The Search for Self

Exploring depersonalization disorder

"I" and My Depersonalization. Comments on Your Comments.

Elena Bezzubova considers four stages of dealing with depersonalization

An old adage states that of all the things doctors learn, the most valuable are learned from their patients. Today we might add, “and blog readers” as well. Let’s see what can be learned about depersonalization from you, the people who read and comment on this blog. Challenging, provocative and thoughtful, your comments convey disturbing pain and vital concerns about depersonalization. Even though each comment is unique and special, many seem to touch upon a theme that could be identified as “I and my depersonalization.” This embraces a wide spectrum of experiences from the very first moment of registering that unusual troubling sensation of “I am not myself,” to the recognition of depersonalization, through the turmoil of hope and despair in struggling with the condition, toward gradually coming to terms with it all and going on with life.

Your comments confirm another old point: depersonalization can be successfully treated, though it usually takes a long time and there is no magical cure. More frequently depersonalization tends to be a chronic condition that stays with you for years. Your stories suggest that in many cases there are four stages of dealing with depersonalization:

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1. Uncertainty prior depersonalization has been diagnosed: “Something is terribly wrong with me but nobody seems to know what IT is.”

2. Hopes after depersonalization has been diagnosed: “Now I finally know what my sickness (that IT) is, and I can focus on getting the best treatment.” 

3. Realization that depersonalization is a difficult to treat chronic condition:  “After I have tried many doctors and treatment regiments, I am more desperate than ever about my depersonalization.”

4. Understanding life with depersonalization and working toward the improvement of this life: “This is not about depersonalization that scares and paralyses me. This is about myself, and how I will be able to deal with my depersonalization.”  

Let’s examine these four stages. The first is described below. The rest will be discussed in upcoming posts.

The first stage, 1. Before depersonalization has been diagnosed: “Something is terribly wrong with me but nobody seems to know what IT is.” Many would consider this stage the most painful and disturbing. Life has been demarcated into “before IT” and “after IT.” IT comes as something so aching, awful and frightening, as only the UNKNOWN could be. Developing gradually or hitting suddenly, IT feels like ground being cut from under one’s feet. “I feel ‘ungrounded’: I do not know who I am anymore.”

The hardship of these first hours, days, weeks and sometimes months is dealing with an UNKNOWN IT, living with unknown IT. You have no idea what is going on with you. Is it “just stress?” Are you “really crazy?” How dangerous is your condition? Does it ever happen to anyone else?

 You may try to unpuzzle the mystery of IT by discussing it with friends and relatives. You feel stuck: IT is so unknown that there are no “known” words to describe it. Every familiar, “known” word fails to convey this strange unreality that shapes the core of IT. You go to physicians and therapists. Depression, anxiety, obsessions and substance-related disorders or in some cases attention deficit disorder and bipolar disorder could be considered. And sooner or later you would come to a disappointing conclusion—these diagnoses are not what your condition actually is. They are not what this unknown IT is. At some point talks with friends or mental health professionals may only aggravate your despair: nobody seems to understand what is happening to you. You feel alone and sometimes angry.  Your disease—IT—does not even have a name.

 You need to figure out what is this IT that eats at you from the inside out. You need to figure out what is IT to understand yourself, to keep your ties with others and to go on with your life. This search for the name of IT may become a feverish ordeal of “overwhelming fixation on self-introspection,” reaching the level of obsession.

 And one day it happens. From your deserted island of throbbing despair and isolation of this IT you see the land populated with other people. They may appear sad, unhappy, and some even more desperate than you are, but they are real people. The more you learn about their stories, the more you feel that they are a kind of “normal” people with depersonalization who, like you, feel unreal and estranged.  

 The internet—and in particular, Jeff Abugel’s Depersonalization web-site (http://www.depersonalization.info/)—has been instrumental in easing the way from the deserted island of being suffocated by IT toward the land of people who have depersonalization.

 For discussion of the other three stages, please, check the blog next month.

Elena Bezzubova, M.D., Ph.D., maintains a private practice as a psychoanalyst in Newport Beach, and teaches at UC-Irvine and the New Center for Psychoanalysis.

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