Questions to reflect on
- Why do I sometimes feel like I’m beside myself?
- Why can my body temporarily feel strange or not quite like mine?
- Why can the world suddenly seem far away, flat, or unreal?
- Why does this sometimes happen דווקא when I’m very tense, tired, or overwhelmed?
- Is every experience of feeling disconnected automatically a dissociative disorder?
- How can I feel more grounded in the here and now again?
- And when is it wise to seek professional help?
What is dissociation?
Dissociation is an umbrella term for experiences in which the usual connection between, for example, attention, consciousness, memory, feelings, identity, body, or surroundings is temporarily experienced differently.
In psychiatry, depersonalization and derealization are among the dissociative phenomena.
Depersonalization means that you can feel detached from yourself, your body, thoughts, or emotions.
For example:
I feel like I’m watching myself from the outside.
My body feels strange.
I do things, but it feels like I’m not fully there.
My emotions seem far away.
Derealization means that your surroundings can feel strange or unreal.
For example:
Everything seems like a dream.
The world feels flat or far away.
Sounds seem different.
It feels like there is a glass wall between me and my surroundings.
DEPERSONALIZATION
“I feel strange
or unreal”
DEREALIZATION
“The world around me
feels strange
or unreal”In a depersonalization/derealization disorder, people generally continue to realize that it is a feeling of unreality and that the world has not literally changed. That intact reality testing is diagnostically important.
A dissociative experience is not automatically a disorder
Temporary experiences of depersonalization or derealization are relatively common. A much smaller share of the population meets the criteria for depersonalization/derealization disorder. A systematic review estimated the prevalence of that disorder in the general population at around 1 percent.
The difference lies, among other things, in:
how often it happens,
how long it lasts,
how severe it is,
how much distress it causes,
and whether daily functioning is limited.
A strange experience
≠
automatically
a disorderA diagnosis requires more than just recognizing one symptom.
What can dissociation feel like?
People describe it very differently.
For example:
As if I’m in a movie.
As if everything is happening behind glass.
As if my body isn’t entirely mine.
I hear people talking, but it sounds far away.
I know I’m here, but it doesn’t feel that way.
My emotions seem switched off.
I’m functioning, but I don’t feel fully present.
Some dissociative phenomena can also involve memory problems, but memory loss does not automatically occur with every form of dissociation. Dissociative disorders include various phenomena and diagnoses.
Why can our brain do this?
Dissociative experiences are seen, among other things, with severe stress, trauma, anxiety, panic, and sleep deprivation. Certain substances and some physical or neurological conditions can also cause similar experiences.
It is sometimes explained simply as:
“Your brain shuts itself off to protect you.”
That may be a recognizable metaphor, but scientifically it is too simplistic.
Research suggests that dissociation is associated with complex processes involving attention, consciousness, emotion regulation, stress responses, and brain networks. There is not one single mechanism that explains every dissociative experience.
A more cautious way to picture it is:
high tension
exhaustion
anxiety
trauma
overload
↓
change in
attention, feeling
or consciousness
↓
distance from yourself
or your surroundingsBut this is not a fixed chain either. Not everyone who experiences a lot of stress dissociates, and not every dissociative complaint has the same cause.
Dissociation and trauma
There is a clear scientific link between trauma and dissociative symptoms.
For example, in some people with PTSD, depersonalization and derealization are so pronounced that the DSM distinguishes a dissociative subtype of PTSD.
However, that does not mean:
dissociation
=
proof of traumaSomeone can have dissociative symptoms without PTSD.
And someone can have experienced severe trauma without clear dissociative complaints.
Personal context remains important.
Example with sudden bad news
Suppose you unexpectedly receive very upsetting news.
Someone is talking to you, but their voice seems to grow farther and farther away.
The room feels strange.
You know rationally where you are, but afterward you think:
“It felt like everything was happening in a haze.”
That can be a temporary experience of detachment during extreme stress.
It is not unusual for attention, sense of time, and bodily awareness to change under intense stress.
bad news
↓
strong stress
↓
everything feels
far away or strangeOne such experience does not automatically mean someone has a dissociative disorder.
And what about driving on ‘autopilot’?
You drive a familiar route and notice when you get home:
“I can hardly remember the last few kilometers.”
