A 26-year-old graduate student presents with persistent experiences of feeling detached from his own body, as if he is observing himself from outside, and a sense that the world around him appears unreal, 'like being inside a movie or dream.' These experiences have been nearly continuous for 8 months. He reports that during these episodes, he knows he is not actually outside his body and that the world is real — but the feeling persists despite this awareness. He denies hallucinations, delusions, substance use, and has no history of seizure disorder. MRI and EEG are normal.