Strange unreality

You may have heard the expression ‘out of body experience’. This is just one of a number of different ways in which we can experience a distortion of reality. For example, we may not feel in quite the same time and place as before; or maybe we sense some confusion about our identity or feel somehow displaced. It is a form of dissociation. Other mild versions of this might be getting completely absorbed in something to the exclusion of all else, or where you can’t remember any details of your car journey to your destination once you get there (‘checking out’). Many people experience something like this at some time. It can come and go and doesn’t usually persist, so for most people it’s just a transient experience.

But there are more persistent and troubling versions of unreality, which can be grouped under the heading of Depersonalisation/Derealisation Disorder (DPD). This is a largely unknown and very much misunderstood condition often mistakenly diagnosed as depression or anxiety, with the customary offer of antidepressants to address symptoms. Because of the general lack of awareness about DPD those who experience it can feel terribly isolated and may often feel that there is something radically wrong with them (e.g. ‘going mad’, a brain tumour, a condition with a life sentence, etc.) In fact, despite the mystery attaching to it, this is not an uncommon condition.

In Carolyn Spring’s excellent explanation of the disorder in Feeling Unreal in the latest issue of Multiple Parts issued by PoDS[1], she lifts the lid on much of the mystery surrounding DPD and provides a number of interesting case studies. She summarises the condition as ‘a mental/emotional defensive strategy which is employed unconsciously to manage unmanageable emotions by shutting down from them. The result of this is that emotions and perceptions are blunted, leading to a feeling of detachment and numbness, of not being fully alive or real, and as if participating in the world at a distance’.

It is a survival mechanism, usually in the face of extreme threat or in traumatic circumstances. If the emotions triggered by such circumstances are not fully processed the condition can persist and the reaction is said to be maladaptive. In other words it occurs persistently in a perfectly normal environment and in circumstances where we do not actually need to defend ourselves. It can occur without warning and be outside our control. The symptoms can range from the unsettling to the terrifying: for example, not recognising one’s own reflection in a mirror, a sense of being split between the person living life and the person observing it (like watching yourself in a movie), or a perceived change in the size and shape of things, including oneself. It is of course a worrying condition for sufferers and the worry itself can make the condition feel more extreme.

There are, however, a number of strategies that can be employed to alleviate and address DPD, as detailed in Spring’s article, including something as straightforward as educating those affected about what is actually going on. This in itself can bring significant relief. So fortunately, although the condition maybe experienced as hopeless, there is in fact a lot that can be done to help.

[1] Positive Outcomes for Dissociative Survivors