Splitting the Unity of Bodily Self: Toward a Comprehensive Review of Phenomenology and Psychopathology of Heautoscopy.
Joanna Szczotka, Michał Wierzchoń
Psychopathology 2023 DOI: 10.1159/000526869 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 9 |
| Population | Patients with heautoscopy from published case reports |
| Topics | Philosophy of mind |
| Keywords | Autoscopic Body ownership Double hallucination Heautoscopy Mirror hallucination Second self Self-consciousness Self-location |
| Citations | 4 |
| Key findings | Only 9 of over 140 case studies met strict criteria for heautoscopy, which from the patient's perspective resembles a somatesthetic-proprioceptive illusion rather than a cognitive delusion. |
Abstract
Heautoscopy refers to a pathological experience of visual reduplication of one's body with an ambiguous sense of self-location and a disturbing sensation of owning the illusory body. It has been recognized to occur in the course of strikingly diverse psychiatric and neurological disorders, such as schizophrenia, space-occupying lesions, frequently of the temporal or parietal lobes, migraine, epilepsy, and depression. The literature on the subject suffers from numerous conceptual inconsistencies, scarcity of clinical data, and a lack of theoretical integratory framework that could explain the uniqueness of these symptoms. In the study, we aimed to review all case reports on heautoscopy we could cull from the literature with an attempt to extract common factors and to foster a theoretical synthesis. All medical and psychological databases were rigorously searched, along with reference lists of the preselected articles. First-person reports were classified according to aspects of bodily self-consciousness primarily affected: body ownership, self-location, sense of agency and consequently, collated with their etiological backgrounds. Out of over 140 case studies, a total of only 9 patients with heautoscopy were selected as satisfying functional criteria, carefully distinguishing heautoscopy from other typically conflated full-body anomalies: autoscopy, out-of-body experience, or feeling of presence. Numerous cases turned out to be mislabeling autoscopy or out-of-body experience as heautoscopy. In addition, several problems with existing neuroimaging experiments were identified. Phenomenological analysis revealed that from the patients' perspective, heautoscopy resembles a somatesthetic-proprioceptive illusion, rather than a cognitive delusion, and occurs much less frequently than reported. A most peculiar symptom, described by some as a sense of "bilocation," appears to stem from dynamic shifts in self-location and expanded body ownership, rather than an expanded first-person perspective. Although extremely rare in its pure form, heautoscopy gives a unique opportunity to explore the brain limits to the plasticity of bodily boundaries and the origin of the first-person spatial perspective.
Comparable studies
Other systematic reviews and meta-analyses on philosophy of mind, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The brain in flow: A systematic review on the neural basis of the flow state. Participants in studies measuring or manipulating flow state with brain activity recording | 2022 | Systematic review | n = 471 |
| Synergistic, multi-level understanding of psychedelics: three systematic reviews and meta-analyses of their pharmacology, neuroimaging and phenomenology. | 2024 | Systematic review and meta-analysis | |
| Evidence synthesis indicates contentless experiences in meditation are neither truly contentless nor identical Expert texts from Shamatha, Transcendental, and Stillness Meditation traditions | 2022 | Systematic review | n = 135 |
| Novel psychoactive substances (NPS) use in severe mental illness (SMI) patients: Potential changes in the phenomenology of psychiatric diseases Patients with severe mental illness (SMI), such as psychotic patients | 2017 | Systematic review | |
| Scoping review on shamanistic trances practices. | 2024 | Systematic review |
Citations in the library
Cited by 3
- How do differences in native language affect out-of-body experiences? Frontiers in Psychology 2024
- Double body effect induced by integrating proprioceptive-vestibular and visual information. iScience November 21, 2025
- Embodiment in virtual reality: an experiment on how visual and aural First- and Third-person modes affect embodiment and mindfulness Virtual Reality March 14, 2025
Cites 21
- The Experimental Induction of Out-of-Body Experiences Science August 23, 2007
- Linking Out-of-Body Experience and Self Processing to Mental Own-Body Imagery at the Temporoparietal Junction Journal of Neuroscience January 19, 2005
- The Out-of-Body Experience: Disturbed Self-Processing at the Temporo-Parietal Junction The Neuroscientist January 4, 2005
- Out-of-body experience, heautoscopy, and autoscopic hallucination of neurological origin Brain Research Reviews July 13, 2005
- Common and distinct brain regions processing multisensory bodily signals for peripersonal space and body ownership. Neuroimage February 15, 2017
and 16 more in the library