DBT For Managing Pain

I have been dealing with severe pain in my leg for about two months now. I had a clot in my right leg which has thankfully resolved itself but the pain is still there if I walk for more than 15 mins at a time. I also get horrible PMT pain around my time of the month. Pain management can be a tricky business, drugs are great in the short term, but not a viable long term solution (the side effects are icky) so I have had to find alternate ways to deal with the pain. Mindfulness has had great success with pain management, so when I read the studies (which claim that mindfulness actually changes the way the mind perceives pain so that it’s more bearable), I thought 'If mindfulness is good for pain, and DBT is based on mindfulness... then why not try using the skills for my pain!'

Living with pain is not only a physical strain—be it merely uncomfortable to outright debilitating – but is also an emotional strain as well. Throw in an emotional vulnerability and you get a bubbling, hot pot of dysregulation spitting and spewing over into our relationships and lives. Feelings of frustration, anger, depression or even despair can deeply impact my quality of life maybe even more so than someone without an emotion dysregulation disorder.

Okay.. enough waffle... let me get straight to the point. Here is how I use the skills to manage my pain.

1. OBSERVE

The idea of being mindful of pain and observing it as it is may seem counter-intuitive. Most people want to forget about their pain, I know I do. I want to escape it, run away from it, I wish I could ignore it or get rid of it somehow. My mind typically launches into a litany of judgements and negative thoughts. I start ruminating about how much I hate the pain and want to wish it away. Then I judge the pain, and that only makes it worse. My negative thoughts and judgements not only exacerbate the pain, they also fuel anxiety and depression. The problem is, ironically, that by fighting and struggling against it, and even by trying to ignore it, I create within myself a state of ‘resistance to what is’ and that means stress, and ultimately more suffering.

The mindfulness skill of OBSERVE teaches us to have a 'Teflon mind'. Don't let your thoughts or experiences 'stick' in your mind. Take a step back and look at the situation with fresh eyes. The ability to step back from what is happening in the moment creates a psychological space. This separation allows you to not get caught in or react to your experience. Without the psychological space, your reactions are automatic. Shame, guilt, anxiety, and depression often collapse your ability to create psychological space and cause automatic reactions (acting the way you feel). Experiencing the moment without getting caught or reacting is a way to extinguish automatic responses. Psychological space creates room for mental flexibility and freedom of choice.

2. Being EFFECTIVE

Sometimes if I spend time simply observing and giving the pain my awareness, just doing that can bring the intensity of it down to a manageable level, if not, it prompts me to stop what I am doing long enough to realise I need to change something. 

For example; I was going to catch a bus yesterday. The stop is about a five minute walk away. I was nearly at the bus stop when I saw a bus coming. I started to jog so I wouldn't miss it, but was instantly hit with a siring pain in my leg. Rather than push through the pain and ignore it, I stopped, OBSERVED it and realised that the most EFFECTIVE thing to do was walk slowly, let the bus go and wait for the next one. There was no use in damaging my leg further for the sake of waiting 10 mins for another bus.

Another example is cancelling plans and getting extra rest, your friends and family will understand, and going out out despite the pain is only going to hinder your recovery and create extra suffering. Your pain might decrease your ability to be interpersonally effective and could lead to bickering or you saying something you might regret. 

Sometimes being EFFECTIVE is as simple as recognising that the pain is more than you can handle and getting help from a health professional. In these cases the next skill can be really helpful.

3. SELF SOOTHE 

One of favourite things to do, especially when dealing with bad pain days is to SELF SOOTHE. It's great for when I am feeling down and need a pick me up. But the thing is, when I am feeling down, or low is not the time I tend to think to myself, “you know what would really make me feel better? Painting my nails, or calling a friend". So, for this reason, the real key to this skill is to have a SELF SOOTHING kit pre-made for those particularly hard days.

I have written as post about different SELF SOOTHING ideas, so check out the link below, make your kit and then let me know how you got on. I adore hearing about others experiences and ideas.

SELF SOOTHING ideas

Stay mindful. xxx

Healthy Weight Loss After an Eating Disorder - Week Two

I was dreading today. I mean what a bloody embarrassment it would have been if I didn't lose anything in my first week, the seemingly easiest week to lose weight according to the literature. It was small but at least it was a loss! Yippee! 

