De-Reality Bites

Living with dissociation and derealization.

[paige-parker]

Depersonalization/derealization disorder (DDD) is a dissociative disorder during which the patient feels as though he or she is detached from the self or from the environment. These episodes can come on suddenly, or persist for months or years. Several areas of the brain have been implicated in depersonalization/derealization disorder, suggesting that it is a brain disorder. According to the DSM-5, depersonalization/derealization disorder is a fairly common disorder, with as many as half of all adults experiencing at least 1 episode at some point during the lifespan, although less than 2% of the population experience pervasive symptoms (American Psychiatric Association, 2013). Symptoms of depersonalization and realization are common during a traumatic experience. Therefore, individuals with a history of trauma or abuse have an increased risk of depersonalization/derealization disorder. Treating depersonalization/derealization disorder includes the treatment of the preceding stressor, as well as development of coping skills that challenge depersonalization/derealization disorder symptoms.

Theravive.com

[paige-parker]

“The Legal Services Advocacy Project (LSAP) is pleased to present the 2014 Session Summaries. These session summaries cover a variety of substantive areas and the specific changes to Minnesota law made by the 2014 Legislature that LSAP believes is relevant to the lives of low income Minnesotans and attorneys and advocates who represent them.”

2014 Session Summaries

[paige-parker]

[My friend died of a heroin overdose a few days ago. Thinking of her.] Abstract: Few studies have examined the relationship between posttraumatic stress disorder (PTSD), substance use disorder (SUD) and dissociation. We studied 77 women with current PTSD and substance dependence, classified into high- versus low-dissociation on the Dissociative Experiences Scale. They were compared on trauma- and substance-related symptoms, cognitions, coping skills, social adjustment, trauma history, psychiatric symptoms, and self-harm/suicidal behaviors. We found the high-dissociation group consistently more impaired than the lowdissociation group. Also, the sample overall evidenced relatively high levels of dissociation, indicating that even in the presence of recent substance use, dissociation remains a major psychological phenomenon. Indeed, the high-dissociation group reported stronger expectation that substances could manage their psychiatric symptoms. The high-dissociation group also had more trauma-related symptoms and childhood histories of emotional abuse and physical neglect. Discussion addresses methodology, the ‘chemical dissociation’ hypothesis, and the need for more nuanced understanding of how substances are experienced in relation to dissociative phenomena.

Dissociation, PTSD, and Substance Abuse: An Empirical Study by Lisa Najavits, PhD, and Marybeth Walsh, McLean Hospital Harvard Medical School Formerly McLean Hospital

[paige-parker]

Apple Orchard 2002

Imagine you’re 12 years old; you’ve just begun puberty and are starting to be aware of the bigger world around you. Life hasn’t been fantastic so far, in fact it’s been pretty chaotic, but consistently chaotic. You’re used to not ever knowing what the fuck is going on, what the rules are, or what’s happening.

You live in the world of religion, closed off from the rest of the “secular” world; you are taught about a 6,000 year old earth, about the evils of free thinking, and that you are inherently stupid and sinful.

A few weeks ago your world become even more chaotic with the introduction of your parents pending divorce. You find out (much later in life) that your father was abusing your mother, she found someone safe, and left. This is not the narrative you have been told.

Your mother is a liar, a slut, a villain. She is destroying your family and putting you at the mercy of a child molester (that someone safe might not really have been).

Your mother, the one who sang and danced with you to Minnie Mouse songs, the one who painstakingly stenciled tiny pink flowers onto your dresser and closet to make you feel pretty, and the one who lovingly sang you to sleep each night while rubbing your back is not who you think she is. She is Satan in disguise.

Your father, the one who shouted and screamed orders at you and your sisters, the one who would make you cry and then punish you for crying, and the one who taught you the only appropriate emotion to display is anger is the one who you must now trust and lean on. He has the truth.

So is it any surprise that a few weeks later, enjoying some apple pie at an orchard with your family, you have your first episode of dissociation? That as you turn away from your plate, your father will finish what’s left, and you’re completely baffled as to what just happened. You question your mind, your memories, your reality. Did you ever actually have the pie in front of you? Did you just eat it really fast? Maybe the waitress came and cleared the plate when you weren’t looking?

No one offers to help explain what happened. You asked no questions because you don’t even know what questions to ask. So you just put the incident away in your mind, like the rest of the chaotic confusing thoughts and realities you’re forced to engage with.

Can you really trust your mind?

