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Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Cognitive Behavioral Model Of Depersonalization Disorder
A licensed copy of Hunter and colleagues (2003) cognitive model of depersonalization.
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Overview
Depersonalization is an experience where an individual feels a sense of detachment from themselves, or estrangement from their perceptions, actions, and feelings. It can be accompanied by derealization, where the external world appears unfamiliar or less real. Both can be transient experiences, are experienced by up to 70% of non-clinical populations, and are often associated with fatigue, stress, or drug use. Depersonalization disorder (DPD) is diagnosed when symptoms of depersonalization and derealization are experienced chronically and cause significant distress and impairment. It can occur in the absence of other conditions or as a comorbid condition. The Cognitive Behavioral Model of Depersonalization information handout reproduces a cognitive model of DPD proposed by Hunter, Phillips, Chalder, Sierra, & David (2003).
Why Use This Resource?
Understanding the key underpinnings of depersonalization is important for effective intervention.
- Understand the mechanisms that maintain depersonalization.
- Explain key aspects of depersonalization, such as avoidance and the use of safety behaviors.
- Develop appropriate case formulation for clients struggling with depersonalization.
Key Benefits
Insight
Deepens understanding of how depersonalization is maintained.
Education
Acts as an informative client handout.
Discussion
Promotes exploration of key factors in depersonalization.
Learning
Supports clinician knowledge and supervision.
Who is this for?
Depersonalisation
Ideal for therapists working with individuals affected by depersonalization.
Integrating it into your practice
01
Learn
Understand more about the cognitive model of personalization.
02
Organize
Use the model as a template to organize your case formulations.
03
Educate
Use your knowledge of the model to explain maintenance processes to clients.
04
Discuss
Engage clients in discussions about their beliefs and behaviors.
05
Tailor
Customize interventions based on individual maintenance mechanisms.
06
Reflect
Use in supervision to discuss case conceptualizations and treatment plans.
Theoretical Background & Therapist Guidance
Depersonalization disorder (DPD) is a chronic condition in which an individual experiences frequent or unremitting detachment from themselves, disrupting the normally integrated sense of self. Critically, people experiencing DPD are not delusional: they retain insight, and their awareness of the disjunction between the observing self and the embodied self causes significant distress (Hunger et al, 2003; Medford et al, 2005). Core symptoms of DPD include depersonalization (DP), derealization (DR), and cognitive changes (e.g., impaired concentration, a changed perception of time, an empty mind or racing thoughts, or difficulty processing new information).
Hunter, Phillips, Chalder, Sierra and David (2003) proposed a cognitive model to account for the maintenance of DPD, which suggests that common, transient symptoms of DP/DR (typically experienced during times of stress or threat) are catastrophically misinterpreted as signs of deteriorating or damaged mental health. This leads to feelings of anxiety and associated physiological reactions, which may then exacerbate the symptoms of DP/DR. Similar to other anxiety disorders, they propose that the cycle is maintained by avoidance, safety behaviors and heightened symptom monitoring and self-focused attention.
What's inside
- A graphical depiction of the model.
- Insights into key maintenance mechanisms.
- Guidelines for using the resource with clients.
FAQs
Depersonalization disorder is a chronic dissociative condition where individuals experience a persistent sense of detachment from themselves, yet maintain awareness of reality, leading to significant distress.
CBT aids in modifying catastrophic misinterpretations and avoidance behaviors associated with DPD, thus alleviating emotional distress and reducing symptoms.
Clinicians use it to guide their case formulation, helping them to effectively target their interventions.
How This Resource Improves Clinical Outcomes
By applying the model, therapists and clients benefit from:
- Targeted interventions focusing on key maintenance mechanisms.
- Enhanced client engagement through increased understanding of their difficulties.
- Improved treatment outcomes by addressing core psychological features.
References And Further Reading
- Baker et al (2003). Depersonalisation disorder: clinical features of 204 cases. British Journal of Psychiatry, 182, 428-433.
- Hunter, E. C. M., Phillips, M. L., Chalder, T., Sierra, M., & David, A. S. (2003). Depersonalisation disorder: a cognitive-behavioural conceptualisation. Behaviour Research and Therapy, 41(12), 1451-1467.
- Medford, N., Sierra, M., Baker, D., & David, A. S. (2005). Understanding and treating depersonalisation disorder. Advances in psychiatric Treatment, 11(2), 92-100.
- Sierra, M. & Berrios, G. E. (2000). The Cambridge Depersonalisation Scale: a new instrument for the measurement of depersonalisation. Psychiatry Research, 93, 153-164.
- Simeon, D., Gross, S., Guralnik, O., Stein, D. J., Schmeidler, J., & Hollander, E. (1997). Feeling unreal: 30 cases of DSM-III-R depersonalization disorder. American Journal of Psychiatry, 154(8), 1107-1113.
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