I had a wobbly week regarding sticking to the programme. I had two major slip ups where I binged. The first was after a night out last Saturday, the second, I'll get to.... I had a fair few tipples on Saturday and soon lost track of how many points I had consumed, actually I stopped even caring about my weight loss plan. I have the best boyfriend ever, as he picked me up from town in the wee hours and 'saved' me from that late night chipper. but as soon as I got home, I actually remember thinking 'Feck it' I'll be good tomorrow, which is saying something... because I remember very little else.

I stumbled into the house and into the kitchen and all of a sudden I was ravenous! I tore open the fridge and turned my nose up at the glossy green apples and colourful selection of veggies I had stocked it with earlier that day. No way was that going to satisfy the roaring hungry lion in my tummy. Within minutes I had the laptop out and I had ordered a pizza from Domino's. Damn the convenience of late night delivery!!!

Despite that set back, I picked up the broken pieces of my programme and tried to glue them back together. I got back to tracking and working out my points, home cooked hearthy, filling and healthy beef meatballs (needed the iron) packed full of zero point veggies and a small portion of wholegrain pasta. Total of 12 points for great sized yummy dinner, and there was enough left over to freeze a portion too.

Great, I am feeling wonderful and it's now bank holiday Monday.... I go to a spinning class and get my weekly dose of torture.. those seats are so painful! Then me and my better half went to my family home where my Mum cooked a beautiful roast chicken and ham dinner with all the works! yum! Points were through the roof... but kept within my 31 daily points and snacked on zero point food for the rest of the day.

I re-started the mindfulness class on Tuesday and have sort of mixed feelings about it. I came home and binged again on pizza after, and it took me a few days to reflect upon why it happened. It was differently emotional eating in response to the new group.

It's very different to the Mindfulness-Based Stressed Reduction group I did last year. It's easier to fit in and actually do the practises as the tracks are only 8 - 15 mins long! No more 45 mins mega sessions. Yay! This course is based on Mindfulness-Based Cognitive Therapy (MBCT).  MBCT has been clinically proven to be at least as effective as drugs for depression and it is recommended by the UK's National Institute of Clinical Excellence - in other words, it works. More importantly it also works for people who are not depressed but who are struggling to keep up with the constant demands of the modern world. This programme focuses on promoting joy and peace rather than banishing unhappiness. It's precisely focused to help ordinary people boost their happiness and confidence levels whilst also reducing anxiety, stress and irritability. All sounds good so far.

This new style of mindfulness suits me to the ground as I am an expert in postponing my practice and in finding reasons why it doesn't matter if I don't practice each day. In addition, sometimes I am afraid to meditate. I'm scared of what I might feel if I am are not busy distracting myself. I'm fearful of being bored or of feeling intense emotions. Looking back to when I first started mindfulness I remember not being ready yet to experience the intense fear or memories of abuse by myself, alone in my own head. I feared that if I meditated, or let go of my usual strategies of numbing or being mindless, I would feel overwhelmed by the intensity of those memories or emotions.

I remember having "an epiphany", I was just so unused to being in the present moment that that was what was making me anxious. This isn't uncommon seemingly - especially for people with anxiety disorders, who frequently live in the future rather than the present. I was not used to looking at what's happening in this moment, never mind trying to bring acceptance to it! So I came home and ate, ate, ate to numb all those emotions that I being trying so hard to escape from.

What I learnt back then and consequently forgot in the last few months is that often what we find in the present is scary, and that's one reason we've been living in the past or the future. In reflection, I learnt or should I say I re-learnt a very valuable lesson this week: negative emotions are shit, really shit, but running away from them just makes you eat more pizza, put on weight and make said emotions even worse.

Anyway here's a shiny new graph charting my loss this week.

Stay mindful friends

Compassion for my Past Self

What if we looked at emotional sensitivity as simply another way to experience life? I would like to live in a world where there is more than one way to be social. 

The expected way to relate to others comes through external channels, such as other people, home, school, work and the general public. These come with a prescribed way of acting and being. 

