New Year, Not So New Me

I know, it's been far too long since my last post to even attempt to give an excuse. So rather than say "I've been too busy enjoying my recovery from emotional sensitivity" which to be honest, I wish were the truth, I'll try to explain whats been going on. I haven't posted because I wanted to leave BPD, EUPD, CBT, DBT and anything to do with my 'old self' as far in the past as I could. I threw the baby out with the bathwater insofar as my life seemed to be going OK, so I foolishly thought: "I don't need to look after my emotional sensitivity anymore". But recovery for an emotional sensitive person is not the same as recovery from a broken bone. You cannot only do the prescribed therapy for a few months after the event. You must learn the treatment, remember it, and continue to practise it as a preventative measure against future injuries. 

Christmas and New year have come and the festivities have died down. I'm left wondering why I feel so emotionally delicate. I mean, I had an uneventful Christmas, almost enjoyable actually. It was quiet and there was little to report. 

Perhaps it's the last 8 months finally weighing down on me. I can't shake the crushing feeling of being a total failure. I'm also currently therapist-less, which I find scary. Really scary. I have completed year one of four of an undergraduate Midwifery degree programme in my dream university. My dream course which will lead to my dream job and to my dream life. Seemingly.

But I'm not living the dream. Im on a year out, working 50+ hours a week for just over minimum wage to pay back crazy university fees that I wasn't expecting. Yet I haven't begun to pay my fees back yet because I'm bang in the middle of a emotional meltdown which sees me self destructing using old coping habits I thought I had left in my past.

So seeing as its a 'New Year, New Me' kinda time of year, Ive come back here to this blog, to where I found peace and recovery before, in hopes I may find it again.

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

DBT Skills for Romantic Relationships

For a very long time I thought I wouldn't ever be able to be part of a healthy romantic relationship. It's often seen a huge trigger for those of us with an emotional vulnerability, and it very often can be. But I soon learnt that having a mental illness does not have to be a reason to avoid being in a relationship. A mental illness may cause more stress and require more work, but having a successful relationship is not impossible. There are few things I had to really work on so my current relationship (of over a year!) could work.

Before I could be in a relationship and worry about another person, I had to prioritize my own health. My current boyfriend actually asked me out a year before we officially started dating, but I was still in DBT and quite unwell. So I decided to wait until I was finished formal therapy and had learnt the DBT skills to help me manage my emotions before I agreed to be in a relationship with him. Luckily he was still around when I finally was in the right place. I'm only going to mention a few DBT skills here to demonstrate how I manage my emotions in relation to how we make things work in our relationship, but there are lots and lots more!

Number 1. PLEASE

Staying on top of any medication I've been prescribed and taking care of my physical health -- exercising, eating well and avoiding alcohol or drugs, is the best thing I can do to regulate my emotions; and therefore the best thing I can do for our relationship. Avoiding alcohol has been a great way of staying present in stressful situations like nights out or large gatherings, where I have had emotional outbursts in the past due to feeling out of control, leading to arguments and behaviours I am not proud of.

Sleep is a difficult one as it can be difficult to get quality sleep for me at the best of times and when he stays over it's even more challenging. I only have a small bed so we inevitably end up elbowing each other in face! If we were to move in with each other, a big bed would be a must!

Number 2. NON JUDGEMENTALLY

Staying non judgemental is *sooooo* important to keeping our relationship healthy. Being non judgemental helps to get my point across in an effective manner without adding a judgement that my partner might disagree with. When I practice this skill, I can look at the weaknesses of others with compassion, not accusation which allows me to respond to them effectively and not lash out in an emotional way.

Believe me, there are plenty of times I am still judgemental. It's a constant effort. We all live with preconceived notions of what's right and wrong, and the minute someone or something doesn't fit our bill of perfection we become judgemental and that affects the way we say things and the things we do.

I practice non-judgementally by OBSERVING my thought patterns. Like all of DBT, this skill requires a few others to make it really work. This might seem hard to do at first, but once you get used to catching your thoughts in ‘judgemental mode’ you can then start to stop them.

I try to develop an understanding of my partner by thinking about why he acts, talks, dresses or just is a certain way. I put myself in his shoes and wonder why his behaviour has emerged. If I want further understanding, I strike a polite (I emphasize polite) conversation using the skills GIVE or DEARMAN.

Once an understanding has been created in my mind of my partners action, acceptance of him just as he is becomes easier. I can accept that this is the way he will react, cause its the way he is made up. There will most certainly always be things we don't agree with, but that doesn't mean I cant accept his presence in the world. When you accept, frustration that leads to judgement takes an automatic back-seat.

On a final note, relationships are hard! They are difficult whether you have an emotional vulnerability or not and require lots of hard work to make them last, and there are so many more things that we need to work on in our relationship, but I have to say that, it's so worth it and really contributes to my life worth living!

