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Psychiatry

Derealization, Concern, and the Feeling of Reality

Studying certain symptoms illuminates philosophical debates about what is real.

Key points

  • Derealization is a symptom wherein a person reports that the world around them does not feel real.
  • What is missing in derealization is something affective or a kind of emotion.

When I look around my room, I see a laptop, a lamp, a coffee cup, and various other odds and ends. The temperature in the room is cool. I hear the rain falling outside and the occasional dog bark. This description is what it is like to be in this room now.

Some philosophers want to say that these sensations have an additional feeling. That is because the scene around me feels real. I feel that I really am in a room, with a lamp, with the rain falling outside. These feelings do not accompany a vague sense of unreality that seems to infect dreams or hallucinations. All of this feels real.

Max Vakhtbovych/Pexels
Source: Max Vakhtbovych/Pexels

What is this feeling? Is there such a thing? One way of considering this question is by considering individuals who report that things do not seem real to them.

Derealization is a symptom wherein a person reports that the world around them does not feel real. It often connects with the related phenomenon of depersonalization, where one feels in some sense detached from oneself.

Derealization may have various causes–trauma is one important cause, though not the only–and various manifestations. Some individuals report feeling that life feels like a movie or a video game. If there is a single thing that individuals with derealization seem to lack, it is what I described above–a sense that all of this is real.

Some philosophers have thought that the sense of reality is nothing other than the awareness of the objects in one's environment. These individuals are perfectly aware of the things in their environment that just don't seem real to them. But consideration of derealization suggests that this cannot be quite right. The philosopher Alexandre Billon recently argued that the phenomenon of derealization should lead us to take seriously the idea that we do have a sense of reality.

Billon surveyed the psychiatric and philosophical literature to consider how to understand the various accounts of how this feeling (and its absence). I want to focus on one such account. What is missing in derealization is something affective–a kind of emotion. As Billon pointed out, this is a view with a long pedigree in the history of psychiatric thought about derealization. There is some evidence that derealization is associated with defects in emotional processing. But, if what is missing in derealization is a kind of emotion, what kind of emotion precisely is it?

Begin with the thought that positive emotions are often responses to value. Love is, in part, a response to the value of one's beloved, and joy is a response to the value of whatever one finds joy in. Maybe individuals with derealization lack a basic affective orientation towards the value of the world and a sort of emotional recognition that the world matters.

To experience derealization is, at least in part, to lack that basic sense of concern. (Billon attributes the idea that the connection between emotion and value is crucial to understanding derealization to unpublished work by the philosopher Richard Dub, though he reports Dub's view is different from the one suggested here).

If that is what it is to lack the feeling of reality, then we also understand what it is to have the sense of reality. For many of us–that is, for those who are not subject to derealization–the feeling of reality can be considered a kind of affective background noise for all of our experience, so constant that we do not notice it until it is missing.

I look around to notice the room, the lamp, and the rain falling outside. I also do so to feel that this matters and concern myself with what happens here.

As Billon pointed out, one objection to this view is that someone may avow a belief that the world is without significance or value (for example, certain pessimists do) without experiencing derealization. But in the present view, the feeling of reality is deeper, or anyhow different, from our beliefs about reality. It is not an intellectual state but an emotional one.

This view may shed light on some philosophical debates about reality. Consider debates about the metaphysical status of virtual reality. Many of us think that virtual reality, fascinating as it may be, is unreal. When I play miniature golf in virtual reality (as I have done), I use an unreal putter to hit an unreal ball.

Against this view, some have suggested that the virtual world is not an alternative to the real world: it is an equally real, though non-physical, part of the world. The philosopher David Chalmers argued that we should regard virtual worlds as real, and in fact that if this entire world turns out to be a computer simulation (as he thinks it might be), then this would not undermine the claim that there really are lamps, and desks, and dogs.

How do we decide between our current boundary for reality and the more expansive one urged by Chalmers? A thought suggested by the foregoing is that this decision is ultimately one for our collective hearts, as much as it is for our heads. Part of what it is for some aspect of our experience to be real is for us to take it to be real and what it is for us to take it to be real is for us to extend a basic attitude of concern towards it.

Whether virtual worlds will count as real will then be a question, in part, of whether they come to matter to us in the way that the familiar physical world, at least for most of us, already does.

References

Billon, A. (Forthcoming). The Sense of Existence. Ergo.

Chalmers, D.J. (2022). Reality+: Virtual Worlds and the Problems of Philosophy. New York: Norton.

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