Acknowledgments

This book was inspired by our work with a few people who moved us with their overwhelming suffering and ultimate resilience. Depersonalization disorder (DPD) is one of many psychological conditions that don’t fit comfortably into one category. Depersonalization might describe an obsessive-compulsive process, a symptom of somatization or hypochondriasis, an extension of panic disorder or post-traumatic stress disorder, an extreme of depression, or really any other form of extreme suffering. However, DPD might instead manifest as numbness, “fogginess,” social alienation, or similar complaints. Because DPD tends to mess with your very sense of self and awareness, it’s one of the more disturbing of the somatization/anxiety disorders. We would especially like to acknowledge those of you with DPD for sharing the stories of your struggles, the stories that pepper this book.

We would also like to acknowledge the tireless clinicians and researchers who have contributed to the empirical foundation for this book. Daphne Simeon, MD; Dawn Baker, D.Clin.Psy.; Elaine Hunter, Ph.D.; Nicholas Medford, M.R.C.Psych.; Emma J. Lawrence, B.Sc., Ph.D.; and Anthony S. David, MD, F.R.C.Psych., have established the framework for contemporary research on depersonalization and other dissociative conditions. Steven C. Hayes, Ph.D.; Kelly G. Wilson, Ph.D.; Kirk D. Strosahl, Ph.D.; Michael P. Twohig, Ph.D.; Jon Kabat-Zinn, Ph.D.; and Marsha Linehan, Ph.D., have provided the research and philosophy that have fueled and given credit to the acceptance-oriented therapeutic movement, which has inspired this book’s therapeutic emphasis.

We would also like to acknowledge the publishers who have worked relentlessly to make this a user-friendly manual. Specifically, Catharine Sutker has provided us with needed guidance and constant feedback. She has been invaluable in her encouragement and support with this and previous books.

Finally, we would like to acknowledge the support of our friends and family members.

Introduction

My friends and family don’t understand what I go through. My parents always say, “You’re crying now. How can you say you can’t feel anything?” Whenever I try to explain, I just feel I’m coming across as defensive. What’s the use? People in my life will never understand me. How can they? They never felt depersonalized, isolated from everything around them, as if they were just going through the motions of living. Who lives like a robot day in and day out? I feel so anxious about my future and afraid I’ll never be able to change this horrible state of unreality. Everything seems so far away, different from the way it used to look. What happened to me, to my brain? Why do I feel like this? Will it ever go away? I don’t want to be around people: it’s just too hard.

The quote above, which a young woman with depersonalization disorder (DPD) provided, highlights a common experience among people with depersonalization: most people in your life don’t understand what depersonalization feels like or how much it makes you suffer. Unfortunately, this includes loved ones and mental health professionals alike. You’ve probably picked up this book because these frustrations are all too familiar to you. Maybe you’ve been down an often-fruitless path as you sought help from the mental health care system. Perhaps you’ve received misdiagnoses and tried countless medications, as you try to feel normal again.

If you are like most people with chronic depersonalization, when you finally came across the term “depersonalization,” you were probably very moved to hear that others feel as you do and that you finally found a word that describes your experience. Yet, maybe you’ve never heard other people talk about their own experiences with depersonalization. Some psychological terms are part of the public vocabulary; if you tell a friend or family member you had a panic attack, that person will generally understand what this means before you describe your experience. Depersonalization isn’t as familiar to most people, which means that not only do you have the pressure to “get better,” but you also have to explain yourself and educate other people about the condition. You may also have to take the initiative for your own treatment. Finding a psychiatrist or psychologist who specializes in treating depression, phobias, or borderline personality disorder may be simple enough, but finding a mental health professional with an expertise in treating depersonalization disorder isn’t always as easy. Fortunately, more and more people are gradually becoming interested in depersonalization disorder.

Research into depersonalization is still in a formative stage, so relative to other psychological phenomena, we have a lot to learn about it. But one thing is clear for the time being: there’s no quick fix, and there are no infallible medical options. If you have a bacterial infection and take antibiotics for it, it’s likely to go away. Depersonalization doesn’t respond in this way. The fact is, there’s no cure for depersonalization disorder, and searching for a way out of it may even do more harm than good. This may be difficult for you to hear, but at the same time, we want you to know that there are things you can do to feel better. DPD is treatable, and you can get your life back. The purpose of this guide is to help you manage your discomfort while staying engaged in life. We’ll explore principles of acceptance and provide strategies that will help you tolerate your discomfort on a daily basis while pursuing what’s important to you. This is essential, because ultimately, beating depersonalization means refusing to let it push you around and dictate how you’ll live your life. While we can’t promise a cure for depersonalization, we can arm you with an approach and a plan that will allow you to take back the reins. And while it’s not your fault that you ended up in this situation, you are the only one who can start the process of moving forward. We believe that no one with depersonalization is doomed to a half-life, and while recovery is a difficult process, it’s not a hopeless one.

The first half of this book will give you more information about depersonalization and DPD. The later chapters will focus on treatment. We’ll introduce acceptance and commitment therapy (ACT) and show you how you can use it to suffer less and live a better life—even with depersonalization. We’ll also introduce mindfulness and grounding strategies, along with other dialectical behavior therapy exercises. Finally, we’ll teach behavioral strategies to help you confront your discomfort and pursue healthy, functional life activities.