# Just Found Another In-depth Podcast on FB Depersonalization Group!



## fighterS (Dec 22, 2017)

Hi Everyone!

It's Elaine Hunter here in a new interview!!

Also I urge you all to join the depersonalization/derealization disorder groups on facebook if you haven't done so and also share these podcasts with others on your social media accounts!!!

Here is the link to the podcast:

http://www.myownworstenemy.org/podcast/depersonalization-and-feelings-of-unreality/


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## thy (Oct 7, 2015)

She says it is all psychological and that there is no evidence that the brains of people with DPD are functioning abnormally, which is factually inaccurate because fMRI studies have shown otherwise. Quite worrying really. No wonder research into DP is going nowhere. Listen from 57 minutes, it is quite staggering what she says.


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## TDX (Jul 12, 2014)

> She says it is all psychological and that there is no evidence that the brains of people with DPD are functioning abnormally, which is factually inaccurate because fMRI studies have shown otherwise. Quite worrying really. No wonder research into DP is going nowhere. Listen from 57 minutes, it is quite staggering what she says.


Really? Then I should also listen to it. I didn't do so, yet, because english isn't my first language, so it's a bit tedious to listen to it. Why can't they just write it down?

But it wouldn't surprise me given what you have told me about your visit to her.


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## Broken (Jan 1, 2017)

thy said:


> She says it is all psychological and that there is no evidence that the brains of people with DPD are functioning abnormally, which is factually inaccurate because fMRI studies have shown otherwise. Quite worrying really. No wonder research into DP is going nowhere. Listen from 57 minutes, it is quite staggering what she says.


I disagree with this. I actually saw her, and at the time I did disagree with her view that it is purely psychological. For me I don't think it was helpful for me to believe this is structural. It put me into 'victim mode' if you will, and that I was a victim of my biology of brain wiring and that there was nothing I could do. That belief left me feeling powerless to this condition. I am starting to make positive steps again recently because I am seeing it as a psychological disorder not a neurobiological disorder..

I am not speaking for everyone here, just myself. But my opinion is if this started with a panic attack and you had anxiety/depression/stress in your life building up to the point it started, it is highly probable it is psychological. Not to say it can't be physical, we just don't know enough. But the functional changes shown in brain scans are what she said; the brain reflecting what we are feeling. There is a structural study where I would say minor to moderate structural changes occur across the brain, as would be expected with functional changes over time. But I think there is too much belief in a magic pill. And as there is no magic pill yet it leaves us feeling powerless to overcome this. The self is an extremely complex thing, it isn't just one part of the brain, or thought, or the body, or emotions. It is all this and more. IME I think it is more a complex PTSD and that has shut me down until I resolve the trauma's and how if those traumas happened again I would deal with them differently


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## thy (Oct 7, 2015)

TDX said:


> Really? Then I should also listen to it. I didn't do so, yet, because english isn't my first language, so it's a bit tedious to listen to it. Why can't they just write it down?
> 
> But it wouldn't surprise me given what you have told me about your visit to her.


This is the relevant part. Pretty much word for word what she said.

"I don't think I've met anyone who's had all the scans etc who has ever come back finding something that actually shows that there is any structural or functional changes in the brain. There has been quite a lot of research that has been looking at that.

The only thing that I think is interesting, but I don't necessarily think its the brain causing the problem, some of our team did a study where they were looking at people when they put them in brain scanners, and they were showing them pictures that were quite disgusting. And the reason for that is that disgust has a very specific part of the brain that tends to get activated with disgust, so its very clear to see whether that's being activated or not. They found that the people with depersonalisation compared to people that didn't have depersonalisation was showing less activation in this part of the brain that indicated disgust. But in a way that is just showing what people were saying, they were kind of saying "I know its disgusting but I can't feel it". So I think the brain was mirroring how they were feeling, but I don't think the brain was causing it. That I thought was interesting.

