Is Derealization a Delusion or Insight?
I shot this scene yesterday in Greenwood Cemetery, Brooklyn, because it gave me a frisson of derealization. The world seemed to be winking at me, telling me not to take things too seriously.
Brooklyn, N.Y., April 1, 2024. Have you ever been gripped by the suspicion that reality isn’t, well, real? Camille, a former student at the school where I teach, has endured feelings of unreality since childhood. “It feels like there’s a glass wall between me and everything else in the world,” Camille says. She made a film about this syndrome, for which she interviewed herself and others, including me. She calls her film “Depersonalized; Derealized; Deconstructed.”
Depersonalization and derealization refer to feelings that your self and the world, respectively, are in some sense illusory. Lumping the terms together, psychiatrists define depersonalization/derealization disorder as the “persistent or recurrent” experience of “feeling detached from, and as if one is an outside observer of, one's mental processes, body, or actions… and surroundings,” according to the Diagnostic and Statistical Manual of Mental Disorders, or DSM.
To reduce word clutter, I’ll just call this disorder derealization. Derealization can be a symptom of severe mental illness, such as schizophrenia, or a reaction to psychedelics such as LSD. Extreme cases of derealization, usually associated with brain damage, may result in Cotard delusion, also called walking-corpse syndrome, the belief that you are dead; and Capgras delusion, the conviction that people around you have been replaced by imposters.
Healthy people commonly experience derealization in stressful circumstances—for example, while speaking in public. Psychiatrists prescribe psychotherapy and medication when the syndrome results in “distress or impairment in social, occupational, or other important areas of functioning,” as the DSM puts it.
Many people, I’m guessing, undergo episodes of derealization without realizing what it is. The feeling distresses you, so you suppress it. You try to put it out of your mind, and you certainly don’t mention it to others. “You’re afraid that if you do tell people, they won’t know what it is,” my former student Camille explains, “and you don’t want people viewing you differently.”
I understand these reactions, because derealization can be unsettling, even terrifying, and it forces you to confront disturbing philosophical possibilities. Sages ancient and modern have proposed that the everyday world, in which we go about the business of living, is an illusion. Plato likened our perceptions of things to shadows cast on the wall of a cave. The 8th-century Hindu philosopher Adi Shankara asserted that ultimate reality is an eternal, undifferentiated field of consciousness. The Buddhist doctrine called anatta says our individual selves are illusory.
The philosophical stance known as solipsism insinuates that you are the only conscious being in the universe; everyone around you only seems conscious. Some interpretations of quantum mechanics undermine the status of objective reality. Philosophers David Chalmers and Nick Bostrom postulate that our cosmos is a simulation, a virtual reality created by the alien equivalent of a bored teenage hacker.
Could derealization have inspired these reality-doubting conjectures? That is what French philosopher Alexandre Billon suggests in “The psychopathology of metaphysics: Depersonalization and the problem of reality.” Philosophers take derealization far too seriously, Billon argues. He seems offended by the notion that the everyday world is but “a dream, shadows, or a computer simulation, somehow shallow and lacking in reality.” Billon told me by email that he had experienced derealization only “after smoking wheat” (by which I assume he means weed).
I would like to believe, along with Billon, that derealization is not an insight but only a delusion, which stems from what he calls a “cortico-limbic disconnection” between perception and normal emotion. I’ve been afflicted by derealization since I was a kid. By far my most serious, sustained episode occurred after a drug trip in 1981, which left me convinced that existence is the fever dream of an insane god. For months the world felt wobbly, flimsy, like a screen on which images were projected. I feared that at any moment everything might vanish, giving way to—well, I didn’t know what, hence the fear.
These sensations have lost their visceral power over me, but the aftereffects linger. My compulsive self-doubt, I’m guessing, and my affinity for skeptical doctrines like negative theology, stem at least in part from my bouts of derealization.
I have moral objections to the claim that reality isn’t real. Whether packaged as Platonism, the simulation hypothesis or my insane-god theology, anti-realist assertions can easily become escapist and nihilistic. Why should we worry about, say, the killing of children during wars if the world is just a video game? I reject any philosophy that undercuts our responsibility to care for each other.
And yet, I’ve come to value derealization as an antidote for habituation. Our brains are designed to accomplish tasks with minimal conscious effort. As a result, we get accustomed to things, we take them for granted. We become like zombies or automatons, carrying out chores and interacting with other people—even those we supposedly love--without being fully aware of what we are doing.
Derealization slaps you across the face, it cuts through your habituation and wakes you up. It reminds you of the weirdness of the world, of other people, of yourself. By weirdness I mean infinite improbability and inexplicability. Weirdness encompasses all the bipolar properties of our existence, its kindness and cruelty, beauty and ugliness.
Seeing the weirdness doesn’t negate our moral responsibility to others. Far from it. By estranging me from the world, derealization, paradoxically, makes everything more real. It helps me see humanity more clearly and care about it more deeply. What once felt like a curse has become a gift, especially when I can share my sense of estrangement with others, like my gifted former student Camille.
Further Reading:
The End of Philosophy: What’s the Point? A Call for Negative Philosophy
Quantum Mechanics, the Chinese Room and the Limits of Understanding
Will Psychedelics Save Us? Nah
Also see Camille’s film “Depersonalized; Derealized; Deconstructed.”
Self-plagiarism Alert: This April 1 column is not a joke. It is a revised, updated, immensely improved version of a paywalled column on ScientificAmerican.com.