The Raging River of Emotion

My intricate network of defective nerves carrying the equally faulty transmitters must have decided to jolt its self back into action today. I sat for a while in the chilly spring sunshine before my weekly ‘me-time’. It really is such a delight to have a whole hour where I can simply talk about me, and I know that my therapist will give me her full, exclusive attention. That sounds conceited, I know, but I don’t care. I have spent too long neglecting my own turbulent mind.  I thought about how privileged I really am while I sat on an ugly and uncomfortable plastic bench outside the treatment centre. ‘I have someone who gives me time to talk and helps me to become a better person; I have a confidant, a sounding board.’ Then it struck me; ‘I have never given myself so freely and truthfully to anyone before and I have never felt such empathy from another human being in my life.’ It feels peculiar, both excellent and shocking at the same time, for I feel extraordinarily exposed and vulnerable having another person on this earth know my secrets, yet relieved that I don’t have to bear the weight of them alone anymore.

We have an idiosyncratic relationship, in so far as I would never choose to disclose such prized and feared confidences to this woman if I knew her casually. To be honest I don’t know if before DBT I would have been able to tolerate her mannerisms. She is quirky and a bit disorganized. Actually she reminds me of my mother; extremely caring yet frustratingly scatty. I got the feeling that I also annoyed her (but of course that could be BPD thinking!). She seemed to resent how little progress I was making despite how well read up I was on the DBT material.

Before we had even met last summer, I had read Marsha’s Training Manual, and shimmed her major body of work: Cognitive-Behavioral Treatment of Borderline Personality Disorder. 1993. I am an intelligent woman when I want to be, and I like to be primed and set to tackle a problem when I feel able. I am always able to read. So for the year between getting my diagnosis and accessing the right treatment to treat it, I read everything I could get my arduous little eyes on. I spent hours scouring the internet for reliable sources of information and weaving together the best comprehension I could grasp outside of a Clinical Psychology Doctorate. Luckily I still had my University student library admittance which afforded me full access online to both the British and American Medical Journals. I also had a good grounding in mental health from my years studying Occupational Therapy.

Now all that stood before me was to somehow turn my culvert of knowledge into tangible skills. And annoyingly, I couldn’t do it alone. She was the bridge I needed (but didn’t want to have to rely on) to pass over the violent river safely. Battling the raging currents of emotion alone was not working anymore, but I couldn’t see that. I fought for weeks not only against my emotions, but against this woman who said she knew a better way across and wanted to help me get there. I didn’t believe her. She couldn’t understand my internal conflict, no-one could.

At first I thought she came across patronizing, one of the many things which annoy me about her. Yet, as the weeks wore on, I realized she was merely reciting little Marsha-isims. “How can you create a life worth living, if you are not willing to participate in the therapy?” And every time I would be self critical or chastise myself for my transgressions, she would pipe up and bluntly cut across me; “That’s a judgment!!!” So for a while I stopped talking, I stopped telling her anything and I continued down my white watered river of destruction!

Now that I am a few months down the watercourse, the rapids are less frequent and some tributaries of support have joined my journey towards the sea of recovery. The emotions are still there as is the water in the river, but I have more energy to swim back and survey the journey as the intensity of the emotions have subsided and the volume of support has grown.

Even though we still don’t always see eye to eye, I am now at peace with my therapist and the service as a whole. I can see how far I have come, and how far I still have to go, but like the river, it only really flows in one direction… towards the sea. I guess my route has simply taken a small meander along that path. 

ACCEPTING the importance of MINDFULNESS

This has been a good week. I am feeling more 'me' again. Its not that the black cloud has gone away, its just I feel like I am better able to cope with the next storm life throws at me. Almost like I am prepared to fight now, posed and ready with my armor of skills and SELF-COMPASSION.

I returned to a meditation class on Tuesday and Thursday evening and it was simply wonderful. It was inspiring to listen to others stories of how meditation helps them in their daily lives. The inner peace they radiate really is infectious. I truly get the importance of MINDFULNESS in DBT this week.

When emotions wreak havoc, it helps to “get it out” — ranting to a therapist, friend or partner, or writing about your feelings in a diary, or blog like this one. Sitting down on a cushion to meditate is seemingly the polar opposite of this catharsis. But could it be that the two approaches are helpful for similar reasons?

Talking or writing about your feelings forces you to call them something. And one technique taught in mindfulness is naming your emotions. It’s part of noticing and detaching from those emotions vs. letting them hijack your bliss. I like to imagine it as 'the mindfulness wedge.” It’s about developing that pause button,' so you can observe emotions from the outside.

The main focus of DBT for me is gaining control over my emotions and it is now known that simply labeling my emotion promotes detachment, providing a stop-gap and the opportunity to choose of a healthier coping mechanism.

