Re:Depersonalization/derealization and OCD

The dissociative states of depersonalization and derealization, as defined by the DSM, are most likely seen as part of another transient dissociative condition, such as Acute Stress Disorder, Fugue, etc. It is rare to see it as a stand-alone symptom and chronically present.

Thus, I will assume that either:
a) the person has another dissociative condition of which this is a symptom, or, more likely given the OCD component,

b) it is a interpretation that the patient is giving that may not in fact correspond to the DSM description. It may be that they are more Schizoid-like, and they are complaining of not being connected somehow to others.

If the former, then teaching a controlled dissociation from their stress and vigilance (of their stressful day) would be helpful. Techniques might include self-hypnosis (where they imagine a way the'd like to be) or an Eastern -based meditation, where one "dissociates" into the moment (and thus, away from their stresses, at least temporarily).

If the latter, then they might benefit from "associating" with their body in a comfortable way, such as is done in Yoga, Tai Chi, Chi Kung and the like.

If you can be more precise about the patient, perhaps I could give more precise feedback.

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