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Kristina S. Fury, PsyD, is a 2023 graduate of the PsyD Program in Clinical Psychology at Antioch University, Seattle.

Dissertation Committee

William Heusler, PsyD, Committee Chair

Melissa Kennedy, PhD, Committee Member

Tyson Bailey, PsyD, Committee Member

Keywords

depersonalization, dissociation, trauma, misdiagnosis, qualitative

Document Type

Dissertation

Publication Date

2023

Abstract

As both The International Statistical Classification of Diseases and Related Health Problems 11th Revision (ICD-11) and The Diagnostic and Statistical Manual of Mental Disorders-5-Text Revision (DSM-5-TR) describe, depersonalization (DP) involves unpleasant episodes of detachment from one’s sense of self or of unreality in the environment. Symptoms include people feeling as though they are an outside observer of their thoughts, feelings, sensations, body, or actions. DP can take the form of emotional numbing, in which people may feel they are watching themselves from a distance or as though they are characters in a play. People can also feel physically numb, disconnected from parts of their own bodies to the degree that they feel as though they are observing the world from behind glass, as if through the lens of a camera, or within a dream (World Health Organization, 2019; American Psychiatric Association, 2022). DP is a form of dissociation and a common protective response to trauma.

People experiencing DP symptoms report a wide spectrum of distortions and impairments to affective, cognitive, and physiological/perceptual functioning. A common experience is fear that what they are experiencing is a sign of irreversible brain damage, and a belief that DP symptoms indicate progression toward insanity is also common. When DP symptoms are misinterpreted either as indicative of severe mental illness or brain dysfunction, a vicious cycle of increasing anxiety and consequently increasing DP symptoms can result. This might lead to avoiding situations known to cause symptoms to escalate. On the clinician side, many without experience with DP might think patients’ descriptions are metaphorical, or they might misinterpret them as psychotic symptoms. Resulting misdiagnoses can lead to ineffectual treatment and prolonged distress.

Trends suggest people are increasingly seeking mental health-related information online. Some research suggests others seek first-person perspectives. A prime place for sharing such experiences is Reddit, a social media platform. Through thematic analysis of posts, themes might emerge that might serve to inform mental health professionals about people’s lived experiences with DP symptoms and suggest new questions to ask about symptoms not yet well understood by many. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu).

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Kristina S. Fury, PsyD, 2023

ORCID Scholar ID# 0000-0002-9027-4755

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