Journal of Traumatic Stress, Vol 6, No.

I, 1993

Depersonalization as a Defense Mechanism in

Survivors of Trauma'
Etay Shilony2 and Frances K. Grossman2
Accepted December 19, 1991

The study examines the relationship between experiencing depersonalization

during traumatic events and subsequent psychiatric symptomatology. Par-
ticipants were 75 Boston University undergraduate students who reported I86
traumatic events. Information about their experiences of depersonalization
during these events was obtained by the Depersonalization Questionnaire (DQ)
a scale based primarily on the Dissociation Experience Scale (Bernstein and
Putnam, 1986). Symptomatology was measured by the Symptom Checklist-90-
Revised (Derogatis, 1977). As predicted the participants who experienced deper-
sonalization during traumatic events were found to be sign8cantly lower than
those who did not on 7 out of the 9 SCL-90-R subscales and the General
Severity Index (GSI) scale. When the severity of trauma was statistically con-
trolled for, the significant differences between the two groups held up on five
of the nine subscales and the GSI scale. These differences remained as sig-
nificant when statistically controlling for the lime that passed since the
traumatic events. These findings suggest that, for this sample, depersonalization
during traumatic events played a significant role in defending [hem f i o m the
fill impact of these events.
KEY WORDS: trauma; depersonalization; symptornatology.

INTRODUCTION

It has been in the last decade that dissociative disorders have been
the focus of clinical research. Janet's (1889) work is often cited and

'This article was accepted for publication under the Editorship of Charles R. Figley.
'Department of Psychology, Boston University, Boston, Massachusetts 02215.

119

0 1993 Plenum Publishing Corporntion

M194-9867/93~100-0119$07.w/o
120 Shilony and Crossman

reexamined in the literature and dissociative disorders are studied as they

relate to different clinical phenomena. A prominent part of this literature
addresses dissociation as a reaction to trauma, a relationship that was also
established earlier by Janet (1889) and later Freud (1896). While it is
generally accepted that there are different types of dissociative reactions
one issue that has not been looked at is the relative benefits or costs of
these different processes in terms of post-traumatic symptomatology.
Within this framework, most contemporary writers in the field con-
ceptualize dissociative reactions as an adaptive process protecting the in-
dividual from a total mental collapse in face of terrifying events (Cameron
and Rychlak, 1985; Green et af., 1985; Putnam, 1989; Wilson, 1989; Ulman
and Brothers, 1988; van der Kolk, 1987). It is argued that by way of protec-
tion the memories of the dreadful events are split-off from normal con-
sciousness and forgotten. Amnesia is viewed, therefore, as an essential
element of this adaptive process. However, much of the symptomatology
that follows the traumatic experience is viewed as forms of re-experiencing
the forgotten material (van der Kolk, 1987).
Not all forms of dissociation, however, involve amnesia. For example,
Depersonalization Disorder appears under the category of Dissociative Dis-
orders in the third, revised edition of the Diagnostic and Statistical Manual
of Mental Disorders (DSM-111-R) (APA, 1987); it does not involve amnesia
but rather the experience of an altered state of reality.
The phenomena of depersonalization were first introduced by a
French clinician Krishaber who wrote of patients who felt “separated from
the world” or seeing figures “as if in a dream” (cited in Nemiah, 1980, p.
952). Laurent Dugas suggested the name depersonalization in 1911
(Nemiah, 1980). Freud (1936) introduced depersonalization as an uncon-
scious defense mechanism. Arlow (1966) described the subjective ex-
perience of depersonalization as follows: “Its just a harmless dream or
make-believe ...This is not happening to me. I’m just an onlooker” (p. 472,
cited in Ulman and Brothers, 1988, p. 25).
As with other dissociative reactions, depersonalization is observed
to occur in response to overwhelming events. In t h e “Glossary of Tech-
nical Terms” of the DSM-111-R (APA, 1987) it is stated that deper-
sonalization is “...sometimes observed in people without any mental
disorders who are experiencing overwhelming anxiety, stress or fatigue”
(p. 397). Jacobson (1959), for example, studied the experiences of deper-
sonalization in women who were survivors of the German concentration
camps. Noyes and Kletti (1976) described 70% of their sample to have
experienced the phenomena of depersonalization in face of life threaten-
ing danger (see also Livingston and Rankin, 1986; Noyes et QL, 1977).
However, despite this interest in depersonalization, it is seen that the
Depersonalization as a Defense Mechnnisrn 121

