Depersonalisation: When things feel unreal.
Understanding Depersonalisation: A Clinical Perspective
Depersonalisation is a complex and often distressing psychological phenomenon in which an individual feels detached from themselves, as though they are observing their thoughts, feelings, and body from an external perspective. This experience, commonly referred to as Depersonalisation Disorder (DPD) when persistent and distressing, is classified under dissociative disorders in the DSM-5 (American Psychiatric Association, 2013). While occasional feelings of depersonalisation can occur due to stress, anxiety, or fatigue, chronic experiences can significantly impact daily functioning and well-being.
Symptoms and Causes
Individuals experiencing depersonalisation often describe sensations such as:
Feeling like an observer of their own body or thoughts.
Emotional numbing or a sense of detachment from reality.
A distorted perception of time, space, and self.
A sense of being robotic or as if they are living in a dream.
Depersonalisation can be triggered by various factors, including:
Severe stress or trauma: Adverse childhood experiences, emotional abuse, or post-traumatic stress can contribute to dissociative symptoms.
Anxiety and panic disorders: High levels of anxiety can lead to feelings of detachment as a coping mechanism.
Substance use: Cannabis, hallucinogens, and other psychoactive substances have been linked to depersonalisation episodes.
Neurological factors: Brain imaging studies suggest alterations in areas related to emotional processing and self-awareness, such as the anterior cingulate cortex and insula (Sierra & David, 2011).
Evidence-Based Therapies for Depersonalisation
While depersonalisation can be challenging to treat, several therapeutic approaches have shown promise in alleviating symptoms:
1. Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR is a structured therapy originally developed for PTSD, but recent research suggests its effectiveness in reducing depersonalisation symptoms (Sierra et al., 2012). EMDR helps process traumatic memories by using bilateral stimulation, such as guided eye movements, to facilitate emotional integration. Studies indicate that targeting early traumatic experiences can decrease dissociative symptoms in patients with DPD.
2. Compassion-Focused Therapy (CFT)
CFT, developed by Paul Gilbert (2009), is particularly beneficial for individuals experiencing high self-criticism and emotional avoidance. This therapy emphasises developing self-compassion, which can be crucial for individuals struggling with depersonalisation-related emotional numbing. By fostering a sense of warmth and care towards oneself, CFT can help patients reconnect with their emotions and reduce dissociation.
3. Cognitive-Behavioural Therapy (CBT)
CBT remains one of the most widely used treatments for depersonalisation. It helps individuals challenge maladaptive thought patterns, reduce avoidance behaviours, and regain a sense of agency over their experiences (Hunter et al., 2003). Mindfulness-based CBT has been found particularly useful in helping individuals stay grounded in the present moment.
Final Thoughts
Depersonalisation can be an unsettling experience, but with appropriate therapeutic interventions, individuals can regain a sense of connection to themselves and their surroundings. If you or someone you know is struggling with depersonalisation, seeking professional help is a crucial step towards recovery.
References:
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
Gilbert, P. (2009). The Compassionate Mind: A New Approach to Life’s Challenges. New Harbinger.
Hunter, E., Phillips, M. L., Chalder, T., Sierra, M., & David, A. S. (2003). Depersonalisation disorder: A cognitive-behavioural conceptualisation. Behaviour Research and Therapy, 41(12), 1451-1467.
Sierra, M., & David, A. S. (2011). Depersonalization: A selective impairment of self-awareness. Consciousness and Cognition, 20(1), 99-108.
Sierra, M., Medford, N., Wyatt, G., & David, A. S. (2012). The neural basis of depersonalization. Cortex, 48(5), 1165-1173.