A Counselor Reflects on Depersonalization and Derealization

Published on 6 March 2024 at 15:57

In this essay I reflect on depersonalization/derealization, contemplative practice, and my experience within a toxic social setting. The intersection of mental distress, social instability, and graduate-level training manifested in my experience with DP/DR and panic attacks. Within this reflection, I question the function of contemplative practice in my own life. I finish with questions that have yet to be answered.

Revisiting a Destabilizing Experience

This essay that follows is a text I wrote in 2023 as I was rounding the corner to finishing my graduate program in counseling. I've been inspired to revisit this scene from encountering, deep in the blog-o-sphere, an intelligent post on the limits of meditation and mindfulness to directly confront depersonalization/derealization. What's more interesting about this post is that the author attempts to locate the "core phenomenology" of these experiences, and to consequently engineer a contemplative approach to address these episodes using that understanding. As someone interested in the limits and potentials of meditative practices with clients (emphasize limits) and myself (emphasize potentials), these interdisciplinary (cognitive, phenomenological, psychological, therapeutic, spiritual) inquiries are essential, given they are critical and cautious enough when broached with clients. 

Another reason for revisiting this episode is that I'm utilizing an expressive journaling practice from James Pennebaker. I stumbled upon this approach during a long cardio session, flipping through podcasts. Essentially, you are asked to write about the most stressful experience of your life, either on 4 consecutive days, or four consecutive weeks. Additionally, you are asked to continuously write, not stopping to edit or correct spelling. An assumption is that the event still holds some emotional power in your life. Seeing as how I've thoroughly processed major childhood and adult trauma through therapy (including the episode I discuss in this essay), I decided that my meditative-induced DP/DR experience should be the candidate.


Finally: I think posts like this reveal an assumption about my clinical practice, one that is somewhat acknowledged in our profession: The clinician's suffering, recovery, healing, and growth are scaffolds for how we extend our abilities to our clients. This isn't always necessarily the case, and surely doesn't imply that you need to suffer from the client's specific ailment in order to effectively treat it. Rather, there are meta-themes that apply across situations, problems, and "disorders" (e.g., tolerating ambiguity in the healing process), which require a clinician's experiential understanding. This could be another post, but suffice it to say that I see my own experiences in growing through this DP/DR episode as an opportunity to grow my clinical skills.



"If you buy into the view that you, as a practitioner, and the client are completely independent, separate selves, then you are vulnerable to having disdain for the client for not measuring up to your standards. You may not appreciate how your pain is actually a window into the client’s pain and that the universal and archetypal nature of pain and suffering actually means that it does not belong per se to any particular being." (Andrew Bein, "The Zen of Helping", 29)

I'm close to finishing my graduate program in counseling. I have grown in many ways throughout this program. However, I have also suffered quite a bit, too. Burnout, that unforgiving cluster of emotional and physical side effects, hit me hard at the beginning of my second year of the program (which is a three year program in total). In general I have adored my time in grad school. Yet as I conclude, I have been reflecting on the ways in which the program has hurt students. This post, which focuses on depersonalization/derealization (DP/DR), is part of that reflection.

Encountering Depersonalization/Derealization


Depersonalization/derealization (DP/DR) has been a feature of my life since high school. In the middle of my teenage years I began having what I then called existential dread episodes: a feeling that is space-y and constricted and alien. In the past two years these episodes have returned with a vengeance, which often leaves me feeling as if I don't have much control over my mental health. It's still hard to explain what these episodes are like, but:


It's as if the world I’m looking at has lost a familiar element, that the humans I’m looking at have lost their humanness, and that I’m observing the world living in an alien creature's body that I don’t understand. It’s as if everything is new—and terrifying. It's like arriving to a new place and being captured by its novelty―yet everything is terrifying because there is a complete lack of familiarity.


The First Abduction


I struggled with severe depression from my teenage years and up into my mid-twenties. Often, the worst episodes would be accompanied by DP/DR. In general, I stayed trapped in a depressive pattern that overshadowed my successes in school and work. However, it was only in my early 20s, after a particularly difficult hospitalization, that I began to take words like "recovery" and "healing" and "wellbeing" seriously. With the help of amazing therapists, the right medication, daily exercise, and a therapeutic meditation practice, I began getting better. I became quite behavioristic in tackling my mental health and wellness. There was a formula for positive change, and it was:


Mood follows behaviors, behaviors are made by habits, and some habits are better than others in improving mental heath.