majority of the literature on dissociation is focused on Multiple Per-

sonality Disorder (e.g., Brende, 1987; Chu and Dill, 1990; Coons, 1986;
Ross and Gaham, 1988; Schafer, 1986).
An important question is: what are the relative costs to future adap-
tation of the different methods of defending? It is possible that deper-
sonalization takes a lesser toll by allowing distancing from the traumatic
experience without the price individuals pay later for forgetting. This
present study examined whether individuals who, in the face of a traumatic
event, experience non-amnestic dissociation, i.e., depersonalization, ex-
perience fewer and less intense subsequent psychiatric symptoms than in-
dividuals who did not have these experiences.

METHOD

Sample

Participants were Boston University undergraduate students from in-

troductory psychology courses who were invited to volunteer for the study
if they had experienced at least 1 of the 10 possible traumatic events ex-
plored by this study: a serious automobile accident, a serious fire, natural
disaster, violent crime, war, sudden physical disability, witnessing a violent
act or crime, unexpected loss of family or a close friend, physical abuse
and sexual abuse. The sample was composed of 50 females and 25 males
( N = 75) with a mean age of 20.5 (SD = 4.5).

Procedure

The data were collected in three separate large-group meetings. The

participants initially received a brief written description of the study and
the informed consent form. They then received a Fact Sheet for
demographic and other family data and several self-report measures to
complete in the presence of the researcher. These included the Stressful
Life Event Check-List, the Depersonalization Questionnaire and the
Symptom Checklist-90-Revised (SCL-90-R).

Measures

A Fact Sheet was designed for this study to gather demographic and
other family data. The Stressful Life Event Check-List (SLEC) is a measure
developed for this study to assess the individual’s experience with 10 pos-
122 Shilony and Crossman

sible kinds of trauma. This measure was developed on the basis of the
DSM-III-R ( M A , 1987) definition of trauma as a “distressing event that
is outside the range of usual human experience” (p. 247) as well as from
the literature on trauma (e.g., Noyes and Kletti, 1976). Individuals were
asked to indicate for each traumatic event whether they had had the ex-
perience, at what age, the number of times, and whether they were injured
or felt in danger of dying. The Depersonalization Questionnaire: (DQ) is
an ll-item questionnaire which asks participhnts a set of questions for each
of the 10 traumatic events they indicated they had experienced. It is com-
posed of eight depersonalization items and three reality testing items. All
seven depersonalization items from the Dissociation Experience Scale
(Bernstein and Putnam, 1986) were used (e.g., I felt my body did not belong
to me; 1 was not sure if things were really happening or I was just dreaming
them). One depersonalization item was added, taken from the DSM-III-R
criteria for Depersonalization (I felt like a robot). The three other items
follow DSM-III-R’s criteria for Depersonalization which requires that
throughout the depersonalization experience “reality testing remains intact”
(APA, 1987, p. 277). In order to be able to assess depersonalization, and
to differentiate it from the maladaptive form of derealization (a phenomena
that involves a loss of sense of reality) it is necessary to establish that the
participants’ reality testing during the event was intact.
The Symptom Check List-90-Revised (SCL-90-R) (Derogatis, 1977)
is an objective 90-item, self-report symptom inventory designed to reflect
psychological symptom patterns. The SCL-90-R has nine subscales: depres-
sion, somatization, anxiety, hostility, interpersonal sensitivity, obsessive-
compulsive, paranoia, phobic anxiety and psychoticism. One of its global
indices, the Global Severity Index (GSI)was used in this study. It measures
the frequency and intensity of distress across all symptom dimensions.
Derogatis (1977) established both test-retest reliability and internal consis-
tency for the nine subscales. Alpha coefficients range from 0.77 to 0.90
and test-retest values are reported to range from 0.78 to 0.90. The SCL-
90-R has been frequently used in the research on trauma and PTSD (e.g.,
Davidson et al., 1986; Lindy, 1986; Murphy, 1986).

