WISEMIND Reflections

                                                                   

Here I am, sat so leisurely, so relaxed, drifting in and along to the smooth background music in a funky hipster vibe café in the south of Ireland. As I nibble at a sweet homemade rhubarb bun, washed down with a silky milky coffee, settled into pretty stratums of caffeine rich liquids of different density, I realise I am happy for the first time in weeks. I am doing everything my heart desires today. I took the 2 hour train ride down here to escape the stress of Dublin, of work, of life, hug my Mother and feel her nurturing impression. A brief respite.

In this veil of contentedness requires me to listen to the WISEMIND voice in my mind that tells me that this internship is just too much for me right now. I am only weeks out of my DBT group; I am still a DBT novice, an apprentice of life. Yet despite all that I am stuffing down my true emotions and all I know is right for me by working 40 hours a week in an internship I am not able for, I can’t manage life and work that much without running myself into the ground. I have no time for writing, my very own creative Prozac. Without my nurturing my creative side, I may as not be taking my medication because, Writing, drawing, taking photos have been an integral part of my recovery.

I have a lot of thinking to do this weekend, but for now I am going back to riding the wave of this emotion of contentedness as I know this too shall pass and the next one might not be so pleasant.

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. 

Distraction. ACCEPTS, Distress Tolerance

Everyone loves progression right? Well I know I do in any case. Today in group we finally moved onto the next module: DISTRESS TOERANCE. Again, this is a nice inoffensive, non triggering topic. This time round anyway. Last time I found it hard to accept that these skills won’t solve all my problems straight away, as in right now! But rather they are designed to help you to bear pain skilfully without making the situation any worse. (Marsha Linehan 1993)

This set of skills is for when in the throes of an emotional crisis. When the problem can’t be solved, or if it can, maybe it is simply not the right time to solve it in that moment. It may not be the right environment to try to solve the problem either; for example, I am not skilled enough yet to stay emotionally regulated around my family during disagreements, so for now, using the DISTRESS TOLERANCE skills is the best solution for me. When I am in a food crisis, where I am trying really hard not to binge or purge, then being at home or around food is most defiantly the worst environment to be in, so some skills might not be as effective. And parallel to that, sometimes I can’t get away from situations involving food; this is when I find DISTRESS TOLERANCE skills really help. I like to think that my cue to use the distress tolerance is when I reach my complex skill breakdown point. It is also a way for me to find wise mind and calm the moment so I can try a solution focused skill like OPPOSITE ACTION, because it’s really important to not spend all my time self soothing or distracting! I would never get anything done!

What I picked up from today’s group is that PREPERATION is the key for these skills to REALLY work, and to allow myself to gain maximum benefit from them. We are always being told to practise the skills in less emotionally intensive situations so as we are familiar with them when we really need them when deregulated. So that is the aim of this post. To put together a list of distraction ideas based on the skill WISE MIND ACCEPTS.

DISTRACTION for CRISES SURVIAL is not the same as ‘zoning off’ when a problem CAN be solved, like staying in bed watching Disney films and avoiding the real world for days on end. That will just make it worse! WISE MIND ACCEPTS is for when you have to tolerate the situation in a way that is not harmful to yourself or others.

WISE MIND ACCEPTS stands for:

A – Activities

C – Contributing

C – Comparisons

E – Emotions

P – Push Away

S – Sensations

These are some of my own ideas; things which I know will help me during a crisis. Again, it is a work in progress and as always I would love to hear all your suggestions.

Activities Throw self into the moment.

·         Reading books – Silly novels, short stories about unimportant topics, Sci-Fi, Harry Potter. NO non-fiction. Magazines, trashy or glossy! Read recovery Blogs, Karyn Hall, Audio Books

·         Exercise - Get active, something intensive which demands focus and attention. Zumba class, Yoga.

·         Hobbies – Music, learn a new song on the guitar. Art and crafts. Writing, blogging. 

·         Mental activities – Memrise.com. Word games, scrabble on phone, Memorize a poem or prayer. Write a poem or short story.

