How to Find a Therapist for Depersonalization (I’m 100% Cured)

I had depersonalization/derealization disorder for 5 months before I got out. Today I’m 100% cured and strongly believe that therapy played a crucial role in speeding up my recovery. Let me share with you what I’ve learned when it comes to choosing the right therapist.

How to find a therapist for depersonalization:

Understand which therapies can be useful for depersonalization
- Psychodynamic-, Cognitive-behavioural- , Acceptance- or Integrative manual therapy
Self-analyse the potential cause of your depersonalization
- Trauma, toxicity, thoughts or feelings
Choose a therapy type using steps 1 & 2
Choose a therapist via psychologytoday.com

Do you want to learn more about these four steps? Then keep on reading.

The 4 Best Therapies for Depersonalization / Derealization Disorder

The 4 best therapies backed by scientific research and or my own experiences are:

Psychodynamic therapy
Cognitive-behavioural therapy
Acceptance and commitment therapy
Integrated manual therapy

Let me tell you a bit about each of these therapy types so you get an idea of what they encompass and how they may help you. Here’s an overview of the origins and founders of the mentioned therapies:

Now we have a basic idea of what’s out there. Next let’s have a more detail look at these therapies, so you can decide which one might help you.

Psychodynamic Therapy

What is psychodynamic therapy? In psychodynamic therapy the therapist uses a method called psychoanalysis. Psychoanalysis can be described as a set of questions designed to help you examine your relationships, deep feelings and past events, which may reveal unconscious motivations and behaviours, which may be affecting you more than you think.

How can psychodynamic therapy help? Psychodynamic therapy helps gain insights into unknown parts of one’s self. By doing so, unconscious harmful motivations and behaviours can be explored and transformed with the goal of achieving symptom remission.

In the publication “The Efficacy of Psychodynamic Psychotherapy“ Dr. Joanathan Shelder outlines the processes and techniques that are characteristic for psychodynamic therapy as follows:

Focus on the expression of emotion and affect
Focus on avoidance attempts of unpleasant thoughts and feelings
Identification of patterns and recurring themes
Past experiences are discussed
Exploration and discussion of interpersonal relations
Exploration of the therapy relationship
Exploration of desires, fears, daydreams, dreams and fantasies

Cognitive-behavioural therapy

What is cognitive-behavioural therapy (CBT)? The core difference between psychodynamic therapy and CBT is that CBT doesn’t focus on uncovering unconscious motivations or behaviours, but rather views the problems as learned behaviours, which can be adjusted. CBT focuses mainly on the present and how to change things in the ‘here and now’.

How can cognitive behavioural therapy help? Anthony S. David published a great book on DDD (Overcoming depersonalization and feelings of unreality: a self-help guide) in which he describes the main steps of CBT as follows:

Identify your main problems and understand how they’re influencing your life

(Obviously it’s depersonalization, but you will work together with the therapist to find possible causes. For example, anxiety, fear or shame)

Identify what you are doing or maybe not doing that causes these problems to stick around. These causes could be the following:
1. Cognitive: unhelpful thinking patterns, beliefs, meanings, attention, images and memory
2. Emotional: negative emotional states or your moods
3. Behavioural: unhelpful behaviours like avoiding situations or taking drugs
4. Physical: body related feeling such as tiredness or pain, or concentrating on visual disturbances
5. Environmental: relationships, work, everyday situations, home
Define changes that will eliminate these causes
Pursue these changes using techniques learned during therapy

The cognitive-behavioural therapist will help you understand the cognitive, emotional, physical and behavioural connections that arise in a variety of everyday situations. You will learn to recognise when your thoughts are getting out of hand, and are creating negative feelings, or when your behaviours are holding you back from leading a meaningful life.

For more information on CBT and DDD, you can also have a look at the amazing work of Dr. Daphne Simeon “Feeling unreal: Depersonalization Disorder and the Loss of Self”.

