Work and World

Why People Detach From Reality | 10 Questions

you cannot heal from traumatic experiences unless you have a foot in the present and a foot in the past my name is justin brown and i’m a licensed clinical social worker here in maine depersonalization derealization disorder is a dissociative disorder where the depersonalization refers to one’s subjective experience of themselves they can experience themselves as not being real they can experience the world like they’re watching themselves there’s a separation and detachment from themselves that’s the depersonalization experience and the derealization experience is one in which reality itself doesn’t seem real so things may seem blurry or it may feel like you’re in a movie people experiencing depersonalization derealization disorder will experience numbness they’ll experience a feeling of lack of energy in the body they’ll experience things as being blurry they’ll experience the sense that they’re in a movie the sense that they are not real or that they’re watching themselves from outside of themselves the most important thing to know about dissociation is that it’s a stress response most people are familiar with the idea of the stress response of fight or flight where the body mobilizes to either fight or to flee a stressor what people aren’t familiar with is that there’s a third mechanism of shutting down where the body shuts down and disconnects as a way to manage stress and dissociation is in that way a really beautiful adaptive stress response where you see dissociative disorders most frequently is in people who’ve experienced prolonged developmental trauma throughout childhood and the reason that the childhood part is relevant and it’s not always that but it frequently is is because a child can’t flee their environment so if a child is in a particularly distressing either abuse or neglect situation growing up or if they’re in just a very unpredictable home they’ll use dissociation as a coping skill because they can’t fight or flee the situation it’s important to distinguish depersonalization derealization disorder from psychosis psychosis is a full-blown break from reality there are a variety of psychotic disorders but in psychotic disorders an individual loses touch with all of their sense of reality they’ll also experience hallucinations and or delusions with depersonalization derealization disorder you don’t see hallucinations or delusions it causes less impairment than psychosis the most helpful treatment option the goal of it is to help people become more embodied so this involves any type of mind-body activity mindful awareness processing traumatic experiences because it’s an approach that involves a lot of different areas there isn’t kind of one treatment model for treating dissociation [Applause] [Music] i think it’s impossible to treat an individual for any mental health disorder without having some context for the social system that they find themselves in the most relevant thing here is technology because what technology has done is it’s just siloed us in so many different ways when people are staring at a phone it’s very easy to see how you could be disconnected from your body for example i can be disconnected from the rhythm of being engaged with another human being face to face basically every way in which we become disconnected as a society creates higher likelihoods of dissociation in individuals because they’re feeling less connected how common depersonalization and derealization disorder is is basically impossible to say the numbers that you will read are that about two percent of folks struggle with this disorder based on the the fact that professionals aren’t trained adequately to assess for diagnose and then ultimately treat dissociative disorders combined with the fact that dissociation co-occurs with so many other mental health disorders make it really hard to say what the actual number is of folks who are struggling with this it is very possible for somebody to develop skills to have a social situation a work situation that they feel embodied enough of the time they experience a decrease in symptoms that they no longer meet criteria the likelihood that they stop experiencing dissociation altogether is very unlikely but the fact that they can see improvement to the extent that they would no longer meet criteria is very possible a lot of clinicians will not be adequately trained in the treatment of dissociative disorders if they don’t feel connected with their clinician i would encourage them to move on the foundational aspect of connecting with a client is in understanding that it is an adaptive response now it’s just an issue of finding a new adaptive way to be in the world it’s not as if there’s something wrong with you that we need to fix but rather we need to recognize that this coping skill you used isn’t serving you anymore [Music]
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