The disturbances of the ego experience. A case of multiple ego (and an inverted self)

The following is a clinical case of a person affected by schizophrenic disorder with a specific Ego development disturbance that has never been previously described. The perceptual-delusional symptomatology does not manifest as a double experience typically described as “external” to the peri-personal space but rather as “internal” and completely “foreign” to the subject. This entity is both active and present, yet it is curiously associated with multiple entities that intervene in hallucinatory perceptual contexts, resulting in a florid symptomatology characterized by auditory hallucinations of commenting voices.

To the best of our knowledge, no prior psychopathological literature has described such a persistent and embodied alteration of the Ego, associated with other multiple entities that successively manifest within the “internal” space of the Self. This intense delusional-hallucinatory symptomatology exhibited a significant response solely to prolonged treatment with Clozapine.