The Depersonalisation Guidance Centre

One-to-one online support for individuals experiencing #depersonalisation & #derealisation, provided by a UK-based mental health nurse.

[The Depersonalisation Guidance Centre @DPguidance]

It was a pleasure to be able to speak with @DavidPuder about #depersonalisation & #derealization on the popular Psychiatry & Psychotherapy podcast.

I'm hoping this'll help to raise much needed awareness of the disorder amongst healthcare professionals.

https://t.co/PYETj8pbXV

[The Depersonalisation Guidance Centre @DPguidance]

@m_scheeringa Encouraging are their definitions of trauma (i.e. ‘criterion A’ events).

[The Depersonalisation Guidance Centre @DPguidance]

@AdJongh Does treatment response predict therapeutic alliance?

[Evelyn Dilkes @EvieDilkes]

🧵 First paper from my thesis out now in Brain, Behavior, & Immunity Health.🎉

We examined whether childhood and contemporaneous inflammation are associated with depersonalisation (DP) and derealisation (DR) from early teens to mid-twenties using data from 3000+ALSPAC ppts

1/10

[The Depersonalisation Guidance Centre @DPguidance]

@sanilrege @QuantPsychiatry Devil’s advocate: mixed episode = concomitant admixture of depressive and manic symptoms. Lamotrigine has no anti manic properties. Why would it work for a mixed state?

[The Depersonalisation Guidance Centre @DPguidance]

@DrAnnieHickox @AshCurryOcd @samthom90 Yes, and it’s framed as though the typical question asked is “what’s wrong with you?”. In my 16 years in nursing (and also as a patient), I’ve never asked or heard someone ask this.

[The Depersonalisation Guidance Centre @DPguidance]

@DrAnnieHickox @AshCurryOcd @samthom90 Well meaning, I’m sure and I hear the question routinely recommended in ‘trauma-informed’ training - however, I’d cringe if I was asked it. It’s a loaded question and rather presumptuous.

[The Depersonalisation Guidance Centre @DPguidance]

@Drsikorav Prognosis is good even without treatment?

[The Depersonalisation Guidance Centre @DPguidance]

@nuwandiss Yes - assessments limited to cross sectional symptom evaluation, with hardly a nod to family history, course, treatment response, etc.

[The Depersonalisation Guidance Centre @DPguidance]

@psycheureka Does this raise a question of construct validity? Premorbid DSO could be a risk factor for experiencing trauma and for developing PTSD post-trauma. I understand prospective studies tend to show pre-existing Neuroticism is a risk factor for developing PTSD. @m_scheeringa

[The Depersonalisation Guidance Centre @DPguidance]

@seanluomdphd @helin_drsaga Have you read The Myth of Trauma by Matthew Paris. The research he points to suggests generally low rates (~10%) of PTSD following any traumatic event, however the incidence is higher in interpersonal traumas like sexual assault.

[Prof. Frank McDonough @FXMC1957]

8 November 2007. Anglican cleric Chad Varah died (aged 95). He founded The Samaritans help line to help people contemplating suicide. He answered the 1st call made to the brand new helpline. A person whose life made a real difference to preserving the lives of others.

[The Depersonalisation Guidance Centre @DPguidance]

@psycheureka Sleep restriction therapy is terribly named (inaccurate and scary sounding). Better referred to as ‘time in bed restriction’. SRT can be to demanding for some, in which case sleep compression therapy appears to be a viable option but is less well tested & has slower effect.

[The Depersonalisation Guidance Centre @DPguidance]

@salRides @m_scheeringa The arguments apply to those also - see ‘The Trouble with Trauma’ and ‘The Body does not Keep the Score’.

[The Depersonalisation Guidance Centre @DPguidance]

@psycheureka Yes, OCD obsessions = generally egodystonic, often contain imagery. GAD worries = generally egosyntonic & mostly verbal-linguistic (cognitive avoidance). GAD ‘compulsions’/safety behaviours tend ‘make sense’. OCD compulsions often irrational (eg repeat 3 words to prevent harm).

[The Depersonalisation Guidance Centre @DPguidance]

@markrdavis @sanilrege @psycheureka @m_scheeringa @Paulyvagal Re: DP - no not at all, unless PTSD is a co-morbidity. (The comment referred more to my NHS Talking Therapies work).

I’ve added it to my reading list.

[The Depersonalisation Guidance Centre @DPguidance]

@markrdavis @sanilrege @psycheureka @m_scheeringa @Paulyvagal If fragmentation is not a (unique) feature of trauma memories, CT ‘reliving’ starts to look a bit like watered down exposure therapy. At that point you might as well do PE. Cognitive reappraisal can conducted during imaginal exposure opportunistically.

[The Depersonalisation Guidance Centre @DPguidance]

@markrdavis @sanilrege @psycheureka @m_scheeringa @Paulyvagal A really interesting thread Mark - and in part explains why I dropped Ehlers & Clark’s CT in favour of prolonged exposure.

[The Depersonalisation Guidance Centre @DPguidance]

@alokvkulkarni @chrisaikenmd But do the therapies studied amount to treatments for personality pathology? If they’re mostly CBT then I’d suggest not.

[The Depersonalisation Guidance Centre @DPguidance]

@markrdavis @ProfRobHoward Hear, hear.