Re: Mindfulness Meditation Research: Issues of Participant S
Posted: Thu Feb 14, 2019 2:18 am
Depersonalization and Meditation
by Richard J. Castillo
Castillo, Richard J Psychiatry; May 1, 1990; 53, 2; ProQuest pg. 158
Copyright © 2009 ProQuest LLC. All rights reserved.
PSYCHIATRY, Vol. 53, May 1990
NOTICE: THIS WORK MAY BE PROTECTED BY COPYRIGHT
FROM a review of the literature on meditation and depersonalization and interviews conducted with six meditators, this study concludes that: 1) meditation can cause depersonalization and derealization; 2) the meanings in the mind of the meditator regarding the experience of depersonalization will determine to a great extent whether anxiety is present as part of the experience; 3) there need not be any significant anxiety or impairment in social or occupational functioning as a result of depersonalization; 4) a depersonalized state can become an apparently permanent mode of functioning; 5) patients with Depersonalization Disorder may be treated through a process of symbolic healing that is, changing the meanings associated with depersonalization in the mind of the patient, thereby reducing anxiety and functional impairment; 6) panic! anxiety may be caused by depersonalization if catastrophic interpretations of depersonalization are present.
Deikman (1963, 1966a), and Kennedy (1976) reported cases in which depersonalization and derealization occurred in individuals practicing meditative techniques designed to alter consciousness. Deikman's cases reported depersonalization and derealization during meditation practice. Kennedy's cases reported these conditions in waking consciousness. In order to determine whether experiences of depersonalization and derealization were occurring in the waking consciousness of meditators, six practitioners of Transcendental Meditation (TM) were interviewed regarding their subjective experiences while engaged in daily activity. All of the persons interviewed reported having at least one experience of what could be classified as depersonalization.
DEPERSONALIZATION
DSM-III-R (APA 1987) defines depersonalization as: "(1) an experience of being as if detached from and an outside observer of one's mental processes or body; or (2) an experience of feeling like an automaton or as if in a dream" (p. 276). Typically, depersonalization is a state in which an individual experiences a "split" in consciousness between a "participating self' and an "observing self." The participating self is composed of body, thoughts, feelings, memories, and emotions. The observing self is experienced as a separate, uninvolved "witness" of the participating self, with the perception that all of the normal aspects of personality are somehow unreal and do not belong to the observing self. There is the experience of being split off from one's participating self and ''watching'' that self behave. The split between the two "selves" is clearly illustrated by descriptions of the experience given by psychiatric patients:
There are also secondary characteristics of depersonalization, which may include: feelings of dizziness, floating, or giddiness, a feeling of the participating self being "dead," a loss of affective responsiveness, and a feeling of calm detachment (Levy and Wachtel 1978).
Depersonalization, an experience in which the perception of the self is altered, is sometimes accompanied by derealization, an experience in which perception of one's environment is altered. In derealization the environment may take on a two-dimensional or "unreal" quality. Sometimes, normally stable, solid, inanimate objects may be seen to vibrate, or ''breathe:' to be unsolid, fluid, or alive. Shapes and sizes of objects may change, or objects may disappear altogether. Colors may be especially vivid, and some objects may be seen as "shimmering."
Persons experiencing depersonalization frequently report an especially distinct separation between the observing self and mental activities. When these mental activities are cognitive in nature, the affected individuals complain that it seems as if they are not doing their own thinking, imaging, or remembering because they can observe an independent flow of these phenomena in their minds. When the mental activities are affective in nature, the persons will often complain not that their emotions are changed in quality, but rather that there is a loss of emotions (Taylor 1982).
DSM-III-R includes a Depersonalization Disorder (300.60), which has as its diagnostic criteria:
Depersonalization may be present as a related symptom in all of these various disorders and is thus a fairly common experience in psychiatric populations.
Depersonalization also occurs in the nonclinical population. DSM-III-R estimates that single brief episodes of depersonalization may occur at some time in as many as 70% of young adults. This estimate is supported by the findings of Dixon (1963), Sedman (1966), and Trueman (1984). Dixon observed that over half of his college student subjects could recognize descriptions of depersonalization as something they had experienced. When one takes into account the high incidence of depersonalization, in both the clinical and the nonclinical populations, it is not surprising that many authors postulate an organic basis or substrate for its occurrence. Mayer-Gross (1935), for example, considered depersonalization a "preformed functional response of the brain": a physiological disturbance that could be triggered by a wide variety of factors.
The etiology of depersonalization is un- known, but in addition to the disorders mentioned in DSM-III-R, depersonalization has been linked with prolonged sleep deprivation (Bliss et al. 1959), ingestion of hallucinogenic drugs (Felsinger et al. 1956; Guttman and Maclay 1936), sensory deprivation (Reed and Sedman 1964), feelings of anxiety (Lehmann 1974; Nuller 1982), and alterations in the person's mode of attention, such as prolonged gazing at a particular object (Deikman 1963, 1966a; Levy and Wachtel 1978; Renik 1978). Psychoanalytic writers on depersonalization have emphasized the defensive function of this experience. Most analytic writers see depersonalization as a means of defending against guilt, painful affects, intense conflict, danger, or conflicting ego identities (Lehmann 1974; Levy and Wachtel 1978; Shraberg 1977; Stolorow 1979).
MEDITATION AND DEAUTOMATIZATION
Deikman has referred to the effects of meditation as the "de-automatization of the psychological structures that organize, limit, select, and interpret perceptual stimuli" (1966b p. 329). In his experiments on meditation, Deikman (1966a) had inexperienced subjects gaze at a blue vase resting on a simple brown end table. The subjects sat for 30 minutes gazing at the vase and were then interviewed regarding their experiences. Most of the Deikman's data came from two subjects, A and G, who completed the longest series of sessions: A, 78 sessions; and G, 106. Some of the reports:
The obvious depersonalization and derealization experiences reported by Deikman's novice subjects while meditating are strikingly similar to the experiences reported below by my more experienced informants outside of meditation. A key to understanding these phenomena may be in studies involving repetitious and stabilized stimuli. Piggins and Morgan (1977) suggest that the stabilized retinal images and repetitious auditory input that characterize some meditation techniques (including TM) may be considered as evoking mild sensory deprivation conditions. This is consistent with the· hypothesis of deautomatization. Sensory deprivation conditions may be interpreted as the mechanism by which the meditator "short-circuits" the automatic functioning of the perceptual and cognitive systems. The diffusion and partial or complete loss of boundary experienced by Deikman's subjects in gazing at the vase is consistent with experiments on visual fixation in which geometrical shapes were observed to fragment, disappear and reappear, as a whole or in part (Evans and Piggins 1963).
DEPERSONALIZATION, MEDITATION, AND ANXIETY
Sheehan (1983) estimates that 50-60% of patients with panic/anxiety disorders have associated symptoms of depersonalization and derealization. The relation between depersonalization and anxiety is still poorly understood. In some cases an experience of depersonalization can precede the onset of anxiety and panic attack (Kennedy 1976; Roth et al. 1965; Sours 1965). However, experiences of depersonalization have been reported in the absence of anxiety (Davison 1964; Deikman 1963, 1966a), and sometimes feelings of anxiety are replaced by depersonalization (Lehmann 1974; Nuller 1982).
Kennedy reported two cases in which patients experienced depersonalization and derealization as a result of meditation practices and suffered sufficient anxiety as a result of their depersonalization to seek psychiatric treatment. In the first of these cases, the patient (a 37-year-old businessman) developed the feeling of being outside his body and looking down on himself after experimenting with a series of meditative exercises described in a book entitled Awareness (Stevens 1971). The patient continued with these experiments over several days until depersonalization and derealization experiences began to occur spontaneously and uncontrollably. The patient sought admission at a local hospital and was treated with tranquilizers and released. However, he sought readmission a few days later in a state of panic because the tranquilizers he had been given (type unstated) seemed to exacerbate his· feelings of unreality. During this second hospitalization ECT was proposed, but the patient refused and was discharged. On the advice of a friend he sought help from a Yoga instructor. The patient stayed with the Yoga instructor for several days, learning about his experiences from the perspective of Yoga psychology. He was then able to return to work, even though the episodes continued to occur, because he felt he had gained enough insight into the occurrences so that he was no longer bothered by them.
