MICROPSIA
JEROME M. SCHNECK M.D.1
1 Clinical Associate Professor of Psychiatry, State University of New York College of Medicine, New York City.
Micropsia may accompany neurological defect or dysfunction as in tumors of the temporal lobe and petit mal. It may be encountered as a psychopathological phenomenon without structural defect. It is described relatively infrequently in medical literature. The symptom involves seeing objects or people as very small, off in the distance, as if one were looking "through the wrong end of a telescope."An impression of objects moving away, into the distance, is often described. A patient in psychiatric treatment told of a series of such episodes during his childhood. His micropsia apparently reflected his expansive needs counteracting a closed-in feeling, his reaction to heavy psychological pressures, an attempt to cope with intense repressed anger, a way of symbolically manipulating people identified as objects, and a method of exercising control to cope with feelings of weakness and insecurity. The micropsia was a mirror of his feeling of separation from people and things about him during those childhood years, and it serves as an indication of his loneliness. It was a sign of diminishing ego strength, but was not followed by a psychotic break. Defenses were evidently reinforced later, judging by the patient's history and the personality patterns that evolved. The oral and aggressive components in this case were witnessed by others in studies of their patients. Pertinent references are mentioned here, and the observations integrated with my own findings. Similarities and differences in the cases are noted. Finally, mention is made briefly of another patient of mine with micropsia although there was no opportunity to evaluate the psychodynamics of his problem.
