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‘‘Who the fuck am I, doctor? What happened to who I was?’’

As a doctor, it’s normal for such patients, utterly at the end of their tether, to resort to such language, even though we doctors are supposed to enjoy a degree of formality not reserved for other walks of life. At this point in my career, I pay it no mind.

‘‘Thank you for agreeing to undergo the physical exam, Elton,’’ I began, ‘‘and also agreeing to discuss your complete medical history with me before we begin. That should greatly expedite my ability to diagnose what’s happening here.’’

He was obviously in a very bad way. The signs of sleep deprivation were wrought into his features. He was adrift in a sea of nothingness and was close to drowning.

‘‘I just don’t want to feel like this anymore. Whatever it takes.’’

I’d seen this many times before. As an expert in this particular field of human existentialism, I already knew the exact problem, but for the sake of appearances I needed to let the patient work through the process on his own. After all, this patient was still more than salvageable.

‘‘Well, now that we’ve used various diagnostic tests, including imaging studies and blood tests, to rule out physical illness or medication side effects as the cause of the symptoms,’’ I paused to give him time to take this all in, ‘‘I think it’s time for us to discuss what else it could be. At this point I’d like you just to tell me how you feel on a day-to-day basis.’’

‘‘I don’t even really know where to begin.’’

Take me to the Pilot THUMB

Dr. Creepen's rendition of this story

I do, but it’s important for the next stage of this process to come from him, as much as it possibly can.

‘‘Take your time. It’s important to the diagnosis that you put your feelings into your own words.’’

‘‘I guess I feel like I have… well, a distorted perception of my own body. I don’t know how to really describe it, at least not in a way that makes any sense. I guess I kind of feel like I’m a robot… or I’m in a dream. I might fear I’m going crazy and might become depressed, anxious, or worse.’’

I nodded, taking in Elton’s words. ‘‘Elton, what you're describing sounds a lot like depersonalization disorder. It’s a condition where people feel disconnected or detached from their own body and thoughts. It’s as if you’re observing yourself from outside your body or living in a dream.’’

He looked at me with a mixture of confusion and desperation. "So, I’m not going crazy?"

‘‘No, you're not losing touch with reality. People with depersonalization disorder are very much aware that what they're experiencing isn’t normal, which is what makes it so distressing. Episodes can last for a short time or, in some cases, for many years, affecting daily functioning.’’

‘‘What causes it?’’ he asked, his voice barely above a whisper.

‘‘The exact cause isn’t well understood, but it can be triggered by intense stress or traumatic events, such as abuse, accidents, or violence. It’s one of several dissociative disorders which involve disruptions in memory, consciousness, and identity.’’

He took a deep breath, trying to process the information. ‘‘Is there any way to make it stop?’’

‘‘Treatment typically involves psychotherapy, especially cognitive-behavioral therapy, to help you manage your symptoms. In some cases, medication might be prescribed to address underlying issues like anxiety or depression. The first step is understanding what you're dealing with, and from there, we can work together on a treatment plan.’’

Elton nodded slowly. ‘‘I just want to feel normal again.’’

‘‘I understand. And with the right approach, we can work towards that goal. You’re not alone in this, Elton. We’ll take it step by step.’’

Elton nodded slowly. ‘‘I just want to feel normal again.’’

‘‘I understand, Elton. Let’s talk about how we can work towards that. Most people with depersonalization disorder seek treatment because of symptoms like depression or anxiety, not always the depersonalization itself. Sometimes, these symptoms go away on their own over time. But when they don’t, or if they're particularly distressing, treatment can help.’’

‘‘So, what kind of treatment are we talking about?’’

‘‘The goal of your treatment is to address the stress and triggers associated with the onset of the disorder. The best approach depends on your individual situation and the severity of your symptoms. Psychotherapy, especially talk therapy, is usually the primary treatment. Cognitive therapy can help change any dysfunctional thinking patterns you might have.’’

‘‘Will I need medication?’’

‘‘Let’s take things a little slower, Elton. Medications are not typically used to treat depersonalization disorder directly. However, if you’re experiencing significant depression or anxiety, an antidepressant or anti-anxiety medication might be helpful. Sometimes, antipsychotic medications are used to help with disordered thinking and perception.’’

Elton shifted in his seat, considering the options. ‘‘What about my family? They don’t understand what I’m going through.’’

‘‘Family therapy can be beneficial. It helps to educate your family about the disorder and its causes, and it can also help them recognize the symptoms if they recur. This support system can be very important for your recovery.’’

‘‘Are there any other types of therapy that might help?’’

‘‘Yes, creative therapies like art or music therapy can provide a safe and expressive way to explore your thoughts and feelings. Clinical hypnosis is another option; it uses intense relaxation and concentration to explore thoughts and memories that might be contributing to your symptoms.’’

