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The No-Cure Model


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#1 curiousmind

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Posted 16 February 2020 - 08:46 AM

There are many ways of knowing. A branch within philosophy, epistemology (theory of knowledge) is a discipline that deals with the question of knowing, and how it is that we as humans can come to "know things" about the world and ourselves, to put it simply. It is very easy for many of us who come from a well-educated background to only believe hard-facts, scientific studies based on "conclusive" findings. However, if you look at it from the branch of epistemology, a scientific way of knowing is not much different than a religious or spiritual way of knowing—in essence both require faith and both are belief systems at the core, never-mind the substantive component of these beliefs. In the latter you have faith in that a higher-being, a metaphysical force, a God is taking care of you and the universe around you, and you use this belief to explain certain things around you in your life, whereas in the former, you have faith in that a.) the scientific methodology is legitimate, that b.) the conclusions of scientists, researchers and scholars is valid and true (whatever these things really mean) and c.) faith in that those who are in the authority to teach us things about the world are indefinitely right. Many like to radicalise the two ways of thinking, one is usually thought of as the rational way, and the other is thought of as nonsensical by many of us today. However this polarisation is just an illusion, the receiver of either ways of knowing is subject to the same biological process in the brain when it comes down to that knowledge becoming stored in the mind and filed to enhance the way he/she sees the world.

 

Many of us with Depersonalization-Derealization Disorder (DPD) are trapped in the belief system that there is no way out, and that we have this condition forever because the scientific studies are inconclusive and they have not yet found "The Pill". I would like to refer you to the following (recently uploaded) video by Julian Cowan Hill who is a psychotherapist and tinnitus expert. In this video Dr. Hill introduces us to- and demonstrates to us the "No-Cure Model", and how this way of interpreting our experience is hindering our well-being and recovery. Julian Cowan Hill is a psychotherapist in London but primarily deals with patients who have tinnitus—a neurological condition—and he makes the sound argument that tinnitus is perpetuated by a loop of anxiety, more specifically the fear of permanence, the fear that you can never get better and that you will have this condition for the rest of you life. This unfounded belief system is what is thought to be perpetuating DPD as well as theorised in a 2003 study by Hunter et al. Many of us experience these symptoms, are terribly frightened by them initially, and then we come online only to find that "there is no cure", which falsely enforces the idea that there is no way out. Now, many of us have had this condition for years..."and I don't feel anxiety". It is the very veil of DPD, the very nature of this condition to mask and push-out of our conscious awareness the fears that we have been consumed by for so long (reference). I would encourage you to listen to what Dr. Hill has to say. 

 

Let me finish off by saying that thoughts are dangerously confused with reality. Thinking that something is true, even being convinced by our internal compass that something is true, does not make the substance of that thought true. I encourage you to question your belief systems, I encourage you to rethink how you view this condition, and I wish you all the best for recovery. It is possible, many have come out of this condition, what is your evidence that you won't too?



#2 Broken

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Posted 16 February 2020 - 09:53 AM

Very well put, I have had this idea many times throughout DPD only to go back to finding the magic supplement. Recently I have been tried meditation again, as a method to tune down the task positive network. I think in that there is a sense that something needs to be done, understood, fixed and changed. I have hypothesised that this network may be overactive, particularly in my form of DPD. I am constantly fixated on understanding and finding the cure, and constantly interacting with objects in my reality with that negative premise.

 

By "objects" I use it in the way it is meant in meditation. Thoughts are an object. As are emotions, body sensations, sounds, tastes, sights. These things are objects in awareness. My new meditation is best known as 'neti neti', translated as "not this, not that". There is no negativity or judgement or rejection of these objects, you just watch them come into awareness and pay them no attention or intention. It is almost a mental shrug, as if to say "whatever" to these things, rather than my usual interaction which is to fixate and judge and say something is wrong here, as it the literal case with all sensations in DP and DR. 

 

So I would presume that this would switch from a more task positive mode of awareness to task negative or the default mode network. This is a complete guess on my part, but it seems to relax me. It gives you a space in the day where you don't worry, try to fix or understand and switch off. 



#3 curiousmind

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Posted 16 February 2020 - 02:57 PM

Very well put, I have had this idea many times throughout DPD only to go back to finding the magic supplement. Recently I have been tried meditation again, as a method to tune down the task positive network. I think in that there is a sense that something needs to be done, understood, fixed and changed. I have hypothesised that this network may be overactive, particularly in my form of DPD. I am constantly fixated on understanding and finding the cure, and constantly interacting with objects in my reality with that negative premise.

