Derealization, a psychiatric illness, raises serious moral and philosophical issues.
Have you ever had the uneasy feeling that nothing is as it seems? Since childhood, a student at Stevens Institute of Technology, where I teach, has struggled with sensations of unreality. She recently completed her senior thesis by making a film about this syndrome in which she interviewed herself and others, including myself. Camille says in her video Depersonalized; Derealized;
Deconstructed, “It feels like there’s a glass wall between myself and everything else in the universe.”Depersonalization and derealization are feelings that the outside world and your own self are both unreal. According to the Diagnostic and Statistical Manual of Mental Disorders, depersonalization/derealization disorder is defined as “chronic or recurrent… perceptions of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions.” For convenience, I’ll refer to both conditions as derealization.
Derealization can strike anyone at any time, but it is more common in stressful situations, such as taking a test or interviewing for a job. When the condition causes “distress or impairment in social, occupational, or other critical areas of functioning,” psychiatrists advise psychotherapy and medication, such as antidepressants. Derealization can be caused by significant mental illnesses like schizophrenia or hallucinogens like LSD. Cotard delusion, also known as walking corpse syndrome, is the belief that you are dead; and Capgras delusion is the belief that people around you have been replaced by imposters. Extreme cases, usually associated with brain damage, may manifest as Cotard delusion, also known as walking corpse syndrome.
I’m delighted Camille brought the disease to my attention, because derealization poses a lot of philosophical problems. Ancient and modern sages have proposed that our everyday world, in which we go about our daily lives, is an illusion. Plato compared our impressions of things to the shadows thrown on a cave wall. Adi Shankara, a Hindu philosopher who lived in the eighth century, claimed that ultimate truth is an endless, undifferentiated field of consciousness. Our individual selves, according to Buddhist theory, are unreal.
According to modern philosophers like Nick Bostrom, our universe is most likely a simulation, a virtual world built by an alien counterpart of a bored adolescent hacker. Solipsism is a philosophical position that asserts you are the only conscious being in the universe, with everyone else simply appearing to be sentient. Some interpretations of quantum mechanics, as I mentioned in a recent essay, call into question the status of objective reality. Could all of these philosophical speculations have been sparked by derealization?
Camille claims that many people experience derealization without even realizing it. You conceal the feeling because it bothers you. You try not to think about it and don’t tell anyone about it. “You’re frightened that if you tell people, they won’t understand,” Camille continues, “and you don’t want people to think less of you.” Derealization may be disconcerting, even terrifying, so I understand these feelings.
After a drug trip in 1981, which left me convinced that existence is a fever dream of a crazy god, I experienced my most significant and long-lasting attack of derealization. For months, the world felt shaky and flimsy, as if it were a projection screen. I was afraid that everything could vanish at any time, giving way to—well, I didn’t know what, thus the fear. These sensations have lost their visceral potency over me with time, but their logical ramifications remain.
I’m conflicted about pondering derealization. Claims that reality isn’t, well, real give me moral pause. Whether it’s Platonism, the simulation theory, or my insane-god theology, these affirmations can easily become escapism and nihilism. If the world is just a computer game, why should we be concerned about poverty, oppression, environmental degradation, pandemics, war, and other forms of suffering? Any theory that undermines our responsibility to care for one another is unacceptable to me.
Nonetheless, I’ve come to appreciate derealization as an antidote to habit. Our brains are built to perform a variety of activities with little conscious effort. As a result, we become accustomed to certain situations and begin to take them for granted. We become zombies or automatons, going about our daily lives and dealing with others—even those we claim to love—without being fully conscious of what we’re doing.
It’s like being slapped in the face with derealization. It wakes you up by cutting through the humdrum of life. It makes you think about the strangeness of the world, other people, and yourself. By weirdness, I mean inexplicability and limitless improbability. Weirdness contains all of our existence’s bipolar qualities, including its beauty and ugliness, kindness and brutality, good and evil.Seeing the strangeness does not absolve us of our moral obligations to others. Not at all. Derealization, by isolating me from the world, paradoxically makes everything more real. It enables me to understand mankind more clearly and to care more sincerely about it. What used to feel like a curse has now turned into a blessing.
At least, that’s what I tell myself. Others, including individuals Camille interviewed for her film as well as Camille herself, had various reactions to derealization. “Your brain’s way of taking a rest,” she says of the syndrome. It assumes you won’t be able to handle certain situations, so it shuts everything off.” She’s discovered that instead of fighting her feelings, she can get through them by “simply letting them flow.” Whatever derealization means to us and how we manage with it, we’ll be much better off if we can discuss it freely, as Camille and others do in her daring, revealing film.
This is an opinion and analysis piece, and the author’s or authors’ opinions may not necessarily reflect those of Scientific American.