We need a CBT approach to treat Depersonalization/Derealization Disorder

I have come across depersonalization/derealization symptoms with some of my anxiety and OCD patients and the standard CBT approaches do not seem to be reducing these clients' DP/DR sxs significantly. I have found some old literature (a case study) where intensive exposure therapy was used 2-3x a week for many weeks that was finally used to eliminate these sxs in one patient, but only some gains were made in another. I have found the same - exposure therapy creates limited gains and that stress can retrigger these symptoms.

I think that one problem is that DP/DR disorders may be neurologically based, but I still think that CBT can offer some good coping strategies. For DP that is connected with panic attacks, this also seems harder to treat for some reason as well.

Any thoughts or suggestions? Would be great if someone came out with a systematic tx protocol for this unusual disorder.
There have been internet bulletin boards, run by people who have this disorder, to try to make sense of their sxs and they have mostly gone the medical route - though many still have lingering sxs.

- Geoff Hutchinson, MS
Doctoral student

Replies:

Hyperventilation and fear of going crazy, by Carl Robbins, 06/24/02 CBT for Depersonalization/Derealization , by Jim Pretzer, 06/24/02 Clients' reaction to this view of Depersonalization/Derealization , by Jim Pretzer, 06/24/02

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