# Hemispheric Approach to understand DPDR symptoms



## SantosB (Jun 4, 2014)

Hi!

I have built a new hyphotesis to explain all the symptoms related with DPDR: a weak or absent neural connection between both hemispheres.

This is the basis of the exercises I propose in my blog to get rid of permanent DPDR. It is a slow process but it works.

http://dpdrenglish.blogspot.com

Regards

Santos Barrios


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## Ningen (Apr 16, 2015)

I agree.


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## Billy Pilgrim (Jan 25, 2015)

Fascinating... I think you are on to something big... tried excercise twelve "comparing", and it was very comforting/helpful.


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## Andre (Jun 2, 2013)

Hi Santos, I found your blog very interesting, and regarding these exercises, do you think Cognitive Behavioral Therapy would have similar results? I was on psychoterapy for 10 months, but I had no significant result. What do you thing about CBT? Thanks!


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## bubniakz (Jun 3, 2008)

Santos, read some articles on split brain patients or commissurotomy, follow the tests done by Sperry and Gazzaniga. If you sever the corpus callosum, the results are far from depersonalization or derealization symptoms. Your theory is way too simplified. Read the case studies on split brain patients.

Disconnection is not between the left and right hemisphere, but between the frontal and limbic brain areas.

"In view of the evidence reviewed so far, it would seem as if there are two distinct neural networks that are relevant to the neurobiology of depersonalization. One first system, relevant to the experience of emotional feelings includes the amygdala, the anterior insula and possibly other limbic-related structures, such as the hypothalamus and the anterior cingulate. The activity of this emotional system is strongly regulated by the prefrontal cortex, and it is suggested that, in depersonalized subjects, *abnormal prefrontal regulatory suppression might be responsible for emotional numbing and the related inability to colour experience with feelings*. Such a hypothesis is indeed supported by the findings of attenuated autonomic responses, underactive amygdala and anterior insula responses, as well as related increased activation in prefrontal regions."


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## *Dreamer* (Feb 18, 2014)

Interesting, but this comes from a layperson's blog. Recent research from the Brain and Behavior Research Foundation has a significant breakthrough in understanding DP/DR as a special subtype of PTSD.

If you consider true PTSD, it is HYPER arousal -- over arousal. DP/DR is HYPO arousal -- a "shutting down." There is some indication that 30% of those with PTSD are in a subgroup that have DP/DR. And PTSD is an anxiety disorder. This gives us new insight.

https://bbrfoundation.org/brain-matters-discoveries/altered-circuits-may-cause-%E2%80%98out-of-body%E2%80%99-symptoms-in-some-people-with-ptsd

Altered Circuits May Cause 'Out-Of-Body' Symptoms in Some People with PTSD
May 01, 2015

Margaret McKinnon, Ph.D.

For some people with post-traumatic stress disorder (PTSD), symptoms go beyond the flashbacks, nightmares, sleeplessness, and tense feelings that trouble many. Up to 30 percent of people with PTSD also suffer from symptoms known as depersonalization and de-realization--that is, they experience "out-of-body" episodes or feelings that the world is not real. These disturbances to awareness and consciousness are known as dissociation.
New research now reveals that brain circuits involved in fear processing are wired differently in these people than in others diagnosed with PTSD. The findings, reported in Neuropsychopharmacology, suggest that such patients need different treatment options.

*PTSD with dissociation is recognized as a distinct subtype of the disorder. It is most common among people whose PTSD developed after repeated traumas or childhood adversity. Genetic factors can also increase the risk of developing PTSD with dissociation.*

Studies have found that reminders of traumatic events trigger different patterns of neural activity in patients with dissociative PTSD than they do in people who have PTSD without dissociation. *In both groups, emotion-regulating brain circuits are thought to be disrupted.* Emotional responses are undermodulated (under-regulated, or controlled) by the brain in most people with PTSD, causing them to relive traumatic events and experience hyperarousal symptoms such as being easily startled. *In people with the dissociative subtype of PTSD, in contrast, emotional responses are overmodulated (over-regulated) by the brain, leading to emotional detachment and the subtype's characteristic feelings of depersonalization and derealization.*

Senior author Ruth Lanius, M.D., Ph.D., of the University of Western Ontario led a team of scientists that included two-time (2007 and 2009) NARSAD Young Investigator grantee Margaret McKinnon, Ph.D., of McMaster University in Ontario. The scientists used functional magnetic resonance imaging to compare activity in the brains of 49 people with PTSD, 13 of whom had been diagnosed with the dissociative subtype of the disorder. Their study also included 40 people without PTSD.

