Out-of-body experience and autoscopy of neurological origin
Open accessAbstract
During an out-of-body experience (OBE), the experient seems to be awake and to see his body and the world from a location outside the physical body. A closely related experience is autoscopy (AS), which is characterized by the experience of seeing one's body in extrapersonal space. Yet, despite great public interest and many case studies, systematic neurological studies of OBE and AS are extremely rare and, to date, no testable neuroscientific theory exists. The present study describes phenomenological, neuropsychological and neuroimaging correlates of OBE and AS in six neurological patients. We provide neurological evidence that both experiences share important central mechanisms. We show that OBE and AS are frequently associated with pathological sensations of position, movement and perceived completeness of one's own body. These include vestibular sensations (such as floating, flying, elevation and rotation), visual body-part illusions (such as the illusory shortening, transformation or movement of an extremity) and the experience of seeing one's body only partially during an OBE or AS. We also find that the patient's body position prior to the experience influences OBE and AS. Finally, in five patients, brain damage or brain dysfunction is localized to the temporo-parietal junction (TPJ). These results suggest that the complex experiences of OBE and AS represent paroxysmal disorders of body perception and cognition (or body schema). The processes of body perception and cognition, and the unconscious creation of central representation(s) of one's own body based on proprioceptive, tactile, visual and vestibular information-as well as their integration with sensory information of extrapersonal space-is a prerequisite for rapid and effective action with our surroundings. Based on our findings, we speculate that ambiguous input from these different sensory systems is an important mechanism of OBE and AS, and thus the intriguing experience of seeing one's body in a position that does not coincide with its felt position. We suggest that OBE and AS are related to a failure to integrate proprioceptive, tactile and visual information with respect to one's own body (disintegration in personal space) and by a vestibular dysfunction leading to an additional disintegration between personal (vestibular) space and extrapersonal (visual) space. We argue that both disintegrations (personal; personal-extrapersonal) are necessary for the occurrence of OBE and AS, and that they are due to a paroxysmal cerebral dysfunction of the TPJ in a state of partially and briefly impaired consciousness.
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A mean lesion overlap analysis in five patients with OBEs centers on the TPJ.
“The figure shows results of a mean lesion overlap analysis in five patients with OBEs.The analysis centers on the TPJ.”
From Empirical perspectives from the self-model theory of subjectivity: a brief summary with examples (2007) · cites this paper as Blanke et al., 2004
The Anatomy section and Fig. 4 caption report a mean lesion overlap analysis of five patients centered on the temporo-parietal junction. But the Fig. 2 caption identifies patients in the lesion analysis with both out-of-body experiences (OBEs) and autoscopy (AS), so describing all five as patients with OBEs is not supported. (LLM, conf=0.88)
Experimental — accuracy not yet measuredBecause the conscious body model is phenomenally transparent, we fully identify with its representational content and are consciously present as bodily selves.
“Because this conscious body model is phenomenally transparent because it cannot introspectively be recognized as a model, we fully identify with its representational content and are consciously present as bodily selves (self-identification) [6,7,23,24].”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
Theoretical considerations (page unavailable) describes a central representation of one’s body, and Discussion Phenomenology (page unavailable) reports preserved self-recognition during autoscopic experiences. The paper does not say that the body model is phenomenally transparent or that inability to recognize it introspectively causes full identification with its content. (LLM, conf=0.83)
Experimental — accuracy not yet measuredOut-of-body experiences are associated with a sense of disembodiment and people always self-identify with the illusory body as represented.
“Out-of-body experiences are associated with a sense of disembodiment and people always self-identify with the illusory body as represented.”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
The Theoretical considerations section links OBEs with disembodiment, and Visual phenomenology reports that all three OBE patients localized their perspective in a second, parasomatic body. This supports the self-location aspect, but the paper does not establish that people always self-identify with an illusory body across OBEs generally; its observation is limited to the patients studied. Page numbers are unavailable in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn heautoscopy, self-identification either refers to the illusory body as represented, the physical body as represented, or to both in alternation.
“Self-identification either refers to the illusory body as represented, the physical body as represented or to both in alternation [23,27,49] (Box 2).”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
The Discussion (Phenomenology) and Fig. 5 (Theoretical considerations; page not provided) describe heautoscopy as involving visual perspectives from the physical and illusory bodies, sometimes in alternation. They do not establish the more specific claim that self-identification shifts between those bodies; visual perspective and self-identification are not the same finding. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIn heautoscopy, self-location and weak first-person perspective might change their experienced position between the illusory and physical body and can occur in rapid alternation.
“Moreover, self-location and weak 1PP might change their experienced position (between the position of the illusory and the physical body as represented) and this can occur in rapid alternation.”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
The Discussion Phenomenology section reports rapid alternation between parasomatic and physical visuo-spatial perspectives in heautoscopy, supporting the first-person-perspective part of the claim. It also says these patients did not feel out of their bodies, so the paper does not establish that their experienced self-location alternated between the two bodies. Page numbers are not available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Other patients can describe an auditory weak 1PP that is spatially distinct from their simultaneously present visual weak 1PP.
