Depersonalization

Winner of F. E. L. Priestley Prize for best essay published in 2017 English Studies in Canada:
"Dr Jagoe’s article stands out for its originality, its generative capacity, its critical acumen, and its accessible style. Dr Jagoe compares and critiques two popular articulations of today’s digitally immersed Zeitgeist—Sherry Turkle’s 2011 book Alone Together: Why We Expect More From Technology and Less From Each Other and Spike Jonze’s 2013 movie Her—in order to propose “an ethics of depersonalized intimacy.” Against the grain of capitalism’s production of an agentic, authentic, and coherent self, Jagoe argues for “a different form of relationality” that challenges how we imagine intimacy and how both humanism and neoliberalism demand selves to be produced. Turkle’s writing and Jonze’s film illustrate Jagoe’s argument in that their representations of human-machine couplings broach the premise of depersonalized intimacy—but fail to push those premises and instead fall back on moralistic and clichéd tropes of and arguments for genuine selfhood and human communication. In the process, their humanist recuperations of organic-machinic interaction “hamper more emancipatory projects of intimacy, community, political action, and social change” that, in contrast, Jagoe’s theory of depersonalized intimacy opens up."

Background Depersonalisation disorder is characterised by emotion suppression, but the cerebral mechanisms of this symptom are not yet fully understood. Aims To compare brain activation and autonomic responses of individuals with the disorder and healthy controls. Method Happy and sad emotion expressions in increasing intensities (neutral to intense) were presented in an implicit event-related functional magnetic resonance imaging (fMRI) design with simultaneous measurement of autonomic responses. Results Participants with depersonalisation disorder showed fMRI signal decreases, whereas the control group showed signal increases in response to emotion intensity increases in both happy and sad expressions. The analysis of evoked haemodynamic responses from regions exhibiting functional connectivity between central and autonomic nervous systems indicated that in depersonalisation disorder initial modulations of haemodynamic response occurred significantly earlier (2s post-stimulus) tha...

The dimensionality of Maslach's (1982) 3 aspects of job burnout--emotional exhaustion, depersonalization, and personal accomplishment--was examined among a sample of supervisors and managers in the human services. A series of confirmatory factor analyses supported the 3-factor model, with the first 2 aspects highly correlated. The 3 aspects were found to be differentially related to other variables reflecting aspects of strain, stress coping, and self-efficacy in predictable and meaningful ways. Implications for better understanding the burnout process are discussed.

Active professional activity of psychiatrists is associated with inevitable emotional and moral overload, which is the basis for the emergence of the so-called syndrome of "emotional burnout." This article provides a brief review of the scientific literature on the topic of burnout among psychiatrists.

Depersonalization Disorder (DPD) is a psychopathological condition in which subjects suffer from a massive alienation from themselves and the world around them. In recent years, several philosophers have proposed accounts that interpret DPD in terms of an alteration in global features of normal consciousness, such as a sense of mineness or emotional coloring. This article criticizes such accounts and develops an alternative to them. On the account I present here, the symptoms of DPD are due to impairments in implicit forms of self-consciousness that characterize many, but not all, types of conscious mental states.

Freud's initial formulations viewed psychoanalysis as working towards the rediscovery of psychic elements - thoughts, feelings, memories, wishes, etc. - that were once known - represented in the mind, articulatable, thinkable - but then disguised and/or barred from consciousness. His subsequent revisions implicated a second, more extensive category of inchoate forces that either lost or never attained psychic representation and, although motivationally active, were not fixed in meaning, symbolically embodied, attached to associational chains, etc. Following Freud's theory of representation, the author conceptualizes these latter forces as "unrepresented" or "weakly represented" mental states that make a demand upon the mind for work and require transformation into something that is represented in the psyche, if they are to be thought about or used to think with. This paper describes, discusses and presents illustrations of this transformational process (f...

