In this article, I would like to describe the main characteristics of depersonalization and derealisation experiences and some of my findings resulting from my research during my postgraduate studies with regard to depersonalization among drug users and meditators.
Definition / Phenomenology
First of all, what is a depersonalization (DP) experience? According to the DSM V, a major, up to date diagnostic manual, DP includes experiences of: unreality, detachment, feeling like an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions. And derealisation (DR) refers to feelings of unreality or detachment with respect to ones surroundings. People with DP/DR can experience others or objects as unreal, dreamlike, foggy, lifeless, or visually distorted.
DP/DR is a very complex experiential phenomena with quite a few components to it. Let’s see just some of the most typical verbalizations of these experiences. A person with dp could say: “I know I have feelings but I don’t feel them“; “I feel like a robot“; “I feel strange, as if I were not real or as I were cut off from the world“. It is important to note, that although people with DP often have the frightening impression that they are going crazy, insane, this state is radically different from actually being crazy or psychotic. People with DP know that there experience is unusual, out of the ordinary. They are painfully aware that something is not right, and they are actually hyper conscious of certain aspects of reality and some of its abstract, philosophical mysteries. On the other hand, a psychotic person would have hallucinations, delusions and would believe firmly that these are reality, and would show bizarre behaviour and speech in line with those. Moreover, people with DP use expressions like “as if” to describe how they are. So they will say: “I feel like a robot, I feel as if I was an automaton.” They don’t say “I am a robot, there is no blood inside me”, that would be someone in a psychotic episode.
How common is DP/DR?
So first wee need to see that depersonalization is a natural part of the wide scale of human feelings and experiences. In a tranzient form, around 70 % of people will say that they remember experiencing some of these things at some point in their lives. But in a form when it is persistent, intense, causes a lot of discomfort and impedes the person’s usual way of life (so in its diagnosable disorder form), it has a two percent lifetime prevalence. This makes it actually quite a common mental disorder.
What causes depersonalization?
DP/DR can also be considered as a natural protective psychological mechanism that suppresses overwhelming emotions and discomfort in times of great stress or trauma. But if for some reason, this mechanism persists even long after the stressful event is over, then paradoxically it can be the cause of a lot of distress.
The immediate triggers of such experiences can be: Stress, trauma, episodes of anxiety disorders such as panic disorder or episodes of depression, drug use (typically marijuana, hallucinogens, ketamíne and ecstasy can be triggers). Meditation can also lead to such experiences, which we will cover in more detail.
So who are more likely to experience DP/DR? (e.g. facing such trigger situations as mentioned above) There can be neurobiological predispositions, and experiencing trauma in childhood can also make someone more vulnerable to DP. However in this discussion, I would like to focus on personality or psychological factors that might predispose someone or help maintain DP/DR symptoms.
Research and clinical experience tells us that people who have more chronic and intensive DP, are often introverted and show great self-focus. Self-focus here doesn’t mean narcissism, but a tendency to monitor thoughts, bodily sensations, inner events intensively, with less attention paid to the outside world. They can be sensitive to signs of anxiety, bodily discomfort. and may be afraid of these sensations. They may regard them as dangerous, and often have a tendency to compulsively try to control their emotions and thoughts. People with DP tend to fear doubt and uncertainty, and can have the distressing befief that the lack of perfect inner control is a sign of mental illness. They are often very intelligent, philosophical, intellectual and prone to contemplate spiritual and metaphysical questions.
Depersonalisation, drugs, meditation
So what are the differences in depersonalization experiences with regard to meditation and drug use? There are various types of meditation, which have specific goals and effects. However, the goal of meditation generally is creating experiences that can be seen as depersonalization experiences, such as: Transcending the sense of an individual self; looking at our being in different, unordinary ways; dissolving in something bigger than ourselves; getting in touch with the inner, silent observer part of ourselves. So, the meditator intends to create such experiences in order to learn from these. He can integrate the experience with the help of the model of that meditative practice. On the other hand, drug induced DP is quite different. It is a totally unexpected byproduct of the drug, totally unwanted, and because of these: scary. And most often, there is no immediate opportunity, help, or frame to interpret and integrate these radical experiences.
Let’s have a look at some of the main things I’ve learned from my research. I wouldn’t go into details about the specifics of the research here, other than it was questionnaire based, and that more than a hundred subjects were included. There was a group of meditators, a group of drug users (mostly so called recreational and experimenter users), and there was a group that included people who both meditated and engaged in drug use from time to time. And the fourth group included people who didn’t meditate or used drugs at all, the control group.
So some of the things I found is that meditators had more DP experiences, and the emotional charge of these were more positive than that of the drug users. So their emotional reaction and overall experience of DP were more positive. And interestingly those, who meditated and used drugs from time to time, reacted with more positive emotions to DP as well, compared with those drug users who weren’t meditators. So it seems as if meditation, as a kind of protective factor, can help DP result in a less fearful, stressful, or panicky overall experience. It may even facilitate a kind of personal growth, as a result of going through and integrating, interpreting these experiences constructively.
Additionally, I found that people who had a tendency to be anxious, depressed, who tend to think a lot about potential dangers, and bad things that might happen, who have an intensive drive to always control things so that nothing bad happens, are also more likely to experience DP. However, it is more likely for them to react with fear and negative emotions to it.
Alternatively, people who show a greater level of self-transcendence (a personality trait described by Cloninger), are more likely to experience DP with a more positive general emotional charge. This trait encompasses qualities such as: A natural inclination to often experience a sense of unity with others or nature, to accept uncertainty more easily, to show a kind of willingness to let go of control and personal boundaries from time to time, and to often get absorbed in activities.
I hope you’ve found something that is interesting and new for you. The things I’ve covered here have important implications with regard to therapy. If you are interested in the therapy of DP/DR, I recommend my related post.
Castillo, R. J. (1990). Depersonalization and meditation. Psychiatry, 53(2), 158–168.
Medford, N., Baker, D., Hunter, E., Sierra, M., Lawrence, E., Phillips, M. L., David, A. S. (2003). Chronic depersonalization following illicit drug use: a controlled analysis of 40 cases. Addiction, 98, 1731-1736.
Simeon, D. & Abugel, J. (2006). Feeling Unreal: Depersonalization Disorder and the Loss of the Self. New York: Oxford University Press.
Steinberg, M. & Schnall, M. (2000). The Stranger in the Mirror: Dissociation – The Hidden Epidemic. New York: HarperCollins Publishers Inc.
If you would like to know more about the topic, I can give you a comprehensive reading list.
I would be happy to answer your questions or hear your comments!