Depersonalization

   The term "depersonalization," meaning the feeling that one’s being and thoughts are unreal, was coined by French philosopher Ludovic Dugas (1857–?) in the Revue philosophique in 1898: "I should define as alienation of the personality or depersonalization the state in which the ego [le moi] feels its actions escaping control and becoming foreign" (p. 502). Even though the phenomenon itself had previously been described in the medical literature, Pierre Janet and Fulgence Raymond (1844–1910), the latter being Charcot’s successor, in their monograph in 1903 on Les obsessions et la psychasthénie, applied the term to several patients, of whom they reported: "She feels that she has lost her personhood, that she is no longer anything. It seems to her that it is not she who is seeing, is not she who is hearing, is not she who is eating. It seems to her that her arms and legs work on their own, without her. . . . Basically it is as if she was dead, at most as if her legs continued to live; but she herself is deceased, or in any event absent" (Les obsessions, I, p. 41). For Karl Jaspers, in his General Psychopathology of 1913, depersonalization belonged to the disorders of "consciousness of personhood" (Persönlichkeitsbewusstsein), in which Jaspers stressed the feeling of automatic thoughts and actions (der Automatismus der Willensvorgänge)—close to some of the "first-rank" symptoms of schizophrenia numerated by his friend Kurt Schneider (see also Schizophrenia: Emergence). Depersonalization thus became shifted from a neurotic to a psychotic symptom, and during the years was mentioned frequently by the asylum psychiatrists who saw severe mental illnesses as well as by psychoanalysts who saw neurotic patients. The term entered the DSM series with the second edition in 1968 as one of the "neuroses": "depersonalization neurosis." The patient is "dominated by a feeling of unreality and of estrangement from the self, body, or surroundings" (p. 41). (The latter sentiment is often called "derealization.") In DSM-III in 1980, depersonalization joined the "dissociative disorders" and remained there essentially unchanged in subsequent editions.

   In 2003 Daphne Simeon (1958–) and co-workers at the Mt. Sinai School of Medicine in New York characterized depersonalization disorder in the Journal of Clinical Psychiatry as typically beginning between 16 and 25 and running a chronic course: "Chronic depersonalization is in part developmentally driven and the adolescent years are a vulnerable period for the formation of a ‘real’ and ‘well-grounded’ selfexperience" (p. 995).