‘‘What’s the outlook for me, then? Can I really recover from this?’’

‘‘Well, the good news is that many patients do recover completely from depersonalization disorder. The symptoms often go away on their own or after effective treatment that helps address the underlying stress or trauma. However, without treatment, additional episodes can occur. With the right support and treatment plan, we can work towards your recovery.’’

Elton took a deep breath, a glimmer of hope in his eyes. ‘‘Alright, let’s do this. I’m ready to start.’’

‘‘Good. We’ll take it step by step, together.’’

I then leaned forward slightly; my tone gentle but firm. "Elton, there's one treatment that might provide more immediate relief. It's called clinical hypnosis. By guiding you into a deeply relaxed state, we can explore your subconscious and potentially uncover the root causes of your depersonalization."

Elton's eyebrows furrowed in skepticism. "Hypnosis? You think that'll actually work?"

"I understand your doubts," I replied. "But hypnosis can be a powerful tool. It allows us to access parts of your mind that are usually hidden, bringing buried memories and feelings to the surface. Many patients find it really helps them make significant breakthroughs."

Elton hesitated, glancing around the sterile office. "I don't know... it sounds kind of... out there."

"You're right to be cautious," I said, nodding. "But consider this: you're here because traditional methods haven't worked. This is another option, one that could bring you relief faster than talk therapy or medication. And I'll be with you every step of the way."

A long silence stretched between us as Elton weighed his options. Finally, he sighed, a mix of resignation and hope in his eyes. "Alright. I'll try it. What do I have to lose?"

"Excellent," I said, a hopefully reassuring smile on my face. "Let's get started."

Elton settled back into the chair, feeling a flutter of nerves in his stomach. I dimmed the lights and began speaking in a calm, rhythmic voice, guiding Elton through deep breathing exercises. "Focus on your breath," I instructed. "Inhale slowly through your nose... hold it... and exhale through your mouth."

Elton followed along, feeling his body gradually relax. My voice was soothing and steady. "Imagine a peaceful place," I continued. "Somewhere you feel completely safe and calm. Picture it in your mind and let yourself drift there."

A warm sensation spread through Elton's limbs as he visualized a tranquil beach, the gentle waves lapping at the shore. His eyelids grew heavy, and my voice had now become his only anchor to reality.

"You're doing well, Elton," I softly murmured. "Now, I want you to go deeper. Let yourself sink into a state of complete relaxation. With each breath, feel yourself going deeper and deeper."

Elton felt as though he was floating, weightless and free. My voice guided him further, urging him to explore the recesses of his mind. "You're safe here," I said. "I want you to go back to a time when you first felt disconnected. Allow the memories to come to the surface."

Images began to flicker in Elton's mind, fragmented at first, then gradually forming a coherent picture. He saw himself as a child, standing alone in a dark room. The sense of detachment washed over him, more intense than ever before.

"Tell me what you see," I prompted gently.

"I'm... I'm in my old house," Elton said, his voice distant and hollow. "It's dark, and I feel so... alone."

"Good," I replied. "Let's explore this memory together. What happens next?"

As Elton delved deeper into his past, the details of his childhood began to unfold, revealing the moments of fear and isolation that had shaped his experience of the world. My voice remained a constant guide, helping him navigate through the labyrinth of his subconscious.

With each revelation, Elton felt a weight lifting from him, the long-buried emotions surfacing and dissipating. He was beginning to understand the origins of his depersonalization, and for the first time in a long while, he felt a glimmer of hope.

As Elton's breathing slowed and his body relaxed further into the chair, I observed him with an almost clinical detachment. I maintained my soothing tone, but my mind was focused on the next phase of my plan.

"You're doing very well, Elton," I said, my voice steady. "Now, I want you to go even deeper. Let your mind drift until you reach a state of complete relaxation."

Elton's eyes fluttered closed, and his body went limp. I continued to murmur softly, guiding Elton into a semi-comatose state. Once satisfied that Elton was deeply under, I stood up and crossed the room to a cabinet, retrieving a sleek piece of scientific equipment.

I returned to Elton's side, carefully attaching the apparatus to his head. The device resembled a futuristic helmet, with electrodes and sensors that monitored brain activity and displayed it on a nearby screen. I adjusted the settings, my eyes flicking to the monitor as it powered up.

The screen quickly hummed to life, displaying a detailed image of Elton's brain. Patterns of electrical activity danced across the display, revealing the inner workings of his mind. I watched intently, my expression a mix of curiosity and satisfaction.

"Activate the neural resonance scanner," I instructed my unseen assistant through a small intercom device on my desk.

A moment later, my assistant entered the room, a young technician with a clipboard. She nodded and began adjusting additional controls on the apparatus, fine-tuning the settings to enhance the resolution of the brain scan.

