stranger_in_the_mirror . http://www.strangerinthemirror.com/questionnaire.html 041123 ... . What is depersonalisation? Depersonalisation is a change in an individuals self-awareness such that they feel detached from their own experience, with the self, the body and mind seeming alien. Terms commonly used to describe depersonalisation include: unreal, disembodied, divorced from oneself, apart from everything, unattached, alone, strange, weird, foreign, unfamiliar, dead, puppet-like, robot-like, acting a part, like a lifeless, two dimensional, 'cardboard' figure', made of cotton-wool, having mechanical actions, remote, automated, a spectator, witnessing ones own actions as if in a film or on a TV programme, not doing ones own thinking, observing the flow of ideas in the mind as independent. What is derealisation? A change in an individual's experience of the environment, where the world around him/her feels unreal and unfamiliar. Terms commonly used to describe derealisation include: spaciness, like looking through a grey veil, a sensory fog, spaced-out, being trapped in a glass bell jar, in a goldfish bowl, behind glass, in a Disney-world dream state, withdrawn, feeling cut off or distant from the immediate surroundings, like being a spectator at some strange and meaningless game, objects appear diminished in size, flat, dream-like, cartoon-like, artificial; objects appear to be unsolid, to breathe, or to shimmer; 'as if my head were inside a Coke bottle and I'm viewing the world through the thick glass at the bottom'. http://www.thelindenmethod.co.uk/depersonalisation-derealisation.htm 041123 ... . Depersonalization Disorder "...Depersonalization Disorder is a disorder affecting emotions and behavior. It is characterized by an change in how an affected individual perceives or experiences his or her sense of self. The usual sense of one's own reality is temporarily lost or changed. A feeling of detachment from, or being an outside observer of, one's mental processes or body occurs such as the sensation of being in a dream. This phenomena involves: A lasting or recurring feeling of being detached from the patient's own body. Throughout the experience, the patient knows this is not really the case. Reality experience is intact..." http://www.psychnet-uk.com/dsm_iv/depersonalization_disorder.htm 041123 ... . "...Persistent or recurrent feelings of being detached from one's body or mental processes and usually a feeling of being an outside observer of one's life. Depersonalization is the third most common psychiatric symptom and frequently occurs in life-threatening danger, such as accidents, assaults, and serious illnesses and injuries; it can occur as a symptom in many other psychiatric disorders and in seizure disorders. As a separate disorder, depersonalization has not been studied widely, and its incidence and cause are unknown. Symptoms and Diagnosis Patients have a distorted perception of themselves, their bodies, and their lives, which makes them uncomfortable. A person may feel as if he is an automaton or is in a dream. Often the symptoms are transient and occur with anxiety, panic, or phobic symptoms. However, symptoms can be chronic and persist or recur for many years. Patients often have great difficulty describing their symptoms and may fear or believe the symptoms mean they are going crazy. The patient often feels unreal and may experience the world as unreal and dreamlike. Some patients are minimally impaired; others become severely compromised or even disabled. Although some can adjust to depersonalization disorder or even block its effect, others have chronic anxiety about their state of mind, worry whether they are going crazy, or ruminate on the implications of their distorted perceptions of their bodies and their sense of estrangement from themselves and the world..." http://www.merck.com/mrkshared/mmanual/section15/chapter188/188e.jsp 041123 ... . Strangers to Our Selves "...When your world seems strange and you've lost your sense of self, you'll be hard pressed finding a name for your affliction. But there is one "Depersonalization Disorder", and it's nothing new. It may happen when you first wake up, or while flying on an airplane or driving in your car. Suddenly, inexplicably, something changes. Common objects and familiar situations seem strange, foreign. Like you've just arrived on the planet, but don't know from where. It may pass quickly, or it may linger. You close your eyes and turn inward, but the very thoughts running through your head seem different. The act of thinking itself, the stream of invisible words running through the hollow chamber of your mind, seems strange and unreal. It's as if you have no self, no ego, no remnant of that inner strength which quietly and automatically enabled you to deal with the world around you, and the world inside you. It may settle over time, into a feeling of "nothingness", as if you were without emotions, dead. Or the fear of it may blossom into a full-blown panic attack. But when it hits for the first time, you're convinced that you're