What happens in the brain when we dissociate in depersonalization and derealization?

"Most people who dissociate never understand what happens in the brain - and I’ll lay it out as clearly as I can. Heads-up, this is a little complex, but hang in, and this will help you understand yourself far better at the end! Dissociation involves a lot of areas when you think about it. It touches areas of memory, consciousness, emotion, and many others that have distinct areas of the brain that underly them…as well as areas that are more diffuse throughout the brain - things like identity, and how we perceive the world.

So, it’s a big whale of a concept, that involves a LOT of neurological areas. What studies have attempted to do, is to do neuroimaging studies (fMRI, PET scans, etc) which is challenging to interpret because it’s hard to know what areas of the brain are affected by the dissociation vs what areas were *already* affected by things like trauma - which tends to be very prevalent in people who dissociate but they’ve parsed it out a bit, and here’s what we know so far.

There is evidence that there is a link between dissociative states and altered activity in places in the brain - including the amygdala and hippocampus (places that are involved in processing emotions & memory), as well as the insula (regulating attention and the sense of what’s going on in your body & outside of it), and the posterior cingulate cortex (which helps you know yourself, refer to yourself - identity in the moment). Some other areas appear to be affected as well when you dissociate and experience depersonalization and derealization…but these seem to be the primary players.

The thing that is so tough about this, is that people use dissociation primarily to detach from emotionally painful things and as a coping skill - but the cost of this coping skill is that these brain areas are a bit compromised to provide the coping skill…which ends up causing symptoms like problems with emotional regulation and self-control when you are *not* dissociating. Essentially, these areas have to be retrained to function properly…which we have the capacity to do with a skilled practitioner.

So this is why things like dissociation and experiencing depersonalization and derealization is *incredibly biological.* There is nothing “crazy” about people who do this, and it’s one heck of a coping strategy that has come about for a reason…it’s just that doing it to survive or cope now has a cost that often causes problems in other areas. Basically how your brain functions during dissociation is the same underlying reason for the problems you can experience when *not* dissociating. Things like emotional regulation, etc. it’s the same areas!"

"Derealization and depersonalization are usually trauma adaptations. When a person has been traumatized, especially in childhood, dissociation from the present reality is often the only thing a child can do to comfort themselves. They are not capable of fighting back against the person who is traumatizing them. In fact, they often depend on that person for food and shelter. Fighting back or even saying anything would result in them being kicked out on their own, and children are in no position to care for themselves, alone, and they know that.

So they disappear from reality. They disappear from their bodies. They disappear from themselves. This leads to the feeling that their body is not really their body and their reality is not really real. It belongs to someone else in some other world, and the true reality is not what seems to be happening. This is comforting for people who are in a great deal of pain because they are lonely, and no one seems to want them to be who they are.

This is how children survive. And when you learn to adapt to pain in childhood like this, it usually becomes a mental habit that survives long after you are grown up and have the capability of fighting back or changing your reality. By the time most people grow up, the habit of using derealization and depersonalization to avoid feeling the pain of life is so strong, people have no idea they are even doing it. It’s instinctual. It’s part of their identity.

Psychiatrists identify these things as a disorder, and that’s a problem because it does not acknowledge that these are survival adaptations. There is a very good reason for people to derealize and depersonalize. It keeps them alive. So when psychiatrists call it a disorder, people tend to believe they shouldn’t use these techniques (since they are signs of disorder), and they try to stop. Unfortunately, they have nothing to replace these techniques in terms of handling pain, so they feel worse and worse instead of better. Psychiatrist handle this by increasing the drug dosages, which just sedates people, but doesn’t teach them anything constructive about handling their pain or surviving their pain.

If you understand these techniques are survival adaptations, you might not decide they have to stop. You might not decide they are problems. Instead, you might appreciate them and learn how to use them more effectively without using sedating drugs.

This could allow you to understand what caused you to need to derealize and depersonalize in order to survive. If you can identify what is causing this adaptation, you can then develop ways to reduce or even eliminate whatever is causing these survival adaptations. That would reduce or eliminate the need for these survival adaptations. They would happen less often.

The psychology behind derealization and depersonalization is that these are effective survival adaptations that allowed children to survive childhood trauma. They became mental habits that persisted into adulthood, long after the person could find other ways to adapt to trauma. If you are appreciative of your survival and you work to understand what trauma you survived, it becomes possible to live without using these techniques instinctually. It is possible to develop other ways to deal with trauma and the current events that trigger habitual trauma responses".