Depersonalization and derealization

Depersonalization and derealization

Depersonalization and derealization

Depersonalization and derealization 1024 677 Paterakis Michalis
Estimated reading time: 8 minutes

What is depersonalization?

Depersonalization is a psychological phenomenon in which the person himself feels disconnected or alienated from himself, his body or his environment. People who experience depersonalization often report a sense of observing themselves from a distance, or that their inner world feels vast and impersonal.

What pathologies does it concern?

Depersonalization can be a symptom of many different psychological conditions, including panic disorder, depression, schizophrenia spectrum disorders, interpersonal communication disorders, and post-traumatic stress disorders. The causes of depersonalization may be related to stress, depression, tension or psychological traumatic experience.

Need an Appraisal?

If someone is dealing with depersonalization and encounters it frequently or finds it bothersome, it is important to seek help from a mental health professional, such as a psychologist or psychiatrist. The professional will be able to assess the situation and suggest the appropriate treatment or coping techniques.

What is the deepest Psychoanalytic approach to the subject?

Let’s approach depersonalization from a psychoanalytic perspective. According to psychoanalysis, depersonalization can be interpreted as a defense mechanism that the unconscious uses to cope with feelings or emotional experiences that are too disturbing or threatening.

According to psychoanalysis, depersonalization can be treated as a result of ego disintegration. The ego represents a person’s conscious and identifiable self, while the unconscious includes subconscious elements and informal remnants of experiences and feelings. Depersonalization can occur when feelings or experiences become threatening to the ego and the unconscious disconnects or rejects them to protect the self.

Psychoanalysts attempt to explore depersonalization by analyzing the crystallizations of symbolic signs and meanings that may lie behind it. Through the analysis of dreams, inaccessible memories (transference) and free associations, psychoanalysts try to reveal the deeper meaning core of depersonalization and to strengthen empathy (I know what is happening to me and I can try to approach what is happening to me) and the completion of the ego.

Note that the psychoanalytic explanation is a guiding principle and the exact interpretation of depersonalization will depend on each individual case and the psychoanalyst dealing with it. Clinically, it depends to a large extent on the intensity of the Ego split which we will talk about right away.

What does ego splitting mean?

In psychoanalysis, ego fragmentation refers to a state where the individual’s ego is not unified or coherent, but is divided into several parts or subunits that may function independently or have different needs, desires, or beliefs. Ego splitting is a psychological phenomenon caused by encountering emotions, experiences, or tensions that are unpleasant, impermissible, or intolerable by the ego.

Ego fragmentation can lead to a sense of incoherence, disconnection, or dissonance in individual experience. The different parts of the ego may compete with each other, have different needs or desires, and exhibit contradictory behaviors. This can lead to a feeling of inner contradiction or alienation from the self.

Ego fragmentation is often linked to having traumatic experiences, such as childhood abuse, neglect, or trauma. These experiences may lead to the ego’s need to disintegrate to protect itself from pain or unacceptable reality. Ego fragmentation may also be associated with disorders such as bipolar personality disorder, schizophrenia, or dissociative identity disorder.

The goal is the unity of the parts of the Ego

The goal of psychoanalysis is to restore the unity and integration of the ego through the analysis of raw emotions and occult symbols associated with dissociation. This process may include analyzing past experiences, releasing emotional tensions, and enhancing empathy and self-awareness.

According to the object relations theory in psychoanalysis, the splitting of the ego can be interpreted as a result of the development of specific internal representative objects (internal objects) and the relationships that the person has with these objects.

According to this theory, internal objects represent acquired images, possibly derived from the individual’s past relationships with parents or significant others. These internal objects form the core of internal representations and influence the individual’s perception of himself and others.

When the relationship with these internal objects is unstable or dysfunctional, ego splitting can occur. This occurs when internal objects represent conflicting needs, beliefs, or desires, and the person has difficulty integrating these contradictions and reconciling them into a coherent understanding of self and others. There the disconnection mechanism is activated.

The disconnection mechanism

The dissonance or disconnection that accompanies ego dissociation may manifest as a sense of incoherence, isolation, disorientation, or disconnection from self or others. This can lead to distrust in relationships, difficulties in empathy and emotional response, as well as difficulties in managing stress or emotional conflicts.