It’s very challenging to bring what you practice on the meditation cushion out in a real-life situation, when you’re actually in that moment — say someone is yelling at you — you have to remember to step back, say, ‘Oh, that’s anger I’m feeling,' and change what you do with that emotion, all in a millisecond. It takes a lot of practice. To help with this, I try to extend my meditation to everyday activities like going for a walk, having a shower, or drinking my morning coffee.

Often when you feel something, you don’t acknowledge it, and by avoiding that feeling, you perpetuate greater pain. Meditation helps me realize that I create my own feelings. If I’m in a state of frustration and I stop and observe it, I realize there’s another way to deal with the pain. Acceptance is key to dealing with distress, and it is without a doubt the hardest part of mt therapy, but each journey starts with a single step right!

DEARMAN Success with Therapist

Love this Meme!

Maybe it's the increased dose of Fluoxetine (Prozac), maybe it's not, but whatever the reason I am feeling lighter this week. I am not beleaguered by the familiar and frantic suicidal thoughts, urges, plans. My ability to stay out of trouble is surprising me. I have not binged/purged much this week, even though all the normal triggers are there. The urge is also still there, but I find myself able to resist the need to act on it. 

I had my individual therapy session today after a 2 week gap. It was because my therapist had to cancel one session due to the illness of her child and then was away on training straight after. I was deeply disjointed over  the abrupt phone call from her that day to say she had to postpone our meeting for 14 days. My immediate thoughts were; "She doesn't care about you" "Once again, you are not important" "She is glad to not have to see you" and so on....

I was really super emotional for at least 2 days after and to be honest, have only come back down to an even base level on the topic this week. Hence why I can only really describe it all on this blog now. I got some excellent support from the recovery network online, and was advised to write down how I was feeling. Which I did! 

I used it an an opportunity to practice the INTERPERSONAL EFFECTIVENESS skill DEARMAN. Here's what I wrote:

On Thursday 16th Feb you regrettably had to cancel our therapy session at the last minute due to the unfortunate sickness of your daughter. I felt disappointed that my appointment with you was cancelled. I had put a lot of work into DBT last week, and felt that I really needed to discuss it with you. I was and am very scared that you will be away for training and then away on holiday. I also feel upset in myself that I am so dependent on our session each week.

I understand that you had no other choice but to attend to your daughter who was sick, and wouldn't have wanted you to do anything other than collect her as she was unwell. I guess the reason I feel the need to write to you is that I think a back-up plan might need to be put into place for if/when this happens again as it is not the first time that you have had to cancel our sessions. I also feel that the gaps in therapy are really affecting my ability to sustain a constant motivation for DBT. Yet I totally understand they need to happen sometimes, we all need a holiday! None-the-less I feel very scared knowing that gaps are coming up.

With support to fill in the gaps when you are away I feel that I could continue with the DBT skills rather than feeling alone and unable to cope. Perhaps there is someone I could call within the service when you are unavailable that understands and is able to offer coaching in the skills?

At the moment I feel like I have no concrete support in my day to day life outside of DBT, and although we are working towards me becoming better able to deal with this, and I look forward to the day that I will be able to cope on my own, I am simply not there yet. This is why having these gaps are scaring me so much. I would like to further problem solve this difficulty in our next session.

Kind regards

Many people over the years have told me about the benefits of writing out a letter to someone about a difficult situation, And I always poo-pooed the idea, thinking it was a load of cod-ology. But I take that back. After minutes of writing this, I almost instantly felt a sense of relief, and as I found my self reading over and over it, noticed how nice it was to be compassionate to my emotions, to validate them as real and not react in way that I was ashamed of.

In the end I did not send or even show this letter to my therapist, as I felt much calmer and understanding after having the 2 weeks to evaluate everything. We came to an agreement about how to solve this problem should it ever arise again. I suggested that we E-mail each other, as I am much more comfortable with that then phoning for skills coaching. This way I always feel that I can turn to her for support, even if she can not get back to me straight away.

I am proud of how well I managed the situation, and happy that I now know I have other options rather than flying off the handle and ending up in A&E, just to feel validated. THIS is a BIG step for me. Long may it last!

PLEASE take care of your body!

We are back to EMOTIONAL REGULATION this week. I like this module, and it is not too triggering for me either. I am a firm believer in returning to basics during a state of emotional deregulation, so it makes perfects sense to me that I must consistently make sure the base of my emotional pyramid is strong and stable.

The PLEASE Skill is about taking care of your mind by taking care of your body.

PL – Treat physical illness. This is about looking after yourself if you are unwell, seeing a doctor and taking meds as prescribed. I find I am grumpy when sick with a headache or flu, so I am more emotionally venerable. I also get very deregulated around my time of the month, but if I validate my pain and take care of myself I can avoid behaviours which I may not be proud of.

E – Balanced Eating. Okay I’m not going to lie here and say that this is something I do…. I have bulimia. But I understand the theory. Balanced glucose levels most certainly even out emotional responses to situations. Someday I might just be able to achieve this one!