I don't think this is a "you thing", rather that this is very much so a DPDR thing; my experience has been that what you just described is in and of itself a symptom of this condition, or the barrier, if you will. We are looking for an answer that doesn't exist; we are looking for something that we will not find. This state of stress (and though you may not feel it, this is definitely is a state of stress) is perpetuated in the knowledge that we feel something is not right, therefore we keep going back to find the cure, to find our way out of our demise. We are symptom-focussed. The research paper by Hunter et al I think really did hit the jackpot. Why do I think this? Because those who recovered and come back to share their stories all say the same thing over and over again (I have studied this extensively). They all say they accepted the condition first and foremost, allowed it to exist, moved on with their lives, tried doing all the things they did before without an obsessive watch over their symptoms, and after some time they felt back to normal. They didn't do anything, there is nothing we can do, its a subconscious disorder, we can't do anything consciously to "redeem" us. "But how do we really know they really recovered"; "but how do we know they even had this disorder"; "but how do we know they had what I have"; "but what if we had different symptoms"; "what if I don't even have DPDR"; "but my brain is damaged" --> these sentences are the blocks, the veils, the dams between us and recovery. Just listen to those phrases, they come from a place of doubt, a place of uncertainty, a place of fear/anxiety. 



#4 Broken

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Posted 16 February 2020 - 03:44 PM

Yeah those last thoughts you wrote I have all had. It is the doubt itself that torments you. The not knowing with this illness.

But I would also say alongside that it is the attitude and relationship with those thoughts. It swings between belief and denial. Fear and desire. Never indifference.

It seems to be that obsession with looking for and finding an answer but it never comes. And that is all thought based, following thought trails until it burns out and then you pick up and follow the next trail. On and on it goes. It's the letting go, the dropping of that desire. How that is done exactly is the million dollar question

#5 PerfectFifth

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Posted 16 February 2020 - 04:41 PM

It is possible, many have come out of this condition, what is your evidence that you won't too?

Let's start with the simple fact that anyone who has recovered from whatever they they recovered from may not be dealing with what I am (or someone else who identifies with the DP disease label is) dealing with. We're relying on subjective interpretation here in conjunction with language, which is not a reliable combination to say the least. How can you have any certainty that my DP is your DP? Just because we can relate to a verbal description to a certain degree does not mean the experience is actually equivalent or that the cause is the same. 

 

EDIT: Perhaps the ones who are cured never had the actual DP to begin with, and those who have it chronically do, or perhaps it's two different ailments altogether, or multiple? Such things are possible due to this problem of subjective interpretation and language.

 

When you take into account how differently people construe DP, those stories don't really weigh much. To some it can be as simple as having obsessive existential thoughts, it seems. They were cured of this form of "DP". Good for them. It has nothing to do with what I'm dealing with, yet it's labelled as a recovery story from supposedly the same disease. Might as well be called something different. 

 

I'm not saying it is or isn't incurable; I'm just saying those recovery stories only go so far due to these inherent problems. 



#6 curiousmind

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Posted 16 February 2020 - 04:59 PM

Let's start with the simple fact that anyone who has recovered from whatever they they recovered from may not be what I am dealing with. We're relying on subjective interpretation here in conjunction with language, which is not a reliable combination to say the least. How can you have any certainty that my DP is your DP? Just because we can relate to a verbal description to a certain degree does not mean the experience is actually equivalent or that the cause is the same. 

This isn't evidence. What is your evidence that what you are dealing with is different from others with this condition? This is not fact, this is speculation, and unfortunately from a place of doubt. You cannot prove that what they are dealing with is the same or different. But in the latter case, you are coming from a place of uncertainty/fear, with the former you are enforcing the idea that you can get better. Please read my second post in this thread. 

 

From a more academic angle, it has been shown that people with DPD demonstrate the same neurobiological underpinning (fronto-limbic model). So no, if you have DPD your condition is the same as anyone else with DPD. We see this in the brain scans of those who were monitored throughout recovery in one of the lamotrigine trials. People with DPD have an overactive rVLPFC which inhibits other brain regions. When lamotrigine worked for patients (as reported by improvements in subjective CDS ratings), they also detected objectively that the rVLPFC and affected brain regions were being normalised [link]. 

 

EDIT: Perhaps the ones who are cured never had the actual DP to begin with, and those who have it chronically do, or perhaps it's two different ailments altogether, or multiple? Such things are possible due to this problem of subjective interpretation and language.

"perhaps" "what if" "but what about" --> none of this is really constructive, uncertainty fuels anxiety, fuels doubt. This is not necessary, if you want to recover, it starts with the belief that you can. Until you question this, you will stay stuck. Please read the full thread. 



#7 PerfectFifth

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Posted 16 February 2020 - 05:18 PM

This isn't evidence. What is your evidence that what you are dealing with is different from others with this condition? This is not fact, this is speculation, and unfortunately from a place of doubt. You cannot prove that what they are dealing with is the same or different. But in the latter case, you are coming from a place of uncertainty/fear, with the former you are enforcing the idea that you can get better. Please read my second post in this thread. 

 

From a more academic angle, it has been shown that people with DPD demonstrate the same neurobiological underpinning (fronto-limbic model). So no, if you have DPD your condition is the same as anyone else with DPD. We see this in the brain scans of those who were monitored throughout recovery in one of the lamotrigine trials. People with DPD have an overactive rVLPFC which inhibits other brain regions. When lamotrigine worked for patients (as reported by improvements in subjective CDS ratings), they also detected objectively that the rVLPFC and affected brain regions were being normalised [link]. 

