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Schilder's definition is accepted which regards this state as one where the ego and the external world seem to the patient different from heretofore, changed and unreal.
Such feelings are commonest among schizophrenics. But every analyst will hear complaints of such a condition in cases of transference neurosis. Histories of six cases are given: The first case described was an hysteric who frequently complained of peculiar feelings of strangeness in his body. He once narrated a dream where a horse in the stable grazed off a sausage suspended high up. Analysis showed it to be a castration dream. During the recital the dreamer experienced a peculiar sensation in the arm as if it did not belong to him; he felt as if the arm were in some corner of the room. The castration symbolically experienced in the dream was continued in the waking state as the loss of a part of his physical self.
Although there is much still obscure, Nunberg concludes: States of depersonalization depend upon a discharge of libido. The actual ego perceives its capacity to give satisfaction to the libidinal desires. The loss of libido is experienced as a narcissistic wounding. The super (ideal) ego can no longer be fulfilled in its ego, having abrogated relationship to its ego. Hence there arises a disturbance in the feeling of self.