·         Cleaning – Bedroom, Kitchen, Bathroom, Make-up, Wardrobe, Cooking, Washing

·         Events – Go see a movie, a play, a show, a lecture. The Silent Room, Meditation class. Google entertainment.ie, Hospital lectures.

·         Friends – Meet up, text, call, chat, email….. But DO NOT talk about crisis.
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Contributing - Focus on something/someone other than yourself.

·         Volunteer time, Hospital, Church,

·         Do something nice for another person. Bake, cook, send letter/card

·         Surprise someone, pay for coffee, buy something

·         Send nice text, Email, facebook

·          Smile at shop assistant, people on the street.

·         Give money to charity, buy food for homeless person

·         Visit Nana, Granny, Someone who is sick

·         Say prayers for the well – being of others

Comparison – Remember, it could always be worse

·         Compare myself to myself this time last year, a few months ago, even a few weeks ago!

·         Compare myself to others in my situations who are coping worse than me.

·         Compare myself to the rest of my family who have the same condition who are not accepting and coping with the disorder.

·         Be thankful for what I have

Emotions – Create opposite emotions to the one you are experiencing.

·         Music – create ‘happy’ playlist, ‘upbeat’ playlist, ‘relaxing’ playlist

·         Movies – Disney, Comedies, Period Dramas, Scary films

·         Comedy show

·         Read romantic books, thrillers

·         Read inspirational stories or poems

Push Away – Allow yourself a break from the emotion/thought

·         Mentally leave the situation, go to another ‘room’ in your mind

·         Give it to God box

·         Do a guided visualisation on Youtube

Thoughts – Focus mind on thoughts, Take a mental ‘Time-Out’

·         Count to ten

·         Count your breath

·         Visualise STOP! Sign

·         Look around, observe the things around you, and name them.

·         Say the same thing over and over in your mind. Breathe in WISE breathe out MIND. Over and over

Sensations – Interrupt physiological action urges with something intense which will not harm

·         Have a very hot or cold shower. Alternate between the two

·         Hold ice, eat frozen fruit

·         Go swimming, use the steam room

·         Suck on a lemon/lime

·         Snap a rubber band on your wrist

I cannot stress the importance of being prepared ahead of a crisis, and also it’s so important to find what works for you. It took me a really long time to figure out that these things work for me.

Distress Tolerance SELF SOOTHE Ideas

Distress.  It is impossible to avoid, no matter how charmed your life may be.  Emotional pain and distress are an inevitable part of life. Yeah, I was annoyed when I heard that first too. But even the Duchess of Cambridge has crap to deal with!  The inability to learn how to effectively cope with intense emotion and distress only leads to increased suffering. I found that using my senses to soothe my distress really helped me to tolerate the emotions which were troubling me, without having to use other people as that crutch to stabilize me.

The goal with self-soothing skills is to comfort yourself emotionally by doing things that are sensually pleasant and, most especially, not harmful. At the same time, focusing your full attention on sensory inputs — on what you are physically experiencing in the moment (mindfulness) usually will get people outside of their own heads (and away from troubling thoughts, feelings, and impulses).

Learning to relax and self-soothe is crucial to healthy emotional functioning.  When you are relaxed, your body is not in a constant state of “emergency,” preparing to fight or run away at any given moment.  Most importantly, your brain is much more capable of coming up with healthy ways of coping with distress when physically relaxed.

I find that having a self-soothe ‘box’ is my saving grace, having it ready and stocked with all the things that I know work for me. What works for me also changes depending on the emotion, for example when I am upset, hugging a teddy is a fantastic, yet when I am angry, having a long hot shower nearly always helps me calm down.

Recently I was brainstorming some new ideas for my box, I asked some wonderful friends in a DBT support group on facebook, and found that it was the best thing I could ever have done! Between us we came up with a list which can be used as a reference when trying to think of something to RELAX AND SELF SOOTHE when undergoing extreme distress.