The second case involved a 24-year-old man who had been practicing meditative techniques for 2 years and had been experiencing episodes of depersonalization and derealization for at least 18 months prior to being seen by Kennedy. The patient mentioned episodes in which "the sidewalk appeared to disintegrate beneath his feet" (Kennedy 1976, p. 1326). These episodes caused the patient no great concern at first but later the occurrences generated anxiety to the extent that he was unable to maintain employment. After a few sessions of psychotherapy, in which the patient's attitude toward the depersonalization was altered to one of acceptance, the patient was able to resume gainful employment. According to Kennedy:
In these cases, depersonalization occurred first and was followed by panic/anxiety. It is significant that in both cases panic/ anxiety was relieved and occupational functioning restored by the reconstruction of the subjective meaning of the depersonalization in the mind of the patient. This was true even though episodes of depersonalization continued. In medical anthropology this therapeutic process involving the transformation of ideational and emotional factors is known as symbolic healing.
SYMBOLIC HEALING
The therapeutic process in the cases noted above, in which the affected individuals were effectively cured of their anxiety and functional impairment, may be analyzed according to a model of symbolic healing formulated by Dow (1986). According to this model the structure of symbolic healing is as follows:
1. The experiences of healers and healed are generalized with culture-specific symbols in cultural myth.
2. A suffering patient comes to a healer, who persuades the patient that the problem can be defined in terms of the myth.
3. The healer attaches the patient's emotions to transactional symbols particularized from the general myth.
4. The healer manipulates the transactional symbols to help the patient transact his or her emotions (p. 56).
According to Dow, every system of symbolic healing (including modern psychotherapy) is based on a model of experiential reality that he calls its mythic world. The word "mythic" is used to imply that there may exist a cultural reality that is inconsistent with other cultural realities but that is experientially true and real to those who belong to the same culture. This implies that both healer and patient share the same presuppositions about the nature of the world. In the therapeutic process the healer actualizes (i.e., makes real in the present situation) the mythic world for the patient through the use of explanation, suggestion, and persuasion. The healer then isolates part of the mythic world relevant to the patient and interprets the patient's problem in terms of this constructed explanatory model. In the actualization process, transactional symbols are formed that become intellectually and emotionally charged for the patient. Transactional symbols can be any ideas, objects, or actions performed by the healer that facilitate the patient's transformation of emotions and subjective experiential reality. If the patient accepts the healer's explanation as a valid model of his or her problem, then by skillful manipulation of the transactional symbols the patient's emotions and lived experience can be therapeutically altered. Dow, following Ehrenwald, refers to this alteration as the existential shift-that is, a change in the patient's experienced reality creating new opportunities for adaptation. In the above cases, a phenomenon that was previously interpreted as a problem and a cause for anxiety in the mind of the patient was transformed into something benign or even valued, with a consequent alleviation of anxiety and occupational impairment.
One of the above cases may be analyzed in order to explicate the concept of symbolic healing. In the case of the patient who sought help from the Yoga instructor, the patient received instruction in how to interpret his experiences in terms of Yoga psychology. This procedure accomplishes steps 1 and 2 in the process of symbolic healing. The patient becomes socialized into the mythic world of Yoga, and the patient's problem is then defined in terms of this cultural myth. In Yoga psychology, a split in consciousness between an observing self and a participating self is imbued with religious significance. Yoga meditation practices are, in fact, designed to produce a permanent split in consciousness of this type. This permanent split in consciousness is considered to be the ultimate goal of yogic practice (Castillo 1985). Thus, the ideation surrounding the experience of depersonalization is modified from that associated with psychopathology to that of religious experience. In this case, the yogic myth identifies the observing self, present in a depersonalized state of consciousness, as the "spiritual self' or "soul:' Once the patient has accepted the definition of the problem in terms taken from the religious model, the patient's emotions will become attached to symbols associated with this mythic world (step 3). The symbols that articulate this myth are such things as religious texts, ritual objects, and the personal teachings of the healer-in this case, the Yoga instructor. By skillful manipulation of these symbols the healer transforms the patient's emotions and overall subjective experience, providing new opportunities for adaptation to life situations (step 4). I suggest this is the process that operated in this case.
The mythic world of Transcendental Meditation is completely consistent with that of traditional Yoga. The presence of an observing self in consciousness is thought to be an experience of the spiritual self or soul, which the TM meditators call "the Witness:' or "the Higher Self:' Having this experience is called 'Witnessing:' Witnessing is described as the experience of being a witness to one's self that is, being split into an observing self and a participating self. TM meditators interpret these experiences as "higher states of consciousness" or "enlightenment:' In the mythic world of the meditators, Witnessing is considered to be highly desirable. The meditators interviewed in this study were asked if they had ever had any experiences of "Witnessing:' and to describe those experiences. The reports fit the criteria for experiences of depersonalization.
INTERVIEWS WITH MEDITATORS
Mr. A is a 33-year-old research associate in marine geology at a major university. He holds a BA in geology and a PhD in oceanography. He has never been married. He has been practicing TM for 12 years. He reports being in a state that could be described as a mild state of depersonalization almost constantly, accompanied by frequent mild episodes of derealization. He reports no impairment in either social or occupational functioning. His first depersonalization experience occurred 10 years ago, while he was on a 3-month TM residence course.
Mr. A reports that he has had a similar experience almost all the time for the past 3 or 4 years. His derealization experiences are characterized by the perception of bands of color around objects and by vibration.
When asked about his emotions he reported a general lack of emotions combined with an almost constant feeling of mild happiness or contentment.
Ms. B is a 34-year-old graduate student in English as a Second Language. She holds a BA in Philosophy and Religion, and an MEd in Educational Administration. She has never been married. She has been practicing TM for 14 years. She had one experience of depersonalization about 11 years ago, which she considers to be a particularly clear experience of "Witnessing."
Ms. B reports that she has not had any similar experiences since that time; however, when questioned about her present-day general emotional tone she reported a general lack of strong emotions and a mild pervasive feeling of contentment. This might suggest an extremely mild condition of depersonalization that has become so well established as to be unnoticeable. She has not had any experiences of derealization and reports no social or occupational impairment.
Ms. C is a 32-year-old horticulturist in a large urban area. She is the director of an organization that maintains 13 community gardens, and she coordinates the activities of approximately 2,600 volunteer workers. She holds a BA in Ethnobotany and has been practicing TM for one year. She has never been married. She reports no current impairment in her daily activities as a result of her depersonalization experience. She had her first experience of depersonalization, accompanied by acute derealization, about 3 years ago, while practicing a different form of meditation that she used to practice before she began TM. In this meditation she would sit cross-legged on the floor face to face with her boyfriend (about 2 feet apart), and they would gaze at each other for hours at a time. During this experience she felt as if she were lifted out of her body. She became very frightened but was unable to do anything about it. She continued with the meditation, and gradually the fear subsided. She then felt a "total clarity" of mind. "It was like being totally open to everything. I looked around at the trees and it was like I was in Nature, like I was Nature. It was breathing, and I could feel it breathing. Everything was kind of pulsating:' The experience of derealization lasted for several hours, disappearing gradually. The depersonalization continued for 6 weeks after the initial onset. A second depersonalization experience occurred a year later, again induced by the same form of meditation practice and accompanied by acute derealization.