Background: We present recommendations for revision of the diagnostic criteria for the Dissociative Disorders (DDs) for DSM-5. The periodic revision of the DSM provides an opportunity to revisit the assumptions underlying specific diagnoses and the empirical support, or lack of it, for the defining diagnostic criteria. Methods: This paper reviews clinical, phenomenological, epidemiological, cultural, and neurobiological data related to the DDs in order to generate an up-to-date, evidence-based set of DD diagnoses and diagnostic criteria for DSM-5. First, we review the definitions of dissociation and the differences between the definitions of dissociation and conceptualization of DDs in the DSM-IV-TR and the ICD-10, respectively. Also, we review more general conceptual issues in defining dissociation and dissociative disorders. Based on this review, we propose a revised definition of dissociation for DSM-5 and discuss the implications of this definition for understanding dissociative symptoms and disorders. Results: We make the following recommendations for DSM-5: 1.Depersonalization Disorder (DPD) should derealization symptoms as well.2.Dissociative Fugue should become a subtype of Dissociative Amnesia (DA).3.The diagnostic criteria for DID should be changed to emphasize the disruptive nature of the dissociation and amnesia for everyday as well as traumatic events. The experience of possession should be included in the definition of identity disruption.4.Should Dissociative Trance Disorder should be included in the Unspecified Dissociative Disorder (UDD) category.Depersonalization Disorder (DPD) should derealization symptoms as well.Dissociative Fugue should become a subtype of Dissociative Amnesia (DA).The diagnostic criteria for DID should be changed to emphasize the disruptive nature of the dissociation and amnesia for everyday as well as traumatic events. The experience of possession should be included in the definition of identity disruption.Should Dissociative Trance Disorder should be included in the Unspecified Dissociative Disorder (UDD) category.Conclusions: There is a growing body of evidence linking the dissociative disorders to a trauma history, and to specific neural mechanisms. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc.

A considerable number of schizophrenic patients develop delusions of technical alien control. In such cases, patients experience their thoughts, movements and feelings to be controlled by mysterious machines and contemporary technologies such as computers, the internet, X-rays and lasers. In this paper, we describe 3 cases of patients with disorders of self-experience and schizophrenic delusions involving a controlling technical device. We also analyse case reports from historical and modern psychiatric literature which describe 'influencing machines' and similar phenomena. Of the 3 patients analysed, all complained of being controlled and impaired by some form of contemporary technology. Moreover, the presented cases illustrate psychopathological phenomena such as self-centrality, loss of ego boundaries, subjectification of perception, 'paradoxes of delusions', morbid objectification and loss of the sense of agency. Delusions of technical alien control and influencing machines constitute a characteristic form of delusional ideation in schizophrenic patients. They may be preceded by prodromal schizophrenic alterations such as disembodiment, alienation and reification of self-experience, depersonalization, derealization and bodily hallucinations. We propose that these prior experiences, especially if technically reifying in nature, may give rise to the phenomenon of technical delusions, thus expressing a particular affinity of basic self-experience in schizophrenia to modern technology. This is also consistent with the pathoplasticity hypothesis.

Depersonalisation is a common dissociative experience characterised by distressing feelings of being detached or 'estranged' from one's self and body and/or the world. The COVID-19 pandemic forcing millions of people to socially distance themselves from others and to change their lifestyle habits. We have conducted an online study of 622 participants worldwide to investigate the relationship between digital media-based activities, distal social interactions and peoples' sense of self during the lockdown as contrasted with before the pandemic. We found that increased use of digital media-based activities and online social e-meetings correlated with higher feelings of depersonalisation. We also found that the participants reporting higher experiences of depersonalisation, also reported enhanced vividness of negative emotions (as opposed to positive emotions). Finally, participants who reported that lockdown influenced their life to a greater extent had higher occurrences of depersonalisation experiences. Our findings may help to address key questions regarding well-being during a lockdown, in the general population. Our study points to potential risks related to overly sedentary, and hyperdigitalised lifestyle habits that may induce feelings of living in one's 'head' (mind), disconnected from one's body, self and the world. The sense of self, the subjective experience of being an 'I' or a 'self ' bound to my body as distinct from the world and others, is a key feature of our mental life 1-5. Depersonalisation (DP henceforth) is a common dissociative experience characterised by profound alterations of one's sense of self 6,7. DP induces distressing feelings of being detached or 'estranged' from one's self and body and/or one's surroundings (derealisation): "I look in the mirror and it does not feel like myself I'm looking at. It's like I'm floating, not actually experiencing the world, and slowly fading away into nothing. It's like I'm on autopilot in somebody else's body" 8 , P. 198. This dramatic 'split' between the self, the body and the world is often reported by those with DP as 'having a pane of glass' interposed between one's self, body and the world 9,10 , affecting one's sense of 'realness' , i.e. the experience of being present and immersed in a real world here and now 11. Emotional flatness or numbness, as well as atypical emotional processing are core features of DP 12,13. Importantly, people experiencing DP report a significant impact of this self-detachment on the quality of their social and emotional life: "Feeling unreal and disconnected from my body and the world around me caused me to lose interest in the people and hobbies I used to love" 8 , P. 190. These distressing feelings of being estranged from one's self and ensuing social isolation and distancing from others 9,10 is a common complaint among people experiencing DP. In December 2019, the first cases of COVID-19 were reported in Wuhan, China and a state of pandemic was officially declared by the Emergency Safety Committee of the International Health Regulations. The COVID-19 pandemic presents us with a situation in which people are strongly encouraged to drastically change their lifestyle habits, to isolate themselves from others, and to maintain social distance. Now, experimentally induced social isolation and its impact on one's self is ethically impossible to study in the lab. Yet, the current exceptional

