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!

Increasing Positive Experiences

Things are most certainly looking up. Whether it's due to some shift in the universe where by it's finally my turn for which nice things are to happen to me, or whether it's down to the increased motivation this recent elevation in mood has brought and therefore a self stimulation of sort of pleasant experiences. Either way, its quite lovely having the positive emotions to balance out not so lovely ones on the 'feelings' scales. I guess the more aware you are of the nice things in your life then the more positivity you attract. Also, on the other hand, I have too experienced the flip side of this with avoidance and negativity. As much as a depression can be a downward spiral into despair and hopelessness, I feel being aware of more positive feelings and emotions breeds more happiness in my life and thoughts.

I got a really big phone bill last month, and needed to try find a way to pay it off. So I signed up to a child-minding/nanny agency in the hopes of finding a small job. Although I still haven't found a job which will pay off the bill...... I WAS offered a six week Au Pair position in the south of Spain for this coming summer!

I am so excited and happy with the job. The family seem to be really nice and, as far as one can tell from a wee, short skype call, I think I can safely say I will settle into the family unit well. I lived in Spain as a child, and can speak Spanish quite well, although it is a bit rusty! I am familiar with the culture and the way of life too from living there. So I really feel I will get on well .

Next thing is a bit abstract, I'm pretty sure it may just be a 'borderline' thing. For the last three and a bit years, ever since I was first admitted to inpatient actually and experienced that intense fuzzy feeling of 'being cared for', and having my family be worried about me, telling me they love me, dropping everything in a heartbeat to be by my side... the feeling of people caring if I lived or died, has consumed me. I kept trying to chase that feeling again, but, like a class 'A' drug, it has been harder and harder to find the same initial hit . Like a classic addict, I would do anything to get the attention I wanted, saying I was sicker than I was, that I was doing worse than I may have been. I didn't comply to treatment plans, I lied to my team..... Then I actually DID get sicker, but by then I had exhausted my family's ability to care for me. 

I guess what I am getting at is that although the urge to want to be cared for is still there, I feel like I don't need to chase the feeling with so much fervour at the moment. It's incredibly liberating to be freed from the shackles of relying on others for the validation that... I matter... that I am worth something. I sort of feel that I am just fine on my own right now and it's really nice. Every so often I catch myself thinking up ways to end my life, but rather than spending hours planning it to the minute detail, like I have done many times before, I can come up with a list of reasons not to go through with it. I push the thoughts aside and simply get on with life. I see the destructive thoughts like a side effect of my emotional sensitivity, a residue that might always be there, but doesn't have to be the main focus.

Self-validation is wonderful. It's allowed me to feel like I am worth it. like the ad says! I went and got my hair done today, not because I needed to, but just because I wanted to. I bought a lovely pair of shoes, and I spent a few hours at a coffee shop, relaxing and being kind to myself. I am eating better and not mindlessly binging (as much), I have had a few incidents where I have over eaten, but I made a conscience decision to and didn't have any urge to get rid of it after.

This all comes under the EMOTION REGULATION skill of BUILDING POSITIVE EMOTIONS. I should actually pull out the list of 176 pleasurable activities and have a gander at it.

Hope you are keeping well dear friends.

Stay mindful. xxx

Lying as a way of avoiding distress.

Masking the truth

This is a topic I find quite painful to discuss. It brings up a lot of shame, leaving me feeling as if I tumbled naked out of a warm bed into a cold room and there was no time to cover up before a crowd arrives to view my embarrassment. Yet, I feel it's important to talk about this. After doing a good deal of reading on shame recently, I see how confronting it head on seems to be the only way to dissipate it fully. 

I must have been about four years old, when my nursery school teacher turned to my mother with a furrowed brow, a concerned tone and said something along the lines of ... "Some children lie, maybe to get out of trouble or to play 'make believe'.... that's harmless and can be corrected as the child grows older, learning it's not nice to be dishonest. But your little one's fibs are troubling. She truly believes her made up fantasies are real. I don't think she sees the difference between reality and fantasy."