RESULTS

The 75 participants reported a total of 186 traumatic events with

physical abuse being the most frequently reported trauma (28%) followed
by auto accidents (16.7%). Forty percent of the participants (n = 30)
reported two events and 21.3% (n = 16) reported three events.
Twenty one percent (n = 40)of the traumatic events included injuries
Depersonalization as a Defense Mechanism 123

Table I. Distribution of Traumatic Events Across Nondepersonalization and Depersonaliza-

tion Groups
Nondeper. Deper.
Event n % n %

Physical abuse 12 24.4 40 29.2

Auto accidents 7 14.3 24 17.5
Witness violent crime I 6.1 13 9.5
Unexpected loss 3 6.1 16 11.7
Sudden disability 7 14.3 12 8.7
Natural disaster 5 10.2 13 9.5
Sexual abuse 4 8.1 11 8.0
Violent crime 2 4.0 5 3.0
War 2 4.0 1 1.0
Fire 0 00.0 2 1.5
Total 49 100.0 137 100.0

and in 34.4% of the events the participants reported a danger of death to

themselves or others. Sixty percent ( n = 45) of the sample reported at
least one traumatic event during which they experienced depersonalization
without reporting any traumatic events during which they did not have that
experience. This group was labeled the “Depersonalization group.” Forty
percent ( n = 30) reported at least one traumatic event for which the ex-
perience of depersonalization was not present. This group was labeled the
“Nondepersonalization” group.
Since the participants’ ability to recall their experience during the
traumatic events might be related to t h e time that passed since the events,
f-tests were performed to compare the two groups on this variable. This
analysis revealed that although the time lapse was slightly elevated for the
Nondepersonalization group (mean of Depersonalization group = 5.2,
mean of Nondepersonalization group = 4.2, f = 1.33, df = 73, p > .05)
there was no significant difference between the two groups.
A Chi-square analysis showed no significant difference in the distribu-
tion of traumatic events across the two groups (see Table I). That is, there
was no evidence that any one event occurred more often in one of the two
groups within the context of all traumatic events.
In order to reestablish the assumption that there is a connection be-
tween experiencing traumatic events and subsequent symptomatology, f-
tests were performed to compare the SCL-90-R GSI scores (see Table 11)
of the participants with the SCL-90-R norms for both “nonpatient normals”
and “psychiatric outpatients” (Derogatis, 1977). This sample’s GSI scores
were significantly higher than the nonpatient normals (mean of sample =
124 Shilony and Crossman

Table 11. Means and Standard Deviations of SCL-90-R Scores

SCL-90-R n Mean SD

Somatization 75 0.85 0.59

0bsessive-compulsive 75 1.01 0.64
Interpersonal sensitivity 75 0.69 0.57
Depression 75 0.94 0.58
Anxiety 75 0.83 0.69
Hostility 75 0.60 0.50
Phobic anxiety 75 1.02 0.75
Paranoid ideation 75 0.91 0.67
Psychoticism 75 0.76 0.64
Global 75 0.85 0.57
Seventy Index

Table 111. t Test: Comparison Between the Nondepersonalization and Depersonalization

Groups on SCL-90-R Scores
SCL-90-R Nondeper. Deper.
Scale (n = 30) (n = 45) I df Sig.

mean sd mean 5d

Somatization 1.03 0.69 0.73 0.48 2.15 73.0 a

Obsessive-compulsive 1.26 0.71 0.85 0.54 2.82 73.0 a
Interpersonal
a
Semit ivity 0.87 0.65 0.58 0.48 2.18 73.0
Depression 1.18 0.70 0.77 0.41 3.12 73.0 b

Anxiety 1.08 0.80 0.66 0.55 2.71 73.0 b

Hostility 0.73 0.53 0.52 0.48 1.83 73.0 NS

Phobic
anxiety 1.31 0.88 0.82 0.59 2.86 73.0 b

Paranoid 1.21 0.76 0.70 0.52 3.41 73.0 b

ideation
Psychoticism 0.94 0.77 0.64 0.53 1.95 73.0 NS
Global
Severity Index 1.08 0.67 0.70 0.44 2.96 73.0 b

"p < .05, two tailed.

bp < .01,two tailed.

