Late Bodily Impairment and Depersonalization: The Case of Four Cameroonian Adults with Diabetic Foot

Abstract

Depersonalization is usually reported as a manifestation in other psychiatric disorders such as psychosis, anxiety, or depression; in physical trauma; or in drug addiction. But it has been very little reported in clinical descriptions relating to bodily injuries such as diabetic foot. This article focuses on the case of four Cameroonian adults with diabetic foot and presenting clinical manifestations close to the picture of depersonalization-derealization. He tries to understand the psychic processes at play in this phenomenon of depersonalization, in the context of diabetic foot in Cameroonian adults with no psychiatric history. To achieve this, we used the case study method. The data were collected from semi-structured interviews with four participants met at the Yaoundé Central Hospital. This data was the subject of a content analysis. The results show that these participants experience intolerable psychological suffering, caused by the damage to the body in its four dimensions, in each of the participants. They then show that this attack causes the gradual rupture of the sense of identity, due to social rejection and self-exclusion. And that this rupture is reinforced by a manifest failure of the work of symbolization. And finally, that, in these conditions where the subject, due to the loss of his social roles on the basis of which he nevertheless defined himself, experiences a massive libidinal disinvestment of his body, causing the withdrawal of consciousness from the body, and producing manifestations of depersonalization. And at the same time, he experiences the withdrawal of the libido from his environment, leading to manifestations of derealization. This study therefore provides a new perspective on secondary depersonalization-derealization disorder in the context of somatic disease management.