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Freud's work on nevrosis can be summarized in a simple sentence: a neurosis is an internal conflict due to unresolved issues.

So... How this can relate to our Depersonnalisation/Derealisation? Well, it's all Anxiety.

The key to understand how DP/DR works is not in the symptoms itself, but in a simple thing we all experience: the "living in our head" problem. If I would summarize the symptoms of DP/DR, I would just say that it's a "Tired Mind Disorder". By constantly living inside your head, you focus on meaningless things and consider those things as important, you are in a constant state of alertness toward your body, you lack interest in the world, and you loose your sense of reality. It's as simple as that. Now... Why are we living in our head?

That's what we can call an emotional dissociation. Your body is like a refuge, a protection against your problems, and by living inside your head all the time, you simply avoid troubles or emotions you dont want/need to feel. And now, I guess it's important to explain DP/DR in details:

1- Dissociation and... Obsessions

Obsessional Compulsive Disorder is an anxious disorder which produce intrusive thoughts. Most of the time, you answer those thoughts by creating a compulsion, which is like a ritual that make the thoughts simply go away. If you need an example, an intrusive thought can be "a thief live next to me", and the compulsion will be to check all the doors many times before leaving to work. But of course, it's not a simple thought that come and go away, like everyone of us experience. It's normal and logical to think about checking your door if you live next to a thief, but it become a disorder when you can only think about that and when you need to check your door multiple times. That's OCD.

Dissociation is a term that refer to the separation (conscious or unconscious) of some of your brain functions. In our case, I'll focus on the emotional and sensitive dissociation. It's an avoidance state where you stop feeling emotions or you lack information on your environment. Directly opposed to the intrusive thoughts you experience with OCD, when you are dissociated, you simply lose your thoughts. Your body and yourself work in a "robot mode", doing things without really experiencing them. That's dissociation.

So, how all this is related to DP/DR?

You may have recognized yourself by reading this chapter on OCD and Dissociation. As I noticed, most of us experience intrusive thoughts, but also the lack of emotions/sense. It is now important to understand what link exist between those two things...

2- Fight-or-flight

For those who dont know what the fight-or-flight response is, it's the way you react to a danger. Imagine a bear is running in your direction, you are afraid, and you only have two options: you can fight the bear, or flee to avoid the fight. Your body will be prepared to do both things, and your logical sense will take the decision.

The fight-or-flight response can be considered as an alertness state you're in, when in front of a danger. Your choices are to either leave, to avoid the danger, or to fight, to live the danger. See where I am going with this?

DP/DR is like being in a fight all the time. Sometimes you'll avoid the fight, and be in a dissociative states. Sometimes, you'll fight and experience intrusive thoughts or intrusive emotions. That's how our body work.

3- Pure-O OCD

When I explained what OCD is, I talked about Compulsions. But now that I explained that we experience some form of OCD with DP/DR, you may ask why you don't have any compulsions. That's why I'll explain what pure-O OCD is:

Compulsions as most of us think, is the sometimes crazy things someone with OCD do to chase away the intrusive thoughts. But it's not always something physical, like checking if doors are closed. Fighting a thought by just ruminating is a form of a compulsion. I would say it's a form of creative way to fight the intrusive thoughts. Because we probably are all logical and creative people, we always try to answer those intrusive thoughts, and after all those years of experiencing them, those thoughts changed from "realistic worries" (is the door really closed?) to "unsolvable worries" (metaphysical thoughts, why are we here?) you'll have no answer to. And you're just doing a Compulsion by trying to fight them, by trying to solve them, to answer them...

And of course, it'll make you anxious. Because it will be like not being able to check your doors while thinking all the time that there is a thief in your neigborhood...

4- What's the danger?

As I explained earlier, DP/DR can be considered as a constant alertness state. It's the fight-or-flight response. When you fight, you experience intrusive thoughts and OCD, and when you flee, you experience dissociation and derealisation/depersonnalisation symptoms. But it would imply that there is a danger... So what's the danger?


No, not anxious feeling. Anxiety. Or as I explained at the beginning of this post, unresolved emotions, unexpressed feelings and unresolved issues you have on a subconscious level.

Now, you may ask... How the problem can be anxiety, if I dont always feel anxious?

The problem is that you think the symptoms is your disease. Just like the flu, you can be infected without having any symptoms, and none of the symptoms you'll have will be related to the flu directly, but related to how your body fight the virus. Anxious disorders work in the same way: anxiety is infecting your body, and your body try to fight it, which make you experience symptoms of your body fighting it.

Anxiety is something that build up inside your brain, often on a subconscious state, and you're not always conscious that it's here.

5- DP/DR is a neurosis

Here we are. I explained to you how the depersonnalisation/derealisations symptoms work. And now you understand how it can be considered as a neurosis: unresolved things inside you (your anxiety) create a danger, which trigger an alertness state (fight-or-flight response), which in turn, create either an avoidance state (dissociation) or a fighting state (intrusive thoughts). DP/DR is like a constant fight against an ennemy you can't see or feel, it's like being on the battlefield, worried that you'll get killed in the next carpet bombing, or ready to fight for your life.

In the next article, I'll focus on how this anxiety is created...

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Dec 28 2013 06:15 PM

Great article.

Except I was having a battle with your spelling of neurosis.

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Dec 28 2013 06:17 PM

Oh, my bad! It's spelled nevrosis in my language, that's why I mispelled it! I'll edit my post, thank you
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Jan 07 2014 08:21 PM

"living in your head"... that's me. It's awful. Thank you for posting this blog entry. It was very insightful. Sometime's getting free of my mind is something I feel I will be fighting to do forever

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Feb 06 2014 04:37 AM

Can we stop referencing Freud? It's 2014.

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Mar 04 2014 02:15 PM

you lack interest in the world, and you loose your sense of reality. I have this, is there any way around this issue?

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Mar 16 2014 09:20 AM

I thought this was a great article and definitely on the money. I often root for the DP'er whose stuck in the obsessional ideas that this is something other than what it is. It's a way to avoid emotional or psychic pain. I swear the worst waste of time in getting better is that people cannot accept that this is a coping solution. No matter how well documented it is. It simply doesn't apply to them. If you Google Depersonalization that's the first thing that comes up but they simply can't believe it. The symptoms of the illness aren't the illness itself but a consequence of it. I enjoyed this article because its very hard for people to get to the place suppuka is. It's inspiring. More efforts should be put into helping people understand that chronic DP isn't a brain tumor, dementia, or schizophrenia. It's a coping skill to anxiety. IT'S JUST NOT A GOOD ONE!
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