But what happens if it’s impossible for you to swallow an approved social remedy? We feel like we are missing out on life because there seems to be a piece missing. We compensate for the overtly stimulating world with coping strategies. I turned to food, study and avoidance. They became the rules by which I could function for a time. They were my compensatory methods for living in a world full of difficulties. In a world which is overwhelming, emotionally over-stimulating, and just too demanding, this was a smart strategy; I had to establish a way I could live amidst a world of social encounters I couldn't relate to. 

Food was my numbing essence, it was comparable to a resolved hug from a caring parent, full of comfort and compassion and unconditional love. I ate until my world made sense again, until I felt the familiar pain and stretch in my stomach that reminded me that I was a living, breathing human being. The food passed my lips like smooth caramel that cascades from high up off a wooden spoon as it’s ladled from a hot sauce pan and falls back into the sweet sticky mass.. I ate to fill the missing piece I lacked in life. I ate until I felt like a full person. 

The release after overeating came like the shutter release on an old manual camera. All it took was one finger gently pressing down on the right spot. The picture of the inside of that toilet bowl will be burned into the back of my mind forever. 

I wasn't a natural academic. I worked hard to find the peace and control good grades offered me. It was a steady focus I could control. It also gave me an excuse to practice my third coping method; avoidance. I arrived to school early most days, and rarely went home before 8 pm  The library and study rooms became my best friends. I loved the stillness; I loved the silence they offered. Finally I found a place that didn't overwhelm me. I had my own small place which I inhabited. Yet due to dyslexia, I couldn't always concentrate on school work for long periods of time, so often I would read or day dream about the stories I read. I became aware through literature how the characters in the books dealt with life. I was drawn into the safety of the stories and the friends I gained by scanning each line. I learnt how to be from those books.

Even when it came to sport, I avoided team games and opted for swimming. It was a solitary exercise. When I put my head under the water, the world became still and quite. The gentle echoes were comforting and safe for me. And this way less people asked questions as to why I came into school so early. I could cry easy in the pool and nobody knew. 

As I look back at my teenage years I can see clearly that I have always been a very sensitive person, easily overwhelmed and highly emotional. I didn't know that then though. I just thought that my general ‘being’ was wrong and non-functional. 

Okay, these coping methods were never going to useful forever, but in a way I am sort of proud of my little adolescent self. She found a way to survive, to live and to get by in a scary lonely world. So now I don’t look back with scorn at my past behaviors  I look back with compassion for a girl who didn't know any other way to stay alive. And in twenty years I will look back on what I will have learnt and see that right now I am doing the best I can do right at this moment. I will always face difficulties, I don't like to think I will be this way for ever, but the harsh reality is that

Apparent Competence Vs Unrelenting Crisis

 So much has been going on over the last few weeks. I have been earnestly applying for internship posts, which finally paid off as I got the precious news that I have been accepted to a great service here in Dublin. 

I am still riding the wave of progress and have realized that if I allow myself to just go with the crashing, foaming tides of negative emotions that sooner or later the tempestuous waters become calm and bearable again.

Anxiety is my constant companion once again, making simple everyday tasks extremely difficult. I was startled by the stunning resident robin in my garden yesterday. He sings a morning tune to me most days yet as he fluttered up to graze on the crumbs I left for him on the window sill, I saw a black ghostly shadow then screamed aloud and scared my poor feathered friend away. Then on the bus into town this morning I felt the all too familiar experience of an oncoming panic attack. I froze. I couldn’t move from the spot I was invisibly glued to, which would have been fine if it were towards the back of the bus, out of the way, but no, I froze right in the entrance passage way staring ahead like I was witnessing a murder! Grumbles and rants from tarde commuters finally brought me to my senses and I ran off the bus and into the quite street around the corner. I burst out crying, snots and all, at the realization that my emotions are starting to control me again rather than me controlling them.

But being the borderline that I am…. my apparent competence shines through whist the unrelenting crisis’s fester away under the surface threatening to assault my passive attempt at creating a life worth living. 

You see, when I find myself amidst of fog of fear, it tends to stay with me for much longer than would be expected in those without an emotional vulnerability, making the next onslaught even more unbearable. Slow return to emotional baseline is the problematic cornerstone for me. Typically, a crisis will occur before I get a chance to return to my emotional baseline, which results in me staying very highly aroused emotionally on a continuous basis.