The psychoanalyst tries to explore these processes of ego splitting by analyzing the relations with internal objects, the contradictions and conflicts that arise. Through this analysis, the patient can gain a deeper empathy for the forces influencing him and seek ways to integrate and homogenize his ego.

A short summary of Derealization and depersonalization

In the context of psychoanalysis, depersonalization and dissociation are two different but related phenomena.

Derealization refers to a feeling of detachment or disconnection from the self, body, or environment. People who experience derealization often report feeling like they are observing themselves from a distance, that their senses are dulled, or that the world seems endless and impersonal. Derealization is usually a symptom associated with various psychological disorders, such as depression, anxiety disorder, post-traumatic stress disorder.

On the other hand, depersonalization refers to a dimension of disconnection or dissonance of the ego from the self or its emotions. This occurs when the patient feels that their emotions are disconnected or indifferent, that they are isolated from the experience of emotions, or that their emotional responses are unstable and incoherent. Depersonalization is usually associated with the development of elaborate defense mechanisms to deal with pain or unacceptable reality.

Therefore, derealization and depersonalization are different aspects of psychological experience, but they may be related and occur simultaneously in certain situations. Both have to do with the disconnection or dissonance of the ego from self or experience, but with different expressions and effects on individual experience.

What are the different expressions and effects of derealization and depersonalization?

The different expressions and effects of derealization and depersonalization on individual experience may include:

Derealization: The patient feels disconnected from himself, his body, or his environment. He may report observing himself from a distance, that his senses are dull, or that the world seems endless and faceless. This can lead to a sense of disconnection, an unreal sense of anesthesia (it is not anesthesia but a feeling of not being able to be in touch with the objects around him) or alienation from reality.

Depersonalization: The patient feels that their emotions are disconnected, indifferent, or distant. He may feel isolated from experiencing emotions or have difficulty connecting emotionally with others. This can lead to difficulties in empathy, relationships and self-recognition.

The effects of derealization and depersonalization on individual experience may include:

Disturbed sense of reality: The patient may question the reality of the environment or himself and feel unsure of what is real and what is not.

Loss of self-awareness: The patient may feel lost in relation to self-recognition and understanding.

Psychiatric Points of Attention:

Disturbance of reality perception is a symptom that can occur in various psychiatric disorders. Some of these disorders include:

Schizophrenia: People with schizophrenia may experience a fragmented, unstable or distorted sense of reality. This can include delusions, paranoid beliefs, auditory or visual hallucinations, and disconnection from the real world.

Attention-deficit/hyperactivity disorder (ADHD): In some cases of ADHD, people may feel that the world around them is overly stimulating and disorganized. This can lead to difficulty concentrating, organizing thoughts and controlling behaviour.

Autism Spectrum Disorders: People with various autism spectrum disorders may have limited social interaction and sensory hypersensitivity. This can make them sensitive to external factors and create a sense of disconnection from the environment.

Psychoanalytic Points of Attention:

In psychoanalysis, derealization is interpreted in relation to the analysis of the psychodynamic forces and raw emotions that influence the individual’s experience. Factors that may contribute to this disorder include:

Defenses: Dissociative defenses such as denial, concealment, or attribution of paranoia may be used to cope with unacceptable reality or emotional experiences.

Covert symbolic messages: mainly refers to schizophrenic states where the person believes that they are communicating with messages from beyond. It is a defensive dimension which essentially concerns the feeling of an infantile omnipotence. The adult becomes a baby to cope with stress. Here the anxieties can only be dealt with in an omnipotent way since adult options cannot be enlisted.

Psychosexual development: Some theories of psychoanalysis focus in terms of etiology on the importance of childhood experiences and emotions related to the sex role. Sexuality here can be experienced as a feeling removed from the self, so the person who enters with his disconnected self into the sexual act, may not be able to experience this experience.

Psychic conflicts: Unprocessed conflicts, such as contradictions between desires and beliefs, may lead to depersonalization as a way of protecting the ego from unacceptable conflict or pain.

Psychoanalysts therefore examine these psychodynamic processes and interpret the derealization dimension in relation to the development of the individual and his perception of himself and the world. The goal is to increase the individual’s empathy for the forces affecting him and to seek ways of integration and harmony in his experience.

How can a psychoanalytically oriented psychotherapy help the symptoms of derealization and depersonalization?

