Posted by SLS on January 8, 2001, at 21:32:45
In reply to Re: derealization » Noa, posted by shellie on January 8, 2001, at 16:35:27
Hi guys.
Since I experienced some rather severe depersonalization and derealization in my early twenties, and continue to experience them when my depression is at its most severe and anxiety is present, I was curious to check out their tie to childhood trauma. I don't think I qualify as a survivor of abuse, although my parents did beat me with a paddle or a belt if I was a bad boy. I had been depressed for at least 5 years before I experienced these things, and they began during a period of monumental stress in my life, not trauma.
QUESTION: How would you guys define or describe dissociative disorder or dissociative symptoms? I really don't have much of a handle on this.
> > About dissociation: the only caveat I would add is that most everything available to read about dissociation links it to trauma, and I think there are probably some people who have dissociative symptoms that are not associated with trauma. I think this is especially true if the dissociation or derealization is a symptom of a panic disorder, social phobia, etc. This is just my opinion. I guess I liken this to the depression continuum--contributing factors can range from the completely biological end to the completely environmental end, and everything in between, with biology and environment impacting on each other. It just bothers me that whenever I read anything about dissociative disorders, it seems trauma is assumed. While that may be mostly true, I have to think that it is not a good idea to assume it is always true.
>
> Noa, I had the same thought, so I did a search on depersonalization. I was actually looking for its link to anxiety and panic attacks. There is one, but from what I've read, the depersonalization lasts only as long as the panic attack. I can't find a link between anxiety or panic and long term dissociation. I do think that dissociation is learned in childhood and is triggered again by an incident in adulthood. Perhaps what is trauma to one child, is not as traumatic to another. An inclination to dissociate is limited to only some children, with a predisposition to dissociate, rather than use other defense mechanisms. If a child fits into that group, horrific trauma usually results in DID (MPD). So what is being referred to as trauma can be less than horrific, but still traumatic enough, perhaps to create a dissociation lower on the dissociative spectrum.
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> And the tendency now, opposed to ten years ago, is to go very very slowly through trauma to keep a person as stable as possible. And EMDR has somewhat replaced hypnosis as a tool to work through traumatic recall--which is not mentioned in Dr. Turkus' paper.
>
> But anyway, I do understand your doubts. Shellie
Both derealization and depersonalization are not exclusive to dissociative disorders proper. Both can be manifestations of moderate to severe depression; their magnitudes linked to severity. However, it seems that anxiety and stress are often necessary components of their occurrences. I experienced both. Weird stuff.
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Nice job ladies!!!!!!!
-------------------------The abstract I included below infers that there is no linkage between the derealization and depersonalization experienced during panic attacks and childhood trauma.
By the way, Michael Liebowitz was the physician who first diagnosed me in 1982. I only wish that my treatment history could have reflected his initial optimism. Real nice guy.
Yes. I am an incorrigible name dropper. I only wish that I could have lived my life without having so many to drop.
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1: Am J Psychiatry 2000 Mar;157(3):451-3Childhood trauma and dissociative symptoms in panic disorder.
Marshall RD, Schneier FR, Lin SH, Simpson HB, Vermes D, Liebowitz M
New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. randall@nyspi.cpmc.columbia.edu
OBJECTIVE: Childhood trauma has been associated with increased risk for both panic disorder and dissociative symptoms in adulthood. The authors hypothesized that among individuals with a primary diagnosis of panic disorder, those experiencing depersonalization/derealization during panic attacks would be more likely to have a history of childhood trauma. METHOD: Rates of traumatic events were compared between panic disorder patients with (N=34) and without (N=40) prominent depersonalization/derealization during panic attacks. Symptom severity in the two groups was also examined. RESULTS: Contrary to the authors' hypothesis, no evidence was found that depersonalization/derealization during panic attacks was associated with childhood trauma. Minimal differences in severity of illness were found between patients with dissociative symptoms and those without such symptoms. CONCLUSIONS: This finding is consistent with a multifactorial model of dissociation. Factors other than childhood trauma and general psychopathology may underlie vulnerability to dissociative symptoms in panic disorder.
PMID: 10698824, UI: 20163946
poster:SLS
thread:50957
URL: http://www.dr-bob.org/babble/20001231/msgs/51220.html