A – Avoid Drugs and Alcohol. I was surprised at how much avoiding excessive amounts of alcohol has helped me to stay out of trouble. All of my suicide attempts have been after drinking too much. I simply cannot over drink until I get a handle on my emotional liability. I don’t miss it too much and certainly don’t miss the hangovers!

S – Balanced Sleep. Sleep is just so important in regulating emotional responses. This has some serious research behind it too. Too little and you are leaving yourself open to irrationality and too much has been proven to increase negative emotions. Sleep hygiene is a bitch but it works. Sleep is a big one for me. If I do not get enough sleep on a regular basis, I get irritable, short-tempered, my judgment is less good and I get upset much more easily. I have to work on it all the time.

E - Exercise. This is another no-brainier, if anyone knows the magic motivation skill for this please let me know! I try to walk/cycle everywhere, and love to run and do yoga.

I guess looking after the basics is the main reasons people go inpatient or into residential treatment, It re-sets a base level from which you can really start to therapeutically manage emotions and behaviours. Most of this is common sense, but for me at least its dramatically boosts my mood. 

HALF SMILE your way to acceptance

Two elegant yet, sheepishly impatient women are making rapid glances around Starbucks, hoping to nab a free space to sprawl out and natter after an afternoon of window shopping. You can tell they are the leisurely type. I overhear them giving out about the lack of seats, and can’t help giggle as the hand approaches the first single digit on my watch, signifying my third hour sat in the comfortable chair by the window which seems to have moulded to my frame by now. I am not moving. I even turn my chair to get a better view out the panoramic glass wall.

People-watching is a not a new hobby of mine, but observing the finer details of said people is. I recently acquired a very helpful possession for this pursuit; eyesight! For some reason or another, cost and hassle being the most likely, I had not replaced my broken specs when the arm unhinged its self from the frame last year. I had grown used to the blur, and liked not living in focus. But when I passed my own father on the street, I thought ‘enough is enough’ and got them fixed.

There are two categories of people who meander up and down Grafton Street in winter. The fast paced snakes who weave their path in plaits around the care-free traffic blockers, who are much more easily distracted as they gather in large semicircular groups around each of the buskers dotted on the side of the street.

The girls compete in the small city style wars, and the guys compete for the most stealthily glances and puffed up chests. The dramatic outfits somehow seem to conspicuously blend in a contradictory fashion with all the rest and it’s the plain and ordinary which stand out. The frizzy haired student, the make-upless lady and the elderly man with a walking stick all seem out of place in this world of perfection and antagonism.

Once, a woman smiled at me as I walked by in a daze. It shocked me, and my initial reaction was to wonder if I had food or bicycle grease on my face. Why it was that something so pleasant made me react in such a capricious manner? I was a suspicious mess, and was almost angry at the woman for evoking such an unstable feeing in me. But of course it was not her error; it was my own lack of self confidence which made me react that way. Then I realised that it was not just anger stirring up in the pit of my stomach, it was jealousy. I wanted to be that woman, who could smile at the world and warm the hearts of others. 

So I guess that the point of this post is that the DBT skill of HALF SMILE is a valuable one. The idea with this one is that there’s a biofeedback mechanism between the face and the brain. If your face is tense, the brain gears up for trouble. If on the other hand your face is relaxed, it tells your brain that everything is fine.

I’m not sure yet how this ties in with accepting reality, but then there’s a lot I don’t understand about accepting reality generally. The book says ‘Half smiling is accepting and tolerating with your body’. DBT seems to ease you gently into ‘accepting reality’ before finally hitting you with Radical Acceptance. I’m hoping that after we’ve covered radical acceptance I’ll understand more where these breathing, smiling and awareness exercises fit in.

I’ve used this skill several times since I learnt it. On the bus when I saw my reflection and realised just how anxious and cramped my face looked. In a crowded market today when I felt overwhelmed and my face was agreeing with me. Both times I consciously changed my face to an ‘I can cope’ expression. And cope I did… Coincidence perhaps; I need to experiment more but I’m definitely prepared to try it out.

DISCOVERING VALUES Individual Therapy

"No thanks, I don't need a husband yet"

I was in a good mood for therapy today. I spent time thinking all week about what was the most effective topics to discuss. I feel I have found my drive this week for recovery which I lost for a while after Christmas. I have accepted it though and learnt that lack of motivation sometimes is part of the process. 

I finally brought up the topic of romantic relationships. I have somehow managed once again to get caught up in a relationship when it is the last thing that I need or want at the moment. I have not been sticking to my values with regards to learning how to stand on my own two feet. I have allowed this boy to sweep me off my feet, when I do not even have feelings for him. I am going out to pubs and drinking when I had sworn to myself not to while in therapy.

Don't lose yourself in attempt to hold on to someone.

