In 1936 Otto Isakower published an article on the psychopathology of phenomena associated with falling asleep: "Beitrag zur Pathopsychologie der Einschlafphänomene " (A contribution to the psychopathology of phenomena associated with falling asleep). It dealt with a varied set of phenomena similar to certain hypnogogic states and capable of being observed "in a number of patients suffering from widely different types of psychological disorders and also in some normal persons" (p. 331).
After studying several clinical cases, Isakower observed:
Most striking of all is the blurring of the distinction between quite different regions of the body, e.g. between mouth and skin, and also between what is internal and what is external, the body and the outside world. We note too the amorphous character of the impressions conveyed by the sense-organs. The visual impression is that of something shadowy and indefinite, generally felt to be 'round', which comes nearer and nearer, swells to a gigantic size and threatens to crush the subject. It then gradually becomes smaller and shrinks up to nothing [. . .] The auditory impression is of a humming, rustling, babbling, murmuring, or of an unintelligible monotonous speech. The tactile sensation is of something crumpled, jagged, sandy or dry, and is experienced in the mouth and at the same time on the skin of the whole body. Or else the subject feels enveloped by it or knows that it is close at hand. Sometimes it feels as if there were a soft yielding mass in his mouth, but at the same time he knows that it is outside him (p. 333).
The reference to the breast is obvious but the description is polymorphous. It appeals to the different senses, it is based on a relative confusion of the boundaries between the outside and the inside. It implies difficulty in evaluating distances; the mouth is often the center of these phenomena, that are sometimes played out in an atmosphere of déjà vu and against a background attitude of self-observation in the subject.
Over and above all the neurophysiological factors that are implied in these sort of phenomena, Isakower attempts to conduct a metapsychological analysis that refers back to a set of experiences that were lived through at a very early age, that may be at the origin of the somewhat unexpected success of this description: regression, splitting of the ego, relative indifferentiation of affects—all elements that led the author to conclude "we can observe the regressive revival of ego-attitudes which from the ontogenetic standpoint are primitive" (p. 345).
Such is the Isakower phenomenon, as it opens a window on the very ancient sensory history of the child, particularly the child at the breast if not, indeed, in the uterus. Hence the conclusion of the article: "In dreams and in the phenomenon which is the subject of this paper we have the best authenticated instances of the way in which that function may be renounced in order to conjure up lost objects and submerged worlds" (p. 345). In his own way and in a literary context, Marcel Proust described somewhat comparable phenomena on the verge of sleep.
See also: Dream screen; Isakower, Otto.
Isakower, Otto. (1938). A contribution to the psychopathology of phenomena associated with falling asleep. International Journal of Psycho-Analysis, 19, 331-345. (Original work published 1936)