going insane, and wait in a cold sweat to see when and if you finally do go over the edge. What you don't know at the moment is that this troubling experience is distinctly human, experienced briefly at some time or another by as much as 70 percent of the population. In its chronic form, popular culture once saw it as part of a nervous breakdown. Some have called it "Alice in Wonderland" disease. Jean Paul Sartre called it "the filth" , William James dubbed it "the sick soul". It's been linked philosophically to existentialism, even Buddhism. Yet to its victims, it's anything but an enlightened state of mind. Welcome to the world of Depersonalization Disorder. The term itself has been around for a long time. A psychologist named Dugas coined it as a unique medical condition back in 1898. While the word "depersonalization" is often linked to "dehumanizing" situations such as prison life or brainwashing, chronic depersonalization is an insidious mental condition that can begin on its own. The individual's perceptions of the self and the self's place in the world somehow shifts into a mindset that is altered from the norm, becoming hellish for most. Depersonalization, as a symptom, is what the majority of us experience at some time in our lives. It occurs briefly, and has no lasting effect. Depersonalization Disorder, however, is a chronic illness that can take a dreadful and long-lasting course. ... a feeling of detachment or estrangement from one's self . The individual may feel like an automaton or as if he or she is living in a dream or a movie. There may be a sensation of being an outside observer of one's metal processes, one's body, or parts of one's body. ... Various types of sensory anesthesia, lack of affective response, and a sensation of lacking control of one's actions, including speech, are often present. The individual with Depersonalization Disorder maintains intact reality testing (e.g., awareness that it is only a feeling and that he or she is not really an automaton) . ...Persistent or recurrent feelings of being detached from one's body or mental processes and usually a feeling of being an outside observer of one's life. Depersonalization is the third most common psychiatric symptom and frequently occurs in life-threatening danger, such as accidents, assaults, and serious illnesses and injuries; it can occur as a symptom in many other psychiatric disorders and in seizure disorders. As a separate disorder, depersonalization has not been studied widely, and its incidence and cause are unknown... ...reality testing remains intact... While a degree of depersonalization may be present in other illnesses, like schizophrenia, this is not a psychotic condition. The person knows that something is terribly wrong, and grapples with trying to figure out what it is. If anything, it's the opposite of insanity. It's like being too sane. You become hypervigilant of your existence and things around you. Indeed, chronic depersonalization often includes a sensation of overconsciousness wherein each thought seems too apparent, or too loud, like the volume of a low-playing radio suddenly turned up to its maximum according to one sufferer. Signs of depersonalization can occur with many illnesses, however isn't clear why the condition persists in some people. Chronically depersonalized persons (or D-People as they're often called) are usually highly intelligent, and prone to intellectual ruminating. Onset is most often seen at an early age, from around puberty to the late twenties. There has been evidence of links in some cases to early childhood trauma, Temporal Lobe Epilepsy, stress resulting from life threatening situations, and Migraine. Evidence has also suggested that it afflicts females to a greater degree than males. In time, depersonalized people can make some accommodations to the condition, Janiger says. They know it won't kill them or make them insane. It isn't a progressive illness. It may constitute a subtle alteration of perception. It's more like adjusting to a pair of glasses that makes everything appear upside down. Eventually one may find ways of adapting. Accordingly, people with DP disorder become masters at maintaining a front, appearing quite normal to friends, family and co-workers. The sense of being an automaton as described in DSM-IV is consistent with going through the familiar routines of a lifetime. You do what you're expected to, and say what others expect you too, all the while feeling as if you're acting out of habit, says John, a 32-year-old filmmaker who has had the condition for six years. Your mind is always a million miles away. All natural spontaneity and joy of living is gone. You know something's wrong, and you're constantly battling with what it might be, and evaluating how you feel. ...Their poignant observations run deeper than simply thinking in circles about the nature of existence they feel the black emptiness of existence that post World War II philosophers struggled to portray. It's what the French have come to call Le Coup de Vide the blow of the