The Japanese journal of neuropsychology

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ArticleTitle	Why am I this body?: Psychopathology and neuropsychology of out-of-body experience
Language	J
AuthorList	Kenjiro Fukao
Affiliation	Department of Psychiatry, Graduate School of Medicine, Kyoto University
Publication	Japanese Journal of Neuropsychology: 27 (2), 131-142, 2011
Received
Accepted
Abstract	Out-of-body experience (OBE) is a pathological experience of special interest, because it concerns mind-body problem in philosophy, implying the possibility of actual separation of mind and body. Historically it has been described as a mystic or occult phenomenon in different cultures, interpreted as the detachment of the soul from the body. In the modern era, it has been described and studied in psychopathogical literature, especially in relation to near-death experiences, producing various psychological interpretations. Recently a localizationist interpretation on OBE proposed by Blanke, in which the phenomenon is localized onto the temporo-parietal junction (TPJ) is being accepted by neuropsychological community, as it is demystifying the phenomenon. In this communication, OBE was reconsidered from a wider view. Firstly it was pointed out that OBE's peculiarity as compared to the other types of autoscopic phenomena, namely, transference of one's own viewpoint to the place outside his/her body, represented by seeing one's own back and top of the head, is hard to explain by Blanke's theory, which is based on the illusory distortion of the body scheme. Secondly, studies on OBE as an epileptic symptom was reviewed and, taking the case of the author's patient, the validity of the localization on TPJ was evaluated. Then the holistic viewpoint was introduced in relation to the disorder of consciousness accompanying epileptic seizures and also dissociative disorder. The difficulty in differentiating between OBE as an epileptic symptom from that as a dissociative one was exemplified using the author's case. Aiming at an integrated view, a hypothesis was proposed that the mechanism of detachment of the observer-self and the self-body should be "built-in" within the mental system in the brain, in order to utilize it in emergencies in which the consciousness is disorganized, whether in epileptic seizures, dissociation or near-death experiences. It was pointed out, however, that OBE could occur in REM sleep without any actual emergency and even in the awaken part of the healthy life, making the interpretation furthermore difficult. In conclusion, it was emphasized that both localizationist and holistic views are necessary in the interpretation of OBE.
Keywords	out-of-body experience (OBE), temporo-parietal junction (TPJ), epilepsy, dissociative disorder, first-person perspective