Speaking of Depersonalization: Reality Testing, Language, and Lived Experience
Philosophy, Psychiatry, & Psychology October 1, 2025 DOI: 10.1353/ppp.0.a973597 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Key points | Argues that framing psychiatric patients in a binary—either knowing bizarre experiences are subjective or wrongly believing them objective—misrepresents depersonalization/derealization disorder, especially severe and continuous cases. Proposes that such patients are better characterized by skepticism or doubt about the reality of the world, driven by a disintegration of lived experience, rather than by conviction either way. |
Abstract
The thesis of this essay is that the desire to categorize psychiatric patients in a binary way—as either recognizing that their bizarre experiences are subjective and unreal or wrongly believing them to be objective and real—has resulted in misleading ways of talking about depersonalization/derealization disorder (DPDR). This has, in turn, obscured how the disorder presents in severe and continuous cases. In particular, it has led researchers to describe DPDR as a subjective experience of unreality which the person knows is objectively untrue. Yet, statements like these fail to capture or even acknowledge a third possibility, namely, that those with severe and continuous DPDR might be best characterized as having not a conviction of the reality of the “objective” world, nor a conviction of its unreality, but a skepticism or doubt about its reality, driven by a disintegration of their lived experience.