- •Contents
- •Foreword
- •Acknowledgments
- •Introduction
- •Assumptions of This Book
- •How to Use This Book
- •What Is Depersonalization? What Is dpd?
- •What Is Depersonalization?
- •When Does dpd Happen?
- •Behaviors, Feelings, and Thoughts Associated with dpd
- •How Does dpd Affect Your Life?
- •When You Need Professional Help
- •Depersonalization as a Dissociative Disorder
- •Summary
- •Why You Can’t Think Your Way Out of dpd
- •Self-Focus Makes Things Worse, Not Better
- •Acceptance: The Alternative to Problem Solving
- •Summary
- •Why Depersonalization Disorder Develops
- •The Impact of Trauma
- •Cultural Factors That Contribute to Depersonalization
- •The Effect of Substance Abuse
- •Neurobiology of Depersonalization
- •Neuroanatomy of Depersonalization
- •Summary
- •Understanding Conditions Related to Depersonalization Disorder
- •The Two Types of Depersonalization
- •Depersonalization and Other Psychological Conditions
- •Figure 4.1 Reciprocally Reinforcing Maintenance of Depersonalization/ocd Symptoms
- •Summary
- •Depersonalization from an Acceptance and Commitment Therapy Perspective
- •Depersonalization According to act
- •Figure 5.1 Psychologically Inflexible Decision Making Juxtaposed with Flexible Decision Making
- •Identifying “You” from Your Beliefs About Yourself
- •Summary
- •Using Acceptance and Commitment Therapy
- •The Functional Approach: Doing What Works Rather Than What Feels Right
- •Summary
- •Using Dialectical Behavior Therapy Strategies
- •The Dialectical Approach
- •Rational vs. Emotional Mind
- •Acceptance vs. Change
- •The Misery of dpd vs. Feeling Numb
- •Mindfulness
- •Distress Tolerance
- •Emotion Regulation
- •Interpersonal Effectiveness
- •Summary
- •Using Behavioral Strategies
- •Behavioral Therapy (bt)
- •Summary
- •Other Treatment Options
- •Other Psychological Approaches
- •Psychopharmacological Options
- •Magnetic Stimulation
- •Cingulotomy
- •Summary
- •Frequently Asked Questions
- •Recommended Reading
- •References
Assumptions of This Book
As we approach the task of helping you manage depersonalization, we assume the following about you—and all people, for that matter. It’s important that you keep these assumptions in mind as you learn the behavioral and acceptance strategies we’ll discuss later on:
There’s nothing inherently wrong with you. Your mind has actually found an important and adaptive way of dealing with the unique obstacles life may have thrown your way. As we’ll explain in chapter 3, when you developed depersonalization, you may have preferred numbness to feeling what you would have otherwise felt.
Your feelings are very important. You have suffered a great deal, and your pain informs us that feeling connected to people and your environment is important to you. If you are miserable because you can’t tap into your feelings anymore, it’s because human connectedness is very important to you. As we’ll discuss in greater detail in chapter 6, it’s important to be willing to experience your pain, because it represents the flip side of what you value the most.
Having respect for your feelings doesn’t necessarily mean acting the way they urge you to do. Even though your feelings are there to protect you, they sometimes pressure you to do things that aren’t in your best interest. As you’ll see in chapters 6 and 7, mindfulness strategies can help you listen to your thoughts and feelings while acting in a deliberate manner, with attention to what actions are actually in your best interest.
It’s impossible to entirely avoid suffering if you are doing anything of value. Love is inherently peppered with disappointment, conflict, and loss; professional advancement requires sacrifice, energy expenditure, and patience; friendships entail selflessness and investment. Nothing worth pursuing is painless, and that includes using the strategies in this book to cope with depersonalization. Expect that this will be a difficult process, and try to keep your focus on how much you value getting better: even though it’s painful, what about this process is worthwhile to you?
The present moment is all you have to work with. Although it’s easy to become preoccupied with past failures or future worries, now is the only thing that’s real. The acceptance and mindfulness strategies we’ll explore throughout this book will help you keep your focus on the present moment.
How to Use This Book
This book is designed to help you understand and overcome DPD. You can skim through the chapters to get an overall understanding of the basic concepts discussed, then go back and read each chapter more carefully. Of course, you won’t identify with everything, because nobody experiences exactly the same symptoms, but there are bound to be things you can relate to, especially in the personal accounts of those who have DPD.
As you go through the book, be sure to take notes, complete the exercises, and follow the suggestions given. It will probably be helpful if your family members also read this book, so they can better understand how you feel. Chapter 7 will cover how to assertively communicate your experience to your loved ones, because sharing your experiences with, and being understood by, your loved ones will help decrease your feelings of isolation.
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