
Yet which part broke first? Dealing with discomfort or entertaining competing narratives?
In truth, I think I am running well beyond the data here, and going all blue-sky on you. But a smarter person than I might benefit from the different angle.