void. Depersonalization is a very unpleasant feeling, despite the fact that is often manifests itself by a seeming lack of feeling, says German psychologist Ursula Oberst. Stories by depersonalized people have a true flavor of existentialism about them. Philosophers wrote about it and theorized about it. But D-people feel it, and the feeling can be too much to bear. Apparently one who wrote about it and felt it was French philosopher Jean Paul Sartre. While he reputedly scorned the term existentialism, his first novel Le Nausee (Nausea), published in 1938, portrays true Depersonalization Disorder with bone-chilling accuracy. Existentialist or not, Sartre clearly knew depersonalization first hand. "I buy a newspaper along my way. Sensational news. Little Lucienne's body has been found. Smell of ink, the paper crumples between my fingers. The criminal has fled. The child was raped. They found her body, the fingers clawing at the mud. I roll the paper into a ball, my fingers clutching at the paper; smell of ink; my God how strongly things exist today. Little Lucienne was raped. Strangled. Her body still exists, her flesh bleeding. SHE no longer exists. her hands. She no longer exists. The houses. I walk between the houses, I am between the houses, on the pavement; the pavement under my feet exists, the houses close around me, as the water closes over me, on the paper the shape of a swan. I am. I am,. I exist, I think, therefore I am; I am because I think, why do I think. I don't want to think any more, I am because I think that I don't want to be, I think that I....because....ugh! I flee." Literary depictions of depersonalization, panic, depression, phobias, and other disorders have threaded their way through most cultures throughout history. Dostoyevsky's Notes From Underground Camus' The Stranger, Borges' The Aleph and others come to mind. The word "panic" itself has its source in ancient lore which attributed a fearful shift in consciousness, or panic, to anyone viewing the face of the Greek forest god Pan. Doing so offered an overwhelming glimpse of the universe that the human mind was not equipped to handle, resulting in insanity. Cosmic knowledge, and the brain's inability to handle it, appears again and again in popular culture from 50s science fiction stories and movies with mind-expanding machines, to Aldous Huxley's Doors of Perception, which suggested that mescaline could open the brain's channels to the higher knowledge sought by those very sci-fi contraptions. An exploration of all that depersonalization involves will take you down many paths ...Paths of self-exploration, or explorations of the lack of self, may ultimately lead one towards the ancient teachings of Buddhism or other eastern philosophies, or western mystic literature and contemporary Christian writers known as contemplatives, Janiger points out. Trancenet (www.trancenet org), a Delaware- based nonprofit group that monitors cult activity and exploitative psychological techniques, sees many similarities between depersonalization syndrome and psychological states found in Transcendental Meditation, specifically as taught by the renowned Maharishi Mahesh Yogi. According to Trancenet, numerous quotes from the 1967 book Maharishi Mahesh Yogi on the Bhagavad-Gita: A New Translation and Commentary directly parallel the descriptions of depersonalization in DSM-IV. One statement from the book, for example, could fall directly under the DSM-IV subcategory of detachment, according to Trancenet: In Nitya-Samadhi, or cosmic consciousness a man realizes that his Self is different from the mind which is engaged in thoughts and desires. He experiences the desires of the mind as lying outside himself, Still, I'm not convinced that Depersonalization Disorder and Samadhi or bliss, enlightenment, or what have you, are the same thing, Oscar Janiger explains. Many people enjoy the states brought about through TM. But Depersonalization is an illness, sent straight from hell. It's a psycho-physiological problem that involves the integrity of the ego and body image. Whether they're treating DP, or just social phobias, psychologists often spend years trying to build up a patient's ego, with little result. There are many people who are successful in their careers and who have received plenty of laurels, awards food for the Ego. And it doesn't do a thing toward alleviating the pain of losing one's self because of this strange and uncanny condition. ...But whether it's linked to the sleep/wakefulness cycle, a natural part of the human condition, or part of an awakening to a heightened consciousness, Depersonalization Disorder isn't going away; D-people will continue to seek relief, and researchers will continue to try to provide it. It's a remarkable condition, notes Janiger, with implications that are fascinating. But it's like the ocean, wondrous and deep unless you're drowning in it. Then all you want is a way out..." http://www.depersonalization.info/overview.html 041123 ... . ... http://www.dreamchild.net/mydp.html 041123 ... . Depersonalization & Derealization