Meditation or Mindfulness Will Not Directly Solve Depersonalization, Derealization, or Lack of a Sense of Self (Like in Borderline Personality Disorder) (~4000 words)

(General content note: A lot of my thinking has really changed since the old days of this blog. There’s some weird, mean, and polemic stuff in there.)

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Warning: Depersonalization and derealization are protective mechanisms. Just reading this essay might temporarily or permanently disrupt those protective mechanisms. If you are relying on them, approach this essay with caution, to avoid provoking an extreme or dangerous reaction.

Note: I am not a licensed mental health professional. I am a random dude on the internet.

Introduction

I wanted to touch on depersonalization/derealization (dp/dr) and lack of a (or weak) sense of self, like in borderline personality disorder (bpd). First, because I’ve experienced a moderate, chronic case of bits and pieces of these phenomena, and, second, because this is a good illustration of how meditation is not a panacea. Meditation increases phenomenal fidelity and helps you find and develop inner levers. But, you won’t always automatically stumble on those levers, and you have to know to pull them. This essay is an example of finding and pulling levers you didn’t know you had, that you didn’t know would help.

Capgras and Cotard

I want to start with an entirely different phenomenon: Capgras syndrome. In this disorder, the sufferer claims that people are not who they look like or claim to be. They think everyone, or few specific people, e.g. loved ones, have been replaced with shells, clones, pod people, robots, or zombies. In my understanding, no amount of reasoning by said loved ones can convince the sufferer otherwise. This disorder has different prognoses, depending on how, and how much, the involved brain regions get messed up. But, neurology aside, what’s going on, phenomenologically? What’s the phenomenology of the sufferer? And is that phenomenology causal or epiphenomenal?

I think in this particular disorder, and similar disorders, the phenomenology is causal, not epiphenomenal. Of course, the phenomenology *is* neural structure and dynamics. But I’m saying that it’s the conscious neural activity qua conscious neural activity that causes the sufferer to make the claims they’re making. (And that’s how I’ll relate this back to dp/dr and bpd.)

Anyway, one hypothesis for what’s going on in Capgras, is that, for the sufferer, the sense of quasi-emotional familiarity is missing, when the sufferer gazes upon other human beings. Ordinarily, all sorts of meta-information either co-arises with, and “colors,” sensory experiences, or closely follows those sensory experiences [1]. This gives a certain “weight,” or “depth,” or “color” to sensory experiences, quite specific ones, though sometimes hard to put into words. Those weights and depths and colors can be dialed up or down, or discretely switched on or off, by the brain. Or they can get temporarily or permanently broken by disease or injury.

When those meta-sensory experiences get shut off or disrupted, this can often lead to predictable descriptions of what that feels like to the experiencer. That is, the experiencer has a distinct experience, and they interpret and describe that experience according to their cultural and linguistic background. And it’s not surprising that some of that language is common to lots of those experiencers, though, of course, a lot of is personal and idiosyncratic, too.

Anyway, in the case of the Capgras syndrome, those people look like, sound like, and act like their son, daughter, or spouse, but they can’t be a loved one. Something is wrong, something is off, they aren’t right. They’re fake, they’re hollow.

As one more quick example, consider Cotard syndrome. In this syndrome, the sufferer infers/believes that they’re dead. No manner of reasoning can convince them otherwise. I haven’t thought too hard about what the phenomenology is for these experiencers. But, I’m fairly confident that rather discrete, normally ubiquitous and pervasive “colorings” of consciousness have been switched off for them.

(Now, would you or I reach the same conclusions if we get messed up in the same way people with Capgras or Cotard get messed up? Maybe yes, maybe no. They may or may not have other stuff going on that makes them unreasonable. But we’d still be experiencing what they’re experiencing. And it might be just as horrible, upsetting, and behaviorally disruptive. But, all things being equal, we’d probably interpret the experience differently, just by having written or read this essay.

DP/DR and BPD

So let’s move on to dp/dr and feeling a lack of a sense of self. Apparently, experiencing derealization is quite common. It can be transient, and alarming, if you don’t know what’s going on. You can also find anecdotal accounts of people experiencing variations of this, mildly or severely for decades. (I say variations on the experience because I’m sure there’s a bunch of interacting brain regions contributing, shifting their excitatory and inhibitory inputs, on individual timescales of seconds to decades, contingent on inner behavior, external choices, and external life situation.)