Acceptance and Commitment Therapies

As mentioned above, loads of DDD recoveries, including myself, state the importance of acceptance during their path back to reality. I will explain the basics of acceptance and commitment therapy (ACT) using the book ”Overcoming Depersonalization Disorder: A Mindfulness and Acceptance Guide to Conquering Feelings of Numbness and Unreality” written by Dr. Fugen Neziroglu as my main source of information.

What is Acceptance and Commitment Therapy? ACT is a form of psychotherapy that originates from cognitive-behavioural therapy (CBT) and traditional behavioural therapy (psychologytoday.com/us/therapy-types/). ACT follows the belief that people tend to live unhappy lives because they let their negative emotions rule their behaviour, ‘I don’t feel like it so, I won’t do it’. ACT addresses exactly these feelings and teaches the patient how to keep on going with their lives using ACT principles. The core difference between ACT and CBT is that ACT focuses on accepting negative thoughts and emotions and CBT aims to change the patient’s thought patterns and thus their emotions.

How can Acceptance and Commitment Therapy help? Having gone through DDD, I know how important acceptance is. Nevertheless, I also know how unhelpful this sounds to someone with DDD. Therefore, I want to ask you to let me give you some examples from Dr. Fugen Neziroglu’s book “Overcoming Depersonalization Disorder” in which she described how ACT could help you live with DDD until you hopefully recover completely. The following dysfunctionalities could be part of the reasons that your DDD is not vanishing. ACT helps you recognise and work through the following six dysfunctional processes:

Cognitive fusion
- Letting your feelings and thoughts influence your behaviour
Differentiating between who “you” are and who you believe you are
- “You” are not necessarily the beliefs that you have about yourself
Worry and rumination
- Can be conquered with mindfulness techniques
Experiential avoidance
- Avoiding situations do to DDD
Not having a clear set of self-defined values
- Defining values can give you back your meaning in life
Narrow behavioural repertoire
- Not acting according to your values may cost you your meaning in life

Integrative Manual Therapy

What Is Integrative Manual Therapy? IMT follows the belief that the body can heal itself but does not always know when or where to start by itself. The treatment compromises a special set of approaches, techniques, and methodologies designed to treat dysfunction, pain, disease and disability. The integrative manual therapy association describes IMT as a health care process, which observes and treats the body at the cellular level.

How can Integrative Manual Therapy help? IMT therapist uses their hands to treat the patient. They place their hands on the patient’s body, in consequence creating a mechano-energetic-interface which will encourage the healing process. One could say IMT functions as a trigger that activates the healing process. The approach taken is integrative and encompasses several systems of the body. Depending on the root cause of the patient problems the treatment will focus on physiological, anatomical, psychological and nutritional approaches. Concerning DDD, IMT can help the body detox and or resolve psychological discomforts that may be causing your DDD.

This was only a brief overview of the Four (4) best therapies for DDD. For an in-depth description, check out my post “Does Therapy Cure Depersonalization? Here Are The 4 Best Therapies”.

Self-Analysis of the Potential Cause of Your Depersonalization

Now that we’ve learned which therapies can help with DDD let’s figure out which one could help you. Here for you should try and guess the causes of your DDD as accurate as possible. I’ve put together a list of all the causes and triggers other DDD sufferers have mentioned to me, have been mentioned in scientific research or I’ve experienced myself. These can be categorized into four main categories:

Trauma: the death of a loved one, involvement in an accident, break-up, family abuse/problems, stress at work, birth of a child, bullying, victim of violence
Toxicity: weed, excessive alcohol, pharmaceuticals, drugs, (other toxins or pollutants). I included other toxins or pollutants in parentheses since I believe that, e.g. mould or air pollution can also play a role in the development of DDD since it increases the body and minds stress levels. However, I didn’t find any scientific publication substantiating this belief, but then again who would be able to make that connection, since unlike smoking a joint you won’t notice when you’re breathing polluted / toxic air.
Thoughts and feelings: I’m not good enough, I’m alone, I’ll never be happy, I feel ashamed, scared and hopeless. All these thoughts and feeling can increase your feelings of anxiety.

