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!

OBSERVE - Listen like a sponge

This very useful skill was taught to me by a extremely talented key worker when I was on the intensive outpatient program last year. She really got through to me and helped me see how little attention I pay to others when they are talking to me.

This is what she told me to try to help improve my relationships by using mindfulness:

"Listen to others as if you are a sponge, soaking up what the other person is saying. Let your mind be quiet, and just take it in. Don't formulate any response in your mind until a response is requested or required."

At first I was quite annoyed, even offended that she thought I didn't listen to people . I became defensive and shut down and guess what... I didn't listen to word she said after that!

Maybe she had a point.

But what I failed to understand is that mindful listening is not common place in our society. It's also known as absorptive listening and really ties in with the DBT skill of OBSERVE. It does not come naturally to most people and most certainly does not come natural to me.

Recently I have started practicing absorptive listening and have become very aware of my inner dialogue;  a mental voice urging the person talking to "hurry up and finish speaking so I can tell you what I think!!!" As you can imagine this voice can interfere with tranquil, attentive listening. I discovered I rarely just allow myself to 'absorb' what the other person is saying without trying to tie it to my own life somehow or come up with a solution to the problem they are telling me about.

I 'but' in to other people's conversations and jump to a new topic before the last has really ended and to be honest I have come across as plain rude in some cases.... not intentionally... but just due to a lack of awareness, a absence of mindfulness.

I know how great it feels to be on the receiving side of absorptive listening, and am blessed to have some fantastically mindful friends who I feel really 'witness' me when I talk, (or write, as I have some great on-line friends). I would love to nurture that talent within myself so that others may feel that total attention from me.

Thoughts are not always facts!

Living one day at a time 

Enjoying one moment at a time 

Accepting hardships as the pathway to peace 

Taking this difficult world 

As it is 

Not as I would have it. 

And in this way 

Opening to Grace 

And the Joy and Peace that comes with it.

Thoughts are not facts. They may not always be your friends.....

In the midst of a full blown emotional dysregulation attack I find myself so much estranged from my heart, body, and spirit, relying almost exclusively on the thoughts in my head for guidance, companionship, criticism, and comfort.

To hear “your thoughts are not facts” was scary to me. If I couldn't trust my own thoughts, was there anything trustworthy I could count on?

I slowly began to understand more about thoughts during the summer (and a bit) I spent inpatient at a hospital in Dublin, their nature and purpose, how they arose and where they went after I stopped paying attention to them.

Along the way, I learned that thoughts were not necessarily my enemies either.

They were just my thoughts.

And even the “my” was up for debate, because technically they belonged to no one until one floated by in my mind and intrigued me, at which time I reached up, nabbed it, and claimed it with a triumphant  “Mine!”

Thoughts, one kind occupational therapist explained, are like clouds. Only much closer to the ground. 

We snatch them up as if it they are the last pair of jeans on sale in our size. We are afraid it will get away before we decide if we want it or not.

I feel I know so little about myself that I seem claim anything and everything so that I will not be left with a shell where a personal identity should be.I must be choosier, I have the right to question each and every thought – to turn the tables and become the exclusive commodity that my thoughts want to hang around!

I am the one who is in demand. I am the one that keeps my thoughts keep hanging around. I have limited capacity for thoughts, and only want the cream of the crop.

Therefore, each thought must go through an extensive screening process, much like a job interview. “What can you add to my life?” “What have you come to teach me?” “Are you here to uplift me or drag me down?” “Are you telling me the truth?” If I see a thought float by that looks interesting, I can pause it, circle its perimeter, ask it a few questions, then decide whether to pull it down into my awareness for further scrutiny and conversation, or just motion it along.

I realize now that I have the right to question my thoughts – but my thoughts do not have the right to question ME. WE choose them, and not the other way around.

OBSERVING the Christmas Challenge

Blogging for wellness - Advent Calender - Christmas Countdown - December 1st

A dear friend Tracey Weldon came up with this blogging idea, where for every day of advent, I will post about ways to manage and enjoy Christmas without letting an emotional vulnerability cause a crisis or unnecessary suffering.

This way of blogging is a little bit different from my normal manner of expressing myself. But I need to challenge myself into action. I am setting challenges in my recovery and in my hobbies and now, this here is another fun challenge to help ease the stressful anticipation of Christmas.

I have had a few years of having to learn to manage coping with the Christmas run-up, the actual event and the after mass. It's like walking on a tight rope full of obtsicules such as family gatherings, trigger foods, flash backs, over-stimulation, financial worries.....Yet the view from up there while you are balanced on the rope is wonderful. Yes its hard, and really challenging, but the key is to just keep putting one foot in front of the other. Stay focused on the moment your are in right now. It a balancing act of vulnerabilities and happy times.

