Intro and Review.
This one is the first book I read completely devoted to analyzing depersonalization as a condition . The analysis under mostly a scientific , psychological, historical lens as well as an analysis of cultural religious beliefs surrounding the condition was impressive compared to most of the scientific literature of this date. As a person who has dealt with Depersonalization myself, the amount of perspectives allowed by the authors on DP/DR is definitely worth a positive review.
what I saliently observed was the authors were trying their best to have a systemic inquiry for an objective cognizance. Many folks in hard sciences do not wanna look in to the religious and cultural viewpoints and makeups surrounding the topics of inquiry and this work has to be marked exceptionally holistic in that regard.
“In the meantime, the experience of depersonalization is nothing new, and its exploration has never been limited to the laboratory or the medical literature”
“Depersonalization is the neurosis of the good looking and intelligent who want too much admiration.
— PAUL SCHILDER , 1939″
also, Most people in Psychiatry and therapists, counsellors lack a deep understanding of depersonalization let alone some haven’t even heard of it .Therefore , this will be precious to provide a map of this condition for anybody interested.
“Depersonalization disorder (DPD) remains one of the most frequently misdiagnosed or underdiagnosed conditions in modern psychiatry. Why? Likely for several reasons. DPD is often accompanied by anxiety, depression, or other disorders, and patients may have trouble or hesitation expressing its vagaries in words that anyone but fellow sufferers can understand. “
“Patients often wind up being treated for depression or anxiety, even though they have tried to make clear that they were depressed or anxious only initially in their depersonalization course, or only well after depersonalization had set in.
The patients are often clear that what they are struggling most with are feelings of “unreality,” “deadness,” or “no self” and that they know the difference from being solely depressed or anxious. Clinicians, however, do not always agree, possibly because they have solid training in—and are more comfortable dealing with—the domains of anxiety and depression”
The book additionally provides a cohesive rundown of all the research done in the past few centuries on DPD from the 18,19 centuries to today’s cutting edge research and findings . The case studies alongside dozens of personal stories will be insightful for understanding by anybody trying to apprehend the condition .
Most cases and academic research are beautifully presented in a way that even a person without an academic background in psychology can understand. On the other hand, this will be an insightful book for those are going through depersonalized states themselves as the book recommend that learning about the condition will be a massive relief for those going through it.
“It is extremely helpful for patients to understand what it is that they are suffering from, in particular when it is the kind of experience that others have in different ways dismissed in the past or have simply been unable to comprehend.
Most sufferers from depersonalization have never encountered another person suffering from their condition, although the development of Internet communication has substantially decreased this isolation in recent years. Giving the syndrome a name and describing to patients how it typically presents itself, what brings it on, and what can be expected in the future can be tremendously reassuring.”
I got to read the 2009 publication and thus, the research done in the past 10 years are not included. However, an overview of all scientific literature and studies of depersonalization until 2006 is concisely summarised here. I must also admit that I had a little bit of a hard time remembering and apprehending the part with neuro- chemicals and receptors cause of the technical terms used and how I sucked at biology class in High school. 😀
[*DPD, DP/DR= Depersonalization Disorder, Depersonalization/Derealization]
-Willie’s star Rating⭐- here it comes! XD
Initially I thought about giving 4 stars ,but of the use ,perspective and the nuance allowed through the book tells me to place it with 5 stars .
⭐⭐⭐⭐⭐
As per a book specialized in understanding DP/DR, this is a highly researched masterpiece.
undoubtedly, this is worth rereading as if you are aiming to get a more deeper understanding on DPD as a disorder.
Key Takeaways* & Summary.
*Please notice that most of these takeaways are paraphrased in my own words or else they might be directly referenced or quoted from the book.
<what depersonalization(DPD) is;
“Depersonalization, a pervasive and distressing feeling of estrangement, known sometimes as the depersonalization syndrome, may be defined as an affective disorder in which feelings of unreality and a loss of conviction of one’s own identity and of a sense of identification with and control over one’s own body are the principal symptoms.
The unreality symptoms are of two kinds: a feeling of changed personality and a feeling that the outside world is unreal. The patient feels that he is no longer himself, but he does not feel that he has become someone else”
<The biggest takeaway for anybody going through DP/DR is that there are millions of people who are currently experiencing depersonalization/derealization .And you are not going insane. Insanity and depersonalization are completely different psychological issues though a common fear of going insane is pervasive among those suffering from Depersonalization.