“Other patients can describe an auditory weak 1PP that is spatially distinct from their simultaneously present visual weak 1PP [23].”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
The Non-visual phenomenology section reports auditory manifestations in two patients, and the Visual phenomenology section says Patient 2b experienced two visual perspectives simultaneously. Neither passage describes an auditory first-person perspective spatially distinct from a simultaneous visual one; the two perspectives reported for Patient 2b were both visual. Our copy provides no page numbers for these passages. (LLM, conf=0.83)
Experimental — accuracy not yet measuredDuring autoscopic hallucinations, the person sees a second illusory own body from the habitual weak 1PP with normal self-location (at the physical body as represented).
“During autoscopic hallucinations, the person sees a second illusory own body from the habitual weak 1PP with normal self-location (at the physical body as represented).”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
The Visual phenomenology section (page unavailable) says the habitual physical visuo-spatial perspective is classically reported in autoscopic hallucinations, and Fig. 5 depicts the perspective as originating from the physical body. But it also reports patients with two perspectives, one of which could be elevated, rotated, or displaced. The paper does not characterize the first-person perspective as “weak,” so the claim is too categorical and adds an unsupported qualifier. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThis is compatible with clinical data in which both types of dissociations have been observed in patients with heautoscopy or out-of-body experiences (i.e. a patient experienced the visual weak 1PP at the position of his body, but self-location 2 m behind his body as represented).
“This is compatible with clinical data [23,38,51,58] in which both types of dissociations have been observed in patients with heautoscopy or out-of-body experiences (i.e. a patient [51] experienced the visual weak 1PP at the position of his body, but self-location 2 m behind his body as represented).”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredDisembodied self location has been linked to lesion or seizure involving the temporo-parietal junction or the posterior insula.
“Disembodied self location, on the other hand, has been linked to lesion or seizure involving the temporo‐parietal junction (Blanke et al., 2004), or the posterior insula (Heydrich & Blanke, 2013).”
From Neural bases of the bodily self as revealed by electrical brain stimulation: A systematic review (2023) · cites this paper as Blanke et al., 2004
In a patient, an OBE-like phenomenal state was artificially induced by electrical cortical stimulation.
“The blue dots show the locus of electrical cortical stimulation in the patient in whom an OBE-like phenomenal state was artificially induced.”
From Empirical perspectives from the self-model theory of subjectivity: a brief summary with examples (2007) · cites this paper as Blanke et al., 2004
The bodily self or MPS is altered and abnormal during out-of-body experiences and heautoscopy, and experimentally manipulated during the full-body illusion.
“It is this bodily self or MPS which is altered and abnormal during out-of-body experiences [23-25], heautoscopy (see Box 2) [15,26,27] and experimentally manipulated during the full-body illusion [13,28].”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
Heautoscopy is highly realistic and the person most often has no insight into the illusory character of the phenomenon.
“Heautoscopy is highly realistic and the person has most often no insight into the illusory character of the phenomenon.”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
In autoscopic hallucinations, all three MPS dimensions (self-identification, self-location, weak first-person perspective) are normal.
“All three MPS dimensions (self-identification, self-location, weak 1PP) are normal.”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
MPS breaks down in neurological patients with illusory global own body perceptions, called autoscopic phenomena, characterized by seeing a second own body in extracorporeal space.
“MPS breaks down in neurological patients with illusory global own body perceptions, called autoscopic phenomena [23,27,37,47-49], that are characterized by seeing a second own body in extracorporeal space: autoscopic hallucination, heautoscopy, and out-of-body experience (Figure 1) (Box 2).”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
In heautoscopy, the position of self-location and weak first-person perspective can differ.
“The position of self-location and weak 1PP can also differ [23].”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
Heautoscopy is often associated with the sensation of 'being split in two selves'.
“Heautoscopy is often associated with the sensation of 'being split in two selves' [23].”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
Self-identification in autoscopic phenomena either refers to the illusory body as represented, the physical body as represented or to both.
“Self-identification either refers to the illusory body as represented, the physical body as represented or to both.”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
In patients with heautoscopy, they claim to jump back and forth between two spatially distinct points of view.
“This is the case in patients with heautoscopy who claim to jump back and forth between two spatially distinct points of view [23,50].”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
Out-of-body experiences are highly realistic, and most often there is no insight into the illusory character of the phenomenon.
“Out-of-body experiences are highly realistic, and most often there is no insight into the illusory character of the phenomenon [23].”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
Heautoscopy is an intermediate form and self-location and the origin of the weak 1PP are either at the position of the physical body as represented or at the position of the illusory body as represented or at both positions.
“Heautoscopy is an intermediate form and self-location and the origin of the weak 1PP are either at the position of the physical body as represented or at the position of the illusory body as represented or at both positions.”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
Autoscopic phenomena indicate that conscious experience can also be characterized by the absence of a unitary visual weak 1PP, or by two simultaneous or rapidly alternating visual weak 1PPs.
