Cognitive Behavioral Model Of Depersonalization (Hunter, Phillips, Chalder, Sierra, David, 2003)
Depersonalization is an experience where an individual feels a sense of detachment from themselves, or estrangement from their perceptions, actions, and feelings. It can be accompanied by derealization, where the external world appears unfamiliar or less real. Both can be transient experiences, are experienced by up to 70% of non-clinical populations, and are often associated with fatigue, stress, or drug use. Depersonalization disorder (DPD) is diagnosed when symptoms of depersonalization and derealization are experienced chronically and cause significant distress and impairment. It can occur in the absence of other conditions or as a comorbid condition. The Cognitive Behavioral Model of Depersonalization information handout reproduces a cognitive model of DPD proposed by Hunter, Phillips, Chalder, Sierra, & David (2003).
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Introduction & Theoretical Background
Depersonalization Disorder (DPD) is a chronic condition in which an individual experiences frequent or unremitting detachment from themselves, disrupting the normally integrated sense of self. Critically, people experiencing DPD are not delusional: they retain insight, and their awareness of the disjunction between the observing self and the embodied self causes significant distress (Hunger et al, 2003; Medford et al, 2005).
Core symptoms of DPD include:
- Depersonalization (DP). A sense of unreality and detachment from oneself. The normal integrated sense of self – mind and body – is disrupted so that individuals feel detached from their thoughts, their bodies and their experiences. Individuals often report watching themselves from a tunnel, behind glass or through a window.
- Derealization (DR). The world feels unfamiliar and artificial. The external world may appear flat or two dimensional, lack colour or appear black and white. Objects do not appear solid, or appear larger or smaller
Therapist Guidance
This is a Psychology Tools information handout. Suggested uses include:
- Client handout – use as a psychoeducation and skills-development resource
- Discussion point – use to provoke a discussion and explore client beliefs
- Therapist learning tool – improve your familiarity with a psychological construct
- Teaching resource – use as a learning tool during training
References And Further Reading
- Baker et al (2003) Depersonalisation disorder: clinical features of 204 cases. British Journal of Psychiatry, 182, p428-433.
- Carlson, E. B. & Putnam, F.W. (1993) An update on the Dissociative Experiences Scale. Dissociation, 6, 16-27.
- Ciaunica, A., Hesp, C., Seth, A., Limanowski, J., & Friston, K. (2021, February 23). I overthink—therefore I am not: Altered Sense of Self in Depersonalisation Disorder. https://doi.org/10.31234/osf.io/k9d2n
- Hunter, E. C. M., Phillips, M. L., Chalder, T., Sierra, M., & David, A. S. (2003). Depersonalisation disorder: a cognitive–behavioural conceptualisation. Behaviour Research and Therapy, 41(12), 1451-1467.
- Hunter, E. C., Baker, D., Phillips, M. L., Sierra, M., & David, A. S. (2005). Cognitive-behaviour therapy for depersonalisation disorder: an open study. Behaviour research and therapy, 43(9), 1121-1130.
- Hunter, E. C., Salkovskis, P. M., & David, A. S. (2014). Attributions, appraisals and attention for symptoms in depersonalisation disorder. Behaviour Research and Therapy, 53, 20-29.
- Medford, N., Sierra, M., Baker, D., & David, A. S. (2005). Understanding and