1. The document discusses various aspects of self, including definitions of self, self vs body and ego, and disorders of self. 2. Key aspects of self discussed include self-concept, body image, and five formal characteristics of self described by Jaspers and Scharfetter. 3. Disorders of self discussed include disorders of being/ego vitality, ego activity, ego consistency/coherence, identity, and ego demarcation. 4. Specific disorders analyzed in depth include depersonalization, derealization, dematization, autoscopy, and dissociative identity disorder.

1. PRESENTER – DR. P. ANKITA
MODERATOR – DR. RAGHUVEER
RAJU

2. CONTENTS
1. Introduction​ - What is self?
Self vs Body
Self vs Ego
2. Self concept and Body Image
3. Self Image and Non verbal communication
4. Disorders of Self
5. Depersonalization

3. 3
What is self?
Self is defined as the way a person thinks about
himself/herself and their virtues, vices, beliefs, and
aspirations.
Ecologica
l self
Interpers
o-nal self
Extended
self
Private
self
Conceptu
-al self

4. 5 FORMAL CHARACTERISTICS OF SELF
4
EGO VITALITY
The feeling of
awareness of
being or existing
EGO ACTIVITY
The feeling of
awareness of
activity
EGO
CONSISTENCY
& COHERENCE
Awareness of
unity of self over
time
EGO IDENTITY
Awareness of
identity
EGO
DEMARCATION
Awareness of
boundaries of
self
• JASPERS describes self awareness i.e., the ability to distinguish I from not I as
having 4 formal characteristics.
• SCHARFETTER added a 5th dimension of ego vitality.

5. SELF VS BODY
• The body is unique in that it is experienced by a person both
as subject of experience and as an object with the same
materiality as any other physical object in the world
• Cartesian dualism – Descartes’ said that there is a
convention that separates out the body from the self in
which the body is regarded as distinct from the thinking
immaterial self.
• Gibbs puts it as “I know who I am, and that I am, in part,
because I see my body…. as I move and experience
specific sensations as a result of action. ”

6. SELF VS EGO
• Ego and self are used more or less
interchangeably. Ego has the advantage of
being a technical term and is more
circumscribed in its meaning.
• FREUD described ‘ego’ as standing for a
reason and good sense and ‘Id’ as the
untamed passions
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7. ID, EGO, SUPER EGO 7
ID
• It is present since
birth
• Instinctive/Impulsive
• Demanding
immediate
gratification
• Works on pleasure
principle
EGO
• It develops when
coming in touch with
reality (4-6 months)
• It covers all the levels
of consciousness but
majorly preconscious
and conscious
SUPER EGO
• It develops by 2-3
years
• Works on morality
principle i.e., right and
wrong,
conscientiousness,
ethics and religion
• It covers all levels of
consciousness but
majorly unconscious
• “The poor ego has to serve 3 severe masters (external world, the super ego and the Id)
and does what it can to bring their claims and demands into harmony with one another.
These demands are always divergent and often seem incompatible. No wonder that the
ego so often fails in this task.”

8. 8

9. 9
1. SELF CONCEPT : It refers to fully conscious and abstract
awareness of oneself.
2. BODY IMAGE : It is more concerned with unconscious
and physical matters and includes experiential aspects of
body awareness
3. BODY SCHEMA : It implies a spatial element and is more
than and is usually bigger than the body itself
Example: Body along with your clothes, your spectacles
or car (while driving)
4. CATHEXIS: It implies the notion of power, force, libido
perhaps analogous to electric charge. The self that makes
things happen!