My therapist and I developed a plan to tackle the anxiety ambushes. I am to do a CBT thought record each time I notice a negative automatic thought. I must fight back with evidence which does not support the thought yet still validate where the fear might be coming from too. Then I create a balanced thought taking all evidence into account. This is proving to be a fantastic way to battle the thoughts.

Next I must reduce my tension through visualization and become more mindful of my body and cultivating compassion for myself. This is done with formal mindfulness meditation. I am loving John Kabit Zinn at the moment. His voice is so soothing and comforting.

Finally if I am to live the life I want to live, I must tackle the behavioral outcome of my anxiety. This involves the graded exposure I so dearly HATE. I mean I just don’t get how exposing a borderline to heightened emotions is a good thing! My heart is even racing now as I type this! I guess going for the interviews did help me get over my fear of interrogation, but I felt HORRIBLE the whole time I was doing it. Truthfully, I am pretty sure I will always feel some degree of dread when it comes to interviews, but least now I know I won’t actually DIE from them like I thought I would before. I will though, still be going as far out of my way as possible to avoid another one in the near future.

I have come to the conclusion and have RADICALLY ACCEPTED that I am always going to feel emotions to the extreme. I will always have to manage and control my urges and behaviors, but like anything; practice makes perfect.

Scared Shitless

Today started out with scary thoughts, insidious negative thoughts which infested my mind. I have a social welfare inspection tomorrow morning. I am so unbelievably scared. I have canceled this appointment so many times already. I even let her turn up to an empty house on Tuesday as I chickened out last minute and fled, pretending that I didn't know about the meeting.

Why I am so terrified? I have no idea. I cannot for the life of me figure out a plausible reason. I did a chain analysis on the event on Tuesday. I am stilled at a lose. So all I can conclude is that my fear does not fit the facts. But this annoys me, this fear is so real to me. I can't just will it away by standing up straight and acting as if nothing is wrong. 

I am confused as to what skill to use for tomorrow. I have tried COPE AHEAD by getting as much documentation gather as I can.I have a letter from my landlady, a letter from the bank and asked for a letter from my therapist.

Other than that I just don't know what else to do! I think I will go hide in my nest of a bed until the time comes that I have to leave its safety!

Impermanence - Finding the Dialectic of Emotion

Nothing is permanent. The goodness in life passes in the same way the bad periods slithers by or sticks to our awareness. Positive emotions and experiences leaves a good taste long lingering in my mouth, but it can be rudely interrupted and all too quickly be contaminated by the next onslaught of pessimism. 

I swing widely between the poles of ‘good’ and ‘bad’ judgement, rarely receiving the respite which a balanced, middle ground provides. Take for example the last 24 hours. This time yesterday I was curled up in bed, steeped in self pity. I felt so ashamed and selfish wasting a whole day doing nothing to help make me feel better. I knew I needed to do the housework, go food shopping, have a shower, go for a walk, meet some friends, go to mass, send emails ….. the list went on and on. I was feeding my negative emotion and allowing it to gain nourishment from each moment spent lying in that bed. I was down in the depths of my emotional rating, and I honestly thought that I was the biggest failure on the planet that I should just give up on life and that nobody would care if I was gone. 

Then I wake up today, still feeling the hangover of negativity surround my aura. I dragged myself to an interview for some potential writing experience with a local newsletter. It took every morsel of energy to find the motivation. It was raining, ‘typical’ I thought. I missed the Bus; I was convinced it was a sign. I didn’t have the full address; I should just give up, it’s not going to work out anyway. It really was a miracle I got there in the end. I hadn’t even researched the organisation, certain that it would be a waste of time as I would never get the job. 

If I look back and evaluate the emotion I was experiencing, I was really nervous. Fear wanted me to run home and hide away, to avoid, sabotaging any chance at a life worth living. But being the suborn mule that I can be sometimes, and because I had told some people about the interview, I felt I must go, even if to say I went. 

I actually found the place with relative ease, and was greeted by two lovely ladies who seemed interested in me and appreciative of what I could potentially bring to the organisation. We brainstormed ideas and I felt excitement build up in my tummy. The more I talked to the two lovely ladies there, the more confident I felt in my abilities. I could really do this. They really do like my ideas. To my delight, they asked me to contribute to the June issue and gave me a deadline for submission next week. 

