Journal of Nervous and Mental Disease, 174, 615-619
© 1986 by The Williams & Wilkins Co.
and Perception Laboratory, The Medical School, University of Bristol,
Bristol BS8 1TD, England.
I would like to thank Dr. 0. T. Phillipson and Dr. J. Harris for
collecting the data, and the Perrott-Warrick Studentship in Psychical
Research and the Society for Psychical Research for financial support.
Questionnaires on perceptual distortions, symptoms of schizophrenia, and
out-of-body experiences (OBEs) were completed by 71 volunteers with a
history of schizophrenia and 40 control subjects (patients in a
hospital accident ward). Significantly more of the schizophrenics
(42%) than of the control group (13%) answered "yes" to a
question about OBEs. However, a follow-up questionnaire showed that
only 14% of schizophrenics (i.e., the same as the control group) had
had "typical" OBEs, in which a change of viewpoint was
reported. Those reporting typical OBEs did not report more perceptual
distortions or symptoms of schizophrenia than did those reporting no
OBEs, although those reporting other atypical experiences did. On this
basis there is no evidence to consider the typical OBE as pathological
or as symptomatic of schizophrenia.
An out-of-body experience (OBE) is an experience in
which a person seems to perceive the world from a location outside of
the physical body. In other words the "self seems to leave the
physical body. Sometimes, although not invariably, the experient
reports looking down on the physical body and having a duplicate body
of some sort (Blackmore, 1982; Green, 1968).
The OBE can occur under almost any circumstances
(Blackmore, 1982; Green, 1968), but it is especially common during
physical relaxation (such as before sleep), when the experient may
suddenly seem to be
hovering above his own body, or as part of the near
- death experience (see Greyson and Flynn, 1984). Patients
resuscitated from clinical death, or those who narrowly escape fatal
injury in car crashes or mountaineering falls, often report being able
to observe the events as though a spectator.
Such experiences have been claimed by up to 50% of
selected groups (e.g., Tart 1971), and in random
surveys about 10% to 20% of respondents claim to have had them
(Blackmore, 1984; Palmer, 1979; for review, see Blackmore, 1982).
Some people thoroughly enjoy their OBEs but others are
frightened by them and sometimes assume that they are "going
crazy." It is therefore important to determine whether the OBE is
a symptom of any pathology, whether it is associated with any
recognized syndrome, and therefore whether its appearance should be
The experience has often been likened to autoscopy,
depersonalization, derealization, and schizophrenic loss of body
boundaries. However, it can be quite clearly distinguished from all of
these. For example, Noyes and
Kletti (1976) likened near death experiences to depersonalization.
However, in both derealization and depersonalization the subject feels
unreal or less real than usual. In OBEs it is typical for exponents to
feel "more real" than ever before. They often describe their
thinking as clear and lucid and their surroundings as realistic, as in
this simple description by a woman who had frequent
left my body as soon as I fell asleep.... My faculties were absolutely
clear as I left the house, and travelled across London"
(Blackmore, 1982, p. 21).
experience may sound bizarre but there is no loss of reality.
Autoscopy was defined by Critchley (1950) as
"delusional dislocation of the body image into the visual
sphere" and by Lukianowicz (1958) as "a complex
psychosensorial hallucinatory perception of one's own
body image projected into the external visual space". Both
these imply that the self remains associated with the physical body
and that a duplicate body is seen at a distance. This is clearly not
an OBE according to the definition given above. The distinction is
confirmed by some cases given. For example, Lukianowicz (1958)
describes a case of autoscopy in which an architect observed a
complete duplicate of himself enter the room, merge with himself, and
then depart again.
However, others have used the term less clearly.
For example, Damas Mora et al. (1980) defined heautoscopy (the term
they prefer to autoscopy) as "the experience of seeing one's own
body at a distance" and Lippman (1953) defines autoscopy as
"hallucinations of physical duality." These could clearly
include OBEs. Indeed, Lippman gives an account of autoscopy in a woman
suffering from migraine. Just before the onset of a headache she was
serving breakfast. She says, "There would be my husband and
children, just as
usual, and in a flash ... I felt as if I were
standing on an inclined plane, looking down on them from a height o a
few feet, watching myself serve breakfast" (p. 346). This clearly
is an OBE as defined here.
I have argued (Blackmore, 1982) that it is useful
to distinguish between the OBE and autoscopy. In the OBE the self
seems to leave the physical body whereas in autoscopy the self remains
with the physical body and a double is seen at a distance.