10. BODY IMAGE
• A person sees themselves and forms their self image in a
social setting. They see themselves in relation to other
people; their view of themselves is not totally dependent
on, but importantly influenced by, how another individual
sees them. It is also determined by how they believe that
people might see them.
• SCHILDER : Body images are never isolated, they are
always encircled by the body images of others.
• BAHNSON: Self image is changeable and amorphous{as
in fig}
• At any one time, the individual perceives only a small
sample from a gallery of possible self images. Different
aspects of self image are developed as the person
increases the scope and complexity of his relationships.
10

11. SELF-IMAGE AND NON-VERBAL COMMUNICATION
• NON-VERBAL COMMUNICATION: All gestures and
postures, movements of the face, and pauses in our
conversation convey meaning to the person we are
talking to and partly, this is also a comment on the way
we see ourselves.
• Non-verbal signals are more powerful: “Actions speak
louder than words”
• Non-verbal signals are less censored and therefore more
likely to be genuine. If conflicting messages are given
verbally and non-verbally, the non-verbal signal is
accepted as truthful.
11

12. DISORDERS OF SELF
1. DISORDER OF BEING OR EGO VITALITY
• The patient’s experience of existence may be altered.
• “I don’t exist, there is nothing here” or “I am not alive anymore” or “I am
rotting”.
• Ex: Nihilistic delusions
• Less pronounced nihilistic ideas are experienced as depersonalization.
12

13. • Moving may show abnormality like in Schizophrenia - passivity
experience or delusions of control.
• Memorizing and imagining may be changed in depression( Feels
like they are unable to initiate the act of memory or fantasy) or in
Schizophrenia( Feels like the activity is not initiated by them but
from outside themself).
• Willing may be altered in Schizophrenia who no longer
experience their will as being their own.
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2. EGO ACTIVITY

14. • Normal- At any given moment, I know that I am one
person.
• Abnormal- Autoscopy( Heautoscopy)
Multiple Personality Disorder(
Dissociative
Identity Disorder)
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3. DISORDER OF EGO CONSISTENCY AND
COHERENCE

15. • In this strange experience, the patient sees
himself and knows that it is he. It is not just a
visual hallucination because kinaesthetic and
somatic sensation must also be present to give
the subject the impression that the hallucination
is he.
Types of Autoscopy (by Brugger & Regard)
• Feeling of presence – The Distinct feeling of
the physical presence of another person. No
visual perception is usually reported.
15
SIX TYPES OF AUTOSCOPY

16. • Negative Heautoscopy – Failure to perceive one’s
own body by either in a mirror or when looked at
directly
( Can be associated with depersonalization).
• Inner Heautoscopy – Experience of visual
hallucinations of internal organs in extra corporeal
space.
• Autoscopic Hallucinations - Patient sees an exact
mirror image of self or of their face or trunk. Usually
brief lasting for seconds to minutes followed by flash-
like recurrences.
16

17. • Out-of-body experience – The patient sees
themselves and the world from a location distinct
from their physical body usually from a distant and
elevated visuo-spatial perspective/position.
• Heautoscopy Proper – In this, the individual sees
their double or doppelganger. There is strong self-
identification with the second body often associated
with perceiving the world from two places at the
same time.
There is growing evidence that autoscopic phenomena
occur in association with seizures.
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18. MULTIPLE PERSONALITY
(DISSOCIATIVE IDENTITY DISORDER)
• In dissociative (hysterical) states, dual and multiple
personalities have been described.
• The essence of multiple personality is the
embodiment of atleast 2 personalities (identities).
• Abse states that “One way amnesia” is usual for
multiple personality. Ex: personality A is amnesic for
the other personality B, but the second, B, can
discuss the experiences of A. Usually A is inhibited
and depressed and B is freer and more elated.
18

19. • The forms of multiple personalities seen are usually :
1. Simultaneous partial personalities
2. Successive well defined partial personalities, or
3. Clustered multiple partial personalities.
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20. 4. DISORDER OF IDENTITY 20
• This disorder of self awareness is characterised by
changes in the identity of self overtime.
• There is a break in the sense of identity of self and
there is a subjective experience of someone
completely different, although still described as
oneself, “Taking over”.
• This is seen in psychotic illnesses, neurotic
illnesses, or in some healthy people in abnormal
situations.
• The person knows that both people before and after
are truly them, but they feel very altered from what
they were.
1. Possession state
2. Lycanthropy

