- •Table of Contents
- •Overcoming depersonalization and feelings of unreality a self-help guide using Cognitive Behavioral Techniques
- •Important Note
- •Isbn 978-1-84529-554-7 eIsbn 978-1-47210-574-5
- •Introduction: Why a cognitive behavioral approach?
- •What is dpafu?
- •How do I know if I have dpafu?
- •When does dpafu occur?
- •Diagnosing dpafu
- •How common is dpafu?
- •Is there a typical dpafu pattern?
- •Dpafu case studies
- •A brief history of dpafu
- •What causes dpafu? Physical explanations: What does the brain have to do with it?
- •Psychological explanations: What does the mind have to do with it?
- •Linking body and mind
- •The cognitive behavioral therapy approach: cbt for dpafu
- •Introduction
- •The cbt approach
- •Dealing with the core problem Defining the problem
- •Setting goals
- •Diary keeping
- •Building an explanation that fits
- •Thinking in new ways: Challenging your thoughts
- •Behaving in new ways: Tackling your avoidance and safety-seeking behaviors
- •Reducing symptom monitoring
- •Managing your own treatment
- •Worry, anxiety and dpafu
- •Low mood and dpafu
- •Recognizing change and preventing relapse
- •Other useful techniques ‘Grounding’ strategies
- •Problem solving
- •Relaxation and mindfulness
- •Exercise, diet and sleep
- •How to deal with problems related to dpafu Low self-esteem and self-confidence
- •Drugs and alcohol
- •Other types of treatment Psychological therapies
- •Medication
- •Other physiological treatments
- •The Cambridge Depersonalization Scale cambridge depersonalization scale (State Version)
- •Depersonalization scale (trait version)
- •What are antidepressants?
- •Blank worksheets
- •Academic articles
- •Classic historical books and articles
- •Websites
- •Organizations
Recognizing change and preventing relapse
People often feel disappointed that progress in overcoming their DPAFU isn’t as quick as they’d hoped. But bear in mind that, for most people, DPAFU is a long-standing condition that may have developed over a number of years (see Alexi’s story on page 19). And though it’s very likely that eventually you’ll feel better, it’s not surprising that it takes time to make progress.
It can also sometimes be hard to see that there’s been a change in your DPAFU. This is why the use of diaries or record sheets is invaluable. When you look back, you’ll often find that change has taken place, though it may have been slow and gradual. Often people have different ideas about what constitutes change. For example, one man started treatment after many years of being unemployed and living at home with his parents. He always reported that ‘nothing had changed, and everything was just the same’. This was despite now having a new girlfriend, doing voluntary work three days per week and living with friends. On the other hand, one woman reported being ‘cured’ although everything else in her life remained constant. She was still unable to do the same things as before. She just felt better.
For these reasons it’s important that you keep your goals in mind and ensure they follow the SMART rules so that you can measure change. You also need to ask yourself whether, if you didn’t have DPAFU, you’d still have these problems. Would you still feel low or anxious at times? And would your relationships be any more successful? The chances are that some problems will still remain. We all come up against a wide variety of problems and difficulties in life. It’s part of the human condition to try to make sense of what is happening to us. That’s why it’s very easy sometimes to blame one thing on another. Research has shown that there is a tendency to attribute all physical and emotional sensations to DPAFU. There may be no good reason to think this except that it feels like this is the case. This is the cognitive error of emotional reasoning.
If, after working through this book, you still feel that you’ve not made any progress, or you’ve had a setback, you could either go along to your GP and ask to be referred to a therapist or try working through the book again. But remember that it is not uncommon to make progress in short bursts. For some, progress may be slow to start; others reach a plateau and feel there is little point in continuing with treatment.
Be aware of the following factors that may contribute towards you feeling that you are either ‘stuck’ or having a ‘relapse’. After all, forewarned is forearmed.
• Spending increasing amounts of time focusing on how you are feeling and what is happening to your DPAFU can make you much more aware of your feelings and can make it seem as if things are getting worse.
• Stressful life events such as bereavement, moving home, beginning or ending a relationship or starting a new job will still happen. Don’t blame all your negative feelings on DPAFU.
• Feeling low or depressed may not be connected to DPAFU.
• Physical illness can leave you feeling emotionally as well as physically drained.
• Using illicit drugs or excessive alcohol as a coping strategy will almost certainly make you feel a bit ‘spacey’ and detached, and will worsen your DPAFU. The side- or after-effects of such substances may also increase low mood and/or anxiety.
If you do find yourself having a setback that is more than the usual fluctuation in health and well-being that we all experience, don’t panic! Instead think what has been happening. Is this setback a response to an event or situation? If so, think about revisiting the sections on managing stress, problem-solving and relaxation. If the setback feels as if it has come out of the blue, use thought records to try to pinpoint the context in which it arose. What do you think the setback means? Are you worrying about DPAFU? Are you noticing more symptoms? You may want to revisit the psychological model on page 35 and see how what is happening to you fits. If you feel that your mood is becoming lower and you’re feeling more despondent, ask your GP for individual (face-to-face) therapy.