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Stewart, W.A. (1964). Depersonalization. J. Amer. Psychoanal. Assn., 12:171-186.

(1964). Journal of the American Psychoanalytic Association, 12:171-186

Depersonalization

Walter A. Stewart, M.D.

Victor H. Rosen commented on the unusual nature of this panel: while no papers were to be presented, the members were far from unprepared; each had written on the subject extensively and had circulated his notes among the other members. In addition, the members had met on two occasions to share their views, a procedure which it was hoped would provide some order to the discussion and yet allow a degree of freedom and spontaneity. Rosen observed that depersonalization probably occurs more commonly than we realize and is often overlooked. James B. Cattell has described it as the third most frequent symptom seen in patients at a mental hospital, exceeded in frequency only by anxiety and depression. He suggested that when the analytic situation is confused, it may turn out to be evidence of the patient's unverbalized feelings of depersonalization or derealization. Rosen outlined briefly some questions which he thought the panel might attempt to discuss. For example: What is the essential phenomenology of the depersonalization-derealization syndrome? A definition of the boundaries of the subject is essential for all later discussion. What is the incidence of this phenomenon in mental illness? Does it carry a diagnostic or prognostic value? What experiences precipitate episodes of depersonalization? Are there specific external and internal conditions required for its appearance? How do the acute attacks of depersonalization come to an end? Are there specific libidinal points of fixation or defects in ego functioning? The last question would suggest some discussion of the role of perception and cognition and states of consciousness in the determination of depersonalization. The panel would undoubtedly discuss depersonalization as a defense. Rosen asked if one of the reasons for the use of depersonalization as a defense, might be the sudden shocklike nature of the trauma underlying it.

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