This article covers clinical territory that can feel alarming when experienced. If dissociative experiences are becoming persistent, distressing, or are significantly affecting your ability to function, speaking with your GP or a psychologist is the right next step. Mind’s Infoline is available on 0300 123 3393. Samaritans are available 24 hours on 116 123.

What these experiences actually are

Depersonalisation is the feeling of watching yourself from outside — being a spectator at your own meetings, conversations, or decisions. The entrepreneur who describes feeling like they are “going through the motions” or that “someone else is running the company” is describing this experience.

Derealisation is the feeling that the environment is unreal — that the office, the team, or the business feels dreamlike, remote, or staged. A founder who experiences a board presentation as if it is happening to someone else, or who describes the company as feeling “not really mine anymore,” is describing this.

Both involve intact reality testing. The person experiencing them knows the experience is not literally real. They know they are in their body. They know this is their life. That is the critical distinction between a stress-induced dissociative episode and a break with reality — and it matters for how these experiences are understood.

How common this actually is

Hunter, Sierra, and David’s 2004 systematic review at King’s College London is the primary epidemiological reference. Transient symptoms of depersonalisation and derealisation in the general population have a lifetime prevalence rate of between 26% and 74%. Between 31% and 66% of people experience them at the time of an acute stressor or traumatic event.

The clinical disorder — the chronic, persistent, clinically significant form — has a prevalence of 1-2% in community samples. The transient symptom — the stress-induced detachment that entrepreneurs describe — is experienced by a majority of adults at some point in their lives.

The three trigger categories identified in the research are interpersonal stress, financial stress, and occupational stress. An entrepreneur navigating a cash flow crisis, a co-founder conflict, and a board meeting about company direction simultaneously is encountering all three primary triggers at once. The prevalence rates in founder populations are almost certainly higher than general population baselines given the chronicity and intensity of these stressors combined.

Up to 74% of the general population have experienced transient dissociative symptoms. The experience is not evidence of serious mental illness. It is evidence of a nervous system responding to overwhelming demand.

The neurobiological mechanism

Dissociation under stress is a documented neurobiological response, not a character failing. The same HPA axis and amygdala systems that drive the fight-flight-freeze responses described in an earlier article in this series are involved — but extended to the point where the nervous system shifts from activation into a protective detachment state. (https://courben.co/article/the-neuroscience-of-stress-responses-in-entrepreneurs-fight-flight-freeze-and-fawn-in-business-contexts/)

The mechanism serves a purpose: it creates distance from overwhelming emotional content to allow continued functioning. A founder who is objectively overwhelmed but still needs to run a board meeting, manage a team, and make decisions can continue to function through a dissociative state that the nervous system has produced precisely to enable that continued function.

The problem is not the acute response. It is when the response becomes chronic — when protective detachment from the stressors of the business gradually becomes a general disconnection from the experience of being alive in the business.

The avoidance trap the research documents

Research published in Frontiers in Psychiatry in 2024 documented a specific pathway: when depersonalisation is used as a chronic coping strategy — when the entrepreneur habitually disconnects from the emotional content of their working life to keep functioning — the short-term relief prevents the emotional processing that would allow recovery.

The founder who can discuss serious business problems with complete clinical detachment has not developed healthy perspective. They have likely developed a protective dissociation that trades short-term functionality for the longer-term inability to access the motivation, meaning, and emotional engagement the business requires.

This overlap connects to the burnout progression described in Maslach’s framework. The cynicism and depersonalisation of the later burnout stages — the emotional distancing from work, team members, and the meaning of what one is doing — shares neurological mechanisms with the dissociative experiences the clinical literature describes. Both reflect chronic stress-induced detachment. Both are downstream of structural conditions that individual coping has not been sufficient to address.

The practical recognition marker: if serious business problems no longer produce appropriate concern, if achievements no longer produce felt satisfaction, if the emotional responses that would previously have been present are conspicuously absent — this may reflect protective dissociation rather than equanimity. The distinction is worth examining rather than accepting.

If reading this produces recognition rather than curiosity — if the experiences described feel familiar rather than foreign — that is worth taking to a professional rather than managing alone. Persistent or distressing dissociative experiences respond well to psychological support, particularly approaches that work with the stress response directly rather than only at the cognitive level.

A book worth reading alongside this

Trauma and Recovery by Judith Herman is the most authoritative clinical account of how overwhelming experiences produce dissociative responses and what recovery actually requires. Her framework for the three stages of recovery — establishing safety, processing what happened, and reconnecting to the self and environment — provides the most rigorous available guide to what moving through these experiences looks like, rather than simply understanding what they are.

This article discusses psychological patterns documented in research on dissociation, stress physiology, and entrepreneurial wellbeing. It is not designed to identify, diagnose, or assess any dissociative disorder or psychological condition. If the experiences described here are persistent, distressing, or affecting your ability to function, please speak with your GP or a qualified mental health professional. UK resources: Mind (0300 123 3393). Samaritans (116 123, free, 24/7). IAPT services are available through GP referral.

This article is for educational and informational purposes only. It is not a substitute for professional psychological advice, diagnosis, or treatment. If you are experiencing significant psychological distress, please consult a qualified mental health professional.

Sources: Hunter, E.C.M., Sierra, M. & David, A.S. (2004), Social Psychiatry and Psychiatric Epidemiology, 39(1), 9–18. García-Campayo, J. et al. (2022), Journal of Trauma & Dissociation. Frontiers in Psychiatry (2024), depersonalisation and avoidance research. Maslach, C. & Leiter, M.P. (2016), World Psychiatry, 15(2).