Again, in this experience the derealization gradually disappeared upon the resumption of normal activity, but the depersonalization continued for several weeks. Since beginning the practice of TM about a year ago, Ms. C has had the experience of depersonalization almost constantly. During a recent TM residence course in which she was doing extra meditations, she experienced pronounced vividness in colors and a ''breathing'' quality in the surroundings. When asked about her emotional tone during her present-day activities she replied:
Mr. D is a 42-year-old professor of Business Administration at a major urban university. He holds a BS and MS in Electrical Engineering, an MBA, and a PhD in Management. He is married, with no children. He has been practicing TM for 15 years. He reports no current impairment in social or occupational functioning, although there was significant social impairment when his depersonalization experience began. He had his first experience. of depersonalization 13 years ago during a 3-month TM residence course. This experience continued for 6 months after the completion of the course.
DEPERSONALIZATION AND MEDITATION
Mr. D has been in an almost constant state of depersonalization for the past several years. However, he no longer finds it an uncomfortable experience. He has grown completely accustomed to this mode of functioning and apparently suffers no impairment from it. The only time he experiences any discomfort is on the rare occasions when the depersonalization ceases. This occurs usually only when he is very tired or ill. At these times he becomes temporarily disoriented and has the feeling of "What am I doing here?" When this occurs he is forced to reorient himself to his new perspective. In describing his present state of mind he reported:
When asked about his present emotional state of contentedness he replied, "Contentedness is one of the last things I would have expected out of meditation when I was starting it all off. I mean contentedness is such a strange kind of existence in life. It's very different from what I would have anticipated. I thought that things would be different. The evenness of it all is remarkable:' Mr. D also has frequent mild episodes of derealization. "Things take on a slightly warmer and slightly glossier appearance-like dew."
Mr. E is a 38-year-old chiropractor in a major urban area. He is married, with one child. He has been practicing TM for 14 years. He reports no social or occupational impairment. He also had his first depersonalization experience during an extended TM residence course, which occurred about 12 years ago. "I left my room after a lot of meditation, and I went down for a meal, and part of me was eating the meal and part of me was sitting inside laughing:' This initial episode was short-lived (only a few minutes), but in recent years he estimates that he has a similar experience in a mild form a large part of the time.
Mr. E also has infrequent experiences of mild derealization. "There is a definite aliveness in the environment, almost as if you're aware that there is consciousness in everything:' When asked about his present emotional experience he replied, "A normal day for me is when everything just goes right. When things don't go right, then I think it's strange. But my emotions are not as ecstatic as you might imagine, it's more even. I would say sort of warm; and it's very fulfilling in a knowing sort of sense rather than in a feeling sense."
Mr. F is a 43-year-old probation officer in a suburban area. He holds a BS in Behavioral Science and an MS in Counseling Psychology. He has been divorced for 10 years. He has three children, one grown and two in the custody of his ex-wife. He has been practicing TM for 12 years. His first depersonalization experience was a brief episode during a TM residence course 8 years ago. He now has a similar experience "more than 50 % of the time."
Mr. F has episodes of depersonalization most frequently while he is working, usually writing up case reports, and he experiences no impairment in his functioning. He reports that the efficiency of his work seems to be enhanced during these episodes and the work seems more effortless. "It would feel just like the writing was flowing out as I was doing it. And yet part of me was just sitting back watching the whole thing taking place." His emotional tone is similar to the other informants. "Usually very contented but not aroused-in other words, not ecstatically joyful, but just a sort of low level of happiness or contentment." He has also had frequent episodes of mild derealization.
None of the informants reported a personal history of psychiatric disorder; however, family medical histories were not obtained. In addition, the informants were not given a physical examination; thus the possibility of organic pathology cannot be ruled out. Nevertheless, the well-documented ease of inducing a depersonalized state through the use of repetitive stimuli and/or stabilized sensory input (as in TM, which utilizes the repetition of a mantra) lends weight to the conclusion that the depersonalization was induced by meditation (Deikman 1966a, b; Lex 1979; Ornstein 1977; Piggins and Morgan 1977; Renik 1978). Moreover, this conclusion is supported by the fact that this type of split in consciousness is the stated intention of yogic meditation practice (Castillo 1985).
CONCLUSION
The salient features of the experience of depersonalization in the meditators interviewed are: 1) the experience can become a continuous, apparently permanent mode of functioning in the individual; 2) there need not be any significant impairment in social or occupational functioning; 3) there may be the subjective experience of improvement of performance in occupational functioning; 4) there is the apparent long-term loss of the ability to feel strong emotions, either negative or positive; 5) a subjective experience of constant mild pleasantness or contentment may be present; 6) the affective nature of the experience appears to be strongly connected to the symbolic content attached to depersonalization; 7) generally mild episodes of derealization are common.
All of the meditators interviewed are successful in their careers, are apparently satisfied with their lives and optimistic about the future, and are very friendly, personable people. Their lives seem to run smoothly, with the absence of any significant anxiety or stress. I maintain that they feel comfortable with their depersonalization because they view the experience positively. I suggest that the relative lack of reported anxiety in response to the depersonalization is a result of the ideational construction of the experiences in terms consistent with the mythic model of TM. In other words, instead of "pathologizing" the experiences - that is, interpreting them as psychopathology according to a medical model of reality - they are "sacralizing" the experiences - that is, interpreting them according to a sacred model of reality. Therefore, I suggest that the presence or absence of panic/anxiety in association with depersonalization can be a function of the nature of the ideational construction of the experience in the mind of the individual.
For example, in a depersonalized condition, if the individual holds catastrophic interpretations of this state, such as, "I am going crazy" (one of the diagnostic criteria of a panic attack), then a panic/anxiety response may result. However, if in the same situation the individual interprets the episode with the thought, "I am having a sacred experience:' then an entirely different bodily response may develop, characterized by lack of arousal and parasympathetic dominance (Lex 1979).
There are implications of this study for research on Depersonalization Disorder. It is possible that Depersonalization Disorder is a culture-bound syndrome. The apparent ease by which depersonalization can be induced and its high incidence in the normal as well as psychiatric populations indicate that it is indeed some sort of natural response of the brain to the environment. However, the response of the individual to depersonalization and derealization seems to be quite variable and subject to shaping by social and cultural factors. The "mythic world" of some individuals, lacking any other alternative for depersonalization/derealization, may be pathologizing what could be viewed as a normal experience, transforming it into an episode of mental illness.
Because it is estimated that 50-60 % of all patients with panic/anxiety disorders suffer from depersonalization (Sheehan 1983), there are also implications for research in this area. Depersonalization is generally seen as a symptom of Panic Disorder, and a diagnosis of Depersonalization Disorder will not be made if panic is present as a symptom. In that case, DSMIII- R recommends Panic Disorder as the proper diagnosis. However, it may be that if the assigned meaning of depersonalization in the mind of the patient includes catastrophic interpretations, then panic may be the result of depersonalization, rather than the reverse, which seems to be the prevailing assumption in present diagnostic opinion. Further, the effectiveness of symbolic healing in alleviating panic/ anxiety in depersonalized individuals, and thereby diminishing functional impairment, suggests psychotherapy as a preferred treatment instead of the use of tranquilizers, which can heighten feelings of dissociation and unreality.
_______________
REFERENCES
AMERICAN PSYCHIATRIC ASSOCIATION (APA). Diagnostic and Statistical Manual of Mental Disorders. 3rd ed., rev. American Psychiatric Association, 1987.
BLISS, E. L., CLARK, L. D., and WEST, C. D. Studies in sleep deprivation-relationship to schizophrenia. Archives of Neurological Psychiatry (1959) 81:348-59.
CASTILLO, R. J. The transpersonal psychology of Pataiijali's Yoga-Slltra (Book I: Samddhi): A translation and interpretation. Journal of Mind and Behavior (1985) 6:391-417.
DAVISON, K. Episodic depersonalization. British Journal of Psychiatry (1964) 110:505-13.
DEIKMAN, A. J. Experimental meditation. Journal of Nervous and Mental Disease (1963) 136:329-43.
DEIKMAN, A. J. Implications of experimentally induced contemplative meditation. Journal of Nervous and Mental Disease (1966a) 142:101-16.