No cause: A hand full of people with DDD mention that DDD just suddenly was there, no mentionable trigger. They were living a normal life, no trauma or contact with toxins, thus in their opinion no cause. Prof. Dr. Matthias Michal, a German doctor who has specialized in DDD, has been treating DDD patients since 2005 in his specially designed DDD-consultation-hours (If your German is any good you should check out his webpage). In his book on DDD, he mentions that many patients claim not to know the cause of their DDD, but often do identify a potential cause during a psychotherapy session. Thus, psychodynamic therapy is the therapy I would suggest for people who state, “no cause” since it uncovers unconscious problems.

Having been in contact with over a hundred people that have had DDD, having had DDD myself and having done immense research on the topic I believe DDD is due to anxiety. This anxiety can be conscious or unconscious, either way, if your anxiety levels exceed a certain anxiety-threshold you enter DDD. If you want to get out of DDD, you must decrease your anxiety levels beneath this anxiety-threshold. Have a look at the following illustration, in which the anxiety-threshold is shown:

Depicted on the left is the sum of your anxiety due to trauma, toxicity, thoughts and feelings. The bar chart on the right has a closer look at these causes.

If the right bar chart represented a human being that got DDD it would read as follows from bottom to top:

This human would have experienced the death of a loved one, bullying, violence, have family problems, have been in an accident, gone through a break up, use pharmaceuticals, drugs such as ecstasy or ketamine, live in a mold infested house, stress at work would be normal, excessive alcohol consumption would be normal, his or her child would have been born not long ago and this person would have gone through a break-up.

This person is thinking about his life and is feeling hopeless and miserable; everything is going wrong; his anxiety increases further, but the anxiety-threshold still hasn’t been crossed. This person decides to smoke a joint, to ease the pain, but rather than feeling relief this person crosses the anxiety-threshold.

This was it, the body and mind can’t take it anymore and decide to start up “self-protection-mode” aka DDD. Now weed triggered DDD, but it most definitely is not the sole cause.

I believe you can decrease your anxiety by working through any of the depicted “anxiety-blocks” (death of a loved one, negative feelings, drugs…). This is where your therapist steps in. He or she will help you work through potential causes, hopefully decreasing your anxiety below the anxiety-threshold and out of DDD.

Next use some self-analysis and figure out which trauma, toxicity, thoughts or feelings may have caused your DDD. After reflecting on your own life and hopefully collecting some ideas of your potential DDD cause, let’s have a look at which types of therapy could help you. Remember, if you couldn’t identify a specific cause, no cause is also a valid answer and will also be discussed.

How to Choose the Therapy That Can Help You With Your Depersonalization

Before we start, I want to mention that the therapist wants to help you. This means, if you choose cognitive-behavioural therapy the therapist is not limited to CBT methods, they can also use some psychodynamic methods if they believe it will help you.

Great, this being said let’s look at which DDD causes can be treated by which therapy. I used my own experience and books on DDD to allocate potential DDD causes to the four types of therapy mentioned above. Here they are:

Psychodynamic therapy: trauma, negative feelings,no cause, past events (death of a loved one, violence, bullying, break-up, involvement in an accident, war…)
Cognitive-behavioral therapy: negative thoughts, negative feelings, family problems, bullying, stress at work, the birth of a child, drug addiction (pharmaceuticals, alcohol, weed, ecstasy, ketamine…), break-up…
Acceptance and commitment therapy: negativethoughts, negative feelings, DDD itself, no meaning in life
Integrative Manual therapy: trauma,toxicity, pharmaceuticals, drugs, negative feelings

Keep in mind I’m not a psychologist, merely someone who also experienced DDD and has the desire to help as many people as possible going through this hell. Next, I want to share some of my personal experiences, insights and thoughts concerning DDD and the four discussed therapies.

Psychodynamic therapy: Several people have emailed me stating they don’t know why they have DDD. If you are one of these people, psychodynamic therapy may be for you, since it is designed to uncover past events or relationships that are unconsciously causing you distress.

When I was six years old, my sister died, leaving a huge void inside of me. One example of how therapist helped me work through this, is by asking me to remember the six-year-old me, then to talk to the younger me, and to tell him that what happened is not his fault.