For dp/dr, people sometimes describe a sense of “being hollow inside,” or that “they’re not quite real,” or that “everything seems like it’s a dream,” or that they’re “trapped in a dream,” or “floating,” or that there’s a screen between them and everything else. For borderline personality disorder, among a gazillion other things, people sometimes describe “not knowing who they are,” or “lacking a sense of self,” or “being empty.” (I made these quotes up, but see [2, 3].)

Conversely, this experience can become so normalized for the individual that they acutely notice the rare exceptions when they don’t feel this way. At those times you get, “Holy shit, I’m me!” “Holy shit, I’m real!” “Holy shit, this is happening right now!”

(I want to make a point that the language above about “self,” “reality,” etc. is pretty orthogonal to all the spiritual and meditative stuff where you see stuff about “self,” “reality” etc. One the one hand, you’re fiddling with your brain, so of course there’s neurological and phenomenological overlap. But, “self,” “reality” — same signifiers, different referents.)

(A second point, if you have some of those “Holy shit” experiences, that doesn’t necessarily mean you’re chronically below baseline. You might be at normal baseline and then intermittently get dialed way above baseline, due to random life experiences or meditation.)

Spontaneous, Tacit Autobiographical Memory

Anyway, for the dp/dr and lack-of-self experiences, I think I’ve identified the common core phenomenology, or lack thereof. Analogous to Capgras and Cotard, I claim that something’s missing: I claim that what’s missing is spontaneous, usually tacit autobiographical memory. For people who don’t experience dp/dr, I claim that memory limns conscious experience most of the time, not necessarily explicitly. It’s a tacit sense of past (and future; overlapping machinery), which sometimes makes it to the level of “quasi-imagery,” and sometimes makes it to the level of consciously reflected-upon memory. I hypothesize that, in dp/dr and bpd, one large facet of the experience is a lack of this pervasive-, ubiquitous-yet-subtle injection of memory-sense into consciousness.

For these individuals, this memory-sense gets reduced or suppressed because it hurts or it’s terrifying or it’s dangerous. The brain evolved to be able to shut it off, and the brain evolved triggers to do so, and so it does. And it can become a mental habit, a mental clenched fist, even after the danger has passed, or because the danger is “ongoing,” even if that danger is endogenous. So, no automatic memory injection via at least one neurological mechanism. Memory maybe does make it through over a certain threshold of intensity, or via evolved neural gating, or via deliberate reminiscence, or via other pathways to consciousness. But not this automatic, effortless, subtle, pervasive limning that I’m talking about, here.

An Aside

(The above is important: dp/dr is lack of automatic memory injection. It’s a mini-punchline. But I need to make an aside, here, for completeness: There’s yet another related phenomenon perhaps called dissociation. I would need to carefully remap all this back to the literature; the signifiers aren’t the important thing, here. I think this phenomenon is yet another distinct type of “reality sense,” yet another phenomenological sense of “this is real” or “this is not real” that the brain can dial up or down or completely switch off. This one is for immanent and ongoing danger, violence, etc., to make the situation unreal, so you can (psychologically?) survive it. I think these are all experientially correlated but separable per unique person and circumstance, and they are probably subserved by overlapping but partially distinct neurology.)

Meditation is Specific and Predictable to a Point, Non-specific and Serendiptous After That

So let’s say that you think you’ve got mild or extreme dp/dr or you feel hollow inside, or like you’re not real, etc. And you’ve figured out that not everyone experiences reality like this, and you’d like to experience self and reality differently; you’d like to be full, and you’d like the world to be full, and you’re like to live your life.

So what do you do?

You might try meditation or mindfulness: being aware of your body, being aware of your thoughts and feelings, being aware of everything around you, like, really grounding yourself.

And that might work! (Or it might work a tiny bit and your brain will freak out and creatively, intelligently counteract your efforts and shut you down.)

But meditation, narrowly defined, is not necessarily going to pull the levers in the brain that switch autobiographical memory injection back on. And this is another one of the main points I wanted to make in this essay:

Meditation might help you get a sense of the feeling and texture of your current experience of being alive, you might become intimately familiar with what you’re experiencing. But meditation isn’t necessarily going to change that experience. It might. You might tacitly or explicitly note subtle variations in consciousness or inner behavior, and you might tacitly or explicitly note how some of those variations are better than others, and that feedback loop might take you in good directions, without you even necessarily being consciously on board. And that’s part of the beauty of it. That is one of the ways that meditation does what it does. And the longer you meditate, if you don’t get stuck in a local maxima, the more you keep climbing a plethora of interpenetrating n-dimensional hills that you can’t fully grasp or understand.