When I was in second class in primary school (8 years old) I told my teacher and friends at the time that my Mum was expecting another baby with my Dad. My parents had been separated since I was four, it was a messy break-up, with lots of anger, manipulation and public arguments.  So you can imagine my Mother''s surprise when she came to pick me up and the other Mum's were congratulating her on her pregnancy and recent rekindling of her marriage. Looking back now, I think I did it to try and solve the problem. If I told enough people I had a happy family, then maybe it would come true. I remember fully believing what I was saying was real. This particular lie had a horrible outcome, it was of course found out and I was humiliated by having to publicly apologise and recant the lie to all my classmates. It not only filled my heart with shame, but compounded the reality of my distress of living within a fragmented family.

Another example is a bit more recent. I don't tend to tell people I had to leave my university course because of illness, I mince the truth, I brush it off, say I did finish and quickly change the topic. There are sooo many other examples, but I don't feel able to disclose them just yet. but I can allow you a glimpse at some conclusions I have come to about my lies.

I lied to avoid the distress and the chaos in my life. However, the truth can and does emerge at times which leads to more chaos in an attempt to avoid the past and the destruction that always follows. I can understand why so many family members and friends started to distance themselves from the me. This then started the cycle of avoidance and low esteem. The feeling of abandonment and the lies. No one likes to admit to making mistakes or "wrong calls".

It was about control with me. When my life was so out of control, I could have a little through lying. Sometimes it was to avoid conflict. I couldn't stand anyone being mad at me. I often find myself lying simply because I can't stand one more moment of my real life. Sometimes the lies are of how I wished things were or happened instead of what the real situation is.

When I am really distressed I can't tell the difference between lying and telling the truth because I say what I think people want to hear. I don't tell whoppers as I am too terrified of being rejected if I am found out - but I fudge, exaggerate, deny things and change my facts all the time. I only just discovered this as I have been lying to myself for so long too about this! It's really hard to realize and admit that lying comes so naturally to me that I don't even notice I'm doing it. I would characterise it against the DSM criterion 'frantic attempts to avoid real or imagined abandonment' - I would say my pathological lying is part of my ongoing attempt through frantic 'relationship management' to make others happy and therefore unlikely to reject me.

People with BPD often experience deep and entrenched shame; lying may be one way to conceal mistakes or weaknesses that increase shameful feelings. People with BPD are often also very sensitive to rejection, so one function of lying could be to “cover up” mistakes, so that others will not reject them.

I think I lie lie as a means of protecting myself from rejection or a survival technique, and it did seem that a good deal of my lying was some kind of defence mechanism to avoid any intense feelings of failure and self-loathing.

Given that a BPD hallmark is interpersonal relationships that alternate between idealization and devaluation, the person with BPD may distort facts aimed at the person with whom they desire a personal relationship. … In the moment, their desired objective, whatever that may be, takes such precedence over speaking the truth or behaving honestly that the potential consequences of their conduct are reduced to shadowy details.”

Sometimes we may judge ourselves harshly and expect others to do the same. Lying serves to deflect shame when something might make us look bad, thereby maintaining whatever self-esteem we have on a temporary basis. … We believe that anything ‘bad’ would make others reject them. … Lies may mask real feelings and put up an impressive façade. Lies may help make sense of why things happen to us in our mixed-up identity.

In other words, some of us with BPD lie to avoid abandonment or to avoid self-hatred.

What are your experiences with lying and the presumption of lying?

Apparent Competence Vs Unrelenting Crisis

 So much has been going on over the last few weeks. I have been earnestly applying for internship posts, which finally paid off as I got the precious news that I have been accepted to a great service here in Dublin. 

I am still riding the wave of progress and have realized that if I allow myself to just go with the crashing, foaming tides of negative emotions that sooner or later the tempestuous waters become calm and bearable again.

Anxiety is my constant companion once again, making simple everyday tasks extremely difficult. I was startled by the stunning resident robin in my garden yesterday. He sings a morning tune to me most days yet as he fluttered up to graze on the crumbs I left for him on the window sill, I saw a black ghostly shadow then screamed aloud and scared my poor feathered friend away. Then on the bus into town this morning I felt the all too familiar experience of an oncoming panic attack. I froze. I couldn’t move from the spot I was invisibly glued to, which would have been fine if it were towards the back of the bus, out of the way, but no, I froze right in the entrance passage way staring ahead like I was witnessing a murder! Grumbles and rants from tarde commuters finally brought me to my senses and I ran off the bus and into the quite street around the corner. I burst out crying, snots and all, at the realization that my emotions are starting to control me again rather than me controlling them.