Also some physiological skin conductance type tests, where its not your conscious mind that is controlling how you react, in terms of sweat being released on your skin, has also shown that people with depersonalisation are less physiologically reactive. But I don't think it is that that is causing the depersonalisation, I think that's just demonstrating that what people are saying, that they can't feel things physically or emotionally, is actually being found in testing. But I don't think it's the cause of it, I definitely see depersonalisation as very much more of a psychological issue. I get evidence for that when people's symptoms go up and down, or change in different circumstances. One lady I work with has no depersonalisation on holiday, when she comes back to her stressful work conditions it comes back again. That doesn't work with a neurological disorder, you don't have Parkinson's for several days then no Parkinson's.

I don't see any good evidence for there being chemistry or neurological explanations for it."


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## thy (Oct 7, 2015)

Broken said:


> For me I don't think it was helpful for me to believe this is structural.


I'm not saying its structural, im saying its functional.



Broken said:


> I am starting to make positive steps again recently because I am seeing it as a psychological disorder not a neurobiological disorder..


Im glad to hear that. It might be the case that deluding yourself to think its something its not helps recovery.



Broken said:


> But my opinion is if this started with a panic attack and you had anxiety/depression/stress in your life building up to the point it started, it is highly probable it is psychological.


I don't see the logic to this. Can panic attacks not cause functional changes in the brain? I believe they can.



Broken said:


> Not to say it can't be physical, we just don't know enough.


We do know enough, there are fMRI studies of people with DP that show functional changes. We know enough to say that at least.



Broken said:


> But the functional changes shown in brain scans are what she said; the brain reflecting what we are feeling.


What does that even mean? People are willing their brains to function abnormally? If someone stuck a knife into a persons brain and the person starting saying they don't feel well, would you say that their brain was just reflecting what they are feeling? Think about the chain of causality. You can't feel something before your brain has undergone activation.


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## TDX (Jul 12, 2014)

> One lady I work with has no depersonalisation on holiday, when she comes back to her stressful work conditions it comes back again. That doesn't work with a neurological disorder, you don't have Parkinson's for several days then no Parkinson's.


To me it sounds like she is starting to tap into the psychosomatic secondary gain victim blaming style. Her argument also only shows that psychological factors might modulate for some people depersonalization symptoms. You cannot conclude from this that they are the cause.

The more I read about Elaine Hunter the more I get the impression that she is just a female version of Matthias Michal, but with CBT instead of psychoanalysis.

Maybe I will look at the whole podcast tommorow myself, because it seems to be more important than I thought.


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## TDX (Jul 12, 2014)

> Another "specialist" promoting their speciality above all else. What a surprise (not).


Which in itself would not be a problem, if they could show or at least somewhat convincingly argue that on sound theoretical grounds they can offer something to patients.


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## fighterS (Dec 22, 2017)

I couldn't agree more with all of you and actually doubt how much of a help she can be to people with dp out there. She is good for the awareness of it but that's it- she is not entitled to make any comments regarding functional or structural changes of the brain- this woman is NOT a psychiatrist, (she actually say that somewhere throughout the interview) she has no knowledge of whatsoever regarding the field of medicine, (she does but not as much as an actual neurologist would have on the conditionI mean) therefore sounds incredibly ignorant when commenting on whether this is chemistry or have neurological reasons for it. I absolutely hate the fact that psychologists trying to play the role of 'being an actual doctor' when in fact they are nothing close to doctors, because they obviously didn't receive the education for it in the first place. Just because you are able to read some scientific work doesn't mean you have enough scientific knowledge on the condition.

And yes, agree with thy's comments totally: If anxiety and panic attacks would not cause any functional changes to the brain why are they conducting research on these conditions in the first place for a long long time now?

They need to ask these kind of important questions to actual neurologists, not psychologists.

With regard to CBT - with all due respect, to me, these management methods are bullshit. They are no cures, they will just help you to manage your symptoms better, for some. When this goes under NHS in England; is this going to be the so-called treatment for dp? CBT!? If they are going to only provide funding for that, that would be sad. Don't get me wrong, it may still work for some, but thousands of cases here on dpselfhelp is proof that CBT doesn't do much really. (I don't know how NHS works though, hoping they will support research around dp?)