 

"perhaps" "what if" "but what about" --> none of this is really constructive, uncertainty fuels anxiety, fuels doubt. This is not necessary, if you want to recover, it starts with the belief that you can. Until you question this, you will stay stuck. Please read the full thread. 

Sure, it's not any evidence of anything at all. I never said that's the point I'm making. I realize some unknown percentage of those who self-diagnose themselves as having DPD actually have it and the rest don't. So yes, it follows that some of those who recovered were probably dealing with actual DPD and others probably didn't due to mis-/differing interpretation. 

 

Regarding the bottom part of your post, I honestly don't believe mental attitude has anything to do with it for me at this point. I've gone long stretches without paying it any attention at all and noticed no effect on it. I can be as pessimistic or optimistic about it as I like, and it won't budge. Trust me, I've gone through all the possible phases. Now I'm at the "I don't really care about it" -phase. Wasn't this sort of acceptance supposed to cure me?

 

It's affected by things such as exercise, which can either make it better or worse. Usually light exercise makes it slightly better, and maximum effort makes it worse. Being tired also makes it worse. 

 

"But how do we really know they really recovered"; "but how do we know they even had this disorder"; "but how do we know they had what I have"; "but what if we had different symptoms"; "what if I don't even have DPDR"; "but my brain is damaged" --> these sentences are the blocks, the veils, the dams between us and recovery. Just listen to those phrases, they come from a place of doubt, a place of uncertainty, a place of fear/anxiety. 

This is called rational deliberation. I'm not one to believe anything without thinking it through. "They come from a place of doubt?" You bet. What's wrong with having doubt when it's warranted? Understandably, this doubt extends to curing oneself through positive thinking alone. Could that work in some cases? Yes, very likely. Will it work in all cases, cases with decade-long chronic DP? Probably not. 

 

I'm not trying to say we should be collectively pessimistic about our recovery. I'm not implying there's no value to being optimistic about it. I'm just saying it's not quite so simple for everyone, especially those who have had it for a long, long time. 



#8 Broken

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Posted 17 February 2020 - 05:17 AM

Have to be honest, this does prove his point perfectly



#9 James_80

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Posted 17 February 2020 - 04:48 PM

Recently I have been tried meditation again, as a method to tune down the task positive network. I think in that there is a sense that something needs to be done, understood, fixed and changed. I have hypothesised that this network may be overactive, particularly in my form of DPD. I am constantly fixated on understanding and finding the cure, and constantly interacting with objects in my reality with that negative premise.

By "objects" I use it in the way it is meant in meditation. Thoughts are an object.


Nicely put. When I went through a particularly bad phase of dp, it felt like my thoughts were all clustered together and swarming on any perceived threat. A bit like a really terrible football team (soccer team if you're in the US) who would collectively all chase after the ball together rather than remain in their positions on the field. It's a weird analogy, I know.

#10 ThoughtOnFire

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Posted 18 February 2020 - 03:59 PM

Been this way for 16.5 years now. I've gradually gotten ALOT better over time. But finally to get completely over it, I'm now accepting that is is 'me' who will emerge from this. See, all this time I've always believed there was a cure, a way out, a recovery. But I subconsciously held on to the belief that the transformation would "kill" the DP'd me. But now I understand who I am in DP, will be the same one to cross back over to reality. Rather than some kind of "DP Ego" Death.



#11 forestx5

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Posted 18 February 2020 - 08:24 PM

"a scientific way of knowing is not much different than a religious or spiritual way of knowing".

Couldn't disagree with you more.  Believing is absolutely different from knowing. Just as a fact is different from a "maybe, maybe not"



#12 PerfectFifth

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Posted 19 February 2020 - 07:29 AM

"a scientific way of knowing is not much different than a religious or spiritual way of knowing".

Couldn't disagree with you more.  Believing is absolutely different from knowing. Just as a fact is different from a "maybe, maybe not"

Yeah, that statement is pretty insane. Hell, it's downright dangerous. Under such a mindset, believing any kind of unfounded dogma is justified. Scientific and logical (read: philosophical) knowing are superior to "I think X is Y because a book says so (or I just feel like it), so it is." At least they're based on something non-arbitrary. 

 

One is based on observation and reproducibility—malleable, constantly evolving as hypotheses are disproven or confirmed and theories formed—the other is based on dogma from ancient books, the only change occurring out of necessity due to certain beliefs becoming too incompatible, nonsensical, and contradictory to be reasonably maintained in an ever-advancing scientific society (see https://en.wikipedia...eria_Christians). Then you have the "non-religious" spirituality which makes mishmash out of certain religious concepts and is ultimately no less devoid of evidence. 

 

There is always some corruption in the form of biased research in scientific circles due to vested corporate interests, but that's still infinitely better than basing your "knowledge" on pure belief, with no evidence to present to anyone. You can philosophize all you want about this and lean on epistemological nihilism and say that "bro, you can't even know that objective reality exists!", but it's a much better bet to trust in science than unsubstantiated beliefs. It's a great way to discover facts about this world. It probably can't answer every question, but I'll take it any day of the week over some ancient books written thousands of years ago. 






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