Grotstein J S
Hillside J Clin Psychiatry. 1983;5(2):259-304.
Autoscopy is thought to be a rare phenomenon in which a person visualizes or experiences a veritable hallucinatory image of his double. It may be more common than has hitherto been thought, however. It has no general pathological significance compared with its counterpart, the Capgras syndrome, where there is the experience of the object as a double, but it can occur in psychotic and borderline states and in afflictions of the central nervous system. Autoscopy has been known since ancient times but came into prominence only in the nineteenth century, both in the romantic literature of the double and in neuropsychiatric research. This paper details its history in literature as well as in psychiatry and neurology and also offers clinical examples from the author's caseload. It is the contention of the author that the phenomenon is far more common as an intrapsychic (nonhallucinatory) experience and that it is especially common in dreams. Autoscopy can ultimately be considered the quintessence of a "Cartesian artifice" in which one mind-body ("I") is caught in the act of regarding its compatriot self as a mind-body with sufficient distance as to register the ultimate meaning of self-recognition. A theory is offered that autoscopy is a special form of depersonalization which may be related to the "split-brain" phenomenon neurophysiologically and which is due to special forms of splitting and projective identification psychically.
自体幻觉被认为是一种罕见现象，即一个人看到或体验到自己的真实幻觉影像。然而，它可能比迄今所认为的更为常见。与类似的卡普格拉综合征（即体验到物体是自己的分身）相比，自体幻觉没有普遍的病理学意义，但它可发生于精神病态和边缘状态以及中枢神经系统疾病中。自体幻觉自古就为人所知，但直到19世纪才在关于分身的浪漫文学以及神经精神病学研究中受到关注。本文详述了其在文学以及精神病学和神经病学中的历史，并提供了作者病例中的临床实例。作者认为，作为一种内心（非幻觉）体验，这种现象更为常见，尤其在梦境中。自体幻觉最终可被视为一种“笛卡尔式技巧”的精髓，其中一个身心合一的“我”在将其同胞自我视为一个身心合一的存在时，保持了足够的距离，从而领悟到自我认知的终极意义。本文提出一种理论，即自体幻觉是人格解体的一种特殊形式，在神经生理学上可能与“裂脑”现象有关，在心理上则归因于特殊形式的分裂和投射性认同。