Notre travail de thèse porte sur l’analyse des rapports entre le normal et le pathologique à la lumière d’un trouble du comportement alimentaire : l’anorexie mentale. Nous cherchons conjointement à élaborer un modèle d’intelligibilité de l’anorexie mentale, et à déterminer ce que ce modèle nous enseigne du rapport normal et sain au corps. La normalité relève-t-elle d’une différence de nature ou de degré avec l’état psychopathologique ? Le critère de la normalité peut-il être saisi dans l’expérience antérieure au développement du trouble chez le sujet anorexique ? Peut-il être recherché dans une norme sociale extérieure au sujet ? Nous avançons que le critère de la normalité ne peut être découvert que de manière immanente, au cœur de l’expérience pathologique et de celle de la rémission. C’est donc à la conceptualisation de ces dernières que nous avons dû nous consacrer. 

Notre travail comprend la conceptualisation de l’anorexie mentale comme d’une forme de production aliénée de la subjectivité dans le contexte sociologique déterminé de l’individualisme moderne. Nous nous appuyons premièrement sur les travaux de Dorothée Legrand, qui, à partir de la notion phénoménologique de « conscience de soi corporelle », voient dans l’anorexie mentale une rupture des liens typiquement complémentaires entre le corps-comme-sujet (le corps vécu depuis une perspective interne) et le corps-comme-objet (le corps visé, perçu extérieurement, mais aussi en tant qu’il partage une matérialité commune avec d’autres objets). Le sujet anorexique est celui qui, d’après cette conceptualité, cherche à transformer, de manière contrôlée, son corps-objet, afin d’en faire une matérialisation ou expression de sa subjectivité. Paradoxalement, l’amaigrissement et même la « négation » du corps-objet sont « auto-constitutives » en ce sens qu’elles contribuent à exprimer et consolider la subjectivité. Le sujet anorexique s’affirme à travers la modification contrôlée de son corps-objet : il fait de la dimension objective de son corps une sorte de miroir de sa subjectivité. Il peut alors, à partir de cette extériorisation maîtrisée, rechercher la validation de sa condition de sujet par d’autres sujets.

C’est parce que le vécu du corps-sujet est trop faible chez la personne anorexique, et celui du corps-objet hypertrophié, qu’elle tente de contrôler le corps-objet pour en faire un support externe doué d’une capacité expressive du soi et par suite une attestation de sa propre existence. Nous pouvons alors comprendre l’anorexie mentale dans une perspective hégélienne : le sujet anorexique « travaille » son corps pour y apposer le « sceau » de son intériorité, les déterminations de sa conscience. Ce faisant, il arrache à la matérialité brute du corps son caractère d’étrangeté et peut s’y reconnaître ; de même, il peut, à l’issue de son travail, obtenir des autres sujets une reconnaissance. Nous pensons cependant que ce modèle n’épuise pas la compréhension de l’anorexie mentale.

