"Defective" and "functional" depersonalization in the concept of K. Haug
The structure, systematization and diagnostic value of depersonalization phenomenon as also its mechanisms of development are analyzed. E. Kraepelin considered depersonalization typical for light depressive phases of manic-depressive psychosis. E. Bleuler, on the one hand, reckoned depersonalization among the accessorial symptoms of schizophrenia, on the other hand, observed it in the cases of melancholia, psychopathies and epileptic twilight states. At the same time, E. Bleuler tried to connect the symptomatic of allopsychic depersonalization with affective disorders, and autopsychic with schizophrenia. K. Haug and W. Mayer-Gross considered that depersonalization is a syndrome that occurs by diagnostically different diseases. K. Haug maintained that the in-depth study of depersonalization phenomenon had a great importance for the understanding of the essence of the psychosis in general and the personality peculiarities and a lesser clinical-practical and diagnostic meaning. K. Haug suggested several systematizations of depersonalization disorders: complete (unfolded) and abortive pictures; depending on the accompanying affect; acute and chronic; according to the «sphere of psyche» (allo-, auto- , or somatopsy-chical depersonalization); causal and others. K. Haug used some already existing systems, but by the systematization according to «causal connections» he originally delineated «functional» - reversible - and «defective» («organic») - or irreversible - depersonalization. Functional depersonalization may occur in the norm, it does not leave traces in the personality or in the personality consciousness by comparison with former state. The defective depersonalization leads to the defect of personality, alienation experiences by this kind of depersonalization are the reaction of I-consciousness on defect or on process leading to the defect. Defective depersonalization is observed by brain tumors, also as a consequence of epidemic encephalitis, apoplectic attacks. Mainly the «dynamics», the development of the state helps to distinguish the schizophrenic (defective) depersonalization from the depersonalization by the other functional disorders (MDP, psychopathy, neurasthenia). According to K. Haug, there are three signs of mild schizophrenic process in the dynamics of depersonalization: stubborn protraction of depersonalization syndrome without fluctuations; growing persuasion in the reality of depersonalization experiences; weakening of formerly lively emotional reaction to these experiences. Also according to K. Haug, «intuitive» depersonalization is more peculiar to schizophrenia, «reflexive» depersonalization - to cyclothymia. K. Haug supported E. Stoerring's concept of four mental mechanisms of depersonalization: increased self-observation, disorders of activity feeling, consciousness modification by «dreamlike obnubilation», alterations of somatic sensations-feelings.