DEIKMAN, A. J. De-automatization and the mystic experience. Psychiatry (1966b) 29:324-38.
DIXON, J. C. Depersonalization phenomena in a sample population of college students. British Journal of Psychiatry (1963) 109:371-75.
Dow, J. Universal aspects of symbolic healing: A theoretical synthesis. American Anthropologist (1968) 88:56-69.
EVANS, C. R., and PIG GINS, D. J. A comparison of the behaviour of geometrical shapes when viewed under conditions of steady fixation and with apparatus for producing a stabilised retinal image. British Journal of Physiological Optics (1963) 20: 1-13.
FELSINGER, J. M., LASAGNA, L., and BEECHER, H. K. The response of normal men to lysergic acid derivatives. Correlation of personality and drug reactions. Journal of Clinical and Experimental Psychopathology (1956) 17:414-28.
GUTTMAN, E., and MACLAY, W. S. Mescaline and depersonalization: Therapeutic experiments. Journal of Neurology and Psychopathology (1936) 16:193- 212.
KENNEDY, R. B. Self-induced depersonalization syndrome. American Journal of Psychiatry (1976) 133:1326-28.
LEHMANN, L. S. Depersonalization. American Journal of Psychiatry (1974) 131:1221-24.
LEVY, J. S., and WACHTEL, P. L. Depersonalization: An effort at clarification. American Journal of Psychoanalysis (1978) 38:291-300.
LEX, B. The neurobiology of ritual trance. In E. Aquili, C. Laughlin and J. McManus, eds., The Spectrum of Ritual: A Biogenetic Structural Analysis. Columbia University Press, 1979.
MAYER-GROSS, W. On depersonalization. British Journal of Medical Psychology (1935) 15:103-26.
NULLER, Y. L. Depersonalization: Symptoms, meaning, therapy. Acta Psychiatrica Scandinavica (1982) 66:451-58.
ORNSTEIN, R. E. The Psychology of Consciousness. 2d ed. Harcourt Brace Jovanovich, 1977.
PIGGINS, D., and MORGAN, D. Note upon steady visual fixation and repeated auditory stimulation in meditation and in the laboratory. Perceptual and Motor Skills (1977) 44:357-58.
REED, G. F., and SEDMAN, G. Personality and depersonalization under sensory deprivation conditions. Perceptual and Motor Skills (1964) 18:659- 60.
RENIK, O. The role of attention in depersonalization. Psychoanalytic Quarterly (1978) 47:588-605.
ROTH, M., GARSIDE, R. F., and GURNEY, C. Clinical and statistical enquiries into the classification of anxiety states and depressive disorders. In Proceedings of Leeds Symposium on Behavioural Disorders. London: May and Baker, 1965.
SEDMAN, G. Depersonalization in a group of normal subjects. British Journal of Psychiatry (1966) 112: 907-12.
SHEEHAN, D. V. The Anxiety Disease. Scribner's, 1983.
SHRABERG, D. The phobic anxiety-depersonalization syndrome. Psychiatric Opinion (1977) 14:35-40.
SOURS, J. L. The "break-off' phenomenon. Archives of General Psychiatry (1965) 13:447-56.
STEVENS, J. O. Awareness. Moab, Utah: Real People Press, 1971.
STOLOROW, R. S. Defensive and arrested development aspects of death anxiety, hypochondriasis and depersonalization. International Journal of Psycho-Analysis (1979) 60:201-13.
TAYLOR, F. K. Depersonalization in the light of Brentano's phenomenology. British Journal of Medical Psychology (1982) 55:297-306.
TORCH, E. M. Depersonalization syndrome: An overview. Psychiatric Quarterly (1981) 50:249-58.
TRUEMAN, D. Depersonalization in a nonclinical population. Journal of Psychology (1984) 116:107-12. PSYCHIATRY, Vol. 53, May 1990
Richard J. Castillo, MA, is a PhD Candidate, Department of Anthropology, Harvard University, and Lecturer in Anthropology, University of Hawaii at West Oahu, Pearl City, HI 96782 (mailing address).
The research for this paper was supported by a National Science Foundation Predoctoral Fellowship.
The author is indebted to Professors Arthur Kleinman, Byron Good and Charles Lindholm of the Anthropology Department, Harvard University, for their many valuable insights and criticisms on earlier drafts of this paper.
by Richard J. Castillo
Castillo, Richard J Psychiatry; May 1, 1990; 53, 2; ProQuest pg. 158
Copyright © 2009 ProQuest LLC. All rights reserved.
PSYCHIATRY, Vol. 53, May 1990
NOTICE: THIS WORK MAY BE PROTECTED BY COPYRIGHT
YOU ARE REQUIRED TO READ THE COPYRIGHT NOTICE AT THIS LINK BEFORE YOU READ THE FOLLOWING WORK, THAT IS AVAILABLE SOLELY FOR PRIVATE STUDY, SCHOLARSHIP OR RESEARCH PURSUANT TO 17 U.S.C. SECTION 107 AND 108. IN THE EVENT THAT THE LIBRARY DETERMINES THAT UNLAWFUL COPYING OF THIS WORK HAS OCCURRED, THE LIBRARY HAS THE RIGHT TO BLOCK THE I.P. ADDRESS AT WHICH THE UNLAWFUL COPYING APPEARED TO HAVE OCCURRED. THANK YOU FOR RESPECTING THE RIGHTS OF COPYRIGHT OWNERS.
FROM a review of the literature on meditation and depersonalization and interviews conducted with six meditators, this study concludes that: 1) meditation can cause depersonalization and derealization; 2) the meanings in the mind of the meditator regarding the experience of depersonalization will determine to a great extent whether anxiety is present as part of the experience; 3) there need not be any significant anxiety or impairment in social or occupational functioning as a result of depersonalization; 4) a depersonalized state can become an apparently permanent mode of functioning; 5) patients with Depersonalization Disorder may be treated through a process of symbolic healing that is, changing the meanings associated with depersonalization in the mind of the patient, thereby reducing anxiety and functional impairment; 6) panic! anxiety may be caused by depersonalization if catastrophic interpretations of depersonalization are present.
Deikman (1963, 1966a), and Kennedy (1976) reported cases in which depersonalization and derealization occurred in individuals practicing meditative techniques designed to alter consciousness. Deikman's cases reported depersonalization and derealization during meditation practice. Kennedy's cases reported these conditions in waking consciousness. In order to determine whether experiences of depersonalization and derealization were occurring in the waking consciousness of meditators, six practitioners of Transcendental Meditation (TM) were interviewed regarding their subjective experiences while engaged in daily activity. All of the persons interviewed reported having at least one experience of what could be classified as depersonalization.
DEPERSONALIZATION
DSM-III-R (APA 1987) defines depersonalization as: "(1) an experience of being as if detached from and an outside observer of one's mental processes or body; or (2) an experience of feeling like an automaton or as if in a dream" (p. 276). Typically, depersonalization is a state in which an individual experiences a "split" in consciousness between a "participating self' and an "observing self." The participating self is composed of body, thoughts, feelings, memories, and emotions. The observing self is experienced as a separate, uninvolved "witness" of the participating self, with the perception that all of the normal aspects of personality are somehow unreal and do not belong to the observing self. There is the experience of being split off from one's participating self and ''watching'' that self behave. The split between the two "selves" is clearly illustrated by descriptions of the experience given by psychiatric patients:
"I had the impression as though I led a double existence. Everything 1 did and said seemed to issue from one ego, yet I also had the definite impression that there was a second ego as well, and that this second ego looked on the activities of the first as though they belonged to a different being .... I could think of this [observed] ego as one thinks of an object and was often surprised by what it did .... What oppressed me most was this incessant observation by my second ego. I moved like a machine in a strange environment." [Taylor 1982, p. 303]
"None of this makes any sense. I laugh but it's like someone else is laughing. It is as though there is a part of me watching and a part of me doing it." [Torch 1981, p. 250]
There are also secondary characteristics of depersonalization, which may include: feelings of dizziness, floating, or giddiness, a feeling of the participating self being "dead," a loss of affective responsiveness, and a feeling of calm detachment (Levy and Wachtel 1978).