But you’re not guaranteed to stumble on the solution to X. In my experience, it’s more often that X becomes more and more and more glaringly obvious. “Suffer less; notice it more.” So you might simultaneously be more accepting of X and also get more and more motivated to solve it. But the solution isn’t necessarily going to be found by meditating more, though sometimes it is.

A Detour Into Overgeneral Autobiographical Memory

A brief detour. There’s yet another phenomenon called “overgeneral autobiographical memory.” People who are at risk for depression, who are currently depressed, or who have been depressed are more likely to exhibit it. It was discovered by accident, and it’s pretty statistically robust. The idea is that you can ask someone to do free recall on their past or you can give them themed prompts. And they sit there and come up with memories, or not. Experimental versus control, both groups come up with about the same number of memories. But the people who exhibit this effect have a slight difference in the type of memory: they are less likely to come up with a memory localized to a particular day. That is, they’re specific a little bit less often: They’re a bit more likely to give you a sentence that summarizes an entire vacation, or a summer, or a repeated series of events. That’s instead of, say, a particular birthday party, a particular funny incident, a particular day…

(By the way, this effect extends to “future episodic memory,” too. Simulating the future. Overlapping machinery. Trapped in present? Able to construct elaborate goal hierarchies but they’re hard to remember? They lack visceral punch? Can’t make them vivid? Can’t get motivated? You might be experiencing this phenomenon.)

***

Ok, so this is a brain thing that’s associated with depression, past, present, or future. There’s no strong reason to think that it can be exploited as an intervention. That is, what if you trained people to come up with specific memories and had them practice regularly. Would that exercise the brain’s specificity machinery? Would people’s mood improve? Would they become less depressed? It’s been tried. The results are mixed.

I haven’t done my own informal meta-analysis on this collection of studies. I don’t know if it really works as an intervention or what mediates and moderates that intervention. I like to read this stuff for hypothesis generation and then I try it on myself and then I write about it.

For a study, you’d want to do this for a few weeks or months with a lot of people. I fancy, being a self-styled experienced meditator and all, that I can tell what’s going on after a few days.

It’s very obvious to me that I have a tendency to exhibit this overgeneral autobiographical memory. I’ve always known this, and I’ve had two therapists bring it up, too, even though none of us knew it was a “thing,” a studied phenomenon.

And when I stumbled upon it being a thing, I just had to play with it. And so I tried the intervention:

As with all the brain stuff I try, first I experience nothing, for five minutes to a couple days. Then, as I keep steadily doing the thing, and get the hang of it, over minutes and days, I experience something fairly dramatic. Then, usually, over a day or two, that dramatic experience fades to something barely perceptible. Sure autosuggestion, but I think I can tell the difference. More often, I think, the brain is just innocently compensating with “structural slack,” shorter-term dynamics. And, you only know whether you’re really moving the needle (useful, more lasting changes in subjective experience and objective structure/dynamics) over a longer time period.

But, in this case, I’m pretty sure the intervention works. I don’t know how much, and  I don’t know for who and why. But it was definitely waking up neural machinery that interfaced with my working memory. For a while it seemed like I had two working memories and I could choose where to store things. They’ve somewhat blended; that experience has diminished. But working memory seems different and expanded, somehow, and I’m curious to strengthen this machinery even further. I may keep doing it. YMMV.

But, here’s what specific memory training didn’t do, and we’re now tying things back into the main narrative. While I was doing this, I noticed that the specific autobiographical memories I was bringing up didn’t really feel like mine. I mean, I knew they were mine. People who have dp/dr can separate fantasy from reality just fine. They reason fine about their memories. But, this is a thing: the memories don’t feel like theirs. There’s another piece to it as well; even recent memories, for dp/dr experiencers, lack a sense of immediacy. It’s as if they could have happened a lifetime ago.

So, doing this memory training wasn’t fixing that aspect of things. I knew there was a still a puzzle piece missing. But, I got flickers of a possible solution, which is how I realized I should look into the dp/dr and bpd stuff in the first place. (This autobiographical memory stuff came first.) And so back to dp/dr.

