He decided to report to the counseling center at his university

after experiencing a series of strange events. The first event happened many years ago, he says. He vividly

recalls, at age 10, a day when he was playing football: he was tackled by another boy and suddenly felt that his

body had disappeared. This sensation was initially episodic but became continuous by age 14. He described it as

"not being in this world. . . I am disconnected from my body. It is as if my body is not there." This

sensation was lessened when he was alone and almost disappeared in his wife’s presence. Social settings made it

much worse.

He has recently had a couple instances in which he has been sitting in class when, all of a sudden, he gets the

strange sensation that he and his professor are the only two people alive in the classroom. He can look around,

but he perceives his classmates as mannequins or "fakes." His last episode terrified him because he

felt convinced that most of his classmates had somehow simultaneously died. It is getting to a point where his

experiences are making it hard to concentrate and work in class or when he is around others.

As a child, Mr. B suffered marked emotional neglect. His parents fed and clothed him but never expressed emotion;

he recalled hardly ever being touched or kissed. His sense of detachment only involved his body and not other

aspects of the self.

Provide an appropriate diagnosis for Mr. B and rate his degree of functional impairment. Include additional

information if it is available. Describe the symptoms that led to your diagnosis.