Interoceptive Exposure Exercises for Evoking Depersonalization and Derealization: A Pilot Study

Abstract

This study examined the potential of 11 interoceptive exposure exercises to produce depersonalization and derealization among high anxiety-sensitive undergraduate students. Inspired by a February 2007 thread on the Association for Behavioral and Cognitive Therapies listserv, we identified nine exercises and compared their capacity to produce depersonalization and derealization with two previously validated tasks: mirror and dot staring. Results indicated that five exercises, including hyperventilation (1 minute), hyperventilation (5 minutes), hyperventilation plus spiral staring, hyperventilation plus strobe light, and strobe light alone, were superior to either mirror or dot staring at inducing depersonalization or derealization. If replicated in a clinical sample, our findings may be used to assist clinicians seeking to evoke these states via interoceptive exposure.

Dissociation and hallucinations in dyads engaged through interpersonal gazing

“…Instead, gazing at a fixed location in the room was left uncontrolled. In fact, previous studies found dissociation when observers were engaged in a task of dot-gazing (Miller et al, 1994;Leonard et al, 1999;Holmes et al, 2006;Lickel et al, 2008). Therefore, further research would be required to disentangle these different contributions made to dissociation in the control group.…”

“…Firstly, in the control group, dissociation was almost surely under-evaluated, since control participants were not required to stare at a point in space (Lickel et al, 2008). Secondly, in the experimental group, the number of participants was quite limited; hence, a larger sample of individuals should have displayed a correlation between dissociation and strange-face illusions.…”

“…Experimental techniques that were used in previous studies of dissociation included the dot-staring task (Miller et al, 1994;Leonard et al, 1999;Holmes et al, 2006;Lickel et al, 2008). During these experiments, individuals stare at a black dot for between 3 and 10 min.…”

The Circumplex Structure of Depersonalization/Derealization

“…The symptoms of DP/DR occur across a wide range of causes such as hypnosis (Wineburg & Straker, 1973), meditation (Castillo, 1990), hypnagogic and hypnopompic states (Lambert, Senior, Phillips, & David, 2000), sleep deprivation (Bliss, Clark, & West, 1959), sensory deprivation (Reed & Sedman, 1964), hyperventilation (Lickel, Nelson, Lickel, & Deacon, 2008), stress (Aderibigbe, Bloch, & Walker, 2001), and drug or alcohol use (Melges et al, 1974). The relatively high rates of reporting of these symptoms, in combination with the diverse range of precipitants, increase the need for clarification between normal and pathological episodes of DP/DR.…”

Anxiety Sensitivity, Distress Intolerance, and Negative Interpretation Bias Strengthen the Relationship Between Trait Anxiety and Depersonalization

“…One reason for this may be the lack of a validated state depersonalization questionnaire, leading researchers to adapt preexisting trait measures of depersonalization for an in-the-moment timescale (e.g., Hoyer et al, 2013). There is conflicting evidence for a state co-occurrence of anxiety and depersonalization (Hoyer et al, 2013;Lickel et al, 2008;Sierra et al, 2002), so we tested all the hypothesized relationships on state levels of both anxiety and depersonalization. To increase variability in symptoms (which we expected to be too low and invariant at baseline for the statistical models), participants completed mild symptom induction tasks.…”