In schizophrenia, body boundary disturbances are
common. Sufferers complain of fusion phenomena, underestimation or
overestimation of the size of body parts, or total loss of parts of
the body. Occasionally his may be confounded with sensations of being
outside the body, as in an OBE. However, Gabbard and Twemlow (1984)
have carefully distinguished the two phenomena. The main difference is
that in schizophrenia reality testing is lost whereas in the typical
OBE it is maintained. Also OBEs tend to be short lived: the identity
remains intact, the location of the body is clear, and the experience
may be integrated into the personality. By contrast, in schizophrenic
disturbances there is chronic difficulty with the delineation
of body boundaries and
the identity is
Gabbard and Twemlow (1984) have also administered a
variety of psychological tests to large numbers of people reporting
OBEs and found that they tend to be unusually healthy and well
adjusted, but of course OBEs are not restricted to the psychologically
The question now arises whether the OBE is a
symptom of any pathology, in particular schizophrenia, or whether it
should be treated as a perfectly normal occurrence. If the former is
the case then we would expect schizophrenics to have an unusually high
proportion of OBEs. If the latter is true we would expect no more OBEs
among schizophrenics than among others. Additionally, if the OBE is a
symptom of pathology then we would expect it to be associated with
other symptoms. For example, those schizophrenics showing most severe
symptoms of their illness would also be expected to have OBEs more
The study reported here addressed these two
questions by means of a questionnaire survey.
The data were collected in conjunction with a study
of perceptual distortions by Phillipson and Harris (1985). Some of the
OBE data have been reported previously and comparisons have been made
with a group of students (Blackmore and Harris, 1983). A more
appropriate control group was used here.
The questionnaire consisted of a typed booklet
containing questions about personal history, perceptual
distortions, symptoms of schizophrenia, and OBEs.
The section on visual distortions explained that we
were interested in "when real objects you are looking at appear
in some way changed, or odd, or not as you would expect them to
look." Hallucinations and "tricks of the light" were
specifically excluded. There were
sections on seven types of distortions: distortions of color,
movement, brightness or contrast, depth, shape, size, and tilt. The
schizophrenics were asked about drug treatment received and whether it
seemed to increase or reduce the frequency of visual distortions or
The section on symptoms included questions of high
diagnostic significance for schizophrenia. These were taken from the
Present State Examination (9th ed.; Wing et al., 1972), and included
questions on thought interference, hearing voices, and seeing visions.
The OBE question was taken from Palmer (1979). It asked, "Have
you ever had an experience in which you felt that 'you' were located
'outside of or 'away from' your physical body; that is the feeling
that your consciousness, mind or center of awareness was in a
different place than your physical body?" Possible answers were
"No," "Yes, once," "Yes, several times,"
"Yes, often," and "Yes, can experience it at
The control subjects were asked for a description
of the experience straight away. Based on these descriptions, all five
of the OBEs reported could be categorized as "typical" OBEs.
Among the schizophrenic group, those who answered "yes" to
this question were later sent a follow-up questionnaire asking for
more details and a description of their OBE(s).
John Harris and Oliver Philipson (Anatomy
Department, University of Bristol) placed an advertisement in the Newsletter of the National Schizophrenia Fellowship asking for
volunteers with a history of schizophrenia to give information about
their experiences (unspecified experiences). No further information
was given at this stage. A total of 71 completed questionnaires were
received from this group. There were 30 women and 41 men, with a mean
age of 36 years. All claimed previous diagnosis as schizophrenics and
only three did not report at least one of the symptoms of
schizophrenia included in the questionnaire.
The control group consisted of 40 patients admitted
to the Accident and Emergency Wards of the Bristol Royal Infirmary.
Patients with head injuries, those taking drugs other than
painkillers, or those younger than 15 or older than 70 years of age
were excluded. There were 14 women and 26 men, with an average age of
35 years. Of these subjects only three answered "Yes" to the
questions about symptoms of schizophrenia.
These questions therefore discriminated extremely well between
the two groups.
The questionnaire was sent by mail to the
schizophrenic group and given to the control group in the hospital to
complete at their leisure. After the completed questionnaires were
received from the schizophrenic group, a second questionnaire was sent
to all those who claimed to have had OBEs. This questionnaire asked
for further details about the experience in an attempt to categorize
it more accurately and compare it with the OBEs reported elsewhere.