But being the borderline that I am…. my apparent competence shines through whist the unrelenting crisis’s fester away under the surface threatening to assault my passive attempt at creating a life worth living. 

You see, when I find myself amidst of fog of fear, it tends to stay with me for much longer than would be expected in those without an emotional vulnerability, making the next onslaught even more unbearable. Slow return to emotional baseline is the problematic cornerstone for me. Typically, a crisis will occur before I get a chance to return to my emotional baseline, which results in me staying very highly aroused emotionally on a continuous basis.

My therapist and I developed a plan to tackle the anxiety ambushes. I am to do a CBT thought record each time I notice a negative automatic thought. I must fight back with evidence which does not support the thought yet still validate where the fear might be coming from too. Then I create a balanced thought taking all evidence into account. This is proving to be a fantastic way to battle the thoughts.

Next I must reduce my tension through visualization and become more mindful of my body and cultivating compassion for myself. This is done with formal mindfulness meditation. I am loving John Kabit Zinn at the moment. His voice is so soothing and comforting.

Finally if I am to live the life I want to live, I must tackle the behavioral outcome of my anxiety. This involves the graded exposure I so dearly HATE. I mean I just don’t get how exposing a borderline to heightened emotions is a good thing! My heart is even racing now as I type this! I guess going for the interviews did help me get over my fear of interrogation, but I felt HORRIBLE the whole time I was doing it. Truthfully, I am pretty sure I will always feel some degree of dread when it comes to interviews, but least now I know I won’t actually DIE from them like I thought I would before. I will though, still be going as far out of my way as possible to avoid another one in the near future.

I have come to the conclusion and have RADICALLY ACCEPTED that I am always going to feel emotions to the extreme. I will always have to manage and control my urges and behaviors, but like anything; practice makes perfect.

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. 

Pros & Cons of Tolerating Distress

I will keep this short. I have been putting off doing this for so long. It's fairly self explanatory in it's title, but the problems lies in ACTUALLY doing it. I have been avoiding doing this for my target behaviors for months now, so here it goes! I am only able to do one for the moment, but I have five behaviors I need to do this for!

Target behavior #1 - Binging. 

Resisting binge.

• PROS:

1. Feeling of accomplishment over skill use.
2. Saves money.
3. Healthier body and mind.
4. I eat to give myself MORE energy. When I become too full, I LOSE that energized feeling.
5. I might be able to change my state of mind and continue my life normally without putting on excess weight
6. I will learn to experience the distress and deal with it in time.
7. Feeling of self control.

• CONS:

1. I will feel the emotion I want to avoid. I wouldn't feel the 'food high'
2. I will be irritable.
3. I will feel deprived.

Giving into urge to binge.

• PROS

1. Instant relaxation.
2. Comforted.
3. Get medical attention
4. Escape emotional suffering momentary.

• CONS

1. Will trigger an urge to purge.
2. Waste of food/money.
3. Weight gain.
4. Self hatred
5. Only hurts me, pain, digestive issues.
6. Does not solve problem

Target behavior #2 - Purging


Resisting purge.

• PROS

1. Will keep the nourishment from the food.
2. Will learn to deal and manage 'full' feeling.
3. Will give myself a chance to use DBT skills.

• CONS

1. I will feel very high anxiety.
2. I will feel dirty, lazy, ugly, fat.
3. I will have to sit with the distress, and feel all the food in my stomach.

Giving into urge to purge.

• PROS

1. Get 'rid' of food and not gain weight.
2. It is a quick and easy way to get the food out.
3. I feel in control.
4. I know my stomach is empty.
5. Its a way to punish myself for negative thoughts/behavior.