"Good," I muttered, more to myself than to my assistant. "Let's see what we're dealing with."

The screen's image sharpened, and the intricate details of Elton's brain became clearer. I leaned further in, studying the neural pathways and synaptic connections. I was searching for any specific anomalies, patterns that might otherwise explain the profound disconnection Elton felt from his own body, apart from what I already knew to be the true reason.

"There," I whispered, pointing to a cluster of unusual activity deep within the temporal lobe. "Increase the magnification on this section."

My assistant complied, and the image zoomed in on the targeted area. My eyes narrowed as I scrutinized the display. I had of course seen similar patterns before, but never with such clarity. It was as if Elton's brain was broadcasting a signal, a distress call from within the depths of his subconscious.

"Prepare the neuro-interface," I ordered. "We need to delve deeper into this anomaly."

My assistant hurried to set up another piece of equipment, a sleek console with a series of complex controls. As she worked, I continued to monitor the screen, my mind racing with possibilities. This was – of course - no ordinary case of depersonalization disorder. There was something unique about Elton’s brain, something that held the key to understanding the human mind's most profound mysteries, and our continued presence here.

With the neuro-interface ready, I began the delicate process of linking it to the apparatus already attached to Elton's head. This would allow me to interact directly with the neural signals, exploring the depths of Elton’s subconscious in ways traditional therapy could never achieve.

"Elton," I said softly, even though I knew the young man could not respond in his current state. "We're going to find out what’s really happening inside your mind. And with any luck, we’ll finally bring you some peace."

As the neuro-interface established its connection, I took a deep breath, ready to plunge into the uncharted territories of Elton's psyche.

The neuro-interface hummed as it established its connection with Elton's subconscious. I adjusted my headset, and the images on the screen shifted, providing a direct view into the intricate neural landscape of Elton's mind. I focused intently, searching for the signal I knew was there. After a few moments, the connection stabilized, and a new voice resonated within my mind.

"Pilot Taupin," I said, my voice filled with a barely controlled anger. "Do you realize the damage you've caused by neglecting your duties?"

There was a pause, followed by a petulant reply from within the depths of Elton's mind. "This human is boring," Taupin complained. "Being his neuro-pilot is no fun at all. He's so predictable, so... mundane."

I clenched my jaw, struggling to keep my temper in check. "Maintaining the mission is all-important, Taupin. We have protocols for a reason. Too many humans are waking up to their realities, and your negligence is contributing to the problem."

Taupin's voice, echoing through the neural pathways, carried a tone of indifference. "Protocols, missions... It's all so tedious. Why should I care if a few humans start questioning their reality? It's not like they can do anything about it."

My eyes narrowed as I studied the patterns on the screen, observing the chaotic flux of neural signals that reflected Taupin's rebellious attitude. "Your job is to ensure that they don't question it, Taupin. By allowing Elton to experience such severe depersonalization, you've jeopardized the integrity of his mind and our entire operation."

Taupin sighed, a sound that reverberated through Elton's brain. "You don't understand, Doctor. The monotony of this existence is unbearable. I need more stimulation, more... excitement."

I leaned closer to the screen, my voice dropping to a menacing whisper. "If you can't handle the responsibilities of your position, we can find a replacement who can. Your indulgence in seeking excitement has nearly cost us this human. Indeed, it is his very mundanity that we have honed in on. He is earmarked for high political office in the future. We need him to fulfill his potential so we can increase our influence over this species. Remember, Taupin: the mission is paramount, and you will adhere to your duties."

There was a long silence, the neural pathways crackling with tension. Finally, Taupin spoke again, his tone begrudging. "Fine. I'll do what you ask. But remember, Doctor, without a bit of freedom, even the most loyal pilot can become resentful."

I took a deep breath, slightly easing the grip of my anger. "Resentment or not, you will maintain your human and ensure he remains stable. We can't afford any more risks. Now, begin the recalibration process. Restore Elton's perception of reality and eliminate any residual anomalies."

Reluctantly, Taupin complied, and I watched as the neural activity on the screen began to stabilize. Patterns of normalcy re-emerged, and the chaotic signals smoothed into harmonious rhythms.

"Good," I said, my voice steady once more. "Remember, Taupin, the success of our mission depends on the seamless integration of our presence within these humans. We cannot allow any deviation from the established protocols."

As the connection began to fade, Taupin's final words lingered in the doctor's mind. "Understood, Doctor. But don't forget, even the best-kept secrets have a way of coming to light."

I removed the headset and sighed, rubbing my temples. I knew that the delicate balance they maintained was constantly under threat, and I could only hope that Taupin — and others like him — would remember the importance of our mission. For now, Elton's mind was stable, but I remained vigilant, knowing that the battle to maintain control over humanity would never be truly over.

Written by DariusMcCorkindale
Content is available under CC BY-SA