Autoscopic Hallucination

The term Autoscopy (the Doppelganger phenomenon) has been used to designate abnormalities of visual perception involving seeing oneself—visual experiences where subjects see an image of themselves in external space viewed from within their own physical body (Dening and Berrios, 1994).

The double or image is seen as if in a mirror; it may appear thin, discolored, even transparent, though usually it is three-dimensional and realistic.

The double is silent, but some tacit communication seems to take place between it and the observer. The effective tone of the experience often has a sentimental character; at times, the observer or the double is anxious.

The double may be dressed and positioned like the observer; a movement of the observer’s arm may be accompanied by a mirror movement in the double. It is usually located directly in front of the subject, about a yard away, and ordinarily disappears after a few seconds (Lukianowicz, 1958).

Although autoscopic hallucination has been of considerable literary interest over the last many decades, clinical cases with definite perceptual abnormality are not common.

Dening and Berrios have reviewed 56 cases, 53 from the literature and 3 of their own. Males predominated, with a ratio of 2:1, and the mean age of subjects was 40 years.

Both neurological and psychiatric disorder occurred in about 60 per cent of cases (different subjects), with epilepsy in approximately one-third. Decreased consciousness occurred in 45 per cent and delirium in 18 per cent, and 9 per cent of subjects were dead within 1 year.

Visual imagery or narcissism was present in one-third of subjects, and depersonalization in 18 per cent. The commonest psychiatric diagnosis was depression.

Autoscopic episodes usually lasted for less than 30 minutes. Almost always, the subject saw his own face; quite often, he was lying in bed at the time. The experience often provoked distress, fear, anxiety and depression. This subjective experience was complex, with different components and causes rather than unitary.