Self-portrait of a Stranger: Self-face Representation and Interoception in Depersonalization Experiences

Depersonalization is a condition that makes people feel detached from one’s self, body and others. The representation of one’s own face is a salient bodily aspect of self-awareness and identity, and empirical evidence suggests that individuals with depersonalization disorder experience disrupted perception of their faces when viewing themselves in photographs or in the mirror, which has been corroborated by first-person reports. However, no study had yet explored the state of long-term self-face representations stored in visual memory in the context of depersonalization. By visualising how individuals saw themselves “in the mind’s eye”, this study provides the first empirical evidence for a relationship between depersonalization symptoms and impairments in self-face representation. Individuals reporting more frequent and intense depersonalization symptoms had lower self-face representation accuracy, but somewhat counterintuitively, also higher precision and informational content of this representation. These results suggested that individuals with high depersonalization were representing a distinct, but inaccurate, facial identity as themselves. The self-face representations of high-depersonalization participants were rated as visibly more emotionless and younger in appearance than those of low-depersonalisation participants, according to independent raters. These features were found to be specifically related to aspects of depersonalization symptomatology related to anomalous memory experiences. Finally, an intriguing role of interoceptive sensibility was revealed in both self-face representational accuracy and in depersonalization symptoms. These novel results highlight the link between interoceptive and exteroceptive bodily self-awareness and memory processes as important in those individuals who experience distressing feelings of being detached from one’s self, body and the world.