The dialectic here is that yes Christmas can be hard, but at the same time it can be a really nice time. When you allow yourself to feel and process the distress that Christmas may evoke, you make room for POSITIVE EXPERIENCES and new happy memories to be created. 

The MINDFULNESS skill OBSERVE is really vital here. You can't just by-pass the negative emotions, you need to feel them, and deal with them. Trust me, I have spent so much time running away from my emotions, wishing so hard that they would just go away entirely,  but that is not reality. 

Check in with yourself regularly over the next 24 days, be kind and compassionate to how hard this time of year can be for everyone, not just those with an emotional vulnerability. Just don't forget that the holidays can also be full of beautiful moments, look out for those too. Its all part of creating a LIFE WORTH LIVING.

Progress

I get little fits of 'energy' from time to time. They scare me, yet paradoxically they motivate me into productivity. Its like I realize that; all too soon I could be back in the familiar haze of depression, so in a fury of energy, I have to take full advantage of any brief respite from the emotional hell when it comes. 

Yesterday the two girls I lived with moved out. They were students and had finished their exams, so have now moved home for the summer. For at least the next three months it is just me and the landlady living together in my house. I like it this way. I really do not enjoy living and sharing my space with other people, yet financially I have little other option. Call me anti-social, I don't mind. I agree!Anyway, back to the topic at hand; It gave me a perfect opportunity to give the kitchen well over due clean. As you can imagine; cleaning is not high on any students agenda. The place was festering with months old grit and grim. 

The most outstanding part to this idea was not that I found the motivation to clean, no. It was that I wanted to clean it for me, not anybody else, so that I would have a nice comforting environment to live in. When I realized this, I sort of stopped in my tracks. I can't remember the last time I was this kind to myself, this compassionate. I see it as progress, I really do. I know from previous 'healthy' periods in my life, that when I take pride in my own choices and in my environment that I am doing well. I am living for myself again now, heck, I want to live! That's a big difference from a mere month ago...

With regards to DBT, I can most certainly see a noted improvement of late also. There are so many things I know have contributed to this bout of wellness, all of which I feel have been needed in conjunction with each other rather than in isolation.This includes my very successful treatment stint in the Center For Living, also I am now attending OA regularly and have started eating and sticking to a food plan daily, my sleep has vastly improved due to a more structured routine, and I am volunteering twice weekly and meeting new interesting people and most importantly I am making friends and family a priority again, I am resisting the urge to isolate. I have reduced my vulnerability factors drastically by really concentrating on PLEASE. By doing this I am giving myself an opportunity to have happy, or 'normal' life, or if we go all Marsha on it 'a life worth living'.

That is not to say that all is peachy all of the time. I had a good chance to practice self soothe only hours ago. I was at a public lecture tonight in a private hospital here in Dublin. The same hospital where I spent five very unwell months two years ago, and where I received my  BPD diagnosis. Even though I loved the security this hospital offered me from reality, the 'bubble' effect I like to call it, I also have very negative memories of the treatment I received there.

One incident in particular involved the very Doctor who was giving the lecture tonight. He was not my Consultant, but he was on call for the night in question when I became very dysregulated. I had not yet received a formal diagnosis at this stage and had no idea what was going on with my emotions. I thought I was a horrible person, my self worth was nonexistent and I was seriously contemplating ending my life. Now, obviously being in hospital, this wasn't really a viable option and thankfully I at least had the sense to express my thoughts to the nurse on duty. 

Little to my knowledge at that time, the formal protocol for suicidal initiation during the night is to page the on call Consultant. I got the addiction specialist, who, in my opinion didn't know any more what to do with a Borderline any more than a man does with a bottle of moisturizer. 

In retrospect, all I needed was to talk, to distract, to be thought distress tolerance. Simple as. But instead I got put in the high security ward as I was a potential danger to myself. I cried and shouted and pleaded and begged, until this Doctor was left with no other option than to sedate me, and turn me into a deserving zombie. I fitted right in on that ward then. 

I was so angry at him. I felt let down by him. All I wanted to do was get relief from the hell going on inside my mind. I needed someone to explain what was happening to me. I needed validation that at that time suicide was the only coping method I possessed. 

So to get back to the present moment, I was taken aback when  this Dr strolled up to the podium and began talking. I had no idea he would be speaking. I got flashback of me, the bawling, screaming mess sitting in-front of him as he sent me 'down stairs'. Down to where the real crazies were.

 I wanted to yell at him "DO YOU KNOW WHAT YOU DID TO ME!" "DO YOU EVEN KNOW HOW WRONG YOUR TREATMENT PLAN FOR ME WAS!!!!!" "STUPID IDIOT!"  I sat stewing in my anger for at least 15 mins. I couldn't take in a word of the lecture. 