Depersonalization, an experience in which the perception of the self is altered, is sometimes accompanied by derealization, an experience in which perception of one's environment is altered. In derealization the environment may take on a two-dimensional or "unreal" quality. Sometimes, normally stable, solid, inanimate objects may be seen to vibrate, or ''breathe:' to be unsolid, fluid, or alive. Shapes and sizes of objects may change, or objects may disappear altogether. Colors may be especially vivid, and some objects may be seen as "shimmering."
Persons experiencing depersonalization frequently report an especially distinct separation between the observing self and mental activities. When these mental activities are cognitive in nature, the affected individuals complain that it seems as if they are not doing their own thinking, imaging, or remembering because they can observe an independent flow of these phenomena in their minds. When the mental activities are affective in nature, the persons will often complain not that their emotions are changed in quality, but rather that there is a loss of emotions (Taylor 1982).
DSM-III-R includes a Depersonalization Disorder (300.60), which has as its diagnostic criteria:
A. Persistent or recurrent experiences of depersonalization as indicated by either (1) or (2) [see above]. B. During the depersonalization experience reality-testing remains intact. C. The depersonalization is sufficiently severe and persistent to cause marked distress. D. The depersonalization experience is the predominant disturbance and not a symptom of another disorder, such as Schizophrenia, Panic Disorder, or Agoraphobia without History of Panic Disorder but with limited symptom attacks of depersonalization, or temporal lobe epilepsy. [pp. 276-77]
Depersonalization may be present as a related symptom in all of these various disorders and is thus a fairly common experience in psychiatric populations.
Depersonalization also occurs in the nonclinical population. DSM-III-R estimates that single brief episodes of depersonalization may occur at some time in as many as 70% of young adults. This estimate is supported by the findings of Dixon (1963), Sedman (1966), and Trueman (1984). Dixon observed that over half of his college student subjects could recognize descriptions of depersonalization as something they had experienced. When one takes into account the high incidence of depersonalization, in both the clinical and the nonclinical populations, it is not surprising that many authors postulate an organic basis or substrate for its occurrence. Mayer-Gross (1935), for example, considered depersonalization a "preformed functional response of the brain": a physiological disturbance that could be triggered by a wide variety of factors.
The etiology of depersonalization is un- known, but in addition to the disorders mentioned in DSM-III-R, depersonalization has been linked with prolonged sleep deprivation (Bliss et al. 1959), ingestion of hallucinogenic drugs (Felsinger et al. 1956; Guttman and Maclay 1936), sensory deprivation (Reed and Sedman 1964), feelings of anxiety (Lehmann 1974; Nuller 1982), and alterations in the person's mode of attention, such as prolonged gazing at a particular object (Deikman 1963, 1966a; Levy and Wachtel 1978; Renik 1978). Psychoanalytic writers on depersonalization have emphasized the defensive function of this experience. Most analytic writers see depersonalization as a means of defending against guilt, painful affects, intense conflict, danger, or conflicting ego identities (Lehmann 1974; Levy and Wachtel 1978; Shraberg 1977; Stolorow 1979).
MEDITATION AND DEAUTOMATIZATION
Deikman has referred to the effects of meditation as the "de-automatization of the psychological structures that organize, limit, select, and interpret perceptual stimuli" (1966b p. 329). In his experiments on meditation, Deikman (1966a) had inexperienced subjects gaze at a blue vase resting on a simple brown end table. The subjects sat for 30 minutes gazing at the vase and were then interviewed regarding their experiences. Most of the Deikman's data came from two subjects, A and G, who completed the longest series of sessions: A, 78 sessions; and G, 106. Some of the reports:
A, 54th session: "It was also as though we were together, you know, instead of being a table and a vase and me, my body and the chair, it all dissolved into a bundle of something which had ... a great deal of energy to it but which doesn't form into anything but only feels like a force:' [1966a, p. 105]
G, 62nd session: " ... things seem to sharpen and there is a different nature to the substance of things. It's as though I'm seeing between the molecules ... the usual mass of solidity loses its density or mass and becomes separate." [1966a, p. 113]
A, 58th session: "The only way I can think of to describe it is being suspended between something and something, because the world all but disappears, you know, the usual world ... so that I'm in a world of converging with that, whatever it is, and that's all there is:' [1966a, p. 113]
G, 74th session: " ... solid material such as myself and the vase and the table ... seems to be attributed then with this extra property of flexibility such as in its natural, fluid state:' [1966a, p. 113]
The obvious depersonalization and derealization experiences reported by Deikman's novice subjects while meditating are strikingly similar to the experiences reported below by my more experienced informants outside of meditation. A key to understanding these phenomena may be in studies involving repetitious and stabilized stimuli. Piggins and Morgan (1977) suggest that the stabilized retinal images and repetitious auditory input that characterize some meditation techniques (including TM) may be considered as evoking mild sensory deprivation conditions. This is consistent with the· hypothesis of deautomatization. Sensory deprivation conditions may be interpreted as the mechanism by which the meditator "short-circuits" the automatic functioning of the perceptual and cognitive systems. The diffusion and partial or complete loss of boundary experienced by Deikman's subjects in gazing at the vase is consistent with experiments on visual fixation in which geometrical shapes were observed to fragment, disappear and reappear, as a whole or in part (Evans and Piggins 1963).
DEPERSONALIZATION, MEDITATION, AND ANXIETY
Sheehan (1983) estimates that 50-60% of patients with panic/anxiety disorders have associated symptoms of depersonalization and derealization. The relation between depersonalization and anxiety is still poorly understood. In some cases an experience of depersonalization can precede the onset of anxiety and panic attack (Kennedy 1976; Roth et al. 1965; Sours 1965). However, experiences of depersonalization have been reported in the absence of anxiety (Davison 1964; Deikman 1963, 1966a), and sometimes feelings of anxiety are replaced by depersonalization (Lehmann 1974; Nuller 1982).
Kennedy reported two cases in which patients experienced depersonalization and derealization as a result of meditation practices and suffered sufficient anxiety as a result of their depersonalization to seek psychiatric treatment. In the first of these cases, the patient (a 37-year-old businessman) developed the feeling of being outside his body and looking down on himself after experimenting with a series of meditative exercises described in a book entitled Awareness (Stevens 1971). The patient continued with these experiments over several days until depersonalization and derealization experiences began to occur spontaneously and uncontrollably. The patient sought admission at a local hospital and was treated with tranquilizers and released. However, he sought readmission a few days later in a state of panic because the tranquilizers he had been given (type unstated) seemed to exacerbate his· feelings of unreality. During this second hospitalization ECT was proposed, but the patient refused and was discharged. On the advice of a friend he sought help from a Yoga instructor. The patient stayed with the Yoga instructor for several days, learning about his experiences from the perspective of Yoga psychology. He was then able to return to work, even though the episodes continued to occur, because he felt he had gained enough insight into the occurrences so that he was no longer bothered by them.
The second case involved a 24-year-old man who had been practicing meditative techniques for 2 years and had been experiencing episodes of depersonalization and derealization for at least 18 months prior to being seen by Kennedy. The patient mentioned episodes in which "the sidewalk appeared to disintegrate beneath his feet" (Kennedy 1976, p. 1326). These episodes caused the patient no great concern at first but later the occurrences generated anxiety to the extent that he was unable to maintain employment. After a few sessions of psychotherapy, in which the patient's attitude toward the depersonalization was altered to one of acceptance, the patient was able to resume gainful employment. According to Kennedy:
The intriguing aspect of this is that apparently by using virtually the same mental maneuvers a syndrome may be produced that, depending on the attitude the person adopts toward himself and then toward the resulting phenomenon, may be experienced either as something to be sought and valued or as something to be feared and called a disease. Perhaps what we need to do with patients who exhibit primarily a depersonalization syndrome is to teach them first to accept themselves uncritically and second to accept their depersonalization. [p. 1327]
In these cases, depersonalization occurred first and was followed by panic/anxiety. It is significant that in both cases panic/ anxiety was relieved and occupational functioning restored by the reconstruction of the subjective meaning of the depersonalization in the mind of the patient. This was true even though episodes of depersonalization continued. In medical anthropology this therapeutic process involving the transformation of ideational and emotional factors is known as symbolic healing.
