I wanted to share a couple of quotes from a phenomenological analysis [link] of DPD by Patrick Mellor from the University of San Francisco published in 2015 titled 'Inside-out Minds: Consciousness, Attention, and Depersonalization'. I would then like to add some comments to his findings. Below in bullet points I have collated some of his findings that I found relevant to my enquiry, but he has a lot more to say than this and I highly recommend the paper in its entirety. They all sound incredibly relatable.
- "Sufferers of DPD often [...] report that their sensitivity to minute changes in their visual field is actually enhanced, along with a focus on minute features to the detriment of seeing larger scale patterns"
- "They also report a diminution of perceived solidity and temporal stability of perceptions of objects".
- "There is a separation of the experiences of the sounds of words from the meanings of those sounds, and in the case of visual descriptions, from the objects referred to by words. All these faculties still function, but they are no longer experienced as an integrated whole, the person simultaneously experiences an understanding of the words with a sense of hearing alien, meaningless sounds."
- "... and are hyper-conscious of complex details of muscular movement in simple tasks, to the detriment of the task itself".
- "These perceptual symptoms are usually accompanied by a feeling of detachment from emotional experience, which feels flattened and "as if" it refers to another person, often to the same person pre-depersonalization, who they sometimes describe as having died. Even with this detachment, most of the time sufferers remain emotionally connected to others, it is their internal experience of emotion that has changed, often along with a diminution of reaction to pleasurable and unpleasant situations, stimuli, and activities they previously enjoyed."
The recurring theme here is perception and the mechanism of attention (to what we give our attention to), an aspect of this condition that I think is under-researched and not discussed enough. Unfortunately, as of yet I couldn't find any systematic reviews of attention in DPD from a neurophysiological point of view, but if you have read one before or have previously stumbled across one then please share it here, I'd be interested in what they found. From a phenomenological standpoint, it definitely sounds like there is a disruption in subconscious attention, a peculiar type of attention dysfunction which manifests distinctly from the symptomatology of attention deficit disorders such as ADD and ADHD.
A study [link] conducted by Daphne et al. in 2000 came to similar conclusions following a PET scan analysis, claiming that the disorder is perhaps best described as a "dissociation of perceptions":
- "Depersonalization appears to be associated with functional abnormalities along sequential hierarchical areas, secondary and cross-modal, of the sensory cortex (visual, auditory, and somatosensory), as well as areas responsible for an integrated body schema. These findings are in good agreement with the phenomenological conceptualization of depersonalization as a dissociation of perceptions as well as with the subjective symptoms of depersonalization disorder."
Many of you are aware of the French trial that was allegedly completed sometime in September 2019 [link]. Apparently it will be published sometime soon. This study looks at the effects of rTMS on the Angular Gyrus which I (and others) think may reveal where some of this alteration of attention/perception is coming from, and the potential solution(s) to this disintegration. The Angular Gyrus is involved in a number of processes related to "language, number processing and spatial cognition, memory retrieval, attention, and theory of mind" [link]. So the study seems to be a promising one.
Interestingly, many patients with DPD also report having tinnitus and visual snow. Maybe it's just a coincidence, I don't know, but preliminary research into patients with tinnitus [link] suggest that the Angular Gyrus plays a crucial role in the unnecessary perception of sound. I speculate that a similar mechanism is also accountable for visual snow (though I haven't really read into this condition). From a phenomenological point of view, all of these symptoms are likely related to unnecessary perceptions of detail and a disruption in subconscious attention.