Skip to main content

Verified by Psychology Today


Dissociation, Out-of-Body, or Derealization?

A case study.


People commonly report out-of-body experiences and cultivate and utilize them for personal growth and spiritual development. While these states may invoke fear for some people, they also constitute a paradoxical “controlled letting go” and often signal new periods of personal growth. The ancient Egyptians understood that consciousness could function independently of and outside of the physical body. They developed detailed ideas about the ka, or the body “double” which separates itself from the physical body and travels at will (Mishlove, 1993). The major distinguishing feature between out-of-body experiences and depersonalization is the positive and negative impact these experiences have, and whether or not they are under the locus of individual control.

Source: Sasha-Freemind/Unsplash

Neurologically, there are similarities between shamanic practices that engender out of body experiences or trance states and dissociation; both are mediated biologically via the opioid and serotonergic systems. The term “out-of-body experience” (OBE) is associated with the field of transpersonal psychology and is a form of depersonalization that occurs under either traumatic or non-traumatic circumstances. Meditation, body work, and trance states that arise out of dancing, healing ceremonies, religious rituals, fasting, the channeling of disembodied spirits, and near death experiences all may lead to depersonalization. The main difference in these states is in whether it is a “controlled” loss of control and a desired state of consciousness or not.


Derealization is closely related to depersonalization and refers to the external world not feeling real or being viewed through a fog or a curtained window. Like other symptoms, people may move in and out of derealization moment to moment, in cycles during the day, or when experiencing stress. Derealization can also commonly occur in response to the use of SSRI’s or cannabis.

Mark’s Story

Mark describes what became a chronic experience of derealization and depersonalization as a result of being raped when he was jailed after an anti-war demonstration:

“I was on the cold cement floor next to my shoes. I just kept staring at them and I no longer felt my body. I felt myself get very small and go into the shoes. I did not feel anything until it was over. Ever since then, I have had trouble feeling anything. I walk around at times touching objects but nothing feels real. Sometimes I can’t get a grip on what I’m doing and what my relationship is to where I am.”

Our work focused on helping Mark identify triggers to “leave his body” and explore his physical and energetic boundaries. Reducing reactivity to triggers and exploring, tolerating, and gaining control of his physical sensations were the first steps we undertook on his path to reclaim his body.

Read more about dissociation, out-of-body, and derealization, in my book Rhythms of Recovery: Trauma, Nature, and the Body.


Korn, Leslie, (2012) Rhythms of Recovery: Trauma, Nature and the Body, Routledge, NY

Mishlove, J. (1993). The roots of consciousness: The classic encyclopedia of consciousness studies. Tulsa, OK: Council Oak Books.

More from Leslie E. Korn Ph.D., MPH, LMHC, ACS, FNTP
More from Psychology Today
More from Leslie E. Korn Ph.D., MPH, LMHC, ACS, FNTP
More from Psychology Today