Bibliotherapy was also a large part of my healing. Books like The Power of Habit and Atomic Habits became practical tools of recovery. And they worked incredibly well: I found implementable coping skills—namely exercise and meditation—that replaced many of the negative patterns which perpetuated my misery. The locus of control moved inward, and I began taking responsibility for the depression.


Yet many assumptions were baked into this process of recovery, maybe necessarily so, that would later become a hurdle. For, as my recovery progressed, the simple behavioristic assumption that X habit leads to Y outcome curtailed and constrained my meditation practice, which was becoming increasingly Theravadin and "spiritual." As a consequence, I became obsessed with meditation maps (specifically the Stages of Insight) and my place on them; I assumed that progressing through this path would be tough but that "awakening" would be the deepest sense of peace, healing, and well-being.

Mapping the risk of mental illness along the vipassana stages of insight, from Daniel Ingram's Mastering the Core Teachings of the Buddha.


So I pounded sensate experience with all the cunning of Daniel Ingram's noting, a practice of intensity and rapidity that deconstructs everything that enters its meditative gaze. And it indeed deconstructs. Noting resulted in a deep relief from depression that deeply healed a wound—my identification with depression—that I thought was permanent. Yet it also revealed another creepy, destabilizing space, what I've come to view as DP/DR. Whether this is a consequence of practice generally, of noting specifically, or of me practicing "incorrectly," the intense depression subsided and gave rise to this alien space that I still encounter today.

Alien Gets an A+


My first meditative-induced episode of DP/DR was in a contemplative environment: a silent 7 day vipassana meditation retreat. This first experience was manageable, however, because I assumed it was simply a consequence of "meditating wrongly" or "meditating too hard." In short, that it wasn't something I would smack up against in daily life, especially since the depression was subsiding.


However, after participating in a group counseling class some 2 years later, I experienced another DP/DR episode in an open, leaky container. But this time, it was from someone looking to use traumatic material for class purposes. Led by a professor with a lacking ethical compass, I was prodded to disclose some traumatic experiences in the group. My disclosure, she assured us (with all of my classmates online, and only the professor and I alone in a classroom), was to be a learning experience of "how to go deep" in group counseling. 


"Ethical" matters here, as one of the most important considerations for counselors is the ability to navigate dual relationships. A counseling classroom, no matter how practical the content, is not a therapy office. Yet this professor made it clear that, in order to get a good grade, students needed to "go deep" in front of their classmates; in other words, violate the boundaries of the classroom and step into therapy-land. So, in the middle of a group session facilitated by the most powerful professor in our program, my painful experiences were put on display―and I allowed it to happen. I allowed this person to "draw me out" in order to teach others a skill. 

The professor's success with drawing me out―some tears in class while re-experiencing traumatic memories of physical violence―was not met with follow-up care, or post-mortem debriefing in any way. Instead, the response: "I guess you have more therapy to do." Coming from a de facto leader of a program whose mission it is to train future healers, those eight words invalidated years of therapeutic and pharmacological work regarding my experience with trauma and violence. This, coming from a person I admired for leadership and dedication to improving our program, who only moments before asked me to recall my trauma for a class lesson—the dismissal of those words, the brevity of the interaction, were made for my embarrassment: You showed too much, and you're the worse for it. I sobbed later that evening to my partner, thinking I was broken so deeply that I could not see it.


After this class, after being left vulnerable and raw for a grade, after being made an example for my peers, and after being led to believe I was a basket-case, I experienced nightmares of the original incident (warped in a fun-house mirror) for the next several months. 

