A Note on Depersonalization1

Some recent material from a patient drew my interest to the subject of depersonalization. This was confirmed by subsequent and reviewed material from other patients. It seemed to me to throw some light on the question of what really happens psychically when the phenomenon first occurs. Further it seemed possible to understand it in terms, not of theory, but of the patient's own available mentality. And also it pointed to a more definite interplay between the psyche and the nonhuman material environment than I had hitherto suspected. That is: things, clothes, furniture, etc., play, it seemed to me, a decisive rôle in this phenomenon in which people seem to lose their personality and become strangely unreal. Sadger2 quotes a classic case (from Ball, 1874). This man described himself as having nothing left but an empty body; his personality had disappeared; he called himself a 'thing'. Other people were 'things', not really existing. Federn3 gives an excellent description of depersonalization. He designates it 'the most frequent transitory narcissistic actual psychosis', and continues 'From our practice and from the literature on the subject we all know the earnest, and always somewhat uncanny, complaints with which severe cases of depersonalization describe their condition, or rather their changing conditions. The outer world appears substantially unaltered, but yet different; not so essentially, so actually, near or far, clear, warm, friendly and familiar; not really and truly existing and alive; more as if in a dream and yet different from a dream. At heart the patient feels as if he were dead; and he feels like this because he does not feel. His feeling, wishing, thinking and memory processes have become different, uncertain, intolerably changed. And yet the patient knows everything correctly; his