Perception › Hallucination

Autoscopy

Autoscopy is the experience of seeing a visual double of oneself, as though looking in a mirror when no mirror is present. The double is usually seen at a short distance and may mimic the person's own movements, and the experience can be brief or, less commonly, sustained.

This has traditionally been distinguished from an out-of-body experience, in which the person's sense of self shifts to a vantage point outside their own body; in autoscopy, by contrast, the person's own perspective stays put and it is the double that is seen from the usual, first-person viewpoint.

Also known as

Phantom mirror-image

A descriptive alternative name for the same experience of seeing one's own double.

Negative autoscopy

The inverse experience: looking in a mirror or reflective surface and failing to see oneself at all, despite standing in front of it.

Internal autoscopy

A related experience of 'seeing' one's own internal organs, as though looking inside one's own body.

Recognition features

• A visual double of the self is seen, typically at close range
• The double may mirror the person's own posture, expression, or movements
• Usually brief, though longer episodes are described
• The person's own sense of viewpoint remains their normal, first-person one throughout

Eliciting it at interview

• Ask directly, as this is rarely volunteered spontaneously: "Have you ever seen a copy or double of yourself, as if you were looking in a mirror, when there wasn't actually a mirror there?"
• For the negative variant, ask separately: "Have you ever looked in an actual mirror and not been able to see yourself in it?"
• Ask how the person made sense of the experience afterwards, since the accompanying interpretation (illness, spiritual significance, fear) is clinically informative

Distinguishing features

• Differs from an out-of-body experience, in which the person's own viewpoint relocates rather than a double being seen from the ordinary first-person perspective
• Differs from depersonalisation, which is a felt sense of detachment from the self rather than a visual perception of a double
• Negative autoscopy differs from a simple failure to notice one's own reflection, in that the person actively looks and specifically cannot see themselves

Common misconceptions

• That autoscopy is purely a literary or folkloric idea (the 'doppelganger'); it is a recognised, if uncommon, clinical phenomenon with both organic and psychiatric associations
• That seeing a double always signals severe illness; brief autoscopic experiences have also been described in extreme fatigue and certain neurological conditions

Related phenomena

Hallucination · Depersonalisation

Practice this

A man describes, with some alarm, having briefly seen a visual double of himself standing a few feet away, mirroring his own posture and movements. Throughout the experience his own sense of viewpoint stayed exactly where his real body was — he was looking at the double, not looking out from it. What is this experience? · A patient describes floating above their own body during a medical emergency, looking down at themselves lying on the ground, with their sense of viewpoint clearly located above rather than in their physical body. Before revealing the answer: is this autoscopy? · A patient describes an unsettling sense of being detached from themselves. Before revealing the answer, decide what single question distinguishes autoscopy from depersonalisation. · A patient has mentioned briefly 'seeing myself' during a stressful period. Before revealing the answer, decide how you would clarify whether this was autoscopy. · Explain why the location of the person's own sense of viewpoint, rather than simply whether they 'saw themselves', is the detail that actually distinguishes autoscopy from an out-of-body experience.

Illustration

A 50-year-old man recovering from a severe migraine describes glancing to his left and seeing himself standing there for a few seconds, wearing the same clothes and mirroring his own startled expression, before the image simply faded away. He found it deeply unsettling and has avoided mentioning it to anyone until now.

References

• Casey, P. & Kelly, B. (2019). Fish's Clinical Psychopathology, 4th ed. Ch. 3, 'Disorders of Perception'.