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.

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. 

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.

WILLINGNESS to get over this bump and OPPOSITE ACTION TO ENVY

Although I would like to think I am calm, rational and a judicious person when it comes to taking an objective standpoint about transgressions in my own life, simply put, these skills is severely lacking from my toolbox. I find it very hard to push aside the judgements which paralyse me and turn my thoughts into narrow, dichotomous lines which only have two end points.

As I mentioned in the last few posts, my emotions have been amplified to way out of manageable levels this past week.  All this lead to me equating many of these emotions as facts; hence I felt had to act on the emotion. The feelings almost felt like they have a mind of their own, and that I was a vessel for them to carry out their action urges. At the time I felt I had no control, but I am not trying to evade responsibility for how I treated my therapist, as I know I could have been more skilful. I could have used OPPOSITE action to my anger, or even HALF SMILE. In reflection, I see that it could have been a perfect week to also practise DISSTRESS TOLERANCE and RADICAL ACCEPTANCE.

Yesterday morning I received a letter stating that a course I had been waiting to get onto for many months had been cancelled due to lack of funding. When I first saw the letter I was super excited, as I thought it was a start date. I had been advised to hold off going to university by my team for another year until I finished DBT and instead attend this collage as it operates under recovery ethics. It seemed a perfect transitory step for me. I decided to do something creative and less academic, so picked a photography course. I really was looking forward to it. 

Now I am so disappointed that my heart literally hurts. I am so afraid; I feel I have nothing really left to look forward to now.

I went to check in with the community nurse a few hours after getting this terrible news. And I am really so very grateful and abashed to admit that he was not the invalidating type I was expecting. In truth, he sat with me for about 45 mins and listened intently to what I had to say. We came up with a plan in order to help problem solve the solution, and jointly agreed that the best outcome would be for me to attend a crisis resolution based therapy group for 8 – 10 days. It came with a warning that I would have to be willing to work at finding solutions to my problems and not to abandon self responsibility. It seems fair, if like a lot of hard work, but I am up for the challenge. I really am so appreciative for how great that nurse was. I really needed his objectivity in that moment. 

I felt calmer and more in control after the meeting, and was much more willing to stay with my family for the night, I tried not to see it as a suicide watch, but as an opportunity to spend quality time with them. I went to see my sister and her husband who are expecting a baby and are in full blown 'nesting' mode. They are buying my family home off my mother, and have done a beautiful job of renovating it and putting their own stamp on the house. I noticed that I had been avoiding seeing the house as I felt great envy towards my elder sister, who has such a perfect life and gets to have everything I want and more, and on top of that gets to have the house I grew up in, the only place I called home. I am afraid I might never fall pregnant again, so am also reluctant to talk to her about the baby and envious of her ability to carry a child. I (quite skilfully in my opinion) figured out that I was experiencing ENVY which really did not fit the facts of the situation

I put on my DBT SKILLS hat and tried to use OPPOSITE ACTION. I knew that the prompting event to the ENVY was that I was being reminded about all the things I really want but can't have. A stable home, a family, nice things.....

My HOT thoughts where:

• 'I will never have what my sister has'
• 'I am such a failure'
• My sister is more successful than I will ever be'
• 'I am inferior to my sister'
• 'My parents think she is the better sibling'
• 'life has treated my so unfairly

The biological changes and bodily experiences I felt with the envy was a slight pain in the pit of my stomach and I was extremely anxious and noticed I was feeling resentment towards my sister and her husband   I began to ruminate about how unfair I felt the situation was and how much of a failure I felt I was. My attention was very narrow and I could barely even talk to them. I OBSERVED how much I had avoided seeing my sister and the house, which had undergone so much renovation that I nearly didn't recognize it! I hadn't even offered to help with painting or decorating because I had been festering in my envy.

Although it is ok to feel envy when others have what you want, the problem here lies with the intensity of which I felt the emotion. I had checked the facts and become conscious that I had not been there to help my sister due to an out of control emotion.

I mindfully asked myself what my assumptions, belies and thoughts were about my sister buying the house and having a baby. I then tried to challenge the hot thoughts which popped up. Here is how I tried to turn the judgments into facts;

• ‘My sister is 7 years older than me, is married and in a good position to raise a child’
•   My sister and her husband have worked very hard to get everything they have and deserve it all
•    I also have many very wonderfully things. I live in a fantastic location and have so many beautiful things. Someday, with hard work, I will also have a house to live in, but for now, recover and health are my greatest assets.
• It is a very good solution to the present economic recession as my sister would not have been able to buy a house like this without help from the family
•   My sister’s children will get to grow up in the same wonderful house and we did
• I am not a failure because I am not the same as my sister, I have other attributes which make me a successful and competent person

My goal is to have a positive and functioning relationship with my sister and brother-in-law, I love them and love the bump too! So my anger and resentment to them was making me avoid them and not nurture and develop a healthy bond with them. That is the main reason that the envy needed to be challenged.

In the moment I made sure to count all my blessings and avoided exaggerating my deprivations, Marsha states that to go ALL THE WAY I must imagine that it makes sense for my sister to have all this, as she has worked hard and deserved it all.

Finally I changed my emotions by changing by behaviors and posture. I unclenched my hands and relaxed my stomach and used HALF SMILE.

I now feel my envy is more in proportion to the situation. I’m not going to lie, it’s still there, but now I feel motivated to work as hard as my sister so I can have what she has. That means I can’t just throw my hands up in the air and moan about how unfair life is, I have to get off my ass and go get it for myself!

I’m really sorry this is so long and thank you so much for taking the time to read this. 

 

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

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

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

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

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

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

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

PROCESS OF OPPOSITE ACTION

Figure out your emotion

Figure out what action goes with that emotion.

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

Figure out what the opposite action is.

Do the opposite action all the way.

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

Wish me luck!

.

Prozac Mind

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

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

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

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

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