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## thy (Oct 7, 2015)

TDX said:


> Her argument also only shows that psychological factors might modulate for some people depersonalization symptoms. You cannot conclude from this that they are the cause.


Exactly



TDX said:


> psychosomatic secondary gain victim blaming style.


what does this mean?


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## TDX (Jul 12, 2014)

> I absolutely hate the fact that psychologists trying to play the role of 'being an actual doctor' when in fact they are nothing close to doctors, because they obviously didn't receive the education for it in the first place. Just because you are able to read some scientific work doesn't mean you have enough scientific knowledge on the condition.


I regard arguments of someone lacking education and therefore him not being worthy of any attention as a bit problematic. In my opinion this should be done the other way round: People should be measured on what they say. Then the lack of education can serve as a possible explanation for them telling bullshit, but not as a counter argument in itself. This could actually backfire on us, because almost nobody here has a formal education in the matters we talk about. We would gag ourselfs, if we argued like that.



> With regard to CBT - with all due respect, to me, these management methods are bullshit. They are no cures, they will just help you to manage your symptoms better, for some. When this goes under NHS in England; is this going to be the so-called treatment for dp? CBT!? If they are going to only provide funding for that, that would be sad. Don't get me wrong, it may still work for some, but thousands of cases here on dpselfhelp is proof that CBT doesn't do much really. (I don't know how NHS works though, hoping they will support research around dp?)


Generally the more I read about CBT the more I realize how limited it actually is. I doubt that it really is markedly effective outside of a couple of mental disorders like anxiety disorders, OCD, depression and PTSD. But even there many patients are resistant to CBT.

Elaine's CBT approach might possibly be effective for some people with depersonalization disorder whose symptoms fluctuate in response to clearly identifiable triggers. But they are the minority. For me her approach is not the future of depersonalization treatment, but more of a dead end.



> what does this mean?


Psychosomatics have the opinion that people with unexplained medical symptoms "somehow" psychologically cause their symptoms to receive secondary gains:
https://en.wikipedia.org/wiki/Primary_and_secondary_gain

This "holiday depersonalization" sounds a bit like that. It suggests the patient is lazy and depersonalizes in order not to have to work. I wouldn't have given such an example in such an interview.


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## eddy1886 (Oct 11, 2012)

Funny how she constantly promotes CBT as a fix but never ever mentions anything about the medicines the people she treats are being prescribed aswell....(you can be sure alot of them are being given meds along with the CBT)

The meds do the hard work whilst the therapist claims the glory....Hmmmmmmm!!!!

Me thinks the success stories she claims are more to do with the meds than the CBT...

"We will talk about that next week" "That will be 50 pounds please" ............This is what comes into my mind when I hear stories like this....


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## eddy1886 (Oct 11, 2012)

I dont know if im being paranoid but she has basically requoted nearly every post ive put up on here in the last 10 years or so LOL...

Free study LOL

I will send you the bill over the next few days Dr Hunter...

LMAO!!!


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## eddy1886 (Oct 11, 2012)

Of course there is the preverbial "New book" plug LOL


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## eddy1886 (Oct 11, 2012)

CBT is like communism...

Great in theory but fails in practice...


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## TDX (Jul 12, 2014)

> CBT is like communism...
> 
> Great in theory but fails in practice...


True in several areas, but also an overstatement. There are literally hundreds of psychotherapy techniques and CBT is one the few that has proven to be useful for least some problems. But except for maybe a minority, I doubt that it's the silver bullet against depersonalization disorder.



> I dont know if im being paranoid but she has basically requoted nearly every post ive put up on here in the last 10 years or so LOL...
> 
> Free study LOL
> 
> I will send you the bill over the next few days Dr Hunter...


Sometimes I asked myself, if doctors who specialized on one problem really read in the discussion groups of patients. I cannot answer this question, but from my years of experience in reading several patient forums I know that they rarely post there.


