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BRITISH MEDICAL JOURNAL LONDON SATURDAY MARCH 3 1951 - VISUAL HALLUCINATION OF THE SELF BY JEAN LHERMITTE, M.D.  Honorary Professor, Faculty of Medicine, Paris

Its Form

While autoscopic hallucinations often come more readily to patients when they are in a state of drowsiness, these visions also appear to subjects whose minds are wide awake, so that we possess a great number of detailed records of this form of hallucination. Usually the image seen is very clear but not vivid in colour.

When the subject attempts to get near it, the image draws back or fades away after having performed movements similar to those of the original.

Sometimes the hallucinatory image appears very thin, as if it were a projection on a screen; at other times, on the contrary, it would seem to be made of a jellylike or glass-like substance, so that the patient can see everything around him through this ghostly illusion, which would be impossible if the image were real. This is not a constant rule, and often the phantom seems to be made of an opaque substance, not transparent to the eye.

One would say that such a strange phenomenon must seem unbelievable and even unthinkable to a reasoning mind. In fact, how can one admit that a subject apparently capable of judgment and self-criticism can come to believe such a vision to be a reality ?

Here I must say that all those who have been victims of autoscopy have not always been immediately convinced of the reality of the image which appeared in front of them. Some, before believing in it, hesitated, and even criticized the authenticity of the vision, but in the end it became almost compelling.

This shows, to my mind, that it is an error to want to set up a barrier between the hallucinations which are questioned and admitted to be illusions of the senses, or a hallucinosis, and, on the other hand, the hallucinations which are not criticized and which would be the only real hallucinations for some authors.

Close Connexion between Image and Subject

'There is one phenomenon on which I want to enlarge because it seems to be peculiar to autoscopic hallucinations.

Never, in fact, do we find it in other sensory hallucinations. It is that the subject not only believes he can see his own image as if it were reflected in a mirror but also has the knowledge that in this image there is a part of himself: he feels connected to this image by spiritual and material links. The life filling it is his own life; indeed, he has the illusion that he lives in this image, which thinks and feels like himself.

No one has given a better description of this intimate relationship between the image and its original than the poet Alfred de Musset in " La Nuit de Decembre":

The intimate relationship between the original and the vision is so close that some authors maintain that the most important fact is not the visual hallucination but the notion of " belonging ' or of material and spiritual dependence between the image and its object. Therefore the delusive figure, the double, feels, thinks, acts in a manner similar to that of the subject himself and sometimes talks to him in a language which is his own language, although, as is the case in dreams, the words expressed are not perceived by the ear but guessed more than heard.

 And yet I have found in the psychiatric literature the case of a subject who was able at will to make his own image appear in front of his eyes, as though in a mirror; it would make the same movements and say words that he would hear and that he knew before they were uttered. But this patient had auditory hallucinations and transferred them to the autoscopic image.

Wigan, in the last century, refers to a similar case in which the subject could summon his own body image, which would laugh as he laughed.