Demystifying Dissociation: Derealization and Depersonalization
For many people with PTSD and trauma-related disorders, “dissociation” is a term that can seem scary and stigmatized. It can be important to demystify and educate ourselves on dissociation to better understand and validate our experiences. Read more about the basics of dissociation here in our prior blog post.
The way that I like to demystify dissociation for people with PTSD is that dissociation is the body’s natural response to intense traumatic experiences. It’s a survival mechanism that comes into play when our brain and body decide that an event is too painful to be fully present for, and that it’s safer and less painful to metaphorically “enter into another room” while dangerous events happen to or around us. While dissociation can get us through traumatic moments, when it becomes a common experience in our lives it can be disruptive, unhelpful, and maladaptive. It can prevent us from being present in our own bodies, which in turn can make it difficult to know our own boundaries or self-care. It can also prevent us from living fully in our present reality.
Dissociation can occur on a spectrum, from “spacing out” for long periods of time, to forgetting long stretches of time during which abuse occurred, to remembering events in “third person” as though you’re watching things happen to you from outside of yourself.
The Diagnostic and Statistical Manual of Mental Disorders describes two different types of dissociation: 1) derealization and 2) depersonalization. Here’s a quick overview of each type:
What is Derealization?
Derealization refers to an experience in which your surroundings start to feel dreamlike, hazy, or cloudy. One way to remember this is that the world starts to feel “unreal” around you.
Patients I have worked with who experience derealization will describe this sensation like feeling they are under water, or that their surroundings disappear around them into a fog. Derealization can be experienced as subtle or quite disruptive. For example, some patients have had a hard time pinpointing what their experience of derealization is like, while other patients have shared that it can be very inconvenient especially if it comes upon them suddenly mid-conversation in social situations.
What is Depersonalization?
Depersonalization refers to a feeling of being outside yourself or feeling detached from yourself. One way to understand this is that you feel detached from your “personhood.”
Some patients will describe depersonalization as feeling like you are watching yourself doing things from outside your body, or that you look into the mirror and don’t recognize yourself. This can be quite disorienting, though many patients I’ve worked with will not necessarily be able to name this experience until they hear about what depersonalization is.
Now what?
My favorite grounding technique I recommend to people who struggle with dissociation is the 5-4-3-2-1 technique. You can read more about this technique and grounding in general here.
If you feel that you are needing professional support healing from derealization and depersonalization, there are many steps you can take to start. You can book a free consultation with our therapist matchmaker to explore online individual (CA residents only) therapy for dissociation and trauma.
These blogs talk more about the basics of EMDR:
You can read more about Ketamine Assisted Psychotherapy here:
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