That is sometimes used as an example of ‘everyday dissociation.’
But it is more accurate to phrase this cautiously. Familiar actions can largely happen automatically while your attention is elsewhere. That is not the same as clinical depersonalization, derealization, or a dissociative disorder.
What it mainly shows is that:
consciously paying attention
and
doing something automatically
are not the sameThat is why a normal experience of being distracted or acting automatically should not too quickly get a psychiatric label.
Dissociation is not the same as psychosis
Depersonalization and derealization can feel incredibly strange and frightening.
As a result, people may think:
Am I going crazy?
Am I losing touch with reality?
With depersonalization/derealization disorder, a person usually does know:
“It feels unreal, but I know it’s a feeling.”
“The world
feels unreal”
≠
“The world is
literally unreal”That difference in reality testing is important.
That does not mean you should try to diagnose yourself. New, severe, or unclear symptoms deserve professional evaluation.
Why can anxiety intensify the experience?
Suppose you suddenly experience derealization.
You think:
“What is happening to me?”
Then:
“What if I completely lose control?”
The fear rises.
Because of that tension, you start paying even more attention to every strange sensation.
strange sensation
↓
“What is this?”
↓
fear
↓
paying more attention to
the strange sensation
↓
even more fearWith depersonalization/derealization, anxiety and constantly checking whether everything feels ‘real’ can make the symptoms even more distressing. Merck describes that anxiety, stress, and lack of sleep can worsen the symptoms.
How can this happen after prolonged stress?
Some people notice dissociative experiences especially during or after periods in which they have been under high stress for a long time.
That can have many different causes:
problems at home,
work stress,
loss,
abuse or trauma,
anxiety,
relationship stress,
prolonged uncertainty,
or several things at once.
That is why it is too simplistic to point to one event afterward as the automatic cause.
How can this be recognizable in current or former members of close-knit groups?
People from any religious or social background can experience dissociative symptoms.
Someone who is or was part of a highly structured or close-knit community can also go through periods of significant stress, for example due to conflict, identity change, loss of relationships, or a major shift in worldview.
Research into former Jehovah’s Witnesses describes, among other things, psychological strain related to shunning, loss of social identity, and the transition after leaving. However, that research does not specifically show that being a Jehovah’s Witness causes dissociation.
That is why this reasoning is too absolute:
“I was a Jehovah’s Witness
and I dissociate
so the religion caused
my dissociation”A more careful question is:
“When do my symptoms occur, what stress is involved, and what other possible explanations need to be considered?”
For one person, religion-related stress may be part of the story.
For another, not at all.
An individual assessment is important.
Even after leaving, the body can react differently from what you believe
Someone may think logically:
“I know I’m safe.”
but during a trigger, you may still experience a feeling of distance, numbness, or unreality.
That does not automatically mean that someone still believes their old convictions.
Conscious beliefs, emotional reactions, and physical stress responses do not always line up exactly.
My mind:
“I am here and
I am safe”
My experience:
“It suddenly feels
far away or strange”Different processes may be involved in such reactions. Dissociation is only one possible explanation.
What is grounding?
Grounding is an umbrella term for techniques that help redirect attention to the present moment and your immediate surroundings.
In depersonalization and derealization, sensory grounding techniques can help some people feel more connected to themselves and their surroundings again.
For example:
LOOK
What do I see right now?
LISTEN
What sounds do I hear?
FEEL
My feet on the ground
ORIENT
Where am I?
What day is it?
What am I doing now?For example, you can consciously:
feel your feet against the floor,
name five things in the room,
feel the temperature of an object,
follow a calm sound,
or say out loud where you are.
The goal is not to yell at yourself:
“Stop dissociating.”
But to gently bring attention back to:
here – now – body – surroundings.
Rest and sleep can be important
Fatigue and sleep deprivation can trigger or intensify depersonalization- and derealization-like experiences.
When symptoms mainly occur during periods of overload, it can therefore be useful to also look at very ordinary factors:
How am I sleeping?
How much stress
am I under?
Am I constantly
overstimulated?
Am I using substances
that could have an effect?
When do the
symptoms get worse?Psychological symptoms do not always have to be caused by one deeper explanation.
When is professional help advisable?
An occasional brief experience does not automatically require treatment.
