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This paper treats of those abnormal states characterized in the main by an acute, though perhaps transitory, feeling of unreality of the Ego. This feeling of strangeness or unreality may be in regard to single persons in the patient's environment, or may embrace his entire surrounding world; it may proceed from the Ego to the environment or vice versa; or the same person may experience a feeling of unreality with reference to himself, at one time, and at another with reference to his surroundings. The attack is always