This follow-up was not possible for the control group because they
were not required to give their names and addresses.
However, they were asked for a description of their OBE in
The incidence of OBEs appeared superficially to be
quite different in the two groups. Forty-two percent of the
schizophrenic group but only 13% of the control group claimed to have
had at least one OBE. The difference is significant (x2 = 10.5, df 1,
p < .01).
However, when the 30 schizophrenics who claimed
OBEs were sent a follow-up questionnaire asking for more details of
the experience, it became obvious that not all those who answered
"yes" had in fact had anything like a typical OBE. Of these
30, 22 returned the completed questionnaire with a description of the
experience. The defining characteristic of an OBE is seeming to have a
viewpoint outside of the physical body. Of these 22, only 9 gave
descriptions that could be categorized as "typical" OBEs.
Some examples are given below.
If the other 13 people were considered not to have
had an OBE the proportion of schizophrenics who had had OBEs dropped
to nine of 63 (excluding the eight who did not respond to the second
questionnaire). This is 14%—almost exactly the same as in the
As expected the schizophrenics reported more
perceptual distortions and more symptoms of schizophrenia than did the
control group (see Table 1) (see Phillipson and Harris  for more
The second question concerns whether having OBEs is
associated with the three symptoms of schizophrenia included here,
that is, seeing visions, hearing voices, and thought interference. All
three symptoms were more common among the 30 who initially claimed
OBEs, and the difference is significant in the case of seeing visions
(x2 = 4.74, df 1, p < .05).
This might imply that the OBE is indeed more common
in those more seriously ill. However, the data were broken down
separately for those who reported no OBE, those who reported typical
OBEs, and those who reported other experiences or
"pseudo-OBEs" (see Table 2—eight subjects who claimed OBEs
in the first questionnaire but did not return the second questionnaire
are excluded). This analysis clearly shows that the effect is minimal
for typical OBEs whereas it is large for pseudo-OBEs. In other words
those subjects who report typical OBEs are no more likely to report
the symptoms of schizophrenia than are those reporting no OBEs.
The same applies when we look at perceptual
distortions. The 30 who initially claimed OBEs report on average more
perceptual distortions (X 2.5) than others (X 1.2, t = 2.8 df 67, p
< .01). However, when they are broken down into three groups as
before, the difference is much smaller (see Table 2).
In the control group there is no significant
difference in the number of perceptual distortions reported between
those reporting OBEs and those reporting no OBEs (X A and .2,
respectively). Symptoms of schizophrenia are too rare in the control
group for any comparisons to be made.
of Schizophrenic and Control Subjects Reporting OBEs,
Distortions and Symptoms of Schizophrenia
Symptoms of Schizoprenia
Schizophrenics (N = 71)
Control Subjects (N = 40)
Symptoms of Schizophrenia and
Perceptual Distortions in
Those Reporting OBEs and Others
No of Distortions
(N = 41)a
(N = 9)
(N = 13)
varies slightly within groups because not all subjects answered all
Finally, the schizophrenics were asked how
the frequency of their OBEs was affected by the onset of their illness
and by any drug treatment they received.
In many cases they reported only one or "a few" OBEs
and so such a comparison is not meaningful. Of the 30 who initially
claimed OBEs, 18 claimed that their OBEs became more frequent with the
onset of their illness, seven that they stayed the same (or they had
too few to tell), and five that they became less frequent. Drug
treatment was claimed to reduce OBEs. Three claimed that their OBEs
became more frequent with drug treatment, 16 that there was no effect,
and 11 that they became less frequent. The numbers here are too small
to consider just typical OBEs. In any case these data must be treated
with caution because it is very hard to estimate changes in frequency
of infrequent events, especially retrospectively.
A lot of emphasis has been placed on the
distinction between typical OBEs and other experiences initially
claimed as OBEs. To give a clearer idea of the kinds of experience
being reported, some examples follow.
Nine schizophrenics reported OBEs that can be
classed as typical or true OBEs. For example, a 43-year-old woman who
reported few distortions and suffered thought interference and visions,
although she never heard voices, reported two OBEs that occurred after
recovery from her illness:
"'A' occurred when I was in bed, resting but not asleep. The
bedroom light was on. I found myself in the position where a rocking
chair was situated near the foot of the bed. I could see my head on the
pillow and the colors of the pillow case and counterpane, which were as
usual. The experience did not last long and I had no difficulty getting
back into my physical body.
