- •Contents
- •Foreword
- •Acknowledgments
- •Introduction
- •Assumptions of This Book
- •How to Use This Book
- •What Is Depersonalization? What Is dpd?
- •What Is Depersonalization?
- •Behaviors, Feelings, and Thoughts Associated with dpd
- •When Does dpd Happen?
- •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
Acceptance: The Alternative to Problem Solving
Notice that self-focus, rumination, and obsession about depersonalization often lead to problem-solving thoughts: What can I do to get rid of this feeling? How am I going to live if I have to go on this way? How can I feel better?When it comes to depersonalization, a problem-solving orientation may work against you. Efforts to get rid of unpleasant thoughts, emotions, and sensations may just make the experiences all the more intolerable. So, what can you do? The alternative is being willing to experience the feeling, to stop the war with negative thinking, and to give your discomfort some room to be there as you work toward living the life you want. In chapters 5, 6, and 7, we’ll address mindfulness and acceptance as an alternative to changing your thoughts and feelings, in order to give you a wider range of strategies and a greater sense of peace. Mindfulness and acceptance might sound difficult, but throughout the book, we’ll teach you practical strategies that you can incorporate into your everyday life.
Just because problem-solving your way out of depersonalization doesn’t work, this doesn’t mean that your life has to continue in the direction of depersonalization or that you’ll never be able to enjoy the things you once enjoyed. On the contrary, what we are suggesting is that worrying and trying to solve an emotional struggle by making the feelings go away is counterproductive and, in fact, may just prolong your agony. Therefore, our focus will be on improving how you function, rather than exclusively on improving how you feel.
Summary
Though it’s human nature for us to try to beat psychological discomfort by getting rid of it, thinking about discomfort may only make the discomfort more real to us. While thinking about our problems may help us to solve problems in the external realm, it only leads to added discomfort in the internal world. Depersonalization may get worse when you try to get rid of it. As you learned from the exercises in this chapter, thinking about your feelings of depersonalization may actually serve to heighten them.
Depersonalization may also get worse when you try to avoid its accompanying feelings of discomfort. When we avoid unpleasant feelings, we also tend to avoid important life areas. Those areas of life we tend to value the most are those in which we suffer the most. Therefore, when you struggle with depersonalization, you may develop an inflexible routine to try limiting your discomfort, but doing so also limits your richness and diversity of experience. As we proceed, we’ll discuss ways you can ensure that you don’t neglect valued life areas while you’re experiencing feelings of depersonalization.
3
Why Depersonalization Disorder Develops
You are probably wondering how and why you ended up with DPD. Where did it come from? Human behavior is influenced by a tremendously vast pool of variables, including environmental, cultural, and biological aspects. In this chapter, we’ll explore what might have led to your developing DPD.