Defensive and arrested developmental aspects of death anxiety, hypochondriasis and depersonalization.

The theoretical distinction between psychopathology based on intrapsychic conflict and psychopathology rooted in a developmental arrest is applied to an analysis of death anxiety, hypochondriasis and depersonalization. The defensive functions of these states are contrasted with instances in which they are symptomatic of interferences with the consolidation of a structurally cohesive and temporally stable self representation. Clinical material is presented to demonstrate that, in their arrested developmental aspects, death anxiety, hypochondriasis and depersonalization are closely related to one another along a continuum of narcissistic decompensation and signal varying degrees or stages of self-fragmentation.