I would like to briefly describe the currently most established psychological treatment approaches to depersonalization that I also use in my work when treating the symptoms. These approaches are based on Cognitive-Behavioural and Acceptance and Commitment therapy interventions. I apply these within a hypnotherapy framework.
Cognitive interventions
We have seen how important the personal interpretation of a DP experience is (see the related post): What one makes of it when he thinks about it; How he sees, and evaluates this experience. These can be called cognitive factors. So one of the things we do in therapy is exploring how can the client see and interpret his DP in other ways, new ways. How we could think about and relate to these experiences in perhaps more helpful ways. We also discover what personal philosophies would be of help in learning to relate to DP with less fear and anxiety. We know that if anxiety about DP reduces, DP itself is very likely to reduce as well. And we would have a general aim to change the overly fearful and catastrophic expectations, worries a client may have. We cultivate a more balanced way of thinking and seeing the future for example, based on rationality, adequate information, and experience. Hypnosis provides a great set of techniques to explore the different ways one can learn to see things and relate to them, which is particularly useful as regards depersonalisation.
Emotion regulation
We have additional strategies to reduce anxiety and DP itself, with: Relaxation training, Attention training, so called Grounding techniques, Mindfulness techniques. We know that nurturing a here and now, present moment orientation have many benefits. It may seem paradoxical, or counternintuitive, but we wouldn’t practise these skills with the purpose of reducing anxiety and DP to zero. On the other hand, We would practice these skills to learn to reduce the discomfort of anxiety and DP as much as we can at a given moment, be it a lot or just a little bit. Then we would explore and practice how we can manage and deal with the sensations that are left. One of the ways we would do this, is for example by learning to tolerate and be with the remaining sensations, with a sense of acceptance. Cultivating such attitudes can have many therapeutic benefits.
Behavioural interventions
We would use so called behavioural strategies as well, to see how can the client still do the things that he would normally do, activities that are meaningful to him, that are in line with his values. We explore how he/she can still pursue his chosen life-direction despite sensations of DP.
Dealing with related issues
We can also deal with related difficulties such as sleep problems, or low self-esteem, using evidence-based interventions to address those.
Hypnosis
We take advantage of hypnosis to strengthen the effects of the inverventions mentioned above, with the use of therapeutic suggestions and visualisation work within sessions and listening to recordings at home.
Just to note, I work with symptoms of DP, but in case it has the intensity, chronicity and criteria for diagnosible DP disorder, I refer the client to a service where the treatment of DP disorder can be further assisted, e.g. with adequate medications.
Recommended reading:
Baker, D., Hunter, E., Lawrence, E., David, A. (2010). Overcoming Depersonalization and Feelings of Unreality (Overcoming Books) London. Constable & Robinson Ltd.
Neziroglu, Fugen; Donnelly, Katharine (2010). Overcoming Depersonalization Disorder: A Mindfulness and Acceptance Guide to Conquering Feelings of Numbness and Unreality. New Harbinger Publications.