Nightmares of Unreality "...Depersonalization : A frightening and/or disturbing experience of not being within one's own body or of being in immediate danger of vanishing/separating from reality – often described as the sensation of living inside a dream. Although cognitive functioning remains intact, the sufferers feel disconnected from their sense of self and often interpret it “as if I am losing my mind.” “ My hands feel like they're made of paper, or like they belong to someone else.” “My own face in a mirror seems foreign, like I have never really seen it before this moment…” “I cannot feel my body, not truly numb, but it is as if I have disappeared into myself, beyond my own flesh and blood…” “Sometimes I literally wonder if I am already dead and existing as a ghost…it feels like my soul is trying to leave its shell and I am fighting with all my strength to hold it inside this body. I don't know if I'm dreaming or awake; I must be going insane…to feel my self wafting away…I know it is only a matter of time…” Derealization : A state of consciousness that creates a sense of detachment from all environments, fogginess, as if a plate of glass is in between the mind and the physical world. Any concentration requires tremendous effort, and the harder the sufferer tries to focus, the more disconnected they become. Often including feelings of déjà vu or jamais vu. Familiar places look alien, bizarre, and surreal – as if they are part of a Salvador Dali painting. In fact, the more familiar the surrounding, the more foreign it seems to be. “In a split second, the world seems to tilt. I am suddenly a stranger in my own neighborhood.” “Reality seems to vanish, or is closing in, as if the literally edge of the world is right beyond the horizon.” “Everything looks ‘off,' like it turned into a stage set or fake replica of how it should really look…” “The world looks like I'm dreaming, or like I have unwittingly taken LSD…” Depersonalization and Derealization involve similar consciousness states, although psychiatric literature discusses them as two different symptoms. The major distinction is that the first is a distorted awareness of self, while the second is a distorted perception of the physical environment. Often patients experience both, simultaneously or alternately. These states of mind are accompanied by an obsessive need to self-monitor, to observe the self moment by moment. The sufferers describe an inability to experience their own lives while stuck in chronic self-observation (also feeling that identity is disappearing, or has already vanished). Usually, but not exclusively, these altered states include debilitating anxiety and overwhelming preoccupation that a total loss of reality is only moments away. There may be pervasive beliefs of literally “willing oneself” to remain sane, along with a morbid fear of (and resisted wish for) total surrender to what seems to be an impending psychosis. Over time, the patients believe they are losing more of the self, and while actual reality-testing remains intact, the feeling of reality diminishes. There are increasing doubts about the actual existence of an external reality and the sufferers often harbor secret thoughts that they have only conjured up the world and their own being. Bizarre ideas may include a notion of being the only person in the world, or of existing merely as a thought without a body. Thoughts can develop about being the singular author/director/producer of one's perceived existence (as is true in a night dream). Such ideas often lead to overwhelming ruminations on the nature of being human. The result is increased withdrawal into one's own mind, which encourages social isolation and enhances the feeling of alienation. Trying to Tell Others Rarely are patients able (or willing) to accurately describe their symptom states. Although desperately wanting to be understood, they fear being labeled insane, and fully realize that other people would find their ideas irrational and disturbing. Even when seeking professional help, patients often call their fears and thoughts “anxiety” or “panic” or “depression” in efforts to sound less bizarre. Physicians, accustomed to hearing those symptoms, may then prescribe medication to minimize the reported anxiety or depression. ...Anxiety disorders and depressive states often co-exist with depersonalization states. Feelings of unreality may begin with a panic attack or disturbing recreational drug trip. The result may be intense self-monitoring of all thoughts, emotions and bodily sensations – soon creating anticipatory anxiety that evolves into social phobia. In time, the sufferers may feel they are living with an overwhelming and pervasive fear of fear. Intense states of unreality also exist without any experience of anxiety or noticeable depression. These patients experience only an emotional deadness, and complain of being unable to feel their own emotions while retaining awareness of what they should, or would feel if they could only re-connect to a sense of self. They may report that they know they