SYMBOLIC HEALING
The therapeutic process in the cases noted above, in which the affected individuals were effectively cured of their anxiety and functional impairment, may be analyzed according to a model of symbolic healing formulated by Dow (1986). According to this model the structure of symbolic healing is as follows:
1. The experiences of healers and healed are generalized with culture-specific symbols in cultural myth.
2. A suffering patient comes to a healer, who persuades the patient that the problem can be defined in terms of the myth.
3. The healer attaches the patient's emotions to transactional symbols particularized from the general myth.
4. The healer manipulates the transactional symbols to help the patient transact his or her emotions (p. 56).
According to Dow, every system of symbolic healing (including modern psychotherapy) is based on a model of experiential reality that he calls its mythic world. The word "mythic" is used to imply that there may exist a cultural reality that is inconsistent with other cultural realities but that is experientially true and real to those who belong to the same culture. This implies that both healer and patient share the same presuppositions about the nature of the world. In the therapeutic process the healer actualizes (i.e., makes real in the present situation) the mythic world for the patient through the use of explanation, suggestion, and persuasion. The healer then isolates part of the mythic world relevant to the patient and interprets the patient's problem in terms of this constructed explanatory model. In the actualization process, transactional symbols are formed that become intellectually and emotionally charged for the patient. Transactional symbols can be any ideas, objects, or actions performed by the healer that facilitate the patient's transformation of emotions and subjective experiential reality. If the patient accepts the healer's explanation as a valid model of his or her problem, then by skillful manipulation of the transactional symbols the patient's emotions and lived experience can be therapeutically altered. Dow, following Ehrenwald, refers to this alteration as the existential shift-that is, a change in the patient's experienced reality creating new opportunities for adaptation. In the above cases, a phenomenon that was previously interpreted as a problem and a cause for anxiety in the mind of the patient was transformed into something benign or even valued, with a consequent alleviation of anxiety and occupational impairment.
One of the above cases may be analyzed in order to explicate the concept of symbolic healing. In the case of the patient who sought help from the Yoga instructor, the patient received instruction in how to interpret his experiences in terms of Yoga psychology. This procedure accomplishes steps 1 and 2 in the process of symbolic healing. The patient becomes socialized into the mythic world of Yoga, and the patient's problem is then defined in terms of this cultural myth. In Yoga psychology, a split in consciousness between an observing self and a participating self is imbued with religious significance. Yoga meditation practices are, in fact, designed to produce a permanent split in consciousness of this type. This permanent split in consciousness is considered to be the ultimate goal of yogic practice (Castillo 1985). Thus, the ideation surrounding the experience of depersonalization is modified from that associated with psychopathology to that of religious experience. In this case, the yogic myth identifies the observing self, present in a depersonalized state of consciousness, as the "spiritual self' or "soul:' Once the patient has accepted the definition of the problem in terms taken from the religious model, the patient's emotions will become attached to symbols associated with this mythic world (step 3). The symbols that articulate this myth are such things as religious texts, ritual objects, and the personal teachings of the healer-in this case, the Yoga instructor. By skillful manipulation of these symbols the healer transforms the patient's emotions and overall subjective experience, providing new opportunities for adaptation to life situations (step 4). I suggest this is the process that operated in this case.
The mythic world of Transcendental Meditation is completely consistent with that of traditional Yoga. The presence of an observing self in consciousness is thought to be an experience of the spiritual self or soul, which the TM meditators call "the Witness:' or "the Higher Self:' Having this experience is called 'Witnessing:' Witnessing is described as the experience of being a witness to one's self that is, being split into an observing self and a participating self. TM meditators interpret these experiences as "higher states of consciousness" or "enlightenment:' In the mythic world of the meditators, Witnessing is considered to be highly desirable. The meditators interviewed in this study were asked if they had ever had any experiences of "Witnessing:' and to describe those experiences. The reports fit the criteria for experiences of depersonalization.
INTERVIEWS WITH MEDITATORS
Mr. A is a 33-year-old research associate in marine geology at a major university. He holds a BA in geology and a PhD in oceanography. He has never been married. He has been practicing TM for 12 years. He reports being in a state that could be described as a mild state of depersonalization almost constantly, accompanied by frequent mild episodes of derealization. He reports no impairment in either social or occupational functioning. His first depersonalization experience occurred 10 years ago, while he was on a 3-month TM residence course.
I was sitting in a lecture listening to someone speak. The first thing I noticed was a slight change in· my vision. The change was like a camera lens zooming out, a pulling back. There was a sort of tunnel vision associated with it so that I had the sensation that instead of looking from the front of my head I was looking from behind, through my eyes. A certain calmness pervaded everything. It was very much a feeling of "watching:' This sensation lasted for about 15 minutes or so, and then faded out. I didn't feel particularly wonderful. I recognized about half way through it what was happening.
Mr. A reports that he has had a similar experience almost all the time for the past 3 or 4 years. His derealization experiences are characterized by the perception of bands of color around objects and by vibration.
I also tend to see bands of color around people and objects. Objects have a slight vibratory quality to them. They don't lose their distinctness of outline though. The boundaries between objects are vibrating but sharp. In other words, the boundaries are not flowing together, but they're not rigid, almost as if objects were alive and breathing. They don't change shape, it's just sort of a liveliness to them.
When asked about his emotions he reported a general lack of emotions combined with an almost constant feeling of mild happiness or contentment.
There are certainly no negative emotions. The emotions are not strong, maybe a mild sense of happiness. It's not a strong feeling-in fact, it's almost an absence of emotion. There's a slight positive emotion, but it's not a "bursting with joy" kind of emotion. It's a more passive state than that. It has the quality more of observing it than experiencing it. I'm used to it now. It's not remarkable anymore. It's just sort of normal. But I don't want to leave the thing sounding better than it is, because it's not bad, but it's not wonderful.
Ms. B is a 34-year-old graduate student in English as a Second Language. She holds a BA in Philosophy and Religion, and an MEd in Educational Administration. She has never been married. She has been practicing TM for 14 years. She had one experience of depersonalization about 11 years ago, which she considers to be a particularly clear experience of "Witnessing."
I was talking to someone and all of a sudden it felt like I wasn't doing the talking. And it was a very disconcerting experience because you always like to feel like you're in charge. And all of a sudden I had the feeling, "Who's doing this talking? It's not me." So I was listening to my voice and the words came out without my doing it. I was continuing to speak but I wasn't part of the experience. It feels like a dichotomy. You're so used to being a part of the experience you're undergoing that to all of a sudden not be part of that is very strange. Gradually the experience just faded. I couldn't make it stop, it just went by itself. It lasted about 45 minutes. It's very difficult to explain. The activity was going on but I wasn't doing the activity.
Ms. B reports that she has not had any similar experiences since that time; however, when questioned about her present-day general emotional tone she reported a general lack of strong emotions and a mild pervasive feeling of contentment. This might suggest an extremely mild condition of depersonalization that has become so well established as to be unnoticeable. She has not had any experiences of derealization and reports no social or occupational impairment.
