Wednesday, May 19, 2021

Helping patients with the emotional literacy to understand depersonalization and derealization

Have you ever had patients described to you their troubling experiences of derealization or depersonalization?

From a transdiagnostic point of view, I sometimes frame derealization and depersonalization as too much “zooming out” from their outside 5senses experiences, or too much “zooming out” from their internal world experiences/self identity respectively.

They may have “gone a bit too far” in a detachment sense.

“Zoom in” a bit more and it may give us “functional detachment”.

“Zoom in” a bit more into the “sweet spot” and it becomes mindfulness.

“Zoom in” a bit more and it becomes “normal stress”.

“Zoom in” a bit too much and it may become fusion, intrusive thoughts/feelings, stress, and obsessive compulsive types phenomenon.

Having the emotional literacy and awareness will help one to navigate this difficult space, and reduce the chance of unhealthy stress.

We can explain the above in a reversed way too...

When someone is super zoomed into thoughts/feelings, they can become a bit obsessed with it, judge it, and may have some OCD tendencies with it.

When we zoom out into the “sweet spot”, we are able to observe thoughts/feelings without judgement and perceive it as “information” in a non biased way and with curiosity. We may have less tendency to react to them impulsively. We allow it to be so to speak, or “play and interact” with it in a helpful way.

When we zoom out further, then there may be more detachment, and if we zoom out too much, then we may experience depersonalization, derealization and even dissociation perhaps.

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