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.

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

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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.