DBT for grief

I am worried what to say to her, but I am sure everyone worries about what to say to a grieving person. But what I really feel is that knowing how to listen is much more important. Oftentimes, well-meaning people avoid talking about the death or mentioning the deceased person, I felt I should bring her Dad up, but when I was grieving for my friends that died a few years ago, I really needed to feel that my loss was acknowledged, I wanted to talk about it.

I wanted to let her know that she had my approval to talk about her dad’s death, even if it had only happened a few hours ago, yet I tried not to force her to open up. I just let her talk when the subject of her dad came up.

I brought food and made pots of tea. It’s what I do. I want to ‘mother smother’ her. That’s my term for looking after a person in time of crisis. I did it for my sister when her baby boy came early and was sick in the hospital. I got some healthy salads and soups, and also some comfort food like pizza and soda bread and giant cookies and coca-cola.

I am going out to her again tomorrow, I would like to make her some food for the freezer, but I am very low on money and can’t afford to buy the meat this weekend. From what I could see, she has enough food in the house for a few days, so can hold off for a while.

Okay… so the