Understanding Depersonalization And Derealization

An accessible and informative guide to understanding depersonalization and derealization, written specifically for clients. 

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Guide (PDF)

A psychoeducational guide. Typically containing elements of skills development.

Overview

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are comprehensive sources of information for your clients. Concepts are explained in an easily digestible way, with plenty of case examples and accessible diagrams. Understanding Depersonalization And Derealization is designed to help clients who experience depersonalization and derealization to understand more about their condition.

Why Use This Resource?

This guide aims to help clients learn more about depersonalization and derealization. It explains what these difficulties are, common symptoms associated with them, and effective ways to address them, such as cognitive behavioral therapy (CBT).

  • Identify symptoms of depersonalization disorder (DPD) and the factors that contribute to it.
  • Understand what keeps DPD going.
  • Explore effective treatments for DPD.
  • Gain insights into how people experience DPD and how they overcome it.

Key Benefits

Comprehensive

Explores what depersonalization disorder (DPD) is and what maintains it.

Relatable

Contains detailed examples and relatable case studies.

Supportive

Written in a friendly and accessible manner.

Hopeful

Outlines effective treatment options.

Who is this for?

Depersonalization And Derealization Disorder (DPD)

Designed to help clients understand and learn more about DPD.

Integrating it into your practice

01

Assess

Identify clients who may be experiencing depersonalization disorder (DPD).

02

Share

Provide the guide to clients who could benefit from it.

03

Educate

Use the content to inform clients about DPD and help normalize their experiences.

04

Reflect

Discuss the client’s personal experience with DPD.

05

Intervene

Plan treatment with the client or direct them to other sources of help and support.

Theoretical Background & Therapist Guidance

At some point in their lives - often when tired or under physical or psychological stress - many individuals experience brief episodes of feeling detached either from themselves or from the world around them. Feeling detached from oneself is referred to as depersonalization; clients might describe this as feeling as though they are dreaming or observing themselves from a distance, as if through glass. Feeling detached from the external world is known as derealization, where the surroundings may seem unfamiliar, artificial, or unreal.

Brief experiences of depersonalization and derealization are common and generally not a cause for concern. However, when these experiences become frequent, more intense, and begin to interfere with daily functioning, clients may be suffering from depersonalization-derealization disorder. It is estimated that between 1% and 2% of the population experience this disorder, with many individuals enduring symptoms for extended periods before seeking help. Encouragingly, cognitive behavioral therapy (CBT) has been shown to be an effective treatment for depersonalization and derealization.

What's inside

  • Introduction to depersonalization and derealization.
  • Guidance for introducing and using the resource with clients.
  • Key references for learning more about depersonalization and derealization.
Get access to this resource

FAQs

DPD is a dissociative condition in which individuals experience persistent or recurrent feelings of being detached from themselves (depersonalization) or from their surroundings (derealization), while maintaining an intact sense of reality.
Important maintenance factors often include interpreting symptoms in threatening ways, avoidance, and the use of safety behaviors.
CBT is an effective therapy that focuses on addressing maladaptive thoughts and behaviors that maintain DPD.

How This Resource Improves Clinical Outcomes

By using this resource in their clinical practice, therapists can:

  • Identify individuals who may be experiencing depersonalization and derealization.
  • Help clients better understand their difficulties and what maintains them.
  • Explore treatment options.
  • Encourage hope and optimism about change.

References And Further Reading

  • Hunter, E. C. M., 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.
  • Medford, N., Sierra, M., Baker, D., & David, A. S. (2005). Understanding and treating depersonalisation disorder. Advances in Psychiatric Treatment, 11(2), 92-100.
  • Dewe, H., Watson, D. G., & Braithwaite, J. J. (2016). Uncomfortably numb: new evidence for suppressed emotional reactivity in those predisposed to dissociative experiences. Cognitive Neuropsychiatry, 21(5), 377-401.
  • Simeon, D., & Abugel, J. (2006). Feeling Unreal: Depersonalization Disorder and the Loss of the Self. Oxford University Press.
  • Schauer, M., & Elbert, T. (2010). Dissociation following traumatic stress. Zeitschrift fur Psychologie/ Journal of Psychology, 218(2), 109-127.
  • Van der Kolk, B. A., & Van der Hart, O. (1989). Pierre Janet and the breakdown of adaptation in psychological trauma. American Journal of Psychiatry, 146(12), 1530-1540.
  • Sierra, M., & Berrios, G. E. (1998). Depersonalization: neurobiological perspectives. Biological Psychiatry, 44(9), 898-908.
  • Baker et al (2003). Depersonalisation disorder: clinical features of 204 cases. British Journal of Psychiatry, 182, 428-433.
  • Simeon, D., Guralnik, O., Schmeidler, J., Sirof, B., & Knutelska, M. (2001). The role of childhood interpersonal trauma in depersonalization disorder. American Journal of Psychiatry, 158(7), 1027-1033.
  • Hunter, E. C. M., Salkovskis, P .M. & David, A. S. (2014). Attributions, appraisals and attention for symptoms in depersonalisation disorder. Behaviour Research and Therapy, 53, 20-29.
  • Myers, D. H., & Grant, G. (1972). A study of depersonalization in students. The British Journal of Psychiatry, 121(560), 59-65.
  • Noyes Jr, R., & Kletti, R. (1976). Depersonalization in the face of life-threatening danger: A description. Psychiatry, 39(1), 19-27.
  • Lewis, G. C., Platts-Mills, T. F., Liberzon, I., Bair, E., Swor, R., Peak, D., … McLean, S. A. (2014). Incidence and predictors of acute psychological distress and dissociation after motor vehicle collision: A cross-sectional study. Journal of Trauma & Dissociation, 15(5), 527–547.
  • Roydeva, M. I., & Reinders, A. A. (2020). Biomarkers of pathological dissociation: a systematic review. Neuroscience & Biobehavioral Reviews, 123, 120-202.
  • Sierra, M., Medford, N., Wyatt, G., & David, A. S. (2012). Depersonalization disorder and anxiety: a special relationship?. Psychiatry Research, 197(1-2), 123-127.
  • Blanke, O. (2012). Multisensory brain mechanisms of bodily self-consciousness. Nature Reviews Neuroscience, 13(8), 556-571.
  • Hunter, E. C., Baker, D., Phillips, M. L., Sierra, M., & David, A. S. (2005). Cognitive-behaviour therapy for depersonalisation disorder: an open study. Behaviour Research and Therapy, 43(9), 1121-1130.
  • Hunter, E. C. (2013). Understanding and treating depersonalisation disorder. In: Cognitive behavioural approaches to the understanding and treatment of dissociation. Routledge Press.
  • Sierra, M. (2008). Depersonalization disorder: pharmacological approaches. Expert Review of Neurotherapeutics, 8(1), 19-26.

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