Walking towards the bus stop I felt elated with happiness. I felt like I had overcome the fear which stops me from doing so much in my life, like I had climbed a personal mountain. I was propelled into a heightened state of positive emotion, a world away from the foul mood I had been in only hours before. I grinned childless to the bus driver and sent a barrage of texts and emails to friends and family bombarding them with my good news. 

Now that the initial exhilaration of this morning’s achievement had subsided slightly, and I am not so ruled by my emotional instability, I can see how exhausting this yo-yoing of emotion is to my emotional stamina. If I try hard to be dialectical in my thinking about today’s events, taking into account the importance of living in the moment, I guess the middle ground might be as follows; 

I spent the day resting in bed yesterday, even though I had a lot to do. By doing this I was reminded that staying in bed all day negatively affects my mood. I do need to lie in sometimes, but next time I might only rest for the morning, and get some tasks done in the afternoon. I allowed my bad mood to continue into today. Each day is a new page in my life. I can start afresh if I do not hold onto the past. It was a great achievement to obtain the job this morning. Congratulate yourself. Now move on to concentrating on the rest of today’s tasks. 

I aim for this balanced way of thinking in all my endeavours. When I read it back I don’t feel any overwhelming emotion either positive or negative. I just want to move onto this afternoon. I have a focus group to attend which has nothing to do with the newsletter. 

Have you ever had a similar experience? How do you stay centred?

Hot Cross Bun (CBT) Model of Thinking/Feeling/Behaving

Today we were asked in group to write down how an emotional crisis looks like and feels like to ‘us’. The worksheet was based on the well known CBT (Cognitive Behaviour Therapy) ‘Hot Cross Bun’ Model. Even though I have seen it a million and one times before, it really helped to revise it, and use it in relation to DBT skills. This is the model in a picture format.

I find retrospective thinking hard to do, as I find it difficult to sense any emotion other than the one I am experiencing at any one particular time, no doubt it’s a BPD thing. None-the-less I tried hard to imagine a scenario where I was overwhelmed by an unpleasant emotion. Here is some of the dialogue which helped me to complete the worksheet. I really found this particular therapist very helpful today, I guess it’s nice to have a change in health professionals every now and again to gain new perspective

.

My Reflection of Myself in a Crisis

Example: Getting letter to say that a course I have been waiting to attend for many months has lost its funding and has been cancelled.

·         How do I feel?

Me; “I feel as if everything is overwhelming.”

Therapist (T);”Can you identify the emotion behind this statement?”

Me; “Well, it’s like I become paralyzed by fear and anxiety or worry.”

T; “So, is it fair to say that anxiety related emotions would be your initial or strongest feeling?”

Me; “Yes, anxiety, fear and worry.”

·         What bodily sensations do you notice

Me; “My body can become very tense; I fold my arms and cross my legs and clench my jaw”

T; “Is this when you would notice you are in an emotional crisis?”

Me; “No, probably not to be honest, it’s more when I feel like I can’t catch my breath, am shaking or have a migraine. Sometimes I become very tearful.”

T; “Ok, it’s really skilful that you can realize that. It gives you scope to work at leaning to catch the anxiety at the earlier stages, rather than it escalating to a higher intensity.”

·         What Thoughts Come to your Mind?

Me; “This feeling will never go away.” “I can’t manage.” “I should be able to manage/cope better” “I need to do something to change/stop how I am feeling RIGHT now”

T; “Well done on identifying these thoughts. The way to help change them is to weigh up the evidence for and against them and challenge them by asking; ‘Are these thoughts rational?’ Can you come up with a fairer, more tangible thought which will be more solution focused?"

·         How Do You Act?

Me; “Well because I can’t think straight, I tend to resort to behaviours which, when in wise mind, I know are harmful in the long run”

T; “What kind of things?”

Me; “I have a list!, I will avoid any situation which feels overwhelming, even if I know it needs to be dealt with and will even avoid doing things I enjoy. I stay in bed, and isolate myself by not contacting anyone. This time I didn’t open any other letters, couldn’t respond to emails or texts.”

T; “That makes perfect sense to me, but as you said, it doesn’t really help solve the crisis at hand.

Me; “No it doesn’t help, even makes it worse. I become very emotionally deregulated and resort to old destructive behaviours such as binge eating/drinking, which leads to secondary emotions of shame and guilt  and then I feel I must punish myself by self-harming to make up for it. Then it basically starts the whole cycle off again doesn’t it!

