Neuropsychiatry of “Selfies”

Photopenia

At the turn of the 21st century, millions of individuals became obsessed with taking pictures of themselves and sharing them with friends as well as untold numbers of strangers. It suddenly became socially acceptable to take innumerable pictures of oneself. These self-portraits, more or less spontaneous, taken with a cellphone or handheld digital camera, became known as “selfies.” 


Graven images were originally reserved for important subjects, like gods. Later, wealthy individuals and others of high social status posed for commissioned painted portraits. With the advent of film photography, framed portraits of family and friends were exhibited sparingly in homes and workplaces. While it had previously been considered egotistical to take a picture of oneself, the invention of inexpensive digital photography, virtually unlimited digital storage, smartphones with cameras, front facing lenses, and popular free Internet online sharing communities such as Facebook coalesced into the perfect storm to facilitate the proliferation of selfies. Even a "selfie stick" has been invented to extend the reach of one's arm and increase photographic possibilities

The popularity of the selfie remains a mystery. It may be related to the fleeting narcissistic pleasure of seeing yet another image of oneself. However, many people hardly look at the selfies they have taken, sometimes merely casting a glance to insure that the picture is in focus. Perhaps there is pleasure in the mere act of taking the picture? Since selfies are often immediately posted online, perhaps it is the joy of sharing that induces and reinforces this unsubstantive, repetitive behavior? The taking of a selfie may also relieve existential angst regarding one’s very existence as a cogito ergo sum argument, i.e., “I took a selfie, therefore I am.”

The lack of a clear justification for the time and energy devoted to selfies raises the possibility that they represent the manifestation of a new psychiatric disorder, “psychogenic photopenia (PP).” Psychogenic photopenia is defined as the widespread delusion that the world contains an insufficient number of photographs of oneself. 



While people take selfies all over the world, Makati City in the Philippines has the highest prevalence of selfie-takers, 258/100,000 people. New York City is #2, with 202 selfie-takers per 100,000. Selfies have become so socially important that there are detailed  “how to” sites with instructions. Nonetheless, one such site candidly admits, “but taking a random photo of yourself with your phone is a silly enough action in itself.” Whether the propagation of selfies will overwhelm data storage capabilities resulting in a catastrophic crash of the "cloud" remains one of the most contentious questions of modern times.

Young adults, particularly women, appear particularly susceptible to PP. However, with increasing age, selfies of men become more prevalent. President Obama has toyed with selfies. It appears that no one is immune .


Causes

Psychogenic photopenia may be a symptom of narcissistic personality disorder. In a recent online survey of 1,000 men aged 18-40, narcissism and psychopathy personality traits predicted an increased number of selfies . Another possibility is that PP represents a subtype of obsessive compulsive disorder. For example, if an affected individual is prevented from taking a selfie, they may experience severe anxiety, which is only relieved with the press of a shutter button. The rapid geographic spread of selfies hints at a contagious phenomenon, perhaps of viral origin. Psychogenic photopenia might also be a subtype of mass hysteria.

Treatment

As with many neuropsychiatric conditions, definitive treatment of PP has lagged behind descriptive semiology. At present, there is no known cure. The most pragmatic approach to the ever present temptation to take a selfie may perhaps be found in the writings of Oscar Wilde, “The only way to get rid of a temptation is to yield to it.” 


Psychogenic photopenia is the false belief that insufficient pictures of oneself exist in the universe. This condition has led to an epidemic of “selfies,” particularly among young women living in major cities such as Manila and New York. Multiple etiologies may be responsible, such as narcissistic personality disorder, obsessive compulsive disorder, infectious disease, mass hysteria, existential self-doubt, or other as yet unidentified causes. There is no proven treatment. On the other hand, the widespread prevalence of PP amongst the general population suggests that taking selfies may represent normal evolutionary human behavior in the 21st century