So I blurted all this out in the session today, we thrashed it out, discussed  the value of a relationship with him, and got to the rot of the problem. I need to learn how to say no. 

To my horror we did a role play. First she played me and said how to end the complication in an effective way. Then we switched and I rehearsed what she had said. It took a few tries before I felt right saying it.

We decided to tell him that I was in treatment at the moment and because of this I was not in a position to be with anyone, and that I really hoped we could still hang out as friends. we agreed that I would wait until next week to tell him as I had already committed to attend the University Ball with him this Saturday.

In other news, but still on the skill of VALUES. I realized that I have a gaping hole in this part of my life. I list education as my number one most important value and yet am not doing anything to fulfill it. So, while I have some motivation, I used it to book a week long creative writing course one of the major Universities in Dublin. I really can't wait to do it!

NON JUDGMENTAL STANCE

Today we finished INTERPERSONAL EFFECTIVENESS and moved onto MINDFULNESS in skills group. Now that I have gained back some motivation to partake in DBT, I feel disappointed that I missed so much of the DEARMAN, GIVE, and FAST skills. I get now why the modules are repeated at least twice and am slowly coming around to being told I must repeat the skills group again next year. So my guilt, although still there, has dissipated somewhat.

This weeks homework is to focus on being NON JUDGEMENTAL. It’s a toughie for me so, is a good one to re-visit (or should I say visit, as I have yet to master it!) It was suggested that I get a tally counter. Which is one of them clickity yokes to count how many times you notice a judgement and learn to associate the ‘click’ with it. So tomorrow I am going on a city wide hunt for one!

A place where I think I will be able to practise this skill is at the Ball I am going to this Saturday night. I will be getting all dolled up and be in the company of beautiful and highly intelligent people (It’s the annual Medical Ball!), so as you can imagine…. I am shivering with nerves already. My challenge is to go and simply notice all the judgements I have about myself, other people and the environment. 

All-though unless I can find a counter to match my gown, I might leave it at home that night!

Wish me luck!

Black and white thoughts, searching for the grey!

Today I was faced with a stark reality check.  I do not have the objective ability to have a balanced view of situations and am thus ruled my my dichotomous thinking. 

Under extreme stress, I find it can be comforting to oversimplify.

I will eat, or I will not eat.

I will live, or I will die.

This rational streamlining allows a sense of peace in the midst of turbulence. Yes, there are plenty of things that are black an white. Simple things. Is the toaster plugged in? Is the door locked? 

But the reason we have words like maybe, probably, partial, more, less, etc. is the grey is all around us. Everything has details, data, different ways to present and interpret the details and data, these different ways of presentation and interpretation is what causes grey.

When the stakes are not quite so high, perhaps a little room for the middle ground would be advisable. There are more choices than you think.A little "wiggle room" goes a long way when navigating through people, events and circumstances. Very little in my own life has ever been distinctly good/bad or black/white in any way, shape or form. Most things are just a subtle shade of gray when examined closely.

So much of the world is best described in an analog way not a digital way and definitely not in the binary way. So much is best described as a continum: I will not eat, I will eat a tiny bit, Iwill eat a moderate amount, and so on with an infinite variety of amounts.

Either / or is just the easy way out. I must leave a little room for humanity to breathe. If the middle ground is removed, how many of us still stand? My life is too complex to be able to discount gray areas in order to accommodate absolutes built on foundations that aren't solid simply because I am are either too fixed in my ideologies to be able to critically assess a situation or too intellectually lazy to do the heavy lifting, so to speak, when it comes to handling difficult ethical dilemmas, I simply use a catch all.

Giving up

I always dwell on the most negative. They say that we human beings are programmed to survive and to overcome and forget pain in time. Not me. The times when I feel grief and emotional distress are the memories which stick with me the longest. This week has gone by so slow, its agonizing sitting and waiting for this wave to die out.

All I keep thinking about is how I am unable to keep going on with DBT. It is exhausting me. I simply can't keep it up anymore. But I am afraid to give up totally just yet, so there must be something inside me willing to keeping pushing past this horrible disorder. I have been making endless amounts of PROS AND CONS list about it. I fought so hard to get into the program, and I know how lucky I am to have even been considered for treatment in Ireland. There are others here literary dying to get this level of support. Yet I wonder if it is the right thing for me, maybe it just is not the right time, perhaps it simply worn't work for me.

I know I have improved since starting this journey, but not enough for the tremendous effort that it involves. It is too hard and I am too exhausted. Then there are all the people I would be letting down if I were to simply give up on yet another thing in my life - My parents, my employers, my partner, my friends, my therapist, my doctor, my readers of this blog, my housemates and all the well wishers. I don't want to let them see me fail, again! So for now, I will try my hardest to battle through this, one second at a time.

FACTORS REDUCING INTERPERSONAL EFFECTIVENESS

Get out of my head!