However, have the symptoms assessed when they:
come back regularly,
last a long time,
get progressively worse,
are very frightening,
disrupt your work, studies, relationships, or daily functioning,
are accompanied by significant memory gaps,
or if you are not sure what is going on.
Depersonalization and derealization can also occur with other mental health conditions, substance use, and some physical or neurological conditions. In diagnosis, other possible causes are therefore considered if necessary.
In the case of sudden new severe confusion, loss of consciousness, a seizure, neurological deficits, symptoms after head injury, or immediate danger to yourself, prompt medical evaluation is important.
What can you do with it?
Try first to observe without immediately choosing an explanation.
Ask yourself:
What exactly am I experiencing?
Does my body or sense of self feel strange, or is it mainly my surroundings?
When did it start?
How long does it last?
What happened just before?
Am I very tired, tense, or anxious?
Does it only happen in certain situations?
Do rest or grounding help?
You can keep a simple pattern log:
BEFORE
What happened?
EXPERIENCE
What felt strange?
DURATION
How long did it last?
AFTERWARDS
What helped?This way, you gather information without immediately concluding what the cause is.
Questions to think about
When do I notice that I feel detached from myself or my surroundings?
What exactly do I feel then: numbness, unreality, distance, memory problems, or something else?
What circumstances usually come before it?
Do fatigue or lack of sleep play a role?
Do the symptoms mainly happen during anxiety or high stress?
Have I become afraid of the experience itself?
Am I constantly checking whether everything still feels normal?
What helps me refocus on my body and surroundings?
Have I already discussed my symptoms with a doctor or psychologist?
Could there be a physical, neurological, or medication/substance-related explanation that should also be investigated?
And perhaps the most important:
What am I
actually experiencing?
and
what explanation
am I giving
myself?Those two are not always the same.
Summary
Dissociation is an umbrella term for experiences in which the ordinary coherence between awareness, attention, memory, feeling, body, identity, or surroundings can be experienced differently.
Two well-known phenomena are:
DEPERSONALIZATION
distance from yourself
DEREALIZATION
distance from your surroundingsTemporary experiences can occur and do not automatically mean that someone has a dissociative disorder. Severe or recurring symptoms may, among other things, be related to stress, trauma, anxiety, lack of sleep, substance use, or other psychological or physical causes.
It is therefore too simplistic to explain every dissociative experience solely as a “survival mechanism.”
Grounding, sufficient rest, and attention to triggers can help with mild experiences. With recurring, severe, or frightening symptoms, professional assessment is advisable.
The core issue is not:
“There is something wrong with me.”
but also not:
“This is probably nothing.”
A more accurate starting point is:
This experience is real
but I should not
jump to conclusions
about the cause too quicklySources and further reading
David Spiegel – Merck Manual, Overview of Dissociative Disorders. About dissociative phenomena, including depersonalization, derealization, memory problems, and the link with stress- and trauma-related disorders.
David Spiegel – Merck Manual, Depersonalization/Derealization Disorder (2026). About symptoms, possible triggers, diagnosis, reality testing remaining intact, and grounding techniques.
Jinyan Yang, L.S. Merritt Millman, Anthony David & Elaine Hunter (2023), The Prevalence of Depersonalization-Derealization Disorder: A Systematic Review. Systematic review of the prevalence of the disorder in the general population and clinical groups.
Ruth Lanius, Bethany Brand, Eric Vermetten, Paul Frewen & David Spiegel (2012), The Dissociative Subtype of Posttraumatic Stress Disorder. About depersonalization and derealization in a subset of people with PTSD and the clinical and neurobiological basis of the dissociative subtype.
Elbert Nijenhuis et al. / research on trauma and dissociation. The scientific literature shows a relationship between trauma and dissociative phenomena, but also methodological limitations and important individual differences. A critical review found that many studies showed an association between dissociation around traumatic events and later posttraumatic stress, but also emphasized limitations in the research design.
Heather Ransom, Rebecca Monk, Adam Qureshi & Derek Heim – Life After Social Death: Leaving the Jehovah's Witnesses, Identity Transition and Recovery. Research on well-being, exclusion, and identity after leaving Jehovah’s Witnesses; relevant to the broader context of psychological strain after leaving a religion, but not evidence that JW membership specifically causes dissociation.