“Depersonalization disorder, by our rough estimates, appears to be common and to affect 1-2% of the population”
“Equally relieving can be the reassurance that depersonalization, no matter how severe, never evolves into something worse or different: people never actually become crazy, psychotic, or schizophrenic as a result of it. There is also no evidence of irreversible brain damage with DPD,”
<This book also illustrates the same scientific stance that this can be mostly a defence strategy/mechanism of the brain.
“Psychoanalytic thinkers have issued their own theories about the origins of depersonalization for many years. The majority of these writers have agreed on one point: that depersonalization serves a purpose as a defensive strategy (“defense mechanism” as described in stricter psychoanalytic lingo) of some sort.”
“Although there is no single accepted theory among psychodynamic authors, most perceive depersonalization as a defense against a variety of negative feelings, conflicts, or experiences, when the individual’s more adaptive defense mechanisms fail. “Defense mechanism” is yet another tricky term that is still controversial as far as dissociation is concerned. Most contemporary theorists would probably agree that dissociation is more than a defense mechanism, (i.e., a largely unconscious way of processing internal conflict); instead, it is a subjectively experienced self-state or state of being.”
“This relates to the general consensus that dissociation is a universal survival mechanism, meant to help humans get through overwhelming stress that would otherwise leave them paralyzed with fear and unable to react. Indeed, in the short term, such a process may be very adaptive”
<clinical understanding of DPD;
“Ultimately, the following can be said with conviction about the presentation of DPD, according to current research:
• The average age of onset is in adolescence.
• Men and women are equally affected.
• It causes profound distress and dysfunction in people.
• Its onset can he either acute or insidious.
• It is typically chronic, constant, and unremitting, although a smaller percentage may have it episodically.
• It frequently overlaps with the presence of mood or anxiety disorders, but none of these disorders has a unique relationship to DPD.
• Personality disorders are also common in patients with DPD, but none of these has a unique relationship to the onset or severity of the disorder.
• The most common triggers are severe stress, episodes of other mental illness, and drug use. In a sizable proportion of cases there is no obvious immediate trigger.
• Childhood trauma, in particular emotional maltreatment, has been associated, with the disorder and with its severity.
Ultimately, all of these findings support the conceptualization of DPD as a discrete disorder, with its own unique characteristics”
<symptoms
“Still, two clusters of symptoms emerged. The nonchanging core symptoms include visual derealization, altered body experience, emotional numbing, loss of agency feelings, and changes in the subjective experiencing of memory. The distress caused by these particular problems is probably why they are reported most frequently.
The second cluster of symptoms, including unreality experiences not related to vision, mind-emptiness (subjective inability to entertain thoughts or evoke images), heightened self-observation, and altered time experience, are less likely to be reported by a patient first and foremost. .”
“By using the year 1946 as a dividing line, Sierra and Berrios reviewed 200 cases of depersonalization appearing in the medical literature since 1898, dividing them into pre- and post-World-War-II groups. In addition to descriptions of unreality, the other key symptoms that emerged throughout the literature include:
• emotional numbing
• heightened self-observation
• changes in body experience • absence of body feelings such as hunger, thirst, and so on
• changes in the experience of time and space
• feelings of not being in control of movement (i.e., loss of feelings of agency); having the mind empty of thoughts, memories, and images’
• inability to focus and sustain attention. ”
<causes
The causes are of many varied forms; Some have a natural ,psychological and personality wise predisposition towards DPD .
Thus some have it since as long as they can remember. Many others have it after a traumatic incident like car accidents or Stressful or shocking life conditions. Some with childhood trauma, emotional and physical abuse too have shown higher levels of depersonalization . Other causes are drug induced permanent depersonalization by Marijuana , Ketamine(ecstasy) , LSD and many other psychedelics like DMT.
<Differences between Awakening Experiences cited in eastern philosophies ,mysticism Vs. Depersonalization.
There is an entire chapter dedicated to compare between different philosophical schools of thinking and the experiences of Depersonalization. The depersonalized states of mind through the use of recreational drugs are much similar to the ones achieved through years of meditation and yogic practices.
“Detachment, depersonalization, and derealization within the context of an anticipated and induced hallucinogenic experience, or within the framework of long-term intentional meditative experience, generally are not perceived as horrific, but rather as eye opening and often liberating. But when it comes on unexpectedly and disrupts one’s life, such experiences are almost invariably horrifying and decidedly unwanted. “
“The psychedelic experiences we’ve examined do not clinically fall into the category of depersonalization disorder”
“Voluntarily induced experiences of depersonalization or derealization form part of the meditative and trance practices that are prevalent in many religions and cultures and should not be confused with Depersonalization Disorder.”