In the wise words of DBT's creator Dr. M. Linehan; 

"The less you know, the more you worry, the worse you feel, the more you can't decide what to do, the more ineffective your are, the more you worry...

The more you experience non-giving, authoritarian environments, the more you worry, the less you practice, the less you know, the worse you feel, the more you can't decide what to do, and so on.."

This post has been more than a little bit difficult for me to write. I have scoured the internet looking for others views on this topic and came up with nothing except confusion. You see, I am ashamedly, immensely self limiting when it comes to my interpersonal relations. This is mostly due to my crippling inability to be NON-JUDGMENTAL. The resounding tone from the group today when introduced to this module with FACTORS REDUCING INTERPERSONAL EFFECTIVENESS, was an echo-chamber of the like-minded, nodding heads and understanding smiles.

Of the five factors covered; LACK OF SKILL, WORRY THOUGHTS, EMOTIONS, INDECISION, ENVIRONMENT, I feel that the one which stands out is clearly WORRY THOUGHTS for me. 

I am always worrying about what others think of me, how I look. "Do I fit in?" "Am I acting right?" "They wish I wasn't here" "They would rather not talk to me". These thoughts distract me from being able to met the social demands of an interpersonal situation.

Mr. Worry!

Another way that I feel my judgments impede my ability with regards to dealing with people, is what I think about others. I am very quick to generalize people based on very little information! I suppose this is the diagnostic criteria of black and white thinking rearing its nasty head. When someone comes out with something I deem unattractive, I am altogether too quick to totally write them off. One acquaintance recently came out with;  "Children are so annoying!". We were in Starbucks, and the local toddle waddle team had set up base beside us. Making lots of noise and very distracting. All of a sudden, I was dismissing my friend and blanking on all her great qualities. All I could think about was, how awful a person she was for saying that. "What a horrible person she must be if she doesn't like children!". I let my judgments get in the way of having a good time and a nice chat. I was stand-offish for the rest of the time we spent together. I short. I wasn't very personally effective! 

What happens when I have a judgment about someone is that I then search for proof of it. I look for ways that that person then conforms to my judgment, and I ignore ways that he or she doesn’t conform. I build a case for my perception and create a story about that person, which then interferes with my reacting purely and simply and EFFECTIVELY in the moment to that individual. My ideas and story get in the way of seeing the whole truth about that person. Furthermore, my reactions to him or her are bound to be quite negative when the story is a negative one, whether I am conscious of that or not. What happens when I feel negative or react negatively to someone? Usually, I get a negative response back, which reinforces my negative feelings. I don’t realize the part I played in creating that negativity. If you were being judged, or even just sensing the negativity behind an unspoken judgment, how likely is it that you will feel positively toward someone and act accordingly? Judgment produces judgment, while love produces love. 

The trouble I see with judgments is that they keep me from connecting withothers. They maintain a sense of separation because what I am judging is the fact that I or the other person is different from me or different from an idea or ideal I hold: either myself or he or she “should” be this way or that way.

I am looking forward to learning how to get past these factors, and with Christmas fast approaching, the timing couldn't be better!

RADICAL SELF ACCEPTANCE

If I let myself, I may start to believe that the magazine cover girls (whose photos are air-brushed and trimmed in, mind you!) are the norm and that the rest of us are somehow deeply flawed. What I get then is the soundtrack of "I hate myself" or "I hate what I see in the mirror" playing over and over again in my head, fuelling my endless dieting cycles and painful frustration.

If I am to have any measure of success, it is crucial that I permanently press stop on that soundtrack and work to genuinely accept my size and, by extension, myself. For someone who has been listening to this self-disgust soundtrack forever, size acceptance is pretty scary. Does accepting yourself the way you are imply that change may be impossible? 

What I am trying to say is that; denial is not acceptance. Rather, self-acceptance means adopting a NON-JUDGEMENTAL STANCE toward yourself. It's the ability to see things as they are in the moment without harmful, self-critical voices interrupting your view of yourself.  Self-acceptance is instrumental to reaching your healthy, natural weight. Size-acceptance means focusing on the things you like about yourself while working to modify what you don't like.

This process is at the core of the dialectic of CHANGE/ACCEPTANCE. If I get back to a DBT skill of weighing up the PRO'S and CON'S of tolerating distress, I must ask; "How well has not liking myself worked so far?"  The truth is, it hasn't. In fact, if I dislike my body, it's that much easier for me to abuse it.

If I try to apply this to my own life and situation, I feel less able to be as practical as is needed to fully commit to this. Maybe the skill TURNING THE MIND might be of use here as I prepare myself for acceptance of my body. I must turn my mind towards accepting the reality that my natural weight and size are not what I feel they should be. I am not part of the 5% of women who are long, lean and have model measurements. Therefore I must commit to choosing that my reality is that I have hips and broad shoulders which are all part of being a woman.