T; “Exactly! Here is where you can intersect the cycle to change the emotional and behavioural outcome by noticing initial bodily sensations before the thoughts and behaviours take over.

We then went on to cover all the ACCPECTS and SELF SOOTHE skills which can be useful to change the intense emotion. I will be making a separate post about the ACCEPTS skills as I am still putting together what works for me.

I guess I just wanted to go over this exercise, and always find that here, on my blog, is a great way to reflect. The biggest lesson I learned today is that I can always learn something new, even if I think I know it all! It feels good to have bashed this out again. I hope it helped you to read it too.

I would love to hear if this model has ever helped you.

Personal Responsibility and Action Plans

For a week filled with extreme emotions and tear stained streaks down my cheeks, I am feeling lighter. Clichéd as it may sound, I feel like a weight has been lifted off my mind, well actually, it’s been yanked off my mind by harsh but powerful words and my own realization that I am the only person who can ‘fix’ me.

If I was to summarize my experience of this last week of intense treatment, it would be in two simple words ‘PERSONAL RESPONSIBILITY’. I have been jolted back into reality being on this programme. No-one is going to do the work for me, no matter how much I want it; it simply is not going to happen. No prince is going to ride in on a shining white horse and save me from the BPD monster, but I can get on my own horse, learn how to ride it and trot away into the sunset myself.  Personal responsibility in my recovery involves taking action and doing what needs to be done to get well and stay well. It involves problem solving, making goals and sticking to them. It involves making promises to myself, not my family, not my team and not my friends. It involves taking ownership of my life and my future. I must remember that am an expert on myself and gain back control of my life.

I have been given a wonderful sense of empowerment, while still validating my emotions. I am so afraid of what my life will bring now that my future is so uncertain. I feel it in the pit of my stomach; I have noticed the inability to catch my breath and the hot sweats I break out in when thinking about what I will do. Yet although these emotions wash over me, and I feel them, they are not going to change or improve my situation.

I have been really trying to use the core skill OPPOSITE ACTION in response to the anxiety. My action urge is to avoid, not thinking about options, not to get advice and not to apply for opportunities. That way I can’t be disappointed again, I can’t be rejected. Yet I am also not helping the problem, I am not giving myself a chance at a LIFE WORTH LIVING, and am pilling more misery on top of misery. More fear on top of more fear.

To go ALL THE WAY with this skill, I have to stop procrastinating and ‘just do it’ as the Nike ad tells us. One of therapists always tells me that ACTIVATION PRECEEDS MOTIVATION, so even if I don’t feel like applying for the internships, jobs, courses or voluntary work I just have to do it, then I will feel the benefits of my labour after.

It’s so hard in real life though, so the way I have tackled it is by making small little steps. The number one reason we put off improving our lives is because big changes feel so scary and unattainable. Which is why breaking goals down into small steps is the secret of success. There’s less fear when you’re just concentrating on what you need to do that day, and as you stick to your good intentions, you’ll be motivated to carry on until your new habits become a way of life. I was told to write your goal down on several pieces of paper.  Hang them up everywhere.  This is my first step to focusing on my commitment. Then make lots of smaller easier to achieve goals for each step of the bigger goal.

 So here it goes; I want to get back to university. I want to do a health science related degree. I either want to study occupational therapy or midwifery. It’s been my dream since I was a teenager, and I was two years into my OT degree when I had to drop out due to BPD.

Step 1: Find out what I need to achieve to get onto course and what university I can study in.

·         I need to have the skills to stay in university for 4 years,

·         Be able to endure 8 hour days of lectures/study.

·         I need to have communication skills to be able to interact with other students.

·         I need to be able to manage stress and have good time management.

·         I need to have the finances in place to support myself for the four years.

·         I need to be physically healthy and emotionally fit.

Step 2: Finish DBT and fully engage in therapy to learn new skills.

·         Attend DBT skills group and individual therapy every week.

·         Complete all homework and be willing to learn new behaviour patterns.

·         Adhere to DBT contract to create a life worth living

Step 3: Attend a less intense course/internship/voluntary work in order to build up skills and confidence.

·         Research opportunities online with voluntary organisations and apply for any that interest me.