Another Abduction


This mental instability collided with a financial inability to get therapy, as collecting counseling hours for graduate school reduced my income significantly. Lacking resources, I turned to a trusty tool that aided me in in the past: intense meditative practice. So, I used the winter break of 2021-2022 to prioritize contemplative practice. Despite my original retreat-induced DP/DR, I had a strong expectation about practice: Meditation helped me overcome depression. It can help me overcome this, too. At this point, "practice" was conceptualized only as meditation, and as a path leading toward to some ultimate, unshakable wellbeing-defined-as-okayness. Part of this was the influence of several meditation teachers I still admire, with terms like "industrial strength mindfulness" and "happiness independent of conditions" lurking in the background. The operative expectation was that an intensive period of meditation practice would "heal" me enough to muscle through my graduate program. This expectation, however, simply fell apart with what came next.


Before continuing with the story, it is worth pulling apart my expectations of contemplative practice. First, I believe it reveals a deeply-held assumption: that my spiritual practices were simply a "way to be okay" despite the shitty, immensely stressful conditions of graduate school. And to some extent this is why I still practice sitting meditation today. The entire premise of Buddhist meditation is understanding how we are intimately complicit in our suffering and struggles. Our habits of mind, along with the causes and conditions of our environment, are always forming and falling apart in ways that cause pain, discomfort, and aversion. Yet I landed way too far on the "individual responsibility" side, neglecting the reality of what I was experiencing in my program. So, practice was simply a way to be okay-enough to continue subjecting myself to intense stress for future economic gain (in the form of a graduate degree).


Second and related, I was subject to a system which has, over recent years, become increasingly toxic. I did not know this then, but this fact has become crystal clear since: I was swimming in a culture of bullying and gaslighting, a culture which targets certain students and silences dissenting faculty. But at the time, I was assuming that my initial response to my experience in the group counseling class revealed a deep individual pathology, not something more collective about the program.


But what if my contemplative experience of destabilization and disconnection was a window into something more social and collective? Glenn Wallis, a critical thinker of Western Buddhism, puts it nicely when speaking about the radical, collective implications of mindfulness (my chosen sitting practice) as they impact the individual:


"[P]laced in a materialist framework, mindfulness ultimately enhances awareness not merely of “subjective experience” but of “social experience”... [M]y “own” experience is but the existential vortex where the social meets me, my body, my awareness, etc. Taking this approach, how can you be sure that your anxiety wasn’t a ping of wisdom? (The truth often hurts, right? How might we view “anxiety” in light of that fact?)" (Source)


Wallis was not in my intellectual life at this time, so instead I used the contemplative tools of modern Buddhist vipassana practice to fix myself rather than direct my practice at the messy system. In no way am I saying this self-directed work isn't important, as the re-emergence of traumatic materials attested to the potential need for more individual therapeutic work. Rather, my conceptual understanding of contemplative practice didn't extend beyond myself.  

So, I was without the necessary tools to understand how toxic environmental factors were being revealed in my personal practice. Thus: In picking up the noting/labeling practice once more, I drastically increased my practice time and completed a self-directed retreat in the dead of winter. It's unsurprising that, without either therapeutic or contemplative guidance, I smacked into a DP/DR episode that recurred over months; an episode that sparked intense, weekly panic attacks; and which took me more than a year to resolve.

The Socratic Alien


At this vantage point, many of my assumptions about my contemplative practice are shifting, albeit quite slowly. Given the larger, macro-cultural waters in which I swim, I am starting to understand how other assumptions―namely, those of the neoliberal subject―are baked into my understanding of healing and resilience, of wellbeing and spirituality. This seems like a dim edge, as it's still unclear how I forge this into something resembling "practice." Maybe writing this is enough. And while I still have the prowess to manipulate my environment and behaviors to "optimize" for certain outcomes, contemplative practice feels like an entirely new ballgame, one that focuses on embodiment and socially-directed action. Of course, sitting is still important, too.

There is so much more to this story, and yet it's important for my past self that I say this: Anxiety and rage are part of the game in systems that disrespect and dehumanize individuals. Avoiding these emotions and experiences requires monasticism, to tuck yourself away in a hillside somewhere far away. 


But if you want to change and forge systems that respect the integrity of the human―including your own humanity―you must find ways to navigate these worlds. Sitting is one way to bolster your resources to enter the arena, but it is far from sufficient.


So, was the DPDR that I experienced a result of "incorrect" practice? Of being enmeshed in dehumanizing systems? Of my "trauma" resurfacing in a broken container? All of the above?


And, with the multiple potential causes in mind, what is my response?

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