Depersonalization
DEPERSONALIZATION
The term "depersonalization" refers to the appearance of subjective impressions of change affecting the person or the surrounding world. Their intensity varies, ranging from a simple feeling of dizziness to painful feelings of physical transformation, from the fleeting feeling of estrangement to the impression that the world has become unrecognizable, dead, or uninhabited. Moments of depersonalization can occur during the customary development of any individual or within overtly pathological clinical settings.
The concept of depersonalization is not directly present in the work of Sigmund Freud. In "Psychoanalytic notes on an autobiographical account of a case of paranoia (dementia paranoides)" (1911c [1910]), the elements of depersonalization perceptible in the subject's memory—themes of physical transformation, nerves of voluptuousness, the "hastily improvised men"—are not treated as such by Freud. Similarly the themes of depersonalization found in the Wolf Man—the "veil" that is torn during successive washings—are not referred to as such even though they are analyzed in depth (1918b [1914]). It is possible that it was only after the development of his concept of narcissism and the reorganization of the concept of the ego it contained that Freud became aware of depersonalization, in "The Uncanny" (1919h) and later in "A Disturbance of Memory on the Acropolis" (1936a). In both cases it is through feelings affecting the perception of the outside world that the topic is addressed, that is through the question of "derealization," which can be considered the result of a type of depersonalization.
Paul Schilder was one of the first authors to take an interest in depersonalization. He saw it as a function of the libido's withdrawal of cathexis from the image of the body. Paul Federn believed it corresponded to an alteration of the distribution of narcissistic libido throughout the body and its boundaries. Hermann Nunberg associated it with the loss of a significant object. Clarence Oberdorf emphasized the polymorphism of the clinical situations in which it could be observed and Andrew Peto investigated the role of the precocious loss of introjection. Maurice Bouvet, in an important study entitled "Dépersonalisation et relation d'objet," demonstrated the similarity of structure between states of depersonalization in their various clinical forms and treated "depersonalization as a state of weakened ego structure." He insisted on the importance of a "rapprochement" with the object, that is a decrease in the creation of psychic distance to the object, whereby the object returns to the position it held in the subject's unconscious fantasies. He also pointed out the character of the object relation that made it a narcissistic object since "the maintenance of the ego structure . . . depends on its unconditional and absolute possession." Bouvet also noted the importance of the conflict between the need to introject the object and the fear of this introjection.
Paul Denis
See also: Boredom; Bouvet, Maurice Charles Marie Germain; Ego boundaries; Ego feeling; Estrangement; Face-to-face situation; Disintegration, feelings of, (anxieties); Rosenfeld, Herbert Alexander; Self-consciousness; Tomasi di Palma Lampedusa-Wolff Stomersee, Alexandra.
Bibliography
Bouvet, Maurice. (1967). Œuvres psychanalytiques. I: La Relation d'objet: névrose obsessionnelle, dépersonnalisation. Paris: Payot.
Denis, Paul. (1981). J'aime pasêtre un autre. L'inquiétante étrangeté chez l'enfant. Revue française de psychanalyse, 65,3.
Freud, Sigmund. (1919h). The uncanny. SE, 17: 217-256.
——. (1936a). A disturbance of memory on the Acropolis. SE, 22: 239-248.
Stewart, Walter A. (1964). Depersonalization. Journal of the American Psychoanalytic Association, 12, 171-186.
Further Reading
Jacobson, Edith. (1959). Depersonalization. Journal of the American Psychoanalytic Association, 7, 581-610.
Renik, Owen. (1978). The role of attention in depersonalization. Psychoanalytic Quarterly, 47, 588-605.
Rosenfeld, Herbert. (1947). Analysis of a schizophrenic state with depersonalization. International Journal of Psychoanalysis, 28, 130-139.
Depersonalization
Depersonalization
Definition
Depersonalization is a mental state in which people feel detached or disconnected from their personal identities or selves. This may include the sense that one is “outside” oneself, or is observing one’s own actions, thoughts, or body.
