Astral Projection: A Strange Out-of-Body Experience in Dissociative Disorder

Out-of-body experiences (OBEs) are hallucinatory visual experiences that involve seeing the physical body placed in an external visual space. Many psychiatric disorders, brain dysfunctions, pharmacological agents, and altered psychological states are reportedly associated with these phenomena. OBEs have been linked to various brain lesions, particularly in the parietal and temporal regions, psychiatric disorders, severe emotional states like a near-death experience, substance use, migraine, and epilepsy, but very few have been reported in dissociative identity disorder. In this report, we present the case of a 15-year-old male patient who described a strange experience where he found himself to be floating outside his own body while he visualized his own body from a third-person perspective. On further evaluation, a diagnosis of dissociative identity disorder and dissociative fugue was formulated. The patient showed improvement after undergoing abreaction, hypnosis, and relaxation training along with supportive psychotherapy. Dissociative disorders occur due to an internal conflict between ego and self, when a person is unable to successfully repress a traumatic experience, or when a repressed memory or experience comes out of the cocooned barrier, leading to an altered state of perception and self-experience, which is described by the patient as OBE. This report presents a scarce differential in the context of psychiatric illness, which might be helpful in the formulation of approaches toward management in cases of such OBE, making it a strange yet intriguing addition to the literature.