'B' occurred about a
week later. I was in bed.... I seemed to leave the
house (I think through the window) and travel a great
She goes on to describe further "travels"
during that OBE and adds that she was studying yoga at the time.
A 43-year-old man who reported no visual
distortions but did suffer from thought interference and hearing voices
described an experience which occurred:
"On stage in the middle of a play at
Her Majesty's Theatre, Barrow-in-Furness. It didn't affect my
performance in any way at all. I went on acting while my center of
consciousness (I) floated about 15 feet above the scene I was in."
Like so many others he feels he needs to add,
"I'm not making this up: it was a very exhilarating experience and
mystery to me."
A 31-year-old woman who reported no visual
distortions, but did have hallucinations and thought interference and
heard voices, reported two experiences. In the second:
was resting on my bed, when I suddenly seemed to withdraw from my body.
'I' was to the side of the bed, looking on my body,
which looked purple and emaciated, and I just had a sure feeling
that I was dead! The next thing I knew, I woke up, perfectly normal,
was back in my own body."
This woman reported that antischizophrenic drugs
reduced the occurrence of her OBEs. She also claimed
that, after a subsequent OBE, "I have never felt afraid of
Contrasting with these are many diverse experiences
that may or may not be comparable to OBEsbut were claimed as such. For example, a
31-year-old man who claimed to have few visual distortions but all three
symptoms of schizophrenia explained:
"During my last schizophrenic breakdown I was transported,
through music, to Titan (Saturn's moon), on which the gods had erected a
theatre in which the fate of the earth was to be determined. I travelled
without a body—as an idea or thought or some intangible aspect of
I do not consider this an OBE because he does not
mention any separation of physical body and self, nor does he describe
leaving the body nor observing it from a distance. He nevertheless
claimed that his OBEs increased with the onset of his illness and were
reduced by the medication he took.
One 44-year-old man, whose only reported symptom
was thought interference and who reported only distortions of size,
described the following experience:
about 20 years ago when I was about 21 and undergoing treatment in
hospital.... I felt that my body had shrunk and that other people and
objects around me had taken on increased proportions.... It was,
however, rather unpleasant and frightening at the time."
He claimed that this experience increased with the
onset of his schizophrenia and was not affected by drug treatment.
Others described apparitions, deja vu experiences,
lucid dreams, experiences of fusion with others, and body image
disturbances of various kinds. None of these can be classed as typical
OBEs, because none involves a change in viewpoint to a position outside
Among the control group only five OBEs were
reported and a follow-up questionnaire was not given. The descriptions
were mostly simple and were clearly typical OBEs. For example, one
22-year-old woman reported feeling "as if I was floating but was
looking down on myself".
A 58-year-old man reported that he seemed to be
"above and looking down on my body in bed" and an 18-year-old
woman reported that her OBEs occurred
"not that often—if I lie in bed and hold breath I can
come out of myself and feel as if I'm floating".
Superficially the results seem to show that the
schizophrenics have far more OBEs than do control subjects and that
those who have OBEs also suffer from more perceptual distortions and
more of the symptoms of schizophrenia. However, when the OBEs are
distinguished on the basis of the descriptions given, into typical OBEs,
in which the person seems to leave the body, and pseudo-OBEs, which
include all sorts of other experiences, then these differences disappear
It seems that the schizophrenics do not have significantly more OBEs
than do control subjects and that having OBEs is not related to either
perceptual distortions or to the symptoms of schizophrenia This confirms
a previous finding in which no relationship was found between having
OBEs and perceptual distortions in a group of students (Blackmore and
Some problems remain concerning the selection of
subjects. The subjects in the schizophrenic group were self-selected
(although not for having OBEs, of course) and those in the control group
were more nearly random Also the schizophrenics were asked about their
OBEs on two separate occasions and the control group on only one. This
might produce spurious between-group differences that have nothing to do
with schizophrenia. The fact that the proportion of typical OBEs was the
same in both groups might imply that
any such effect was minimal. Nevertheless, further
research without these problems is obviously warranted.
On the basis of the findings reported here, we may
answer our original questions very simply. OBEs do
not seem to be pathological. People who experience them may fear
that they are "going crazy" but in fact
normal control subjects experience just as many typical OBEs as
schizophrenics do. Also, among schizophrenics, those who report more
symptoms are no more likely to have typical OBEs. There seems to be no
basis for considering the appearance of OBEs as an indication of
pathology or as a symptom of schizophrenia.
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