“autoscopic phenomena indicate that conscious experience can also be characterized by the absence of a unitary visual weak 1PP, or by two simultaneous or rapidly alternating visual weak 1PPs.”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
During an out-of-body experience, self-location and the weak 1PP are at the position of the illusory body as represented (at a position that is most often elevated with respect to the position of the physical body as represented).
“During an out-of-body experience, self-location and the weak 1PP are at the position of the illusory body as represented (at a position that is most often elevated with respect to the position of the physical body as represented).”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
The patient has the impression to see the environment from the physical body as represented in the case of autoscopic hallucination, from the illusory body as represented in the case of out-of-body experience and alternatively or simultaneously from the physical and the illusory body as represented in the case of heautoscopy.
“The patient has the impression to see the environment from the physical body as represented in the case of autoscopic hallucination, from the illusory body as represented in the case of out-of-body experience and alternatively or simultaneously from the physical and the illusory body as represented in the case of heautoscopy (after [23]).”
From Full-body illusions and minimal phenomenal selfhood (2009) · cites this paper as [23]
Neurological observations suggest that certain brain regions might be responsible for generating the habitual experience of being located within one's body and of owning it, but they tell little about the underlying processes.
“Although these neurological observations suggest that certain brain regions might be responsible for generating the habitual experience of being located within one's body and of owning it, they tell us little about the underlying processes.”
From If I were you: Perceptual illusion of body swapping (2008) · cites this paper as [15]
Damage to, or abnormal physiology of, frontal, parietal and temporal regions can be associated with feelings of being outside the body.
“Similarly, damage to, or abnormal physiology of, frontal, parietal and temporal regions can be associated with feelings of being outside the body [15], [16].”
From If I were you: Perceptual illusion of body swapping (2008) · cites this paper as [15]
Lesions or seizures in the TPJ may alter the experience of self-location, such as during out-of-body experiences.
“Lesions or seizures in the TPJ may alter the experience of self-location, such as during what are often called out-of-body experiences.”
From Bodily ownership and self-location: Components of bodily self-consciousness (2013) · cites this paper as Blanke et al., 2004
Heautoscopy patients experience seeing a double of themselves in extrapersonal space.
“Another striking clinical example of dissociation between self-location and ownership is heautoscopy, during which patients experience seeing a double of themselves in the extrapersonal space (Blanke et al., 2004;Blanke & Mohr, 2005;Brugger, Blanke, Regard, Bradford, & Landis, 2006;Brugger, Regard, & Landis, 1997).”
From Bodily ownership and self-location: Components of bodily self-consciousness (2013) · cites this paper as Blanke et al., 2004
As reported by many of these patients, the elevated location is not represented as embodied in a person's body and patients report not perceiving or having reduced perception of somatosensory cues from their body.
“As reported by many of these patients this elevated location is not represented as embodied in a person's body and patients report not perceiving or having reduced perception of somatosensory cues from their body.”
From First person experience of body transfer in virtual reality (2010) · cites this paper as [34]
The spatial coordinates of the viewpoint transformation were chosen based on such transformations in neurological patients with out-of-body experiences [33], [34].
“The spatial coordinates of this viewpoint transformation were chosen based such transformations in neurological patients with out-of-body experiences [33], [34].”
From First person experience of body transfer in virtual reality (2010) · cites this paper as [34]
Clinical data suggest that remapping of self-location and first-person perspective from the physical body position to an elevated and distanced position and first-person perspective in extrapersonal space at the TPJ is based on a double disintegration of bodily signals, including disintegration between visual and vestibular signals.
“These clinical data suggest that remapping of self-location and first-person perspective from the physical body position to an elevated and distanced position and firstperson perspective in extrapersonal space at the TPJ is based on a double disintegration of bodily signals, including disintegration between visual and vestibular signals.”
From Multisensory mechanisms in temporo-parietal cortex support self-location and first-person perspective (2011) · cites this paper as Blanke et al., 2004
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Self-citation
- Authors
- Blanke, O., Landis, T., Spinelli, L., & Seeck, M.
- Affiliations
- University Hospital of Geneva (CH)
- Corresponding author
- Blanke, Olaf
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-02
- Volume
- 127
- Issue
- 2
- Pages
- 243-258
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- OpenAlex
- W2099202374
- Cited by
- 747
- References
- 91
- Citations by year
- 2026: 18 · 2025: 35 · 2024: 26 · 2023: 32 · 2022: 25 · 2021: 32 · 2020: 23 · 2019: 41 · 2018: 31 · 2017: 40 · 2016: 27 · 2015: 37 · 2014: 43 · 2013: 35 · 2012: 25
- FWCI
- 48.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Brain (publishedVersion)
- PubMed (publishedVersion)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (67105, 65323, 68105)
- Fondation Leenaards
- Topics
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Keywords
- out-of-body experiences, autoscopy, temporoparietal junction, body perception, body schema, vestibular illusions, extrapersonal space, proprioception, neurological patients, sensory integration
- MeSH terms
- Body Image, Depersonalization, Electric Stimulation, Electroencephalography, Female, Hallucinations, Humans, Magnetic Resonance Imaging, Male, Psychophysiology, Space Perception, Epilepsy, Complex Partial
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