Selon nous, l’anorexie mentale relève plutôt d’une stratégie à composante addictive par laquelle, tout à la fois, le sujet tente de devenir un individu performant sur la scène sociale, et échappe à une réelle expression de sa subjectivité. Nous pensons que le « soi » du sujet anorexique est une notion opaque pour lui, dont les contours sont mal définis, et qu’il ne peut par suite extérioriser les composantes de ce « soi » dans le corps-objet. Comment le pourrait-il, en effet, s’il ne se connaît pas réellement lui-même ? Nous avançons ainsi que l’anorexie mentale procède d’une angoisse fondamentale : celle de l’indétermination de la subjectivité, notamment en raison de la prévalence de l’alexithymie dans la personnalité. Or, cette indétermination subjective interne coexiste, dans les sociétés occidentales modernes, avec l’injonction, intensément ressentie par les sujets anorexiques perfectionnistes, d’être « quelqu’un » – c’est-à-dire de devenir un individu accompli et d’obtenir à ce titre une validation sociale. Enfin, comme le mettent en évidence les travaux de Hilde Bruch, les personnes anorexiques souffrent d’un « sentiment d’inefficacité » intrinsèque, qui les persuade qu’elles ne sont pas réellement capables d’atteindre l’autonomie et d’avoir une incidence positive sur le monde extérieur par leurs efforts. L’amaigrissement joue alors un triple rôle : (a) il délivre une identité de substitution (sorte de « faux-self ») à la personne anorexique qui ne parvient pas à savoir qui elle est, (b) il permet, via cette identité substitutive, d’apparaître comme un individu ultra-performant dont les qualités de discipline et de réussite sont saluées par les autres, (c) il privilégie le rapport immédiat au corps et échappe aux difficultés propres à d’autres formes d’accomplissement individuel, comme le travail, qui mettent le sujet en relation avec une réalité extérieure potentiellement aléatoire et immaîtrisable. Le corps, lui, est a priori directement soumis à la volonté du sujet.

À l’issue de nos analyses, nous pouvons mettre en évidence les articulations nodales de la rémission, qui relèvent de l’acquisition d’une réelle autonomie par le sujet. Celle-ci est indissociable (1) d’une capacité à connaître et à discerner ses états émotionnels internes et à développer une notion immanente du « soi » qui n’est alors plus indexée sur des indices externes ; et (2) corrélativement, d’une aptitude à démêler les signaux inhérents au corps et à atteindre une forme corporelle dont la norme est donnée par le corps lui-même. Quand le corps n’est plus chargé de symboliser une subjectivité dont les notions internes sont trop faibles voire inexistantes (alexithymie et faible sentiment intrinsèque du soi), il peut alors obéir à des normes qui lui sont propres, ce qui constitue le critère du rapport sain au corps. Le rapport pathologique au corps est ainsi celui qui instrumentalise le corps pour en faire la preuve externe compensatoire d’une subjectivité vécue comme inexistante et discontinue ; le rapport sain au corps est celui, qui affranchi de cette finalité d’être le marqueur externe de la subjectivité, peut se régler sur ses propres besoins.

Objective: Much research has broadly examined the dimensionality of the Maslach Burnout Inventory (MBI; Maslach and Jackson 1981) but yielding inconsistent and conflicting results. An understanding of the factorial composition of the MBI is crucial when the instrument is used to screen for burnout syndrome. In line with this need, the present study is aimed at determining the most psychometrically sound representation of the structure of burnout among a sample of high school teachers. Method: Principal axis factoring exploratory factor analysis and least square confirmatory factor analysis were performed to identify the underlying factorial structure on a whole sample of 309 participants. Random data parallel analysis was conducted to determine the number of factors to retain. Results: According to some previous research (Densten 2001, Firth et al. 1985), findings highlighted a four-factor structure model: "Personal Accomplishment", "Strain", "Depersonalization", and "Frustration". Two items failing to meet the retention criteria were not retained, resulting in a 20-item scale. Conclusions: This emerging solution presents some differences compared to traditional structure. Emotional Exhaustion separated into two factors: "Strain", referring to feelings of being emotionally drained and burned out from work, and "Frustration", referring to feeling of stress and frustration about working with people. Limitations and need for future research avenues are discussed.

