Derealization is a psychological phenomenon that affects many individuals. Although it is not classified as a mental illness, it can cause significant distress and impact the quality of life of those who experience it. It is described as the sensation that the external world feels unreal, distant, or devoid of meaning. People who suffer from it may feel as if reality is distorted, their perceptions are strange, or there is an invisible barrier between themselves and their surroundings. In some cases, it may be accompanied by depersonalization, where individuals feel disconnected from themselves.
Derealization can be transient or persistent and is linked to factors such as chronic stress, anxiety, depression, or traumatic experiences. It can also occur in disorders such as panic disorder, post-traumatic stress disorder (PTSD), and some dissociative disorders. For many, derealization is terrifying because they do not understand what is happening to them or how to escape from that state.
Fortunately, psychological treatment has been proven effective in reducing and eliminating symptoms. Various therapeutic strategies help restore a sense of connection with reality and improve emotional well-being. Below, we explore in-depth the causes, psychological mechanisms involved, and the most effective treatments to address this phenomenon.
Causes and Mechanisms of Derealization
Derealization is often a defensive response of the brain to stressful or perceived threatening situations. It is believed to be a protective mechanism that allows a person to detach from intense emotional experiences that might otherwise be overwhelming. Here are some of the main causes:
- Chronic Stress and Anxiety: Prolonged activation of the sympathetic nervous system can lead to dissociative states, including derealization.
- Anxiety and Panic Disorders: During a panic attack, the brain's alert system becomes overactivated, leading to sensations of unreality.
- Traumatic Experiences: Situations involving abuse, accidents, violence, or any event that exceeds an individual’s coping capacity can trigger dissociation as a survival strategy.
- Use of Psychoactive Substances: The consumption of drugs such as cannabis, hallucinogens, or even certain medications can induce episodes of derealization.
- Extreme Fatigue and Sleep Deprivation: A lack of adequate rest alters perception and sensory integration, promoting episodes of disconnection from reality.
- Depression and Post-Traumatic Stress: In some cases, derealization appears as a symptom within a broader depressive or traumatic context.
Therapeutic Approaches
The treatment of derealization requires a combination of psychological strategies focused on nervous system regulation, cognitive management of the experience, and gradual exposure to triggers. Below are the most effective therapeutic approaches:
1. Cognitive-Behavioral Therapy (CBT)
CBT helps modify dysfunctional thoughts associated with derealization. Techniques include:
- Cognitive restructuring: To challenge catastrophic beliefs about derealization.
- Controlled exposure: To help patients become accustomed to triggers without inducing anxiety.
- Coping skills training: To manage stress effectively.
2. Nervous System Regulation Techniques
- Mindfulness and sensory grounding: Improve connection with the present moment.
- Heart coherence and diaphragmatic breathing: Help reduce nervous system activation.
- Physical exercise and nature exposure: Enhance sensory integration.
3. Trauma-Based Therapies
- EMDR (Eye Movement Desensitization and Reprocessing): Processes underlying traumatic experiences.
- Sensorimotor therapy: Helps integrate bodily sensations and repressed emotions.
4. Acceptance and Commitment Therapy (ACT)
This approach encourages acceptance of the experience and helps individuals focus on their values rather than struggling against derealization.
5. Therapeutic Support and Emotional Bonding
The therapeutic relationship plays a fundamental role in recovery. A sense of security and emotional validation facilitates the integration of experiences and reduces fear associated with symptoms.
Final Reflection: Towards Comprehensive Recovery
Derealization is a complex but treatable experience. Understanding its mechanisms and learning emotional regulation strategies are essential steps in reconnecting with reality. Through a combination of therapeutic techniques, personal work, and professional support, it is possible to reduce and even eliminate episodes of derealization. Seeking psychological help is an act of courage and the first step toward a more fulfilling and balanced life.
Author: Psicólogo Rafael Gómez