I am not happy with my legs, they are riddled with varicose veins and often retain water. That is a fact. Starving myself is not going to change it. So for today, I am making a commitment to RADICALY ACCEPT that these things are part of me, I may not like them, nor say that I am happy about them, but they are there.

RADICAL ACCEPTANCE

I often wish I could change the past and make it perfect. I feel like I am attempting to paint a masterpiece of which I am so proud of and is so wonderful, but the ground work for it has been tarnished and what went before has destroyed the base that I now am working off. But in reality, ‘perfect’ is a fallacy, because, no canvas is ever bump free, and anyway, why would anyone want that? There would be nothing to catch the light!

I understand that there is nothing that anyone can tell me to make my past seem more perfect, because, in short there is no way for that to happen. Here is where the skill ‘RADICAL ACCEPTANCE’ can help, if I could only get my head around it.

The introduction of this skill was very turbulent in our group, with many willing to learn about it, but in practise not quite able to put the skill to use just yet. I personally can see the benefit of acceptance, but every time I try to apply it to my life I am met with a niggling voice, complaining that I shouldn’t sit back and accept all the injustice in my life, I should stand up and make noise about it! Give out, make a scene and don’t take it lying down!

So what is ‘RADICAL ACCEPTANCE’? It is an honest acknowledgment of what is going on inside you, and a courageous willingness to be with life in the present moment. You can accept an experience without liking it. In fact, let’s say you are feeling stuck in anxiety and disliking the feeling. RADICAL ACCEPTANCE includes accepting both the feelings of anxiety and the aversion to it. In fact, acceptance is not real and not healing unless it honestly includes all aspects of your experience.

The difficulty with ‘RADICAL ACCEPTANCE’ is that it requires patience and ability to be present with your own emotions. Both of which, for me, are very hard to learn also.

I find that at the moment, all I can do is be happy with what I am trying to achieve right now and be proud of every little achievement I accomplish that I wouldn't have been able to do skilfully before. All that matters, in reality is the here and now, you have to be here now in order to live now! The past is nothing that we can work with, and in a perfect world, nothing that we should concern ourselves with.

Things of the past have influenced me as a teen, a student, a daughter, a sister, a friend and now as a woman. The past most defiantly still influences me and the person I have become. Therefore I cannot simply put it out of my head and forget about it. It is part of me.

I also think that as I have gotten older, I have learnt the importance of reflection. Take for example, my situation with University; I often feel it unjust that my fellow classmates have all graduated and are now moving on to exciting careers and new stages in life. I have felt that that is where my life should be, that I am a failure for having to drop out two years ago when I became unwell. It reached the point that I could not be there as a friend for them and congratulate them on the amazing success of completing a degree in Occupational Therapy. I was green with spite and envy. I denied myself the opportunity to be happy with them in their success and lost some friendships in the process.

If I am to apply the skill of ‘RADICAL ACCEPTANCE’ to this situation, I must change my reality of the situation. Okay, I may have had to drop out, move home and be admitted to a mental hospital for five months. But I wouldn’t be getting the help I am now if it were not for that series of events. I would not be facing up to my problems in the hopes of someday living symptom free. That series of events HAS happened and cannot be changed, I CANNOT turn back time. All I can do is deal with events which crop up NOW, in this moment and plan to cope with those that may arise tomorrow. Notice how I am not saying it was fair that I have this mental illness, or that I like it (in fact, I hate it!) I am simply acknowledging that it is something that happened and that I can do nothing about other than work my hardest now so that it does not continue to affect my life in a negative way. It doesn’t mean that the feeling is “right” or “wrong.” Nor does it mean that I must be passive, and not take actions that might be helpful.  ‘RADICAL ACCEPTANCE refers to my relationship with the reality of “what is” in the present moment. By arriving honestly and with openness to this moment’s experience, I might just have a chance to create the possibility of then responding with wisdom and compassion. 

These big things in my past are my biggest barriers, my biggest burdens. But, it is more so my attitude towards these big things in my past that hinder my recovery.

Mindfulness In Action

'Serenity' 

Remember when you were a kid, and you got a new toy for Christmas or a birthday, and the whole world of time stopped while you played and became totally engrossed in the process of discovering how it worked and what you could do with it? Well, after my not-so-successful attempt to PARTICIPATE in a mindful eating exercise earlier today, I remembered how I used to get so involved in arts and crafts that time would slip away before I knew it. 

Until recently my ability to concentrate on a hobby or on anything much was zero-to-none. And while I was acutely unwell I simply just did not see the point in trying. But I slowly built up my tolerance and frustration since those lonely fives months in hospital and began to partake in activities which tested my concentration. Most notably reading and writing, but art is also one of them. 