Maslach ve Jackons'un tükenmişlik modeli bağlamında tükenmişlik kavramı
Özet: Bu çalışmanın amacı, Maslach ve Jackson'un çalışmaları bağlamında tükenmişlik kavramına ilişkin kavramsal bir çerçeve çizmektir. Tükenmişlik; sıklıkla “bireylerle diyalog halinde çalışanların bitkin düşmesi, etrafındaki olaylara ve gelişmelere olan ilgisinin azalması ve bunlara bağlı olarak performans düşüklüğü yaşaması” olarak tanımlanmıştır. Mesleki tükenmişlik, ise“çaba ve ödül arasındaki algının tutarsızlığından kaynaklanan işle ilgili bir sendrom” olarak tanımlanmıştır. Tükenmişlik kavramının 1980'lerin başında yaygınlaştırılmasından sonra, değerlendirilmesi, özellikle insan hizmetleri sektörlerinde, sendromu inceleyen birçok araştırmacının ilgisini çekmiştir. Tükenmişlik, özellikle insana hizmet veren meslek gruplarında sık görülen bir sorundur. Tükenmişlik fenomenini açıklamaya çalışan çeşitli teoriler vardır. Maslach ve Jackson (1981), başlangıçta sendromu ölçmek için kullanılan Maslach Tükenmişlik Envanteri'ni (MBI) geliştirdi. Maslach ve Jackson (1981) en çok kabul edilen tükenmişlik modelini üç boyut olarak tanıtmıştır: Duygusal tükenme, duyarsızlaşma ve düşük kişisel başarı. Duygusal tükenme, duyarsızlaşma ve kişisel başarıda düşme hissi olarak üç alt boyuttan oluşan tükenmişlik, bireylerde duygusal, davranışsal ve bedensel bazı belirtilerle kendini göstermektedir. Duygusal tükenme; tükenmişliğin bireysel stres boyutunu belirtmekte ve bireyin duygusal ve fiziksel kaynaklarında azalmayı ifade eder. Duyarsızlaşma; tükenmişliğin kişiler arası boyutunu temsil eder. Kişilere yönelik negatif, katı tutumları ve işe karşı tepkisizleşmeyi belirtmektedir. Düşük Kişisel Başarı ise; kişinin kendisini olumsuz olarak değerlendirmesidir. İşte verimlilik ve yeterlilik duygularında bir düşmeyi ifade etmektedir. Sonuç olarak tükenmişlik; başağrısı, mide ve bağırsak hastalıkları, yüksek tansiyon, şeker hastalığı, kas kasılmaları, kronik yorgunluk, kaygı, depresyon, ve uyku düzensizliği gibi ruhsal ve fiziksel problemlere yol açabilir. Bu çalışmada, literatür incelemesi yapılmıştır.
Anahtar Kelimeler: Duygusal tükenme, duyarsızlaşma, düşük kişisel başarı, tükenmişlik sendromu.

The concept burnout in the contex of Maslach and Jackon's  burnout model
Abstract:  The purpose of this study is to establish a conceptual framework for the concept of burnout in the context of Maslach and Jackson's study. Burnout is determined the factors that affect the occupational burnout of lawyers, the most basic assurance of the right to seek and defend the right to exploit, which is often defined as the exhaustion of those who engage in dialogue with the individual, the diminishing of the events surrounding it. Job burnout was characterized as “a work-related syndrome that stems from an individual‟s perception of a significant discrepancy between effort (input) and reward (output)”. After the popularization of the burnout concept during the early 1980s, its assessment attracted the interest of many researchers, particularly those who study the syndrome in the human services sectors. Burnout is a common problem especially in occupational groups serving people. There are various theories trying to shed light on the burnout phenomenon. Maslach and Jackson (1981) developed the Maslach Burnout Inventory (MBI) which was initially used for measuring the syndrome. Maslach and Jackson (1981) introduced the most widely accepted conceptualization of burnout that has three dimensions: Emotional exhaustion, depersonalization, and low personal accomplishment. Burnout, which is formed by three sub-dimensions that are emotional exhaustion, depersonalization, low personal accomplishment shows itself by emotional, behavioural, and physical symptoms in the individuals. Emotional exhaustion indicates the individual stress dimension of burnout and decreases the emotional and physical resources of the individual. Depersonalization represents the interpersonal dimension of burnout. It refers to negative, rigid attitudes and unresponsiveness to work. Low personal accomplishment referring to a decline in one’s sense of competence and and/or productivity at work. As a result of burnout can cause psychophysical problems such as, headaches, gastrointestinal illness, high blood pressure, diabetes, muscle tension, chronic fatigue, anomie anxiety, depression, and sleep disturbances. In this study was conducted literature review.
Key words: Emotional exhaustion, depersonalization, low personal accomplishment, burnout syndrome.

With the advance of science, the concept of " the self " as some kind of separate Cartesian entity appears increasingly implausible. Nevertheless, it is hard to dismiss the intuition that an entity which can be classified as " the self " does indeed exist, independent of the body (the dualistic stance). This paper argues that the self-body separation is enhanced by two phenomena: inner talk and self-reflections (e.g., in mirrors). In both cases there is a fundamental split between the self-as-subject and the self-as-object. Furthermore, both of these phenomena allow us to gain a third-person perspective (3PP) upon ourselves. As a result, it becomes almost impossible for one give up this 3PP and return to the primitive experience of the first-person perspective (1PP).