Diary keeping

Keeping a diary of your DPAFU sensations can be very helpful for several reasons:

 

•   It can give an accurate measurement of the frequency and intensity of your DPAFU as it stands now. After you’ve tried out the techniques we describe in the following sections of the book, you can keep another diary. Then you can compare them to see how your sensations of DPAFU have changed and in what ways.

•   Rating the intensity of your DPAFU sensations at frequent intervals can help you identify whether there are any fluctuations.

•   Noting down your thoughts, emotions and current environment can help show any patterns accompanying your DPAFU. This will help you see patterns of which you may have been previously unaware.

•   Gaining a better understanding of what affects your DPAFU will give you a greater sense of control. This is because it will enable you to try to decrease the situations that cause your DPAFU to worsen and increase the situations that improve it.

Before we go on, a word of caution. Keeping a diary of this kind is a staple of CBT treatment for a number of conditions, especially anxiety and depression, and has been used by probably thousands if not millions of people over the years. We think it can help many people with DPAFU. However, DPAFU can take different forms and, as you’d expect, people can react to it in different ways. So some people may not find keeping a diary beneficial. One of the patterns of thinking and behavior that we have observed in our depersonalization clinic is that it is easy for people to get caught up in observing themselves and their actions – not to find ways of breaking cycles of behavior, but rather as a way of proving to themselves that they really are experiencing DPAFU. It becomes a self-fulfilling prophecy. For example, you might say to yourself: ‘I bet when I go to work tomorrow I will be mechanical and unspontaneous, not like a real person’. You then spend all your energies analysing a minute gesture made by a colleague or a chance remark made by a friend for ‘evidence’ that they think you’re not behaving normally. You then devote far too long to recording tiny instances when maybe you could have reacted differently. If this is what you do, you need to change your approach.

With these cautions in mind, there are two types of diary we recommend. The first is a diary in which you rate the severity of your DPAFU on an hourly basis. This is useful if your DPAFU is constant and/or appears to lack any variation. The second type of diary is one in which you record the situations, thoughts, emotions, behaviors and sensations that accompany your DPAFU. This type of diary is best if you experience DPAFU intermittently.

The hourly diary for continual DPAFU

People who suffer with continual DPAFU frequently report no variation at all in how they feel. Their sensations seem constant and unremitting. However, after closer examination, it is often found that there are very slight and subtle variations in the DPAFU sensations. These may be difficult to recognize at first.

Table 6.7 on pages 76–78 presents an example of a partly completed diary to show you how it might look when it is completed. Table 6.8 on pages 80–81 is a blank hourly diary for you to complete. You’ll find another blank copy in Appendix III. You will see that the diary looks rather like a timetable, with the days along the top and the time (in hours) down the side. For each hour, briefly describe the situation you are in and then rate the intensity of your DPAFU, from 0 (indicating none whatsoever) to 10 (indicating the worst your DPAFU has ever been). There are no right or wrong responses to this – just note down whatever score seems most appropriate to describe how you are feeling.

Alexi’s partly completed diary is on pages 76–78.

If we look at Alexi’s diary we can see that, although he experiences DPAFU all the time, the intensity of this varies quite significantly depending on his situation. Using the detailed information from the diary we can see the times when his DPAFU is at the lowest and highest points and see if any patterns emerge. One way of doing this is to categorize his activities according to their DPAFU scores:

High DPAFU activities (scores from 8–10)

 

•   Meeting with boss

•   Shopping in supermarket

•   Travelling to work (when busy)

•   Presentation to clients

•   Talking to clients

•   Talking to new people (in social situation)

•   Meeting Liz for meal

•   Driving

Moderate DPAFU activities (scores from 4–7)

 

•   Travelling to/from work

•   Paperwork at work

•   Phone calls at work

•   Preparing presentation

•   Meeting at work

•   Meeting friends for a drink in a bar

•   Shopping and lunch in town

•   Chatting in the club house

•   Watching film with Liz

•   Drinking in pub with Liz

Low DPAFU activities (scores from 0–3)