I dislike doing things I am not very good at, and oftentimes I will not do something at all if it will only turn out mediocre. My judgments of myself get in the way. Therefore I was surprised to find out this evening, that I really enjoyed drawing this picture, so-much-so that I found myself lost in time for a little while. I was PARTICIPATING. I was so fully engaged in 'the flow' of drawing, that 20mins were happily spent mindfully attending to each stoke of the pencil on the smooth paper. I had to make a choice as to which color to use and where to put a mark on the page. 

For 20 mins I wasn't annoyed by unpleasant thoughts. Of worries about the future, or flashbacks from less happy times. I wasn't afraid of the food slowly digesting in my stomach or planning ways to rid my body of the calories. I was simply present in the moment, participating and acutely aware of how I was doing it.

'Participation' Is Torture

This week we have been set the goal of in incorporating the 'What' Skill (from the Mindfulness module) PARTICIPATION into our everyday lives. Thing is, with every good intention of being a diligent member of DBT group therapy, I made a plan. But annoyingly, I keep forgetting to fully participate in a task in order to be mindful to my experiences. 

"I used to think mindfulness is some form of passive observation… it is NOT passive.  In fact, mindfulness requires you to be both the participant and the observer simultaneously.  In this way, you are the observer of your experience at the same time as you are the experience itself.  As thoughts, feelings, and sensations naturally arise, they arise with the same vessel that observes them.Mindfulness is not a denial of your experience and a retreat into nothing but detached observation.  It is a type of open observation that is experiencing that which it is observing." Laura Schenck MA

Some skills from DBT are like little treats for the soul, while others are more akin to TORTURE! This is one of them. When you are fully awake to an experience you have actively spent a good proportion of your life trying to avoid, it is not a nice experience to then have to be aware of all the unpleasantness.

Does that make sense? I can't seem to explain what I mean in the way I want to. For example, a way I have tried to incorporate participation into my life this week, is to fully engage in eating. I really tried hard to experience every morsel of food. To taste the differences between sweet, bitter and salt. I noticed the variances in temperature and texture. Then I switched from external stimuli to the internal. To my thoughts, judgments and emotions.

Here is where the problem with this skill arose for me. No matter how hard I concentrated on noticing my thoughts, there was a strong resistance to participate in the task any longer. It was too hard to observe, then describe, then participate with eating when my head was screaming floods of guilt. 'Fat cow' 'You have no self control' 'You will be alone forever' 'This is what you deserve, fatness and unhappiness' .... 

This skill needs practice I think. And its not what I want to do. Its hard and annoying, but I guess if I was to pull from another skill, and weighed up the pros and cons, is it harder to live with an eating disorder or to just practice this skill?

Are Borderlines manipulative bitches, or just in need of validation?

As some readers of this blog may know, I am currently in therapy. More specifically, Dialectical Behavioral Therapy. I am almost four months into it now and have covered three of the four modules which are; mindfulness, emotion regulation and distress tolerance. We will be moving on to interpersonal effectiveness next week. Just in time for the silly season too! And thank goodness, because Christmas tests everyone's ability (not just the emotional unstable's) to relate effectively to others.

After a particularly bad week, regarding ability to think, behave and generally function at reasonable level, I plonked myself down in my individual therapist's chair, ready to blow off steam and I suppose, get some sympathy for my shit week. As always, I tentatively handed over the diary card (a tedious twice daily exercise with which I have a particularly Black/White relationship). I hate this part, detest it even.  I find it so cringe-worthy, and shameful letting someone else know my most private and secretive behaviors urges and actions.

Anyway, so what I wanted was someone to validate how shit I was doing. And don't get me wrong, my therapist obviously was paying attention during that part of training, because she is an expert at making me feel like I have a right to feel the way I do. Yet she also knows how to push the boat when it comes to pulling the dialectic of change just a tad too hard for for my liking.

She used the words 'you have the ability to evoke a nurturing response from people when you are upset'. Oh lordly, what a thing to say to a borderline. My head went into a spin of judgments about myself, about her... the running commentary was a bit like this; 'what does she mean evoke a response!' 'Does she think I am a needy bitch who wants attention all the time?' ' She thinks I am faking, doesn't she!' 'She must think I want to feel this shit so others feel sorry for me' 'How dare she!' 'She is sick of me' 'She is going to kick me out of therapy' 'She hates me' 'I hate her!'and so on and so forth!

Thing is... on reflection, she's right. I love to feel like someone cares about me, that someone thinks and feels for me. I find myself thinking does she think about me in-between sessions? Have I made an impact on someone? Will they remember me?

So I guess the point of this post is to reflect on the point she brought up about needing to feel cared for. Its something that I am now aware of that could be problematic for me. I rely on the feedback from others that I am deserving of nurture and care, but shouldn't I really be fostering that for myself, and convincing myself that I don't need external ques of love and affection to feel validated? The answer is clear. Yes. but how to go about doing it? I haven't the foggyist!