Preparing for Direct Intervention

Finally, finally, I figured out I was experiencing at least pieces of canonical dp/dr, and now I was looking for ways to decrease the dp/dr experience. For the longest time, I was a fish in water: I didn’t even know there was a different way to be, in that I couldn’t remember experiencing reality any other way. Except that I had had a couple of those “Holy shit, I’m real!” experiences. (And faint flickers again while playing with the autobiographical stuff.) So I knew that was at least a thing. But I didn’t know how to reliably trigger it, or inhabit it. And I didn’t know if it was something worth inhabiting or something “designed” to be inhabited. Maybe it was just a brain fart. For some people it probably is, if they’re already at a healthy baseline.

Sometimes you can find a reliable inner training protocol to engage in, that you can at least do for a few weeks or months before it loses its punch. For example, “meditation” (sometimes you eventually make it to a protocol that stays useful forever) or the memory specificity training above. Other times, there’s no known training protocol or the phenomenon that you’re looking for kind of evolves, you need to gently follow it or chase it, and there isn’t a good algorithm that you can lay down and follow.

I had a few leads to try from past experiences, and one of them was mirrors. The first time I had a disruption of dp/dr was when I was looking in the mirror after a traumatic emotional experience. For some reason, that triggered the “Holy shit, I’m real!” sensation. Very memorable. I’ve been able to repeat that with a mirror, but it’s not reliable. And I had the intuition that that route would stop working, that doing that was more of a hack than a reliable method. Maybe it would be a good method for someone else.

I had some results with sort of “threading my way into my body.” I don’t know how else to describe it. But that wasn’t reliable either.

I had success, too, with sort of homing in on a “unique feeling flavor of self, utterly unique, feeling like me, uniquely me.” That’s worked pretty well. I may play with that some more.

But I really wanted to pin down exactly what was going on, that I could relate to everything else I knew, that I could sort of pin down in a way that I could more reliably re-execute, that wouldn’t eventually slip away from me as my brain wiggled out from under me. And I wanted to be able to better describe what I was doing, so I could tell other people and more reliably lead them to be being able to enact what I was doing for themselves.

Direct Intervention

Sometimes if you can really precisely nail what’s going on, you can apply “direct intervention.” That is, you can learn to directly dial up or down whatever’s being injected (or not injected) into consciousness. It’s usually always at least a little bit indirect. This isn’t like operating skeletal muscle. It’s a shade more “intention and paying attention and feedback loops.” But where and how you pay attention matters; the better you understand what’s going on, the less magic, the more your intention is on the actual levers and lead indicators, the more likely everything’s going to work. The less you’ve got that, the more likely it is that the brain is going innocently or intelligently compensate, slip away from you, etc.

***

So I needed something that I could hang my hat on, as it were. I needed to better pin down what I was doing, so things didn’t slip away from me when I tried to do direct intervention. And that’s when I came up with the memory hypothesis above. That is, dp/dr, and the feeling of being hollow in bpd, is due to the blocking of spontaneous injection of memory associations into consciousness.

So I had to gently, directly “remove” that block.

Sometimes this sort of thing doesn’t work. Sometimes you’ve got the levers wrong—there’s no there, there. No lever to pull. Sometimes intelligent, higher brain centers, smartly or compassionately misguided, are like “fuck no,” and they either distract you or actively push back the other way on the lever.

So, here’s what I did:

I knew I couldn’t just bluntly, deliberately remember specific memories. I’d already found that that didn’t work. I wanted memory associations to fluidly, fluently come up, with appropriate strength, appropriate salience, and appropriate relevance, all by themselves.

So, it was more of an allowing and coaxing. I was allowing/coaxing. Looking around my environment at books, at photographs, allowing/coaxing spontaneous memory, giving permission for this to happen, gently countering fleeting objections, gently allowing some initial cortisol and anxiety.

That’s “all” I did. And I may take time out each day to keep doing that for weeks or forever. I wish I could spell out incantations and hand gestures, a complex but clearly defined ritual. But, in the end, I was using some, novel, hard-to-communicate inner behaviors.

That’s it.

Is that a huge letdown? Is that the same thing as telling someone who’s depressed to, like, just feel better, man? Or, is this the same thing as, just, like, visualize, man?