The skills and techniques listed below are a starting point only. Everyone has to find what works for them, and it may even be things that are not on this list at all, but if you are stuck, try some and see if they work. A good way to orientate yourself to self soothe is to really and mindfully focus on your senses while using these. Not all these things fit into my 'box' but that's why I am writing this post, so I can look at it when I am in distress.

RELAX and SELF SOOTHE ideas! (Please feel free to add ideas in the comments, this list is a work in progress!)

• Try something little to begin with, such as using a nice moisturizer on your hands and face after you wash them, also face and hair masks are bliss. I've been trying to do this for the past few weeks and not only does it help me to feel as if I am WORTH looking after, it has also dramatically improved my skin tone etc... (Life worth living!)

• Curl up with a blanket wrapped around you and a teddy bear. This is great for when I'm feeling little and afraid or upset and tearful. I like lavender filled wheat bags, heated in the microwave and placed on my neck.... I do this regularly when I write! 

• Watch a favorite movie (that way you can zone out and don't have to concentrate) Something mindless or funny is even better! My personal choices are; Pride and Prejudice, Shrek, Beauty and the Best, Emma, Actually..... any of the period dramas! I love the dresses!

• When was the last time you took a moment to gaze at the ocean and just watch and listen to the waves hit the shore?  It can be a wonderfully mesmerizing and stress relieving experience.  How about watching an exquisite sunset, or the leaves on a tree blowing in the wind?  These experiences are natural stress relievers and can provide wonderful moments of tranquility.

• Do you have a favorite piece of clothing to wear, something you instantly feel safe and comforted when you put it on? I have a pair of old baggy battered velvet purple pajama bottoms. They are so old and raggity, but I can't get rid of them! And I like to wash them in a nice smelling washing powder that my Mom used to use.

• Candles are relaxing and scented candles are truly a plus.  Most people enjoy the soothing benefits of soft candle light combined with the pleasing scents that aromatherapy candles can provide. I personally love Yankee candles as they are strong and are inexpensive. I have a fireplace in my room which cannot be lit anymore, but I fill it with candles and have a little meditation session when I am stressed, always works a treat!

• The best way to self sooth myself, I find during extremely intense emotional experiences is to retreat to my bedroom, and put on a tried and trusted self compassion relaxation. It was introduced to me by the wonderful Amanda Smith from Hope for DBT.  Here is the link for the 15 min meditation; 

 Self compassion meditation for intense emotions

• I find that art and crafts has a very soothing effect on me, and while I was inpatient I learned about mandalas, which are a form of meditative art, although they have a spiritual aspect to them, I find simply coloring in the patterns so relaxing and creative. Here is a link to a site where you can download and print out some to have ready for when you need them.

Website for Mandalas

• Photography forces me into the present, I have to be mindful to my surroundings and almost get a sense of external perspective through the camera lens. So if I feel the urge to binge.... I grab my ready packed camera pack and head outside and snap away! Even looking at happy memories through old pictures helps me too, like of the time I went traveling, or my 21st party.

• As I suffer from an eating disorder, using my sense of taste can be hard, but I have bought some lollipops to suck when I am angry as for some reason they help! I also find going out for a hot milky drink soothing, I have hot chocolate since I gave up caffeine last month, especially from Starbucks!

• Music is my lifeline, always has been ever since I realized that I can use my voice to express my emotions when words fail me. I love to sing and play guitar. Classical music are art to me, so I have few pieces which always help me calm down, especially during exam stress or when I was grieving a loss. I have made a playlist on youtube, which I am not going to post on here because everyone has different tastes, but I will post a song, which I feel describes how important it is to validate your emotion.

Heathers - Forget Me Knots

• Finally, a good old fashioned hot bath or long hot shower will always bring me back to the present, relax my body and calm my mind

For a very good alternative explanation of SELF SOOTH go to dbtselfhelp.com , This site is my online bible!

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.

Panicked and afraid

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

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

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

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

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

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

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

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