Weed can be a joy. It can induce belly laughs with friends about the incomprehensible and greatly enhance sensory experiences. As Amy Winehouse (2004) once slurred:
"All the songs sound better when you're next to me
Yeah, 'cause you come naturally"
Yes, weed can be a joy until it's not. On the flip side of the good trip is, of course, the bad trip. And some trips can be very bad.
Depersonalisation and Weed
Skunk, hash, and other forms of cannabis with high levels of the compound tetrahydrocannabinol (THC) commonly and reliably trigger depersonalisation and derealisation (DPDR) in individuals disposed to experiencing such states. In some cases, one only has these alterations in perception whilst under the influence of THC. What is less understood is why individuals continue to experience depersonalisation after the effects have worn off (Sierra, 2009: 63) (Moran, 1986) (Berkowitz, 1981).
Jane Charlton, a founding member of the Unreal (the UK's only charity dedicated to DPDR), described her experience as follows:
"I'd smoked cannabis once before [and on previous occasions, the effects] passed quickly. This time, after eating the second yoghurt, something terrifying happened. My perception drew back into my head, almost as though I was now looking at the world from the back of my own eye sockets. I perceived a delay between an external event, and my brain understanding or processing it. Suddenly there was a fracture between the world and me. While my body was still in the world, my mind had become a disengaged observer. The next morning, the shift in perception remained, and would in fact remain for every second of every day for the next three years." (Charlton & Ciaunica, 2018).
The memory of experiencing DPDR for the first time under the influence of cannabis is often described as feeling terrifying and life-threatening (Moran, 1986). These distressing states usually occur when the person is under significant stress. Following the onset of DPDR, severe anxiety, agoraphobia and panic are also reported (Sierra, 2009: 63).
Many people, like Jane, who have experienced chronic DPDR after using cannabis often say they had used it before without this effect. However, the situations that lead to these protracted effects are described as similar or the same as when they first used it.
Psychic Defences and Trauma
Cannabis is eliminated from the body after several weeks, and so how its dissociative effects can remain for months or years after this requires explanation (Sierra, 2009: 63). Szymansky states that "once patients had experienced depersonalisation, intrapsychic factors may have contributed to its continued use as a defence mechanism after acute intoxication" (Szymansky, 1981: 232). I imagine that these intrapsychic factors are those that I have spoken about in previous articles, such as repression of affect, forming an identification with a destructive superego and identification with the observer (Freedman: 2024a-d).
Berkowitz (1981) suggests that cannabis-induced DPDR can be understood as a variation of a conversion disorder. The traditional notion of a conversion disorder is one where physical symptoms or complaints replace repressed psychological states. In this case, DPDR are psychological symptoms that replace some other psychological conflict that the individual is struggling with and attempting to repress.
Intuitively, this makes sense for the following reasons. Firstly, many individuals with drug-induced depersonalisation can become preoccupied with the notion that their symptoms have an organic cause, such as being symptoms of a brain tumour. Thus, although the symptoms are psychological, one is still able to fixate on the notion of the symptoms having an organic cause in the same way that the physical symptoms of a conversion disorder are thought to have an organic cause.
Secondly, the DPDR symptoms after ingesting cannabis are usually triggered during a period of severe stress or life transitions. As cannabis usually causes the mind to free associate and become more creative, depersonalisation or derealisation may kick in to prevent the individual from becoming aware of what is really concerning them. For example, say someone is on the receiving end of domestic abuse in their marriage. Such a person may repress the idea that what they are experiencing is abuse, may rationalise the abuse or is too afraid of the consequences of leaving. It is possible that, after they smoke weed, the repressed is at threat of becoming unrepressed through the drug's abreactive effects, and so, the DPDR kicks in to protect the individual from this conflict or knowledge.
Therapy for Cannabis-induced Depersonalisation and Derealisation
Based on what I have outlined above, I'm convinced that drug-induced depersonalisation or derealisation could potentially be effectively treated using the methods I previously proposed for dynamic therapy. This is because, the symptoms may be protecting the person from what would have become known or felt. An area for further inquiry is the potential benefit of addressing precipitating or concomitant factors that were present before the onset of DPDR. This approach may offer valuable insights into the underlying effects, desires, conflicts, and more that the DPDR is shielding the individual from.
Sources
Berkowitz, H.L., 1981. Marijuana-induced depersonalization. American Journal of Psychiatry, 138(10), pp. 1396-a–1396.
Ciunica, A. and Charlton, J., 2018. What can depersonalisation disorder say about the self. [online] Available at: https://aeon.co/essays/what-can-depersonalisation-disorder-say-about-the-self [Accessed 30 June 2024].
Freedman, J.K., 2024a. Depersonalisation, trauma, alexithymia, and psychodynamic therapy. Counselling Directory. [online] Available at: https://www.counselling-directory.org.uk/memberarticles/depersonalisation-trauma-alexithymia-and-psychodynamic-therapy [Accessed 30 June 2024].
Freedman, J.K., 2024b. Depersonalisation and childhood trauma: A psychodynamic perspective. Welldoing. [online] Available at: https://welldoing.org/article/depersonalisation-childhood-trauma-a-psychodynamic-perspective [Accessed 30 June 2024].
Freedman, J.K., 2024c. Depersonalisation and the disembodied ego. [online] Available at: https://www.jakekanefreedman.com/post/depersonalisation-and-the-disembodied-ego [Accessed 30 June 2024].
Freedman, J.K., 2024d. Depersonalisation and the superego. [online] Available at: https://www.jakekanefreedman.com/post/depersonalisation-superego [Accessed 30 June 2024].
Moran, C., 1986. Depersonalisation and agoraphobia associated with marijuana use. British Journal of Medical Psychology, 59, pp. 187-196.
Szymanski, H.V., 1981. Prolonged depersonalization after marijuana use. American Journal of Psychiatry, 138(2), pp. 231-3.
Winehouse, A., 2004. Mr Magic. On: Frank [Album]. Island Records.
le on depersonalisation and weed.