A psychoanalytically oriented psychotherapy can help deal with the symptoms of derealization and depersonalization in the following ways:

Exploration of psychodynamic processes: The psychoanalyst helps the patient explore the intrapsychic forces and conflicts that may lead to derealization and depersonalization. Through analysis, the psychological mechanisms and raw emotional experiences associated with the onset of symptoms are revealed.

Reconnection with reality: Through the therapeutic relationship, the patient can reconnect with reality and gain a more coherent sense of themselves and their environment. The psychoanalyst offers a reliable, safe and invaluable framework for exploring the patient’s feelings and emotional reactions.

Enhancing empathy: The psychoanalyst stimulates the patient’s empathy and his ability to recognize and understand his feelings and thoughts. This can help strengthen the ego and discover new ways of perceiving and reacting to reality.

Discovery of hidden meanings: The psychoanalyst seeks to discover the hidden meanings that may lie behind the symptoms of derealization and depersonalization. This discovery can illuminate the informal pressures, desires, or conflicts that influence the individual’s experience.

Reunion and Recomposition: Through psychoanalytic therapy, the patient has the opportunity to reassemble the fragmented elements of himself and his experience. This can help reconnect disconnected parts of the self and develop a more complete sense of reality.

Awareness and self-awareness: Psychoanalytic therapy promotes awareness and self-awareness of the individual. The patient discovers his inner strengths, needs and desires that influence his experience. Through this awareness, the patient can seek healthier ways of coping with symptoms and reality.

Re-creating the self-story: Through psychoanalytic therapy, the patient can re-create the self-story in new ways. This includes exploring raw emotions, relationships with others and past experiences, with the aim of discovering new interpretations and reflection.

Development of alternative coping mechanisms: During psychotherapy, the patient seeks alternative ways of coping with the challenges and symptoms of derealization and depersonalization. Through analysis and exploration, the patient can develop new psychological capacities and adaptive mechanisms to face the reality and challenges of his life.

Completion and authenticity: Through psychoanalytic therapy, the patient seeks self-completion and the achievement of authenticity. This entails discovering and accepting the different aspects of oneself and integrating them into a coherent and comprehensive perception of self and reality.

The above ways are a general description of how a psychoanalytically oriented psychotherapy can help to deal with derealization and depersonalization. The process is individual and adapted to each person’s needs and challenges.

Overall, psychoanalytically oriented psychotherapy seeks to understand and find the deeper root of derealization and depersonalization symptoms. Through this process, the patient can discover new ways of perceiving, self-understanding, and self-recognition, thereby promoting well-being and self-fulfillment.


In conclusion, depersonalization and derealization refer to disturbances in individual experience. Depersonalization is attributed to the loss of a sense of personhood or authenticity, while derealization is associated with a sense of incoherence, disconnection, or dissonance in one’s experience. Both disorders can occur in psychiatric conditions such as schizophrenia, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorders.

From a psychoanalytic point of view, these disorders are interpreted as the result of psychodynamic processes and unprocessed emotions. Psychoanalysis can help address these disorders by exploring the psychological forces, defenses, and conflicts that influence them. Also, through the therapeutic relationship, the patient discovers new ways of dealing with reality, recreates his or her own history, and seeks fulfillment and authenticity.

These processes enhance empathy, awareness and the development of alternative adaptive mechanisms. Through psychoanalytic therapy, the patient gains a more complete sense of reality and self, allowing him to more effectively deal with derealization and depersonalization disorders. The goal is to reconnect with reality, uncover and deal with raw emotions, and achieve a more authentic and complete self.

In summary, the psychoanalytic approach to derealization and depersonalization seeks to discover the roots and psychodynamic processes of these disorders and to provide a framework for dealing with them. Through the therapeutic relationship and the discovery of new interpretations and responses, the patient can regain empathy, achieve unity of self, and develop healthier ways of coping with reality.

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The process of psychotherapy requires commitment, dedication and is only for those who are serious about changing their lives. If you are considering embarking on this journey, call me at 211 71 51 801 to make an appointment and let’s see together how I can help you.

Michael Paterakis

Psychologist Psychotherapist

37 Karneadou Street, Kolonaki

I accept By appointment

Tel: 211 7151 801

    Πατεράκης Μιχάλης
    Ψυχολόγος Αθήνα


      Psychologist Athens