Ms. C is a 32-year-old horticulturist in a large urban area. She is the director of an organization that maintains 13 community gardens, and she coordinates the activities of approximately 2,600 volunteer workers. She holds a BA in Ethnobotany and has been practicing TM for one year. She has never been married. She reports no current impairment in her daily activities as a result of her depersonalization experience. She had her first experience of depersonalization, accompanied by acute derealization, about 3 years ago, while practicing a different form of meditation that she used to practice before she began TM. In this meditation she would sit cross-legged on the floor face to face with her boyfriend (about 2 feet apart), and they would gaze at each other for hours at a time. During this experience she felt as if she were lifted out of her body. She became very frightened but was unable to do anything about it. She continued with the meditation, and gradually the fear subsided. She then felt a "total clarity" of mind. "It was like being totally open to everything. I looked around at the trees and it was like I was in Nature, like I was Nature. It was breathing, and I could feel it breathing. Everything was kind of pulsating:' The experience of derealization lasted for several hours, disappearing gradually. The depersonalization continued for 6 weeks after the initial onset. A second depersonalization experience occurred a year later, again induced by the same form of meditation practice and accompanied by acute derealization.
We were sitting face to face, and his whole face turned to plastic, and then it melted, and then there were just his eyes. Then he disappeared, and all I could see was golden light, and then green light, and then white light. For three days we just sat there. We got up to get water and to go to the bathroom, and we slept at night, but the rest of the time we just sat there because we were so amazed.
Again, in this experience the derealization gradually disappeared upon the resumption of normal activity, but the depersonalization continued for several weeks. Since beginning the practice of TM about a year ago, Ms. C has had the experience of depersonalization almost constantly. During a recent TM residence course in which she was doing extra meditations, she experienced pronounced vividness in colors and a ''breathing'' quality in the surroundings. When asked about her emotional tone during her present-day activities she replied:
I don't feel elated or anything, it just feels normal. I feel very comfortable. My monthly period is not affecting me like it used to. I'm hardly getting any reaction from that, and that's usually the only problem I have with my emotions now; a certain time of the month and a certain change in the hormones, and that's about it. Although I do feel sort of half in the world and half out.
Mr. D is a 42-year-old professor of Business Administration at a major urban university. He holds a BS and MS in Electrical Engineering, an MBA, and a PhD in Management. He is married, with no children. He has been practicing TM for 15 years. He reports no current impairment in social or occupational functioning, although there was significant social impairment when his depersonalization experience began. He had his first experience. of depersonalization 13 years ago during a 3-month TM residence course. This experience continued for 6 months after the completion of the course.
DEPERSONALIZATION AND MEDITATION
It was like being a pure impersonal observer watching a movie. There was a real distance between the inner being and the outer being. There was a real pureness and coolness, and noninvolvement, and no emotions. Everything I would say and every emotion that I had from the viewpoint of that "inner thing:' which is what I was, was just phony. It was like living in a movie where you knew it was a movie. Emotions had no relationship to that "inner being"; they were as phony as a bad movie. This made me uncomfortable. It was very different living than the kind of living you ordinarily have. People that I had known for years - they meant nothing to me. There was no real connection. It was like I would just sit there and watch it all go by.
Mr. D has been in an almost constant state of depersonalization for the past several years. However, he no longer finds it an uncomfortable experience. He has grown completely accustomed to this mode of functioning and apparently suffers no impairment from it. The only time he experiences any discomfort is on the rare occasions when the depersonalization ceases. This occurs usually only when he is very tired or ill. At these times he becomes temporarily disoriented and has the feeling of "What am I doing here?" When this occurs he is forced to reorient himself to his new perspective. In describing his present state of mind he reported:
Now it's like a movie, but it's a good movie. I am content, but I'm not moved by it, or thrilled by it. I'm content with it. I'm part of it but separate from it at the same time .... There is really a sense of non attachment to life. I'm definitely there, and my life is definitely going on around me-and I'm part of it, but I'm not part of it .... I have a problem when I get kicked out of this thing. Because it takes real time to change over and function in another state. I can't go between them just like that [snapping his fingers].
When asked about his present emotional state of contentedness he replied, "Contentedness is one of the last things I would have expected out of meditation when I was starting it all off. I mean contentedness is such a strange kind of existence in life. It's very different from what I would have anticipated. I thought that things would be different. The evenness of it all is remarkable:' Mr. D also has frequent mild episodes of derealization. "Things take on a slightly warmer and slightly glossier appearance-like dew."
Mr. E is a 38-year-old chiropractor in a major urban area. He is married, with one child. He has been practicing TM for 14 years. He reports no social or occupational impairment. He also had his first depersonalization experience during an extended TM residence course, which occurred about 12 years ago. "I left my room after a lot of meditation, and I went down for a meal, and part of me was eating the meal and part of me was sitting inside laughing:' This initial episode was short-lived (only a few minutes), but in recent years he estimates that he has a similar experience in a mild form a large part of the time.
My experience in general though is that it's not a clear something that I remember, but it could be happening more often than I notice. Sometimes when you first start having these experiences they seem flashy, but after a while you're not even sure if you've had them. The first few times it's really flashy, but then you probably have them a lot more and you don't really notice. Although sometimes there's a perceptual shift-like you're looking through a tube or a telescope-like you're looking at something from somewhere else. But I think that you would become comfortable with that if it was happening all the time.
Mr. E also has infrequent experiences of mild derealization. "There is a definite aliveness in the environment, almost as if you're aware that there is consciousness in everything:' When asked about his present emotional experience he replied, "A normal day for me is when everything just goes right. When things don't go right, then I think it's strange. But my emotions are not as ecstatic as you might imagine, it's more even. I would say sort of warm; and it's very fulfilling in a knowing sort of sense rather than in a feeling sense."
Mr. F is a 43-year-old probation officer in a suburban area. He holds a BS in Behavioral Science and an MS in Counseling Psychology. He has been divorced for 10 years. He has three children, one grown and two in the custody of his ex-wife. He has been practicing TM for 12 years. His first depersonalization experience was a brief episode during a TM residence course 8 years ago. He now has a similar experience "more than 50 % of the time."
I don't know how to describe it. It's like I'm not totally there while I'm doing the activity. But it's not like I'm not paying attention. It's like I'm not totally caught up in the activity. It's like my body and the activity are doing it themselves and I'm just sort of watching it. ... Thoughts are going on by themselves more in relationship with the activity, and it's like I'm something other than that watching it.
Mr. F has episodes of depersonalization most frequently while he is working, usually writing up case reports, and he experiences no impairment in his functioning. He reports that the efficiency of his work seems to be enhanced during these episodes and the work seems more effortless. "It would feel just like the writing was flowing out as I was doing it. And yet part of me was just sitting back watching the whole thing taking place." His emotional tone is similar to the other informants. "Usually very contented but not aroused-in other words, not ecstatically joyful, but just a sort of low level of happiness or contentment." He has also had frequent episodes of mild derealization.
It's like spots or something. I don't know what you'd call it. In other words, it's like there's all kinds of little moving things [laughter]. Objects are not as solid. They're more like - millions of little spots would be the nearest. And boundaries between objects are more fluid. They're less defined because the whole object itself seems to be moving-not literally moving, but sort of on some level moving, almost like you looked through heat - how it shimmers. Sort of like that, but not exactly like that, but along that line.
None of the informants reported a personal history of psychiatric disorder; however, family medical histories were not obtained. In addition, the informants were not given a physical examination; thus the possibility of organic pathology cannot be ruled out. Nevertheless, the well-documented ease of inducing a depersonalized state through the use of repetitive stimuli and/or stabilized sensory input (as in TM, which utilizes the repetition of a mantra) lends weight to the conclusion that the depersonalization was induced by meditation (Deikman 1966a, b; Lex 1979; Ornstein 1977; Piggins and Morgan 1977; Renik 1978). Moreover, this conclusion is supported by the fact that this type of split in consciousness is the stated intention of yogic meditation practice (Castillo 1985).
CONCLUSION
The salient features of the experience of depersonalization in the meditators interviewed are: 1) the experience can become a continuous, apparently permanent mode of functioning in the individual; 2) there need not be any significant impairment in social or occupational functioning; 3) there may be the subjective experience of improvement of performance in occupational functioning; 4) there is the apparent long-term loss of the ability to feel strong emotions, either negative or positive; 5) a subjective experience of constant mild pleasantness or contentment may be present; 6) the affective nature of the experience appears to be strongly connected to the symbolic content attached to depersonalization; 7) generally mild episodes of derealization are common.
