Depersonalization and derealization – Grounding techniques I’ve found effective

Stay connected to yourself in the present…

out-of-body-experience

For all of you lucky enough not to be in the know, both depersonalization and derealization are states falling under the category of dissociation, which the Mayo Clinic defines as “a disconnection and lack of continuity between thoughts, memories, surroundings, actions and/or identity.”

Depersonalization is when people feel separated from their physicality. They feel detached from their own feelings, emotions, bodily sensations and movements. Experiencing depersonalization may feel like you’re observing yourself from outside of your body (a sort of scary “out of body experience”), or it may feel more like being absent from yourself. Perceptions of time and space may seem distorted. Emotions and physical feelings may feel numbed.

Derealization, on the other hand, is when one feels that the external world is unreal. The outside world may be perceived in a dream-like state. Objects seem foggy, and often visually distorted.

Even though both of these conditions’ episodes are generally harmless, they can be deeply troubling. Most people at some point in their lives have experienced depersonalization and/or derealization briefly and to mild degrees. For example, you might be driving and daydreaming at the same time, but at one point realize that you didn’t notice the last mile of the trip. Or under some mild distress, you thought you saw something move and then passed it off later as a mind trick. But those who experience such episodes frequently and/or to the point of significant distress may possibly meet the criteria for full-fledged depersonalization/derealization disorder diagnosis.

Although I’ve never received a diagnosis of depersonalization/derealization disorder, both my psychiatrist and psychologist have acknowledged I’ve experienced both on occasions to somewhat distressing levels. During times of great stress, particularly sudden moments of stress, I have had various experiences that included thinking I was observing myself from the outside, actually seeing my body walking briskly away (in a panic) and even by some means knew which way to go. I’ve had experiences when I thought I saw people doing or saying things I later realized were impossible and also absurd. At other times, I thought I said things only to find out later, from the person I had been with, I hadn’t.

These occasions almost seemed like optical illusions of distortions, whose absurdity I realized soon after. Typically, my mind would suddenly go blank right afterwards as if I experienced some sort of amnesia. I’d drive home, and after an hour or so, suddenly realize what might have happened. But, sometimes, I had my doubts along the lines “Did that happen? Or not?” On more than one occasion, I actually called the person I had been with, and flat out asked about the “event”. One time, I was with a person and later realized I had sort of blacked out for minutes at a time. I remembered what I said (or what was said) right before the black out, and immediately after. What I said in between is still a mystery. That particular event was especially distressing.

Identifying your triggers

As I mentioned, my depersonalization and/or derealization experiences were almost always triggered by a sudden onset of severe stress or anxiety. Somewhat surprisingly, the “stress” was at times ultra-positive excitement. I’d realized it was crucial to plan my fight against these events ahead of time. I spent time identifying what my triggers were. I knew that if I saw certain people or went to certain places, I’d become mega vulnerable. Yes, on occasion, I’d be caught off guard. In those cases, if I was able to start using coping skills as soon as possible, I could prevent the dissociation. If I waited too long (I’m talking a couple of seconds or so), it was too late.

Grounding techniques and staying in the present

For me, mindfulness (focusing one’s awareness on the present moment) and grounding techniques (pretty much the same idea) have been the most helpful coping skills I’ve learned to prevent depersonalization and derealization. I learned using mindfulness while attending DBT (Dialectical Behavioral Therapy), but I’ve learned many grounding techniques from both DBT and CBT (Cognitive Behavioral Therapy). The following grounding techniques have been helpful for me:

mindfulness Mental grounding

Prepare for a stressful event in advance – If you know you will be entering a triggering environment, rehearse a sample conversation (or reassuring words) in your head ahead of time. Visualize yourself remaining grounded or making pre-planned movements or responses.
Take a special note of your surroundings and how much time has passed since you did “this or that” – Zero in on something you’re familiar with (like a painting or a house along your route), and describe it in your mind or out loud (if appropriate).
Distract yourself with a “game” in your mind – Sing a funny song in your head. Count to six. Listen to the tapping of your foot on the ground.
Visualize a calming place that you’ve been to in the past – Remember the feeling of being at the beach and hearing the pleasing sound of the waves. Imagine being in bed hugging your pillow.
Reorient yourself to the current place and time – Ask questions like what time is it? Who am I speaking to? What is my name? Where am I? So what is this day about? What am I trying to (or want to) accomplish today?” With this in mind, it can even be good to keep a “To Do” list and cross things off as you do them or create a general outline of what you plan to do and accomplish.
Pick your music right – I sometimes find myself drifting away from my surroundings listening to certain types of music. This can be dangerous when driving, riding my bike, or even walking.

touch

Physical grounding

Use your senses to keep yourself in the moment – Smell a flower, the room, the perfume on your wrist. Feel the softness of your alpaca sweater. Lightly touch or squeeze your arm or the steering wheel. Hold onto the sides of the chair you’re sitting on firmly and say “I’m here and I’m grounded.” Reach into your pocket and feel the piece of lint.
Be aware of your breathing – Make an effort to hear your breathing. Breathe in at a slow rate and breathe deep. Recognize that the breathing is yours and that you control your body.
Drink a sip of water, or other drink – Stay aware of your swallowing. Take notice of the taste and heat (or coolness) of the beverage. Clear your throat.

The above are just some routines I’ve practiced. Have you used other types of grounding techniques that worked for you? I found that the more I practiced, the better they worked. They’d sometimes kick in at the second I started dissociating and cut the experience short.

I’m happy to say I’ve been mostly free of depersonalization and derealization experiences for over two years. I still keep possible triggering events on my mind and prepare ahead of time. It feels good to feel grounded. I am also more confident being around people in public, and even when driving. I no longer “lose myself” or “lose time” like I used to.

Bird Flight

Expat life of a middle-aged lady