deeply love someone, but lack any access to their own emotional responsiveness and are unable to enjoy any experience. Reality continues to be “one step removed” from their sensory life, and in its place grows a barren terrain that is “two dimensional” or “flat” – “as if everything I experience is really happening to somebody else.” Normal Dissociation Feelings of unreality are also experienced in ordinary people under extraordinary and/or traumatic circumstances – both good and bad – severe car accidents, being victimized by a violent crime, or suddenly winning a million dollar lottery. When the reality of a situation seems so incongruous to the reality of the moment occurring before, the mind may create a dissociative reaction in efforts to maintain reality's status quo. Under extreme conditions, it is the result of a normal function of a human brain with at least a mild predisposition towards altered states of unconsciousness. But to the depersonalization/derealization sufferer, it seems there was no provocation for this bizarre state of mind. In actuality, the brain is often reacting in response to thoughts that exist outside conscious awareness – thoughts that were perceived as potentially threatening to the self's status quo. In such cases, the mind dissociates as a form of protection – without any discernible trauma or shocking event as motivation. The “danger” was internal, and the potential assault was against self-identity, not the physical body. Over time (and reinforced by obsessing over the original experience) the mind seems to develop a habit of re-invoking the symptom/neurological reaction. The patients usually become convinced that the way out of their nightmare lies in focusing more and more inward, relentlessly self-observing for any sign of returning reality. But like a child's straw finger puzzle, the harder one tries to pull free, the tighter grows the trap. Relief Patients must strive for experiences that allow them to re-engage as actors in the drama of their own lives rather than clutching fearfully to the role of observer..." http://www.dpselfhelp.com/jbaker_print.htm 041123 ... . "...Childhood interpersonal trauma as a whole was highly predictive of both a diagnosis of depersonalization disorder and of scores denoting dissociation, pathological dissociation, and depersonalization. Emotional abuse, both in total score and in maximum severity, emerged as the most significant predictor both of a diagnosis of depersonalization disorder and of scores denoting depersonalization but not of general dissociation scores, which were better predicted by combined emotional and sexual abuse. The majority of the perpetrators of emotional abuse were either or both parents. Although different types of trauma were modestly correlated, only a few of these relationships were statistically significant, underscoring the importance of comprehensively considering different types of trauma in research studies. CONCLUSIONS: Childhood interpersonal trauma and, in particular, emotional abuse may play a role in the pathogenesis of depersonalization disorder. Compared to other types of childhood trauma, emotional maltreatment is a relatively neglected entity in psychiatric research and merits more attention..." http://ajp.psychiatryonline.org/cgi/content/abstract/158/7/1027 041123 ... . "...As society has become increasingly aware of the prevalence of child abuse and its serious consequences, there has been an explosion of information on posttraumatic and dissociative disorders resulting from abuse in childhood. Since most clinicians learned little about childhood trauma and its aftereffects in their training, many are struggling to build their knowledge base and clinical skills to effectively treat survivors and their families. Understanding dissociation and its relationship to trauma is basic to understanding the posttraumatic and dissociative disorders. Dissociation is the disconnection from full awareness of self, time, and/or external circumstances. It is a complex neuropsychological process. Dissociation exists along a continuum from normal everyday experiences to disorders that interfere with everyday functioning. Common examples of normal dissociation are: highway hypnosis (a trance-like feeling that develops as the miles go by), "getting lost" in a book or a movie so that one loses a sense of passing time and surroundings, and daydreaming. Researchers and clinicians believe that dissociation is a common, naturally occurring defense against childhood trauma. Children tend to dissociate more readily than adults. Faced with overwhelming abuse, it is not surprising that children would psychologically flee (dissociate) from full awareness of their experience. Dissociation may become a defensive pattern that persists into adulthood and can result in a full-fledged dissociative disorder. The essential feature of dissociative disorders is a disturbance or alteration in the normally integrative functions of identity, memory, or consciousness. If the disturbance occurs primarily in memory, Dissociative Amnesia