• CONS

1. Will damage teeth.
2. Does not get rid of all of the calories.
3. Makes me feel week from dehydration.
4. Dizziness and headaches.
5. Heart palpitations.
6. Gives me spots, dry skin and causes my hair to fall out.
7. Sleep issues.
8. After a few days - swelling in legs
9. Constipation.
10. Reduced appetite which will lead to further foody behavior 

Impermanence - Finding the Dialectic of Emotion

Nothing is permanent. The goodness in life passes in the same way the bad periods slithers by or sticks to our awareness. Positive emotions and experiences leaves a good taste long lingering in my mouth, but it can be rudely interrupted and all too quickly be contaminated by the next onslaught of pessimism. 

I swing widely between the poles of ‘good’ and ‘bad’ judgement, rarely receiving the respite which a balanced, middle ground provides. Take for example the last 24 hours. This time yesterday I was curled up in bed, steeped in self pity. I felt so ashamed and selfish wasting a whole day doing nothing to help make me feel better. I knew I needed to do the housework, go food shopping, have a shower, go for a walk, meet some friends, go to mass, send emails ….. the list went on and on. I was feeding my negative emotion and allowing it to gain nourishment from each moment spent lying in that bed. I was down in the depths of my emotional rating, and I honestly thought that I was the biggest failure on the planet that I should just give up on life and that nobody would care if I was gone. 

Then I wake up today, still feeling the hangover of negativity surround my aura. I dragged myself to an interview for some potential writing experience with a local newsletter. It took every morsel of energy to find the motivation. It was raining, ‘typical’ I thought. I missed the Bus; I was convinced it was a sign. I didn’t have the full address; I should just give up, it’s not going to work out anyway. It really was a miracle I got there in the end. I hadn’t even researched the organisation, certain that it would be a waste of time as I would never get the job. 

If I look back and evaluate the emotion I was experiencing, I was really nervous. Fear wanted me to run home and hide away, to avoid, sabotaging any chance at a life worth living. But being the suborn mule that I can be sometimes, and because I had told some people about the interview, I felt I must go, even if to say I went. 

I actually found the place with relative ease, and was greeted by two lovely ladies who seemed interested in me and appreciative of what I could potentially bring to the organisation. We brainstormed ideas and I felt excitement build up in my tummy. The more I talked to the two lovely ladies there, the more confident I felt in my abilities. I could really do this. They really do like my ideas. To my delight, they asked me to contribute to the June issue and gave me a deadline for submission next week. 

Walking towards the bus stop I felt elated with happiness. I felt like I had overcome the fear which stops me from doing so much in my life, like I had climbed a personal mountain. I was propelled into a heightened state of positive emotion, a world away from the foul mood I had been in only hours before. I grinned childless to the bus driver and sent a barrage of texts and emails to friends and family bombarding them with my good news. 

Now that the initial exhilaration of this morning’s achievement had subsided slightly, and I am not so ruled by my emotional instability, I can see how exhausting this yo-yoing of emotion is to my emotional stamina. If I try hard to be dialectical in my thinking about today’s events, taking into account the importance of living in the moment, I guess the middle ground might be as follows; 

I spent the day resting in bed yesterday, even though I had a lot to do. By doing this I was reminded that staying in bed all day negatively affects my mood. I do need to lie in sometimes, but next time I might only rest for the morning, and get some tasks done in the afternoon. I allowed my bad mood to continue into today. Each day is a new page in my life. I can start afresh if I do not hold onto the past. It was a great achievement to obtain the job this morning. Congratulate yourself. Now move on to concentrating on the rest of today’s tasks. 

I aim for this balanced way of thinking in all my endeavours. When I read it back I don’t feel any overwhelming emotion either positive or negative. I just want to move onto this afternoon. I have a focus group to attend which has nothing to do with the newsletter. 

Have you ever had a similar experience? How do you stay centred?

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. 

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. 

Personal Responsibility and Action Plans

For a week filled with extreme emotions and tear stained streaks down my cheeks, I am feeling lighter. Clichéd as it may sound, I feel like a weight has been lifted off my mind, well actually, it’s been yanked off my mind by harsh but powerful words and my own realization that I am the only person who can ‘fix’ me.