21. POSSESSION STATE
• This is classified in ICD – 10 under dissociative
(conversion) disorders. [F44.3 – trance and possession
disorders].
• There is a temporary loss of both the sense of personal
identity and full awareness of the surroundings.
• It can occur in normal healthy people in unusual situations,
individually or as a group phenomenon (Mass hypnosis).
• Person believes himself to have been, taken over by – a
spirit, a force or even another person.
21

22. LYCANTHROPY
• In this disorder the patient believes that he is transformed into an animal,
usually a wolf.
22

23. 5. DISORDER OF THE BOUNDARIES OF
SELF OR EGO DEMARCATION
• It refers to the disturbance in knowing where I ends and not I
begins.
• Seen in schizophrenia, in LSD intoxication, and ecstasy
states.
• In state of ecstasy, the person might describe feeling at one
with the universe, merging with nirvana, experiencing unity
with the saints, identifying with the trees and flowers, or a
oneness with God.
23

24. It includes :
1.Thought insertion, thought
withdrawal, thought broadcasting
2.Passivity phenomenon
3.Delusion of control
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25. DEPERSONALIZATION
• FEWTRELL : defined depersonalization as a subjective
state of unreality in which there is a feeling of
estrangement, either from a sense of self or from external
environment.
• SEDMAN: Used the term depersonalization to designate
a peculiar change in the awareness of self, in which the
individual feels as if they are unreal.
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26. ACKNER’S FEATURES
1. Depersonalization is always subjective; it is a disorder of experience.
2. The experience is that of an internal or external change characterized by a
feeling of strangeness or unreality.
3. The experience is unpleasant.
4. Any mental functions maybe the subject of this change, but affect is invariably
involved.
5. Insight is preserved.
26

27. EXCLUDED FROM DEPERSONALIZATION :
1.The experience of unreality of self when there is delusional
elaboration.
2.The ego boundary disorders of schizophrenia.
3.The loss or attenuation of personal identity.
27

28. COMPONENTS OF
DEPERSONALIZATION
According to SIERRA and BERRIOS,
1. Emotional numbing
2. Changes in body experience
3. Changes in visual, auditory, tactile, gustatory, olfactory experiences.
4. Loss of feelings of agency.
5. Distortions in the experience of time.
6. Changes in the subjective experience of memory.
7. Feeling of thought emptiness.
8. Subjective feelings of an inability to evoke images.
9. Heightened self observation
28

29. • After depression and anxiety, depersonalization is the most
frequent symptom to occur in psychiatry.
• Depersonalization can be associated with :
1.Anxiety disorders
2.Mood disorders
3.Organic diseases like epilepsy, migraine and traumatic
brain injury
4.Cannabis, hallucinogens, ecstasy and alcohol
29

30. • Depersonalization can also occur in healthy normal
individuals during :
1.Powerful emotional stimuli
2.Life crisis
3.Extreme happiness
4.Falling in Love
5.Bereavement
6.Extreme fear and anger
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31. DEREALIZATION
• Derealization often accompanies depersonalization.
• It is a similar feeling of unreality with regard to
awareness of the external world.
• The environment appears as flat, dim in color, smaller,
distant, cloudy, dream – like, still, “nothing to do with me”
and also lacking in emotional significance.
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32. 32

33. DESOMATIZATION
• It is a localization of feeling of unreality to an individual organ
• Changes in size or quality, for example – patient may feel his
legs are weightless or being unfamiliar or filled with water.
• Ex: Koro syndrome – It is a culture bound specific manifestation
of acute anxiety in which the patient believes his penis is
shrinking and fears that it will ultimately disappear.
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34. DEAFFECTUALIZATION
• It is described as the consistent loss of the capacity
to feel emotion, so that the person seems unable to
cry, love or hate.
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35. REFERENCES
• FISH’S clinical psychopathology 4th edition
• SIMS symptoms in mind 7th edition

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