 

•   Meals at home

•   Lunch in the park

•   Watching TV

•   Reading in bed

•   Showering

•   Chatting to best friend/father

•   Doing housework

•   Playing football

•   Listening to the radio

•   Lunch with family

Review of Alexi’s Diary

Alexi’s DPAFU sensations appear to be at their worst in stressful work and social situations. This is especially when he has to interact with new people, lots of people or people who increase his anxiety (such as his boss or having a meal with Liz). Crowded and brightly lit environmental situations, such as travelling and supermarket shopping, also increase his DPAFU. Alexi’s DPAFU sensations worsen when he has to drive. However, when he is at work and in social situations where he feels more comfortable, his DPAFU is lower. The lowest levels are when he is quiet at home, experiencing physical sensations such as showering or playing football, or when he is with close family and friends.

Try to keep your own hourly diary for a week – but no longer than that. Next, look to see what patterns emerge. If you fill in the DPAFU rating as soon as possible, rather than leave it till the end of the day, it will be more accurate. If you forget about the diary for a time, don’t worry. Just start again and fill it in when you remember. It’s better if the information is accurate but patchy than if you complete it in retrospect by trying to remember how you felt at the time. If the week you chose to keep the diary turns out to be very untypical of your normal pattern, then it may be advisable to try again another week. The longer you complete the diary, the more information you’ll get, but generally a week or two is enough for clear patterns to emerge.

The STEBS diary for intermittent DPAFU

If your DPAFU is intermittent and comes and goes at different times, you might want to complete a diary that records your situations (S), thoughts (T), emotions (E), behavior (B) and sensations (S) (or STEBS) in order to detect any patterns that may be affecting your sensations. One suggestion is to think back over the day, identify the best and worst bits, and then record what you were doing at these times. What were your thoughts at these times? How did you actually feel and what did you do? This will help you notice any variations. You may find this difficult at first, because it may feel like there are no best or worst bits. However, you may notice times when you expected to feel something but did not, and vice versa. Try to be specific when you describe how you were feeling. For example, instead of saying you felt ‘upset’, see if you can distinguish whether you were sad, frustrated or anxious. Similarly, try to be as precise as you can if you feel cut off from your emotions. Instead of stating that you felt ‘nothing’, perhaps you can pin down whether you felt detached, numb, blank or spaced out.

Overleaf is a sample diary. There’s no set format to this type of diary so we suggest you try something similar to the example provided and then adapt it to meet your needs. The essential components are to record how you’re feeling physically and emotionally. Also record the thoughts associated with these feelings and what you were doing before, during and after these thoughts. We have included a blank diary sheet for you to copy on page 83 and in Appendix III.

Once you have kept a diary for a week or two you will begin to get a clearer picture of how DPAFU is affecting you. This will provide a good basis for you to really pinpoint how the sensations associated with DPAFU impact upon your life. At this point, we recommend that you look over the list you made at the end of Chapter 4 of how DPAFU affects you on different levels. You can now add to or amend this list.

One word of caution: our research has found that it is very common to notice an increase in DPAFU sensations when you first begin to talk or think about them more. Again this ties in with the model outlined in Chapter 4. The more you think about symptoms or sensations, the more you look for them and monitor them, and so the more you notice. The more you notice, the more you think about them, look for them and monitor them. However, this initial stage is an important part of self-managing your DPAFU.

Diary keeping is a powerful tool. Use it for a specific purpose – e.g. ‘I want to see if my sensations differ according to the time of day’ – not as an open-ended habit or substitute for living. Restrict diary keeping to the sort of formats recommended above and don’t make it a repository of how bad you feel and all that is wrong with the world. If you’re worried about becoming obsessed with observing yourself, or if you’ve recognized that this is a problem you would like to avoid, restrict yourself to a set period of updating and review – say half an hour in the evening.