<Treatment.
There is not many successful medications that has proven to be successful in treating DPD though many have shown promising results .
The stance of the prevailing knowledge is that a more successful treatment can be achieved through a combination of therapy and meds.
Few Other practices that have been found to be effective are ;
Diary keeping of how the depersonalization sets in, breaking the cycle of anxiety and DPD, grounding exercises, modulating arousal ,CBT and keen observation of symptoms.
“Even doctors with strong biological biases concede that in the case of DPD, an effective combination of medicine and therapy is a wise course of treatment. “People who have suffered with DPD for years, and have tried everything are anxious to take that chance,” Torch says. One patient who had found relief through a variety of medications, expressed his ongoing dissatisfaction in this way: “Medications have helped my depersonalization a lot, but they’ve been like showing a cross to a vampire. The cross keeps him at bay, but I’m still looking for that spike in the heart that will finish him off.”
“To date, there are no specific pharmacological treatment guidelines for depersonalization, though both pharmacological and psychotherapeutic efforts have been shown to be effective. Historically, DPD has been notoriously resistant to treatment. That’s the bad news.
The good news is that the individual ways in which DPD manifests itself can often be treated effectively, if those manifestations include anxiety, obsessiveness, or depression, or if a patient suffers concurrently from these more widely recognized and treatable conditions.
Clinical research as to what works best for depersonalization has been limited, although there have been numerous anecdotal reports implicating the possible success of several medicines and forms of treatment, often in combination”
“While the clinical data cannot verify it, most observers regard people with DPD as highly intelligent and introspective. Beneath the fog of the feeling of no self may in fact lay a fiercely individualistic personality that has been held in check by fear. That self has not disappeared; it just feels as if it has. If you’re battling DPD, remember that the ultimate goal is not to be like everybody else,”
“There are different ways of helping patients, even those who perceive their symptoms as most unwavering, to start to notice that indeed they vary, and that they can make sense out of these variations.
One way to help patients become more aware of fluctuations is to have them keep a written or mental diary of their depersonalization and to note even minimal fluctuations in its intensity, attempting to relate them to changes in internal emotional state. Patients can be helped over time to put more sophisticated labels on their experience, from the simple stressed or depersonalized, to saddened, angered, overwhelmed, anxious, frightened, and so on.
Patients can also start to use various cognitive-behavioural techniques to help modulate the intensity of their symptoms. If these techniques meet with any initial degree of success, even transient or partial, patients may come to appreciate that their symptoms do not completely have a life of their own, but can be controlled.”
<The research so far has found very little evidence for depersonalization to be inherited via genes . But it must be noted that some people through genes or with upbringing, stressor factors and combined effects of many factors, might have more vulnerability towards DPD.
Closure.
all in all, I can call forth this as a high quality scientific literature. Synergising of various viewpoints whilst maintaining the scientific observation is notable for the lack of such works in most modern reductionist ,materialist scientific literature . We need more of these holistic literature on board.
the authors are also openminded to count in the sort of similar awakening experiences appearing in eastern and mystical traditions as no-self.
“Any scientific model, no matter how strong it seems in theory, needs to be tested empirically. Data need to be collected in the real world. As Thomas Kuhn has described in talking about the nature of the scientific hypotheses, the scientific data that we collect will either support or refute a hypothesis/ We can never prove a scientific model with certainty; better fitting or more comprehensive models could arise at any time.
We can, however, disprove a scientific model by collecting empirical data in the real world that is simply not compatible with the model. “
As the authors repeatedly suggest, researching and learning about the syndrome will most likely help those who suffer from it in many folds. For that purpose, this book will be of great value.
Ton of studies on the condition are yet to be done and published. The past century has significantly brought this in to psychiatric awareness but, a lot more studies , research on DPD in the coming years will likely bring better methods of treatment.
In conclusion, I must arrive at the point whence I believe DPD is much more than a neurological condition. The various similarities in experiences between awakening experiences , drug induced Depersonalization must indeed have a some sort of correlation that we might uncover in the coming years of research.
“If the patient can tolerate the experience of unrealness for a time, he can make for himself a new reality which is more solidly grounded for his own needs and perceptions, and in a sense more “real” than his old compromises were, however comfortable and familiar they might have felt. — J.S. LEVY and P.L . WACHTEL”
|Willie|
Serene Perfection 