or Fugue (APA, 1994) results; important personal events cannot be recalled. Dissociative Amnesia with acute loss of memory may result from wartime trauma, a severe accident, or rape. Dissociative Fugue is indicated by not only loss of memory, but also travel to a new location and the assumption of a new identity. Posttraumatic Stress Disorder (PTSD), although not officially a dissociative disorder (it is classified as an anxiety disorder), can be thought of as part of the dissociative spectrum. In PTSD, recall/re-experiencing of the trauma (flashbacks) alternates with numbing (detachment or dissociation), and avoidance. Atypical dissociative disorders are classified as Dissociative Disorders Not Otherwise Specified (DDNOS). If the disturbance occurs primarily in identity with parts of the self assuming separate identities, the resulting disorder is Dissociative Identity Disorder (DID), formerly called Multiple Personality Disorder. DSM IV Dissociative Disorders from DSMIV 300.12 Dissociative Amnesia (formerly Psychogenic Amnesia) A. The predominant disturbance is one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness. B. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder, Dissociative Fugue, Post traumatic Stress Disorder, Acute Stress Disorder, or Somatization Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a neurological or other general medical condition (e.g., Amnestic Disorder Due to Head Trauma). C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 300.13 Dissociative Fugue (formerly Psychogenic Fugue) A. The predominant disturbance is sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past. B. Confusion about personal identity or assumption of a new identity (partial or complete). C. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy). D. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning 300.14 Dissociative Identity Disorder (formerly Multiple Personality Disorder) A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self). B. At least two of these identities or personality states recurrently take control of the person's behavior. C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. D. The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). In children, the symptoms are not attributable to imaginary playmates or other fantasy play. 300.6 Depersonalization Disorder A. Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one's mental processes or body (e.g., feeling like one is in a dream). B. During the depersonalization experience, reality testing remains intact. C. The depersonalization causes clinically significant distress or impaintient in social, occupational, or other important areas of functioning. D. The depersonalization experience does not occur exclusively during the course of another mental disorder,such as Schizophrenia, Panic Disorder, Acute Stress Disorder, or another Dissociative Disorder, and is not due to the direct physiological effects of a substance(e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy). 300.15 Dissociative Disorder Not Otherwise Specified This category is included for disorders in which the predominant feature is a Dissociative symptom (i.e., a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment) that does not meet the criteria for any specific Dissociative Disorder. Examples include 1. Clinical presentations similar to Dissociative Identity Disorder that fail to meet full criteria for this disorder.Examples include presentations in which a) there are not two or more distinct personality states, or b) amnesia for important personal information does not occur. 2. Derealization unaccompanied by depersonalization in adults. 3 -States of dissociation that occur in individuals who have been subjected to periods of prolonged and intense coercive persuasion (e.g., brainwashing, thought re- form, or indoctrination while captive). 4. Dissociative trance disorder: single or episodic disturbances in the state of consciousness, identity, or memory that are indigenous to particular locations and cultures. Dissociative trance involves narrowing of awareness of immediate surroundings or stereotyped behaviors or movements that are experienced as being beyond one's control. Possession trance involves re placement of the customary sense of personal identity by a new identity, attributed to the influence of a spirit, power, deity, or other person, and associated with stereotyped "involuntary" movements or amnesia. Examples include amok (Indonesia), bebainan (Indonesia), latab (Malaysia), pibloktoq (Arctic), ataque de nervios (Latin America), and possession (India). The Dissociative or trance disorder is not a normal part of a broadly accepted collective cultural or religious practice. 5. Loss of consciousness, stupor, or coma not attributable to a general medical condition. 6. Ganser syndrome: the giving of approximate answers to questions (e.g., "2 plus 2 equals 5") when not associated with Dissociative Amnesia or Dissociative Fugue 041123 ... . http://www.dissociation.co.uk/intro.htm 041123 what's it to you? who go blather from