Description
People experiencing depersonalization may feel so detached that they feel more like robots than human beings. However, such people always are aware that this is just a feeling; there is no delusion that one is a lifeless robot or that one has no personal identity. The sense of detachment that characterizes the state may result in mood shifts, difficulty thinking, and loss of some sensations—a state that can be described as numbness or sensory anesthesia.
Depersonalization can also occur transiently in people in many different stress-inducing situations, including sleep deprivation, test taking, or being in a traffic accident. The feeling of detachment also can arise as a result of anesthesia or from using nitrous oxide. In addition, people experience depersonalization in different ways. People may feel like they are floating on the ceiling, watching themselves, or as though they are in a dream. Individuals with depersonalization may feel that events and the environment are unreal or strange, a state called derealization. Derealization, a dissociation symptom, differs from depersonalization in that it is the environment that seems unreal or dreamlike.
Episodes of depersonalization can last from a few seconds to years. The frequency may increase after traumatic events such as exposure to combat, accidents, or other forms of violence or stress. Treatment depends on the context of the depersonalization episode or episodes.
Depersonalization can be a symptom of other disorders, including panic disorder, borderline personality disorder, post-traumatic stress disorder (PTSD), acute stress disorder , or one of several dissociative disorders, including depersonalization disorders. A person will not be diagnosed with depersonalization disorder as the primary problem if the episodes of depersonalization occur only during panic attacks or following a traumatic stressor.
Depersonalization is a common experience in the general adult population, although twice as many women as men receive treatment for it. However, when a patient’s symptoms are severe enough to cause significant emotional distress or to interfere with normal functioning, they may meet the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (the DSM-IV-TR) for “depersonalization disorder.”
See alsoAcute stress disorder; Dissociation and dissociative disorders; Post-traumatic stress disorder; Schizophrenia.
Resources
BOOKS
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Text rev. Washington, D.C.: American Psychiatric Association, 2000.
“Depersonalization Disorder.” The Merck Manual of Diagnosis and Therapy, eds. Mark H. Beers, MD, and Robert Berkow, MD. Sec. 15, Chap. 188. Whitehouse Station, NJ: Merck Research Laboratories, 2001.
Medical Economics staff. Physicians’ Desk Reference. 56th ed. Montvale, NJ: Medical Economics Company, 2002.
ORGANIZATIONS
International Society for the Study of Dissociation (ISSD). 8201 Greensboro Drive, Suite 300. McLean, VA 22102. Telephone: (703) 610-9037. Web site: <http://www.issd.org/index_actual.html>.
National Institute of Mental Health. 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663. Telephone: (301) 443-4513. Web site: <www.nimh.nih.gov>.
National Organization for Rare Disorders. P. O. Box 8923, New Fairfield, CT 06812-8923. Telephone: (203) 746-6518. Web site: <www.rarediseases.org>.
Society for Traumatic Stress Studies. 60 Revere Drive, Suite 500, Northbrook, IL 60062. Telephone: (708) 480-9080.
OTHER
The Mayo Clinic. “Dissociative Disorders.” <http://www.mayoclinic.com/health/dissociative-disorders/DS00574/DSECTION=5>.
Dean A. Haycock, PhD
Emily Jane Willingham, PhD
Depersonalization
Depersonalization
Definition
Depersonalization is a mental state in which a person feels detached or disconnected from his or her personal identity or self. This may include the sense that one is "outside" oneself, or is observing one's own actions, thoughts or body.
Description
A person experiencing depersonalization may feel so detached that he or she feels more like a robot than a human being. However, the person always is aware that this is just a feeling; there is no delusion that one is a lifeless robot or that one has no personal identity. The sense of detachment that characterizes the state may result in mood shifts, difficulty thinking, and loss of some sensations— a state that can be described as numbness or sensory anesthesia. Twice as many women as men are treated for depersonalization, which can last from a few seconds to years. Episodes may increase after traumatic events such as exposure to combat, accidents or other forms of violence or stress . Treatment is difficult and the state is often chronic, although it may occur during discrete periods or increase and decrease in intensity over time. Individuals with depersonalization often feel that events and the environment are unreal or strange, a state called derealization.
See also Acute stress disorder; Dissociation and dissociative disorders; Post-traumatic stress disorder; Schizophrenia
Dean A. Haycock, Ph.D.