Children often blame themselves for the things happening around them. Why is mom upset? Why is dad mad? It must be my fault.

Growing older we forget these things happened or lock them away intentionally. Consciously these traumata don’t seem to be an issue anymore, but unconsciously they can be causing your mental health to deteriorate.

Cognitive-behavioural therapy:I was asked two questions during my DDD recovery that helped me enormously. Both questions were characteristic for cognitive-behavioural therapy, which is why I find this type of therapy so interesting concerning DDD. Also, CBT is mentioned in a vast amount of research about depersonalization. Thus, I strongly believe CBT has a huge potential for DDD suffers. Here are the two questions I was asked that helped me a lot:

If you feel deep inside yourself and ask how long depersonalization will last, what would you say?
Describe the feelings you associate with depersonalization?

I talk about the effect they had on me in more detail in this post: “Does Therapy Cure Depersonalization? Here are the 4 Best Therapies.“

Acceptance and commitment therapy:I felt completely numb during my time with DDD and often contemplated my life’s worth. Was it worth it to do anything? Was it worth it to face my discomfort, be social and meet people? Looking back and having some perspective, I can say, yes, absolutely! During this time, I had one of the most meaningful relationships of my life. And I’d like to emphasize the word meaningful. Even though I felt numb inside, and while having sex I felt so little emotions do to my depersonalization, this relationship still had immense meaning for me.

In retrospect, this is fascinating to me, because the numbness almost made me blind to the value of live itself.

DDD cannot take away your freedom of living a meaningful life unless you let it.

Integrative Manual therapy: I’m an engineer; I love logic, facts and things I understand. In consequence integrative manual therapy (IMT) isn’t my favourite topic to explain, since it’s ‘energy-work’ and has an esoteric feel to it. But I do trust my experiences, and through my parents, I’ve had contact with alternative medicine and bodywork all my life. And I can say, as a fact, some people can feel into your body and resolve your problems with merely a touch of their hands.

Let me give you an example: More than once have I been, e.g. in an IMT treatment and not said where I was having pain and the therapist went right to the body part that was bothering me and said something like “I feel an inflammation in your knee” and I was left thinking to myself “how the hell did they know/feel this? Nevertheless, be aware, as in every profession there are good and bad therapists. Don’t blindly trust the first one you encounter.

How to Find a Suitable Therapist (on the Internet)

In case you have someone in your life that has experience with psychotherapy, ask them for advice! It’s so hard to find a good therapist even if you know what type of therapy you are looking for. I strongly recommend trying three to four different therapists. This way you get a feel of how different they can be and who you feel the most comfortable with.

How to find a therapist on the web: Follow these three steps:

Go to: https://www.psychologytoday.com/us/therapists

Choose your country.
Type in your city or zip and hit search
Scroll down and select your sought-after therapy type in the left menu titled “Types of Therapy” (e.g. cognitive-behavioural).

Click on the name or picture of the therapist you find appealing
Check the therapist treatment specialities, cost and qualifications (I recommend taking a close look at the topics the therapist listed beneath “issues” and “mental health”. Check if the topics have any relevance for you.)

In case you can’t find a therapist using the method above, you might find a therapist searching the category “dissociative disorder”. This might be useful since the “Diagnostic and Statistical Manuel of Mental Disorders (DSM-5)” categorizes DDD as “dissociative disorder”, thus therapist specialised on dissociative disorder might be able to help you better than others with your DDD recovery. Use the following link to search for a dissociative disorder therapist:

https://www.psychologytoday.com/us/therapists/dissociative-disorders
Enter your city or zip
Choose and contact a therapist

Lastly, I want to give you the link to the integrative manual therapy centre in Connecticut, where IMT was developed:

https://imtwellnesscenter.com/

IMT is a special type of treatment and is not listed on psychologytoday.com. Feel free to check out the IMT website and contact them for more information. I do not know though if they will have heard of depersonalization, since I went to a different IMT centre, located in Munich, Germany.

I sincerely hope I could give you some valuable information on how to find a therapist for DDD and that you recover soon! Hang in there and feel free to comment on this post if you have any further questions =).