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## eddy1886 (Oct 11, 2012)

eddy1886 said:


> CBT is like communism...
> 
> Great in theory but fails in practice...


EDIT!!!

As regards Depersonalization Disorder

You cant talk your way out of DP and you certainly cant put CBT into practise with it because it wreaks havoc with cognitive abilities in the first place and secondly because the thinking patterns that go along with chronic DP are too obsessive to break down...Grounding techniques, Automatic Negative Thought Assessment etc etc etc does nothing to break DPs incessant grip of constant terror....

If your lucky enough to have lots of money and apply CBT regularly in a stress free environment maybe it might work...But for most of us who have to work regularly or have children and wives and bills to pay this simply isnt practical....

How many of us on here have tried to hold up a job amongst other everyday responsibilities whilst sick with chronic DP....Its not possible....Try throw CBT practices in on top of all that 50 times a day???? See where im going with this????


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## Broken (Jan 1, 2017)

CBT seems to simple a therapy for me. The type of therapy I am arguing is by a well trained psychologist for years. Nobody has access to that.

Back to the whole functional/structural argument. Functional changes aren't controlled by us but they are a defence mechanism that can be reversed I believe. The issue is resolving the underlying fears and beliefs, something so bad that it sticks you in a form of the 'freeze response'. My experience is I don't fight and stick up for myself. I also don't flight and run away from the situation.

For some reason (deep down psychologically) I freeze, or leave myself in that situation ie bullying and even to this day I have 'friends' that are arse holes and make shitty comments, but I don't stick up for myself or remove them from my life, I stay. It is a reflection of my low self esteem or self worth. I don't think I am worth protecting in a sense.

So I still GET the emotional fight or flight response but I don't EXPRESS that socially that causes me to shut down. I have it 24/7 which might mean that has happened continuously over time to cause it to be over active.

I'm open minded to meds reversing this, but I haven't found any. So rather than giving up I am choosing to believe that working on my self through exploring the past and going through how things could have been done differently to get better results.


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## Broken (Jan 1, 2017)

Autonomic Space Monkey said:


> Most specialists are the same, & tend to fall into the same faulty reasoning, i.e.
> 
> I specialize in X,
> & my patients suffer with Y,
> ...


Lol yeh. "I haven't heard of depersonalization disorder so it can't be that". My last GP even put depersonalization 'syndrome' down as my diagnosis. I don't think he actually believed in my condition


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## eddy1886 (Oct 11, 2012)

Autonomic Space Monkey said:


> What I meant was this:
> 
> I specialize in Psychotherapy,
> 
> ...


Mainly so ya keep going back......

To line their pockets


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## Broken (Jan 1, 2017)

Yeh I was just illustrating how an individual's biases can affect their diagnosis as well as their treatment. Some genuinely do have a god complex. They think they must have the answer because they had so much training. When sometimes they simply don't. And then they wamt to be the hero (although financial reasons most probably influence this as well).

So they are convinced their specific training is the answer to this and they can save the victim (whilst being rewarded rather handsomely financially). People truly beleve involving money doesn't influence the practitioners decisions and biases. Human beings are not objective in nature. You may not consciously think the money affects you, but you unconsciously know that money is important and self preservation is the primary objective

So I am sure many are convinced they are good people helping others. But if they were truly honest and reflected on their experience/abilities, they are clueless. 'I don't know' would be their honest answer about DPD. Except they're not aloud to say that now are they. 'I don't know' should probably be the first chapter in any medical textbook lol


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## eddy1886 (Oct 11, 2012)

Broken said:


> Yeh I was just illustrating how an individual's biases can affect their diagnosis as well as their treatment. Some genuinely do have a god complex. They think they must have the answer because they had so much training. When sometimes they simply don't. And then they wamt to be the hero (although financial reasons most probably influence this as well).
> 
> So they are convinced their specific training is the answer to this and they can save the victim (whilst being rewarded rather handsomely financially). People truly beleve involving money doesn't influence the practitioners decisions and biases. Human beings are not objective in nature. You may not consciously think the money affects you, but you unconsciously know that money is important and self preservation is the primary objective
> 
> So I am sure many are convinced they are good people helping others. But if they were truly honest and reflected on their experience/abilities, they are clueless. 'I don't know' would be their honest answer about DPD. Except they're not aloud to say that now are they. 'I don't know' should probably be the first chapter in any medical textbook lol


Therapist once told me....