Then suddenly, my WISE MIND kicked in. "He was only following procedure, he was doing his job. He didn't know the correct way to deal with an emotionally sensitive person. He was making sure I was safe. " 

My anger started to decrease slightly. I then reminded myself that I was not under his care and that I had a wonderfully supportive treatment team who specializes in treating BPD. I used OBSERVE to bring myself back into the present moment and really paid attention to what he was saying, letting all judgement flow through me. I then took out my hand cream from my DBT emergency kit and soothed myself back into calmness by gently massaging the cream into my skin. 

It was only on the bus on the way home that I reflected on my fantastically skillful evening. Who would have thought that the quivering wreck of a girl in that ward nearly 2 years ago would be able to mange her emotions in a such a skillful way! I really wanted to go up to the Consultant after the lecture, to show him how far I have come. I imagined the wonder and pride on his face and hoped he would feel humbled by my progress. Maybe I even wanted an apology from him. But once again my wise mind took the driving wheel and stirred me away from confrontation by asking what I really wanted from him.

I wanted validation and I know well enough now that looking for it from others is not as reliable as giving it to yourself. So one blog post and a very skilled evening later, here I am patting myself on the back, and forgiving myself for the chaos I created that faithful night 2 years ago. I didn't know any other way to manage my emotions. Thank God I do now. 

Upgraded Armour. Reflection on The Center for Living

I abilities feel stronger, robust even. My suit of armour has been fixed and polished. Inside the suit I am vulnerable, full of emotions and open to triggers, but now that all the chinks and dents have been smoothed out, I am prepared for the onslaught of emotion, armed and ready with more skills. I feel humbled and so glad that the Centre for Living proved me wrong. It’s not easy for me to say that. I like to be right, but I was really mistaken about the programmes ability to help me evolve in my understanding of DBT.

The most valuable morsel of information I am leaving with today is that my life is never all-or-nothing. Just because I had a bad morning, say I eat more than I planned, it does not mean that I need to discredit all the other good things I achieved that day.

One particular therapist was really wonderful. It’s not that she thought me anything new; in fact at first I found it hard to participate in her sessions as I thought I had heard it all before! But the longer I sat there, the more everything just ‘fell’ into place. It’s about using the DBT skills together, in tangent with each other, it’s about weaving the mindfulness skills into everything I do, not just sitting quietly observing my thoughts for 10 minutes a day. It’s about noticing the grumbles of anxiety before the fear takes over and I loss control. It’s about catching the little niggles of frustration and quenching it with self soothing skills, so that intense anger stays at bay. It’s not about the food, or the behaviours. I need to be mindful long before I get to that stage. It’s always about the emotions. This therapist clawed me back to WISE MIND and is a perfect example of the therapy really working, of it making sense.

I found such great validation in the other service users I met over the last 2 weeks. We were all at different stages of our recovery journey. Most were at the beginning of treatment, just becoming accustomed to the structure of DBT, and still exploring the diagnosis. Some had accepted it, others were still fighting it. Some simply didn’t understand it and hence couldn’t make an informed decision either way! We were all sitting in that room because of a common link. We all in some shape or form lacked the ability and skills to deal with our emotions. I found comfort in being reminded that I was not alone, that there are other people out there going through this hell. 

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.

Objective Self Compassion

So, after spending time in the south of Ireland with my sister (and the baby bump!) and brother-in-law, where my Mother lives with her new husband and his daughter, I am pleasantly relived. I was really worried about spending so much time with my family, as previous comparable experiences have resulted in vexing squabbles and quarrels. I understand now that my sensitive and highly emotive character can be very vulnerable to the criticisms and teasing which occurs within my family unit. Simply OBSERVING this helped me to muddle through the weekend. It also helped me to take a NON JUDGMENTAL STANCE towards myself, something which, until recently I have found incredibly difficult to do. Self compassion just was not something that I was able to accomplish before. A constant record was stuck on self hate in my mind. I believed that I was not deserving of compassion and was not allowed to give it to myself. One of the greatest lessons I am learning in therapy is the gift of self compassion. I am starting to treat myself as I would like to be treated by others, and also how I treat those around me, as I have a great ability to be compassionate to others, but am terrible when it comes to being kind to myself. 

I had so much time to think between the car journeys and early nights with little to do in the countryside. I astounded myself with a realization of how far I have really come in the last year. It hit me that it has been a year since I last attempted to end my life. Which when compared to the year before, is really an achievement. The reason I say this is because the accomplishment lays not just in the absence of suicidal actions, but the ability to now deal with and manage the same feelings and urges (which are still at the same intensity as before) with new, healthier coping mechanisms. I can truly say that I am proud of myself. 

This last week has been a real eye opener for me. I have had huge swings of intense emotions along with some really dangerous action urges. Instead of carrying though with the urge to end my life, I reached out for help, and most importantly; accepted the help I received. Of course it took a while for me to get my head around the acceptance part of this process, as you can tell from the posts on this blog from earlier in the week!!! 

