Views & Reviews Medical classics

The Metamorphosis

BMJ 2007; 335 doi: (Published 05 July 2007) Cite this as: BMJ 2007;335:49
  1. Cyrus Abbasian, specialist registrar in psychiatry
  1. Lambeth Hospital, London
  1. abbasian{at}

    “When Gregor Samsa awoke from troubled dreams one morning, he found that he had been transformed in his bed into an enormous bug” is Franz Kafka's superbly mesmerising opening to his novella The Metamorphosis. Kafka describes, in colourful, evocative detail, how this initially bed bound and haplessly transformed creature tries to survive. Its predicament could be interpreted as psychotic: dreamlike and detached from reality. He barricades himself in his bedroom to avoid family, and his voice changes to “animal-like”—monosyllabic and unintelligible. With disordered speech, perplexed and lost in time, but paradoxically calm and initially insightless in a nightmarish yet serene universe, the “bug” struggles on. Psychosis has been associated with loss of personal identity—hence a bug—and a variety …

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