Depersonalization/Derealization Disorder 303
“I know I have feelings but I don’t feel them”), thoughts (e.g., “My thoughts don’t feel like
my own,” “head filled with cotton ”), whole body or body parts, or sensations (e.g., touch,
proprioception, hunger, thirst, libido). There may also be a diminished sense of agency
(e.g., feeling robotic, like an automaton; lacking control of one’s speech or movements).
The depersonalization experience can sometimes be one of a split self, with one part ob-
serving and one participating, known as an “o ut-of-body experience” in its most extreme
form. The unitary symptom of “depersonalization” consists of several symptom factors:
anomalous body experiences (i.e., unreality of  the self and perceptual alterations); emo-
tional or physical numbing; an d temporal distortions with anomalous subjective recall. 
Episodes of derealization are characterize d by a feeling of unreality or detachment
from, or unfamiliarity with, the world, be it individuals, inanimate objects, or all surround-
ings (Criterion A2). The individual may feel as if he or she were in a fog, dream, or bubble, or
as if there were a veil or a glass wall between the individual and world around. Surround-
ings may be experienced as artificial, colorles s, or lifeless. Derealization is commonly ac-
companied by subjective visual distortions, su ch as blurriness, heig htened acuity, widened
or narrowed visual field, two-dimensionalit y or flatness, exaggerated three-dimensional-
ity, or altered distance or size of objects (i.e ., macropsia or micropsia). Auditory distortions