·         Talk to and ask others about different opportunities.

·         Update CV and write cover letters.

·         Follow up on all leads and correspondence.

Step 4: Get finances in order

·         Talk to social welfare office

·         Find out about financial aid for going back to university.

·         Continue to babysit and pick up small manageable jobs

·         Set up credit union account.

·         Try to save when I can.

Step 5: Work on personal relationships

·         Stay in touch with friends, and be appreciative of their love and support.

·         Reach out to family; be considerate and patient as they are also learning new skills.

·         Make efforts to create new friendships.

·         End destructive relationships.

·         Be honest

Step 6: Foster and develop creative talents and interests

·         Make regular time to write/attend writing classes

·         Listen to music daily, sing.

·         Keep art supplies stocked and ready to use

·         Make cards/collages/draw/paint

·         Learn new things as often as possible.

This is all I can think of right now, but I know that more steps and action plans will emerge from these rudimentary goals. It feels good to have a plan, something to work towards. i don't feel so empty ans lost. 

'I Shall Go To The Ball' OPPOSITE ACTION To Fear

 I am sitting here waiting, wishing for the moments to pass more slowly. Dreaded time has caught me by surprise this morning, dragging me into a place I would rather run and hide from. Yes tonight is the night that I have been both looking forward to yet silently wishing would never come. I admittedly have not been listening to my emotions about this event. If I am honest, I have not observed the suffocating sensation in my neck, or how hard it has been to catch my breath between the shallow gasps.

I am in full blown distress mode this morning. I feel titteringly close to losing control once again. So I must turn to DBT skills to quell my EMOTION MIND and find the calm which accompanies WISE MIND.

Firstly I can recognize that my fear is disproportionate to the situation. Yes OK, I acknowledge that it is out of my safe place. A formal ball with hundreds of new unfamiliar people is not going to be comfortable, but it will not harm me in anyway. With this in mind, the obvious skill to use is OPPOSITE TO EMOTION ACTION. For it to work, I must go ALL THE WAY with this skill to distinguish the fear and snuff out the flame of panic

Sometimes in order to change how we feel we have to act opposite to how our emotions are telling us to act.  With anxiety, instead of running from the feared circumstance, we need to approach and engage in it.

Acting opposite to how you’re feeling only works when:

• The fear is not justified.  Fear is justified when a situation is a threat to your life, health, or well being.
• You do opposite action all the way. Not just by acting opposite to how you’re feeling, but also by thinking opposite to how you’re feeling.

PROCESS OF OPPOSITE ACTION

Figure out your emotion

Figure out what action goes with that emotion.

Ask yourself ‘do I want to reduce this emotion?’

Figure out what the opposite action is.

Do the opposite action all the way.

So I will firstly decide to go and follow through with that plan. I will fix my tan, go to the hairdressers and get my make-up done. I will dress up and make sure I feel as confident as I can before I go. Once I get there it is really important that I continue to be present, and stay in the skills mindset. I will use HALF SMILE to center my nerves and help accept that it is a difficult night for me. I must make sure that both my body and mind are at the party, so no hiding in the bathroom or keeping quite. I will make small talk and remember to breath!

Wish me luck!

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Panicked and afraid

I came out of my one to one therapy session yesterday feeling utterly ashamed of myself. I am a fraud, a fake, an undistinguished manipulator, who's sole aim is to gain attention and pity from those who are only trying to help me. I can't cope with life. My miserable and  shameful life. I have no clue who I am, and the scary thing is that don't think I want to find out. I am terrified that when I find out who I am, I won't like the real me.

It's better to be unwell, and use that excuse to explain my horrible personality than to accept that ultimately this may be who I am and that I choose to behave the way I do. I am so afraid of myself.

I found myself calling a suicide hotline last night and wondering if I would ever have the courage to go through with it, but I am too weak. That is the conclusion I came to, that my drive is there, but I am to scared to really go through with it. Its like a marathon runner who has trained for their entire life for a big race. The have the ability and the drive to run, but the day before they break their foot and can't go through with it because they physically can't.

Today I panicked again. I need answers to the hazy questions circulating in my mind. I didn't go to work and instead festered in bed with my unwashed thoughts.  I don't care about anything. I didn't even pick up my social welfare payment this week. I am back to thinking about starvation and attention seeking.