I have an open mind about the upcoming admission. I really think it will help me figure out some of my current problems. I will hopefully have a good team of people around me to keep me regulated. And I also have this wonderful outlet, my own form of personal form of therapy. My blog is another gift I received this past year. Writing is the best way for me to find objectivity during difficult situations, where due to my intense emotions my judgement is often compromised. 

I am so grateful for all my readers too, as you always offer such sound feedback, and often make suggestions which have helped me to act in more efficient ways with more successful outcomes.

Why do we need emotions anyway?

Before fully engaging in therapy, I honestly thought that if I could just 'turn off' my emotions, then all would be fine. This is seemingly a very common request with BPD sufferers according to my group facilitator. Greenberg and Paivio (1997) capture nicely the generally agreed upon functions of emotions, which are that they;

1. Prompt and organize us for action
1. Give us important information about whats going on in a given situation
2. Are for motivating
3. Are for communicating to others
4. Are fundamentally adaptive

So I now realize that my emotions are like a motion-detection or warning system telling me that something is happening that I should know about. Another important lesson I have resonantly grasped is that my emotions never last forever, even though some may last longer than others and I tend to be more sensitive than my peers to emotional stimuli. It also depends on my current level of skillfulness in handling emotion and other factors such as sleep, health, stress, and support.

As Marsha Linehan explains so wonderfully in her book; 

'Emotions are like tides of the ocean, they ebb and flow, they come and go; they're transitory.'

When I forget this simple piece of advise, I am more inclined to act impulsively when in the throws of an intense emotion. But when I can tell myself calmly in the heat of the moment 'This too will pass' I am so much more able to open up a variety of options and not feel so helpless.

When emotions do what they are supposed to do, they are called PRIMARY EMOTION. They are unlearned and fundamental to human functioning. When you hear a loud noise, you jump, you feel afraid. Its a perfectly normal response. They are helpful. 

The problem lies in what are called SECONDARY EMOTIONS. These are complicated, non adaptive patterns of emotions about emotion. You feel shame for jumping and feeling afraid at the loud noise. 

When I learned about the different levels of emotion, I felt relived. It all started to make sense. I had never understood why I felt such random emotions in reaction to a situation. My secondary emotions were very often generated and intensified by judgments I had about how I was supposed to feel rather than how I actually felt.

My 'Judgement' Counter

The best thing I did to help me OBSERVE the judgments which lead to SECONDARY EMOTION was to get a counter. I found one in my local knitting shop, and its actually a stitch/row counter. A tally counter can also be used. I carry it in my pocket and click it every time I realize I am having a judgement. I observed how critical I can be of myself when i catch my reflection and I noticed how cruel I am with my self talk.

Try it out for yourself. I bet you will be surprised at the results of you judgement monitoring.

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!

Angry Andy!

My Hometown

I am seriously angry at my individual therapist. The week before Christmas, which incorporates a week therapy break, she rang to cancel our hourly session, stating that she had childcare issues. Instead, she offered a quick 'chat' at 9am that day. I felt so unimportant and let down. Christmas week is so triggering for me.  I was left feeling like she just simply did not care less about me and how alone she made me feel. How was I supposed to get through 3 weeks without proper therapy?


My reaction to her has been to passively give DBT the finger! I haven't filled in any food diaries, or daily emotion cards or even looked at my notes. I know I am going to get stick when I go back but honestly, I just feel so fed up and tired from having to be so diligent to it!

On a more positive note I am noticing that I am doing some skills much more automatically now. On Christmas Eve. I just knew that I needed to get away from the craziness of my family, so I went for a beautiful run and then sat and looked at the waves crashing on the beach. I simply OBSERVED how beautiful the town I grew up in was.

BEING MINDFULLY WILLFUL

 Today I spent the day with myself. I was alone, but not lonely. I made a choice to live and partake in life.

I grabbed my camera and gear in a hurry when I noticed a niggle of a destructive urge raising to the surface, and went to soak up the atmosphere in the city. I tried to notice things that I would not ordinarily notice if I were not being mindful.

I observed the light fading within the space of the 50mins I was shooting. I realized that there were so many tourists enjoying the Christmas lights. I chuckled at the wonderment of a group of Americans and the emotion of a gaggle of Spanish girls arguing. I really listened to the soundscape of Grafton Street in December. 

I  often stopped and was awed by the decorations, of the music, the smells and the people. I observed my own emotions as people got in my way or bumped into me, then I 'realized' I was realizing and had a giggle at myself.

I was NON-JUDGMENTAL. I allowed myself to shoot what ever took my fancy rather than wait for a perfect opportunity. I tried not to care what the picture turned out to be.

 Here are the results of my MINDFUL efforts. I hope you enjoy them as much as I enjoyed taking them. xxx