Autoscopy may occur in brain damage, schizophrenia, depression, or neurosis. It is a hallucination or illusion in which a double image of oneself appears. It occurs in those depressions where ego libido is diminished and there is withdrawal of object and self-cathexis. Using Freud's concept of the life and death instincts, the author explains the phenomena as that of primary narcissism associated with ego energy depletion where the activated death instincts are forced outside the ego onto the double, in an attempt to diminish pain. The dearth of libidinal energy precludes projection of this rejected self onto an object, as in paranoia, while the prevalence of primary rather than secondary self-observation prevents ego splitting with depersonalization. Autoscopy occurs in individuals who normally are introspective in a manner called by the author primary self-observation of the type belonging to the archaic ego in which attention is paid to one's feelings rather than to the self. Two brief cases are presented in support of the thesis.