0.85, mean of normals = 0.31,i = 8.22, df = 74,p < .OOl) and significantly
lower than the psychiatric outpatients (mean of outpatients = 1.26, f =
-6.12, df = 74,p < .OOl).
T-tests were performed to test the hypothesis that predicted a sig-
nificant difference between the Nondepersonalization and the Deper-
Depersonalization as a Defense Mechanism 125

Table IV. ANCOVA: Comparison Between Nondepenonalization and Depersonalization

Groups on SCL-90-R Scores, Controlling for Injury and Danger of Death During the
Traumatic Eventfsl: Controlling for Time Passed Since the Traumatic Eventfs)
~~~~ ~

Injury and danger of Death Time since traumatic events

SCL-90-R
Scale F(1. 71) Sig. F(1, 72) Sig.
Somatization a
3.82 NS 5.10
Obsessive-
compulsive b b
6.66 7.97
Interpersonal
sensitivity 3.66 NS 5.06
Depression b
8.34 10.74
Anxiety a
5.66 7.79
Hostility 2.62 NS 3.17
Phobic
anxiety b b
6.78 8.21
Paranoid b b
10.31 11.09
ideation
a
Psychoticism 2.61 NS 4.36
Global
Severity Index b 9.13 b
7.10
"p < .05.
bp < .01.

sonalization groups on SCL-90-R scores. There were significant dqferences

between the groups on seven of the nine SCL-90-R subscales and on the SCL-
90-R GSI scale (see Table III). In all cases, the group that reported at least
one traumatic event without depersonalization showed higher levels of
Jymptomatology.
Analysis of covariance was performed to examine these relationship
while controlling for the time lapse between the traumatic events and the
time of the study. The significant differences between the two groups held
up on eight of the nine SCL-90-R subscales and on the SCL-90-R GSI
scale. Analysis of covariance was also used to control for severity of trauma
as measured by having being injured during the event or reporting a danger
of death to oneself or others. The significant difference between the two
groups held up on five of the nine SCL-90-R subscales and on the SCL-
90-R GSI scale (see Table IV).

DISCUSSION

The primary hypotheses of this study addressed the relationship be-

tween depersonalization during traumatic events and subsequent future
126 Shilony and Crossman

symptomatology. It was established that trauma victims who participated

in this study and experienced depersonalization during trauma were less
symptomatic than those who experienced at least one traumatic event
without depersonalization. These findings support the experiences of
trauma survivors as they are reported in the literature. Vietnam veterans,
f o r example, describe dissociative numbing as helping them survive
catastrophic life experiences. The relationship between depersonalization
and the numbing experience is worth further exploration. It is possible that
depersonalization sewes as a vehicle for the numbing experiences and that
numbing is made possible by its presence.
In this study, the severity of trauma was statistically controlled by par-
tialing out the participants’ responses to questions about whether they were
injured or felt themselves to be under danger of death. Also explored was
the relationship between the time elapsed since the trauma and the dif-
ferences between the groups. In this study these variables were not found
to have a significant effect on the relationship between depersonalization
and symptornatology. Previous investigations of post-traumatic responses
have put great emphasis on controlling for the severity of the traumatic
event. Figley’s (1985) Structured Interview for Post-Traumatic Stress Dis-
order in combat veterans asks for details such as the number of times the
participant had fired rounds at the enemy; Russell’s (1986) questionnaire
asks for particular details regarding every incident of sexual abuse and rates
these incidents by severity according to who the perpetrator was, whether
intercourse took place, and so forth. It is possible that further detailed in-
vestigation into the severity of each of the 10 events would have shown an
effect on the presence of depersonalization, but none was suggested by
these findings.
A few limitations of the study should be noted. First participants’
memories of traumatic events are potentially biased. Further, the study did
not include individuals who have a total amnesia of the events as often
occurs. While this study was able to establish a relationship between the
nonamnestic type of dissociation and symptomatology, future research is
suggested to further assess the differences between depersonalization and
amnestic types of dissociation as they are related to syrnptomatology. Fur-
ther research is also important to explore nonstudent, nonvolunteer par-
ticipants. Also of interest would be to design a longitudinal study in order
to explore the relationship between depersonalization and symptomatology
over time.
T h e goal of the study was to explore a relationship between a
d e f e n s e mechanism activated during trauma and subsequent
symptomatology. While further research with a larger and more diverse
Depersonalization a s a Defense Mechanism 127

sample, using well controlled variables can provide confirmation, none-

theless this is an important first step in establishing these relationships.

ACKNOWLEDGMENTS

This study is based on a dissertation prepared in partial fulfillment

of the requirements for the degree of doctor of philosophy, the psychology
department, Boston University. The first author wishes to acknowledge
primarily the contributions, guidance, and support of the dissertation com-
mittee members: Frances K. Grossman, Douglas M. McNair and Michael
Z. Fleming. This work had also benefited from the continuous feedback
of the participants in the Boston University Resiliency Project.

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