*The researchers focused their analysis on parts of the brain that connect to the amygdala*, a small structure deep in the brain that is involved in emotion and fear processing. They examined connections to two parts of the amygdala: the basolateral amygdala, which evaluates sensory information and helps integrate emotions, and the centromedial amygdala, which helps execute fear responses.

*They found that in the brains of patients with the dissociative subtype of PTSD, the amygdala was more strongly connected to brain regions involved in consciousness, awareness, emotional regulation, and proprioception (the sense of body position) than it was in PTSD patients without the dissociative subtype. The researchers say that patients' dissociative symptoms may be directly related to these alterations in the brain's functional circuitry.*

..........

Senior author *Ruth Lanius, M.D., Ph.D.*, of the University of Western Ontario led a team of scientists that included two-time (2007 and 2009) *NARSAD Young Investigator* grantee *Margaret McKinnon, Ph.D.*, of McMaster University in Ontario.


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## bubniakz (Jun 3, 2008)

Newest and free PubMed Central® article from march 2015 by McKinnon and her colleagues

Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions

Ruth A. Lanius, Paul A. Frewen, Mischa Tursich, Rakesh Jetly, and Margaret C. McKinnon

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390556/

"Traumatized individuals who exhibit emotional overmodulation frequently suffer from a profound detachment from their emotional states and a lack of interoceptive awareness (the sense of the physiological condition of the body) as evidenced by dissociative experiences such as depersonalization and derealization, emotional numbing, and alexithymia, with accompanying* insula underactivity*. Detachment from one's emotional states often occurs in response to repeated traumatization during which the traumatized individual is frequently unable to initiate defensive actions due to overwhelming feelings and emotions. Emotional shutdown, numbness, and detachment instead ensue to the point where the traumatized person can become devoid of any positive and negative emotional experience."

"Body scan meditations are a core part of the mindfulness-based stress reduction program developed by Jon Kabat-Zinn and are thought to* enhance interoceptive awareness and assist in overcoming emotional detachment in traumatized populations*. Body scans encourage individuals to become aware of and to monitor bodily sensations experienced throughout the body. Given that an individual's subjective conscious emotional experience is thought to be based on the perception of physical sensations/bodily states arising from musculoskeletal, autonomic nervous, and endocrine system influences mediated by the *anterior insula*, mapping what physical sensations are associated with specific emotions can then be used to *help individuals identify what emotional feelings they experience*."

*"Increasing awareness of bodily sensations and encouraging individuals to map what sensations are associated with specific emotions may therefore be an important strategy in overcoming emotional detachment and thus restore salience detection (directing behavior to the most pertinent actions) and insular and salience functioning in traumatized individuals."*

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## danjohnbig (Feb 3, 2015)

Mindfulness


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## TDX (Jul 12, 2014)

Michal has used mindfulness meditation for more than 10 years as an adjunct for his treatment of depersonalization and he says that it only works for "a very short time". He didn't come up with anything else in this long timeframe. No theories, no clinical trials, so I doubt that mindfulness will be the solution.

But the article is interesting.


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## SantosB (Jun 4, 2014)

Despite all the scientific papers written about DPDR, I did it. I could escape from a 25 years of erroneous way of thinking.

I am aware that my theory is naive and too simple but maybe could be improved from a scientific point of view.

Why does DPDR affect to the perception of colours, and 3D view of the world??? My consciousness remained confined within the logical part of my brain whenever it is (Prefrontal Cortex in the left hemisphere?, I don't know) A consciousness without emotions is a the consciousness of a robot. A logical machine. I can explain what is living 25 whole years with all those symptoms.

Mindfullness is necessary but not enough to remove DPDR fully.

Thanks for the scientific articles


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