Last year, a woman told me about a tree she’d grown drawn to on her morning walks, episodes of merging with it, her sense of self dissolving into overwhelming love and tears, then eventually a full sense of leaving her body. She began hearing a guiding inner voice, distinct from her own thoughts, that once pushed her to approach a homeless man near the tree. She started reading meaning into small coincidences, as if the world were sending her messages. At her lowest point, she considered checking herself into a psychiatric hospital, hoping medication would let her feel “normal” again.

Her experience touched several things at once—a felt merging with nature, a guiding inner voice, meaning seen in coincidence—but it was the last part, the sense of leaving her body, that eventually became the center of her fear. That’s also where this piece will focus: the disembodiment feeling, and the question of what it means, clinically, when the “self” seems to leave the body.

I share her story because she is far from alone in asking the question that sits at the center of so many of these encounters: “Am I crazy?”

A question that’s more common than you’d think

A disembodiment feeling—often called an out-of-body experience, and the term I’ll use interchangeably here—is the sense that one’s center of awareness has left the physical body. It isn’t rare; it occurs in roughly 10-25 percent of the population. Yet when it happens, especially on an ongoing basis, many people quietly wonder if something has gone wrong with their mind. One of the few studies to look directly at this found, for instance, that 4 percent of experiencers felt they were going crazy during or immediately after the experience, 26 percent felt confused, 23 percent kept it a secret, and 24 percent felt upset or frightened afterward.¹

That reaction doesn’t come out of nowhere. For decades, disembodiment feelings have been folded into psychiatric frameworks, discussed alongside dissociative identity disorder, schizophrenia, borderline personality disorder, depersonalization, and disorders of body ownership.

When the questionnaire becomes the problem

Some of the very instruments used to screen for dissociation or psychosis describe a disembodied feeling almost word-for-word, with no room for context or outcome. A widely used depersonalization/derealization questionnaire asks: Have you ever felt that parts of your body were disconnected from the rest of your body? That you were a “detached observer” of yourself?² If someone answers “yes” to a list like this, what have we measured? Psychosis, or simply a disembodiment feeling that a huge portion of humanity also has, at some point?

Or consider a questionnaire developed to measure body disturbances related to schizophrenia, which originally used a set of images depicting unusual bodily experiences—several of which are, unmistakably, depictions of classic disembodiment phenomenology.³ For comparison, the same instrument includes images of experiences everyone has at some point (headaches, an itch, scratching, butterflies in the stomach) implicitly presented as “normal,” while the disembodiment-adjacent images sit in the pathology column.

This overlap runs straight into how dissociation is formally diagnosed. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) defines depersonalization/derealization disorder as persistent episodes of feeling detached from one’s own body, thoughts, or surroundings—a description sitting uncomfortably close to out-of-body experiences.

The DSM-5 includes three safeguards before the label is applied. First, “reality testing” must stay intact: the person retains insight that this is subjective, not an objective change in the world. (In practice: “It felt as though I left my body” reads as depersonalization; “My soul literally left my body” pushes some clinicians toward a label closer to delusion—even though the DSM-5 explicitly excludes beliefs ordinarily accepted within a person’s culture or faith. However, that protection isn’t always applied consistently.) Second, symptoms must cause clinically significant distress or impairment. Third, the experience can’t be better explained by substance use or another condition.

Indeed, data suggest that people who report feelings of disembodiment show somewhat higher levels of dissociation and body dissatisfaction than those who haven’t.⁴,⁵ My own study found a similarly complicated picture: People who’d had a disembodiment feeling showed more mental health diagnoses, more treatment history, and higher dissociation and childhood trauma.⁶ But one detail changes things: A shorter time since the first disembodiment feeling predicted greater current mental health difficulty—distress clustered near the onset, not indefinitely afterward. That points toward disruption and adaptation rather than fixed pathology; the feeling may sometimes be less the cause of difficulty than a consequence of it, or an adaptive response.

Dissociation Essential Reads

What actually predicts distress

If the presence of a disembodiment feeling doesn’t predict psychological trouble on its own, what does? Research on this points to something more specific: Anxiety tends to be higher when the experience involves a loss or dissolution of one’s sense of self, and when the person struggles to make sense of what happened to them.⁷ People who can’t integrate or explain their experience report more anxiety and self-concept confusion—which can feel a lot like “losing it,” even when nothing about their mental health has actually changed.

In other words, it’s not necessarily the experience itself driving distress nearly as much as the appraisal of it—whether a person comes to understand what happened as spiritual, meaningful, neutral, or as a sign that they’re losing their mind. Distress is more likely when the experience is intense, poorly understood, or interpreted as illness. Calmer, and often deeply positive, reactions tend to follow when someone finds a framework—spiritual, neutral, or otherwise—that lets the experience make sense.

None of this means disembodiment feelings can never co-occur with mental illness, but their presence alone should never be treated as evidence that someone is unwell. The better clinical questions are about suffering, context, functioning, trauma history, and integration—not simply whether someone has had an unusual experience.

I ask them because, in my inbox, I regularly hear from people carrying enormous shame around disembodiment feelings like hers, afraid to tell even those closest to them. That silence is its own kind of harm.

The woman I met last year didn’t check herself into the hospital. What she needed, it turned out, wasn’t medication to make the experience stop—it was language for what had already happened to her and permission to trust it. That’s the frame I keep coming back to: not “Is this pathology?” but “Does this person have what they need to make sense of what they’ve lived through?”