If I was to summarize my experience of this last week of intense treatment, it would be in two simple words ‘PERSONAL RESPONSIBILITY’. I have been jolted back into reality being on this programme. No-one is going to do the work for me, no matter how much I want it; it simply is not going to happen. No prince is going to ride in on a shining white horse and save me from the BPD monster, but I can get on my own horse, learn how to ride it and trot away into the sunset myself.  Personal responsibility in my recovery involves taking action and doing what needs to be done to get well and stay well. It involves problem solving, making goals and sticking to them. It involves making promises to myself, not my family, not my team and not my friends. It involves taking ownership of my life and my future. I must remember that am an expert on myself and gain back control of my life.

I have been given a wonderful sense of empowerment, while still validating my emotions. I am so afraid of what my life will bring now that my future is so uncertain. I feel it in the pit of my stomach; I have noticed the inability to catch my breath and the hot sweats I break out in when thinking about what I will do. Yet although these emotions wash over me, and I feel them, they are not going to change or improve my situation.

I have been really trying to use the core skill OPPOSITE ACTION in response to the anxiety. My action urge is to avoid, not thinking about options, not to get advice and not to apply for opportunities. That way I can’t be disappointed again, I can’t be rejected. Yet I am also not helping the problem, I am not giving myself a chance at a LIFE WORTH LIVING, and am pilling more misery on top of misery. More fear on top of more fear.

To go ALL THE WAY with this skill, I have to stop procrastinating and ‘just do it’ as the Nike ad tells us. One of therapists always tells me that ACTIVATION PRECEEDS MOTIVATION, so even if I don’t feel like applying for the internships, jobs, courses or voluntary work I just have to do it, then I will feel the benefits of my labour after.

It’s so hard in real life though, so the way I have tackled it is by making small little steps. The number one reason we put off improving our lives is because big changes feel so scary and unattainable. Which is why breaking goals down into small steps is the secret of success. There’s less fear when you’re just concentrating on what you need to do that day, and as you stick to your good intentions, you’ll be motivated to carry on until your new habits become a way of life. I was told to write your goal down on several pieces of paper.  Hang them up everywhere.  This is my first step to focusing on my commitment. Then make lots of smaller easier to achieve goals for each step of the bigger goal.

 So here it goes; I want to get back to university. I want to do a health science related degree. I either want to study occupational therapy or midwifery. It’s been my dream since I was a teenager, and I was two years into my OT degree when I had to drop out due to BPD.

Step 1: Find out what I need to achieve to get onto course and what university I can study in.

·         I need to have the skills to stay in university for 4 years,

·         Be able to endure 8 hour days of lectures/study.

·         I need to have communication skills to be able to interact with other students.

·         I need to be able to manage stress and have good time management.

·         I need to have the finances in place to support myself for the four years.

·         I need to be physically healthy and emotionally fit.

Step 2: Finish DBT and fully engage in therapy to learn new skills.

·         Attend DBT skills group and individual therapy every week.

·         Complete all homework and be willing to learn new behaviour patterns.

·         Adhere to DBT contract to create a life worth living

Step 3: Attend a less intense course/internship/voluntary work in order to build up skills and confidence.

·         Research opportunities online with voluntary organisations and apply for any that interest me.

·         Talk to and ask others about different opportunities.

·         Update CV and write cover letters.

·         Follow up on all leads and correspondence.

Step 4: Get finances in order

·         Talk to social welfare office

·         Find out about financial aid for going back to university.

·         Continue to babysit and pick up small manageable jobs

·         Set up credit union account.

·         Try to save when I can.

Step 5: Work on personal relationships

·         Stay in touch with friends, and be appreciative of their love and support.

·         Reach out to family; be considerate and patient as they are also learning new skills.

·         Make efforts to create new friendships.

·         End destructive relationships.

·         Be honest

Step 6: Foster and develop creative talents and interests

·         Make regular time to write/attend writing classes

·         Listen to music daily, sing.

·         Keep art supplies stocked and ready to use

·         Make cards/collages/draw/paint

·         Learn new things as often as possible.

This is all I can think of right now, but I know that more steps and action plans will emerge from these rudimentary goals. It feels good to have a plan, something to work towards. i don't feel so empty ans lost.