[paige-parker]

Comorbidity definition: In psychiatry, psychology and mental health counseling comorbidity refers to the presence of more than one diagnosis occurring in an individual at the same time. However, in psychiatric classification, comorbidity does not necessarily imply the presence of multiple diseases, but instead can reflect our current inability to supply a single diagnosis that accounts for all symptoms.

Wiki (please do not cite Wikipedia as a scholarly source, however it is a useful starting point.)

[paige-parker]

Adverse Reactions to Mindfulness (confronting anxiety or depressive symptoms with Mindfulness can often trigger derealization or dissociation.)

[paige-parker]

[Photo says “A Series of Metaphors for Dissociation.” The top left square depicts a cartoon person standing with their brain floating above them like a balloon, attached to a string. The top right square shows the inside of a cartoon persons head in which a tiny cartoon person is trapped in a jail cell. The bottom square depicts three cartoon people in various poses: in mid walk, sitting in a chair, and lying face down on the floor. Each person is a cut-out paper version of themselves.]

[paige-parker]

I really have discovered something at last. Through watching so much at night, when it changes so, I have finally found out. The front pattern does move - and no wonder! The woman behind shakes it! Sometimes I think there are a great many women behind, and sometimes only one, and she crawls around fast, and her crawling shakes it all over. Then in the very ’ bright spots she keeps still, and in the very shady spots she just takes hold of the bars and shakes them hard. And she is all the time trying to climb through. But nobody could climb through that pattern - it strangles so…

Charlotte Perkins Gilbert, The Yellow Wal-Paper

[paige-parker]

Dissociation is characterized by a disruption of usually integrated functions of memory, consciousness, identity, or perception of the environment.

American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders DSM-IV

[paige-parker]

The process of dissociation is an elegant mechanism built into the human psychological system as a form of escape from (sometimes literally) going crazy. The problem with checking out so thoroughly is that it can leave us feeling dead inside, with little or no ability to feel our feelings in our bodies. The process of repair demands a re-association with the body, a commitment to dive into the body and feel today what we couldn’t feel yesterday because it was too dangerous.

Alexandra Katehakis, Mirror of Intimacy: Daily Reflections on Emotional and Erotic Intelligence

[paige-parker]

Derealization common experiences/symptoms: The detachment of derealization can be described as an immaterial substance that separates a person from the outside world, such as a sensory fog, pane of glass, or veil. Individuals may complain that what they see lacks vividness and emotional coloring. Emotional response to visual recognition of loved ones may be significantly reduced. Feelings of déjà vu or jamais vu are common. Familiar places may look alien, bizarre, and surreal. The world as perceived by the individual may feel like it is going through a dolly zoom effect. Such perceptual abnormalities may also extend to the senses of hearing, taste, and smell. The degree of familiarity one has with their surroundings is among one’s sensory and psychological identity, memory foundation and history when experiencing a place. When a person is in a state of derealization, they block this identifying foundation from recall. This ‘blocking effect’ creates a discrepancy of correlation between one’s perception of one’s surroundings during a derealization episode, and what that same individual would perceive in the absence of a derealization episode.

Wiki

[paige-parker]

Derealizatiom description: Derealization or derealisation (sometimes abbreviated as DR) is an alteration in the perception or experience of the external world so that it seems unreal. Other symptoms include feeling as though one’s environment is lacking in spontaneity, emotional colouring and depth. It is a dissociative symptom of many conditions, such as psychiatric and neurological disorders, and not a standalone disorder.

Wikipedia (I do not usually cite Wiki, this just happens to accurately describe my experience.)

[paige-parker]

Dissociation treatment: Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, involves talking about your disorder and related issues with a mental health provider. Your therapist will work to help you understand the cause of your condition and to form new ways of coping with stressful circumstances. Over time, your therapist may help you talk more about the trauma you experienced, but generally only when you have the coping skills and relationship with your therapist to safely have these conversations. Although there are no medications that specifically treat dissociative disorders, your doctor may prescribe antidepressants, anti-anxiety medications or antipsychotic medications to help control the mental health symptoms associated with dissociative disorders.

Mayo Clinic

[paige-parker]

Dissocation common symptoms: -Memory loss (amnesia) of certain time periods, events and people -Mental health problems, such as depression, anxiety, and suicidal thoughts and attempts -A sense of being detached from yourself -A perception of the people and things around you as distorted and unreal -A blurred sense of identity -Significant stress or problems in your relationships, work or other important areas of your life

Mayo Clinic

[paige-parker]

Dissociation definition: Someone with a dissociative disorder escapes reality in ways that are involuntary and unhealthy. The person with a dissociative disorder experiences a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity.

Mayo Clinic