"I spent alot of time training for this so Im entitled to charge 100 euros an hour for therapy sessions" .....This person worked in a suicide prevention place....Scarey!!!

Another therpaist in the same place told me she was......"Empowering me to get better" .........Even scarier LOL


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## eddy1886 (Oct 11, 2012)

I have nothing against therapists charging people for their services.....But it becomes legalized extortion when they actually know deep down they cannot help you but keep you coming back again and again.....

Just proves how many of them are chancers and fraudsters only in it for the money....

Integrity my ass!!!


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## TDX (Jul 12, 2014)

There is another aspect in the whole discussion, that you have hinted: Cost-efficency. Let's say a session psychotherapy costs 100€. According to his book Michal wants to put all patients with depersonalization disorder through longterm psychotherapy consisting of "at least 50 to 120 psychotherapy sessions over a timeframe of one to three years" (page 91). This would be an amount of 5000€ to 12000€. Not to mention that he said "at least", so he wouldn't disagree to even more sessions.

Let's compare this to drugs: A tablet of 200 mg Lamotrigine costs about 1.5€, which means if you need to take 400 mg/day to obtain relief from your symptoms, your treatment costs about 3€ per day. You would have to use this treatment for 4.6 to 11.0 years to exceed the costs of longterm psychotherapy. If you only needed 200 mg/day it would be 9.2 to 22.0 years.

The high costs of his proposed longterm psychotherapy treatment would only be justified if he could demonstrate that it does not only have efficacy, but solves the patient's problems for good, hence after completing all sessions the patient is cured. But he never came up with something like that, while there is some evidence for Lamotrigine being effective for at least some people.

Even for the ones where it doesn't provide relief, it doesn't eat much cash, because then it is just discontinued following some months of treatment. In contrast in the german forum there are numerous people who had years of psychotherapy, which was in most cases for nothing. Seems like you have to run through all the sessions to "find out" if it can work or not (usually insurance cuts off the money supply).

In my opinion for depersonalization disorder psychotherapy is no "treatment of choice", like Michal says, but a very expensive off-label treatment without much evidence supporting it. I would say almost all drug treatments should be preferred to it, because they are much more likely to work, the non-response much easier to detect and thus much more cost efficient.


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## Broken (Jan 1, 2017)

I have an issue with psychotherapy as a 'profession' because you can't call it that. They seem to govern themselves. If I wanted their credentials they would show me a certificate. What about important stuff like success rate? Patient satisfaction? Whether they found it helpful at all or value for money?

It frustrates me because I have recently come to see it as helpful, slightly through my new therapist. But mainly through by my own research into it and then analysing my past myself.

The issue with therapists is a lot believe in free association. In theory, they let the patient talk until they start to repeat the same problem, which would be what needs to be addressed. However, the theory doesn't add up to me. It implies ALL people voluntarily will eventually start talking about the worst parts of their lives and trauma.. I mean, people avoid thinking and talking about these things because they are painful and upsetting. It's masochistic in a sense to willfully drive yourself to talk about those things... it is also IMO the place where the answer is because it is the only place you havent looked!

It takes a skilled and experienced therapist to drive you into those subjects in a subtle way without it becoming overwhelming. But the vast majority I have experienced seem to just let you talk and avoid whatever the real problem is (because youre are not goin to willfully talk aBout your shitty past). Free association my arse. They don't have to deal with anything of any importance or responsibility, and still get payed and you keep coming back because there is 'more to be done'. Of course there is because nothing is being done by a lot of them!


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