All of the meditators interviewed are successful in their careers, are apparently satisfied with their lives and optimistic about the future, and are very friendly, personable people. Their lives seem to run smoothly, with the absence of any significant anxiety or stress. I maintain that they feel comfortable with their depersonalization because they view the experience positively. I suggest that the relative lack of reported anxiety in response to the depersonalization is a result of the ideational construction of the experiences in terms consistent with the mythic model of TM. In other words, instead of "pathologizing" the experiences - that is, interpreting them as psychopathology according to a medical model of reality - they are "sacralizing" the experiences - that is, interpreting them according to a sacred model of reality. Therefore, I suggest that the presence or absence of panic/anxiety in association with depersonalization can be a function of the nature of the ideational construction of the experience in the mind of the individual.
For example, in a depersonalized condition, if the individual holds catastrophic interpretations of this state, such as, "I am going crazy" (one of the diagnostic criteria of a panic attack), then a panic/anxiety response may result. However, if in the same situation the individual interprets the episode with the thought, "I am having a sacred experience:' then an entirely different bodily response may develop, characterized by lack of arousal and parasympathetic dominance (Lex 1979).
There are implications of this study for research on Depersonalization Disorder. It is possible that Depersonalization Disorder is a culture-bound syndrome. The apparent ease by which depersonalization can be induced and its high incidence in the normal as well as psychiatric populations indicate that it is indeed some sort of natural response of the brain to the environment. However, the response of the individual to depersonalization and derealization seems to be quite variable and subject to shaping by social and cultural factors. The "mythic world" of some individuals, lacking any other alternative for depersonalization/derealization, may be pathologizing what could be viewed as a normal experience, transforming it into an episode of mental illness.
Because it is estimated that 50-60 % of all patients with panic/anxiety disorders suffer from depersonalization (Sheehan 1983), there are also implications for research in this area. Depersonalization is generally seen as a symptom of Panic Disorder, and a diagnosis of Depersonalization Disorder will not be made if panic is present as a symptom. In that case, DSMIII- R recommends Panic Disorder as the proper diagnosis. However, it may be that if the assigned meaning of depersonalization in the mind of the patient includes catastrophic interpretations, then panic may be the result of depersonalization, rather than the reverse, which seems to be the prevailing assumption in present diagnostic opinion. Further, the effectiveness of symbolic healing in alleviating panic/ anxiety in depersonalized individuals, and thereby diminishing functional impairment, suggests psychotherapy as a preferred treatment instead of the use of tranquilizers, which can heighten feelings of dissociation and unreality.
_______________
REFERENCES
AMERICAN PSYCHIATRIC ASSOCIATION (APA). Diagnostic and Statistical Manual of Mental Disorders. 3rd ed., rev. American Psychiatric Association, 1987.
BLISS, E. L., CLARK, L. D., and WEST, C. D. Studies in sleep deprivation-relationship to schizophrenia. Archives of Neurological Psychiatry (1959) 81:348-59.
CASTILLO, R. J. The transpersonal psychology of Pataiijali's Yoga-Slltra (Book I: Samddhi): A translation and interpretation. Journal of Mind and Behavior (1985) 6:391-417.
DAVISON, K. Episodic depersonalization. British Journal of Psychiatry (1964) 110:505-13.
DEIKMAN, A. J. Experimental meditation. Journal of Nervous and Mental Disease (1963) 136:329-43.
DEIKMAN, A. J. Implications of experimentally induced contemplative meditation. Journal of Nervous and Mental Disease (1966a) 142:101-16.
DEIKMAN, A. J. De-automatization and the mystic experience. Psychiatry (1966b) 29:324-38.
DIXON, J. C. Depersonalization phenomena in a sample population of college students. British Journal of Psychiatry (1963) 109:371-75.
Dow, J. Universal aspects of symbolic healing: A theoretical synthesis. American Anthropologist (1968) 88:56-69.
EVANS, C. R., and PIG GINS, D. J. A comparison of the behaviour of geometrical shapes when viewed under conditions of steady fixation and with apparatus for producing a stabilised retinal image. British Journal of Physiological Optics (1963) 20: 1-13.
FELSINGER, J. M., LASAGNA, L., and BEECHER, H. K. The response of normal men to lysergic acid derivatives. Correlation of personality and drug reactions. Journal of Clinical and Experimental Psychopathology (1956) 17:414-28.
GUTTMAN, E., and MACLAY, W. S. Mescaline and depersonalization: Therapeutic experiments. Journal of Neurology and Psychopathology (1936) 16:193- 212.
KENNEDY, R. B. Self-induced depersonalization syndrome. American Journal of Psychiatry (1976) 133:1326-28.
LEHMANN, L. S. Depersonalization. American Journal of Psychiatry (1974) 131:1221-24.
LEVY, J. S., and WACHTEL, P. L. Depersonalization: An effort at clarification. American Journal of Psychoanalysis (1978) 38:291-300.
LEX, B. The neurobiology of ritual trance. In E. Aquili, C. Laughlin and J. McManus, eds., The Spectrum of Ritual: A Biogenetic Structural Analysis. Columbia University Press, 1979.
MAYER-GROSS, W. On depersonalization. British Journal of Medical Psychology (1935) 15:103-26.
NULLER, Y. L. Depersonalization: Symptoms, meaning, therapy. Acta Psychiatrica Scandinavica (1982) 66:451-58.
ORNSTEIN, R. E. The Psychology of Consciousness. 2d ed. Harcourt Brace Jovanovich, 1977.
PIGGINS, D., and MORGAN, D. Note upon steady visual fixation and repeated auditory stimulation in meditation and in the laboratory. Perceptual and Motor Skills (1977) 44:357-58.
REED, G. F., and SEDMAN, G. Personality and depersonalization under sensory deprivation conditions. Perceptual and Motor Skills (1964) 18:659- 60.
RENIK, O. The role of attention in depersonalization. Psychoanalytic Quarterly (1978) 47:588-605.
ROTH, M., GARSIDE, R. F., and GURNEY, C. Clinical and statistical enquiries into the classification of anxiety states and depressive disorders. In Proceedings of Leeds Symposium on Behavioural Disorders. London: May and Baker, 1965.
SEDMAN, G. Depersonalization in a group of normal subjects. British Journal of Psychiatry (1966) 112: 907-12.
SHEEHAN, D. V. The Anxiety Disease. Scribner's, 1983.
SHRABERG, D. The phobic anxiety-depersonalization syndrome. Psychiatric Opinion (1977) 14:35-40.
SOURS, J. L. The "break-off' phenomenon. Archives of General Psychiatry (1965) 13:447-56.
STEVENS, J. O. Awareness. Moab, Utah: Real People Press, 1971.
STOLOROW, R. S. Defensive and arrested development aspects of death anxiety, hypochondriasis and depersonalization. International Journal of Psycho-Analysis (1979) 60:201-13.
TAYLOR, F. K. Depersonalization in the light of Brentano's phenomenology. British Journal of Medical Psychology (1982) 55:297-306.
TORCH, E. M. Depersonalization syndrome: An overview. Psychiatric Quarterly (1981) 50:249-58.
TRUEMAN, D. Depersonalization in a nonclinical population. Journal of Psychology (1984) 116:107-12. PSYCHIATRY, Vol. 53, May 1990
Richard J. Castillo, MA, is a PhD Candidate, Department of Anthropology, Harvard University, and Lecturer in Anthropology, University of Hawaii at West Oahu, Pearl City, HI 96782 (mailing address).
The research for this paper was supported by a National Science Foundation Predoctoral Fellowship.
The author is indebted to Professors Arthur Kleinman, Byron Good and Charles Lindholm of the Anthropology Department, Harvard University, for their many valuable insights and criticisms on earlier drafts of this paper.