I called my Doctors office not to long ago knowing full well that my therapist was out of the office today and couldn't call me back. Now I am waiting for a call back from some randomer and I have no clue what to tell them about why I called. All I know is that my insides are screaming in silent agony with confusion and guilt and that I am terrified of myself.

Why did I call? It was an instinctual reaction to the emotional pain. My head wants me to be devious and secretive yet also wants to let others know when I am hurting too. As if by sharing the hurt that it will somehow soften it and justify its reality. But the instant I open my mouth it won't let me explain it in a way that gets me any help.

Oh I am not making much sense I know, and I am also well aware that this blog has taken a radical turn from recovery to something much more dark and disturbing and I really am sorry about that.

Just off the phone with the on-call doctor there. He was nice, but detached and was reading my notes as we spoke. We agreed that I must put in place my distress tolerance skills and reminded me that these feelings rarely last... so in the words of Marsha.... I must ride the wave of the emotion.... I fucking hate surfing. Could never stand up on the board and always got thrown off into the white thunderous water. But she tends to be more wise than me when I am feeling like this so I'm off to self soothe in a hot shower and wash away the dirt of my anxiety, then I will paint my nails and paint a half smile on my face in order to ride out this period. 

Prozac Mind

Oh wow, what an odd week this has been. Trepidation and deregulation have burdened my mind with troublesome thoughts, causing me to suspend life and live apprehensively, awaiting some unforeseen dreadful event. The sensation lies deep in my thoracic cavity, somewhere between my heart and soul, like a boil ready to burst and spread its nasty disease to all unlucky enough to be nearby. 

My family are worried, heck my WISE MIND is worried too, but at both ends of the pole, the two destructive EMOTION/RATIONAL MINDS are at war. Devoid of emotion my RATIONALITY states that “all is lost, there is no hope, no-one wants you around, and no-one even likes, let alone loves your fat ass!” With that spurring it on, my EMOTIONS are loaded to attack and pounce on an opportunity to destroy myself with all the vigor and drive needed to succeed. So what’s stopping me? 

My exhaustion is. I have barely made it out of bed all week, too afraid to even go to the kitchen or bathroom for fear that something will happen, afraid of others and ashamed that they might see me this way. Surface to say, food is not high on my agenda. I haven’t eaten a real meal for days, and I am scared at the all too familiar glory I feel from my hunger pains. “Success!” whispers my ED in a snaky slighter of a voice! “Keep it up and soon you won’t feel anything except thinness and happiness!”

As long as I can stop myself from binging I think I will be ok, just until I see my Consultant on Monday and therapist then too. Just have to keep myself safe and out of the kitchen, away from temptation. Restricting is less destructive for me than binging and purging.

The dose of Prozac (20mg) makes me nauseas anyway so eating is not all that appealing to me right now, Add the intense anxiety I feel and a weak stomach is an understatement. Food repulses me at the moment. Long may it last!

Morning Contemplations

MMmmm Coffee...

As I sit here with my cup of steaming hot coffee and stare out my little window at the trees, I find myself wondering the question which, at some stage, I think everyone will ask themselves, 'What is my purpose in life?' It is by no means the first time I've asked myself this remarkable question.

I say remarkable because to me, it has stirred up a multitude of diverse and utterly different emotions each time I ponder it. At times when my mind has been tainted by the black thoughts which come with depression, it has conjured up feelings of utter hopelessness and despair. But today, as my anxiety reaches new, unreached heights, it fills me with fear. As in order to have a purpose in life, one must partake in life. So this time, it’s not the thought of the vague, bleak future which fills me with distain; it’s the fact that I must overcome my social anxiety. 

This is the temperament of emotionally unstable personality disorder which many fail to understand. The way we feel and therefore live our lives are imperative to the emotions we battle with. Our minds are never mute or calm, yet always churning with the unfiltered thoughts of self hate, perfectionism or fear of failure. I have never experienced that magical moment of trust of certainty. I have never had the moment where I feel comfortable dropping my mask and letting the world know the real me. But as I sit here clutching my empty cup, I realize, this is all I can do for now. I am the best I can be right now, because although my emotions control my life, they don’t control who I am. I am Andy, and that is all I need to be.

Live life and enjoy today. xxx