No. There was so much front-end work:

First, nailing the heart of the phenomenon, nailing it so precisely that it couldn’t slip away. That took a lot of thinking and a lot of previous playing around in my mind, working on other problems. (Sometimes you do just have to proceed gently, sensitively, compassionately with something slippery, though.)

Second, there was all the prior meditative work, being able to deftly work with attention and mental muscles and staying on task and a generalized sense of allowing/coaxing and probably plenty of additional tacit experience.

Third, there is a difference between, say, 1) visualizing, 2) intending, and 3) pushing and pulling inner levers. (1) and (2) are a subset of (3). (3) encompasses a vast number of cognitive, noncognitive, and metacognitive non-skeletal-muscle behaviors.

***

And, so, I looked around, and was slowly met and suffused with a faint, tacit sense, fleeting quasi-images, and memories that I hadn’t recalled in decades, that until that moment, I didn’t even know I had. I couldn’t remember what I couldn’t remember, until I did. That was really cool. And things were… different. I’m still exploring this. Time will tell whether tugging on this lever will actually move the needle, whether this is a real lever, a real inner muscle I didn’t know I had, or whether it’s a virtual lever, a non-real inner movement, whether it’ll ultimately be slippery, turn to smoke, and then I’ll reevaluate my next move. Sometimes the phenomenology isn’t distinct, but sometimes it’s very obvious that you’ve got a real lever (you feel it), that you’re really tweaking a specific submodule using an evolved, non-skeletal behavior–as opposed to wandering around phase-space in some generalized brain system. (In the latter case, you’re less likely to have a lot of leverage to a move a needle permanently.) That’s how this sometimes works.

But, at the moment, things are already more… real. Past, present, and future are more available, more comforting, the good and the bad. Goals are more natural, less slippery, they seemingly go deeper. Perhaps, perhaps. It’s too early to tell. But it’s exciting.

A Final Note on Panaceas: Meditation is Not a Panacea. Direct intervention is Not a Panacea.

Direct intervention is neat. But phenomenology and function are slippery. There’s so much going on, interpenetrating, limning, convolving, shading experience. And it’s affected by cognition, inner behavior, external behavior, the way self and world responds, life situation, nutrition, microbiome, physiological regime (like blood gas tolerances), and much more. And when you intervene, body and brain fight back or innocently compensate. And maybe you’re permanently moving the needle, and maybe you’re not. And sometimes you have to wait and see, and sometimes you need to add another ingredient. And so it goes.

A Final Note on Resistance

(Notice above that I had inner “resistance,” read compassionate protection, brilliant or misguided. That’s best resolved with patient inner dialogue and/or with a therapist. This stuff raised my anxiety. It sucked at first. My mouth got metallic the first several times and probably into the future: cortisol went up. So be careful. Your brain had a reason for turning off memory injection, and that reason might be long past or very, very present. You could trigger an extreme cognitive and emotional reaction, e.g. you could become suicidal. Or, you’ll just experience some transient discomfort. It depends on your unique situation and prior work that you’ve done.)

Conclusion

So let’s see what this essay has illustrated. I kept track of my experience over a long period of time and looked for patterns. I used anomalous experiences I had had to shed light on “normal” experience. I used clinical and basic research to help assemble signifiers to describe my inner experience. I made a worksheet and logged an experimental intervention to keep me on track. I formed a hypothesis backed by neuroscience and clinical psychology about “what was going on.” I used that hypothesis to pin down a “direct phenomenological intervention.” And then I tried it.

I hope this is useful in dp/dr and bpd-land. Play at your own risk. Again, I am not a licensed mental health professional. This could be dangerous. Like suicidal urges. It happens. YMMV. Be careful.

And, I hope this is useful as an example for how to work with decades-long, pervasive, ubiquitous aspects of your experience. Where you didn’t even know that things could be a different way. But you started to get a hint that things could be. And you didn’t even know where to start. But I hope now you do.

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[1] Mangan, Bruce. “Sensation’s Ghost.” Psyche 7 (2001): 18.

[2] Collum, Julius M. “Identity diffusion and the borderline maneuver.”Comprehensive psychiatry 13, no. 2 (1972): 179-184.

[3] Sierra, Mauricio, Dawn Baker, Nicholas Medford, and Anthony S. David. “Unpacking the depersonalization syndrome: an exploratory factor analysis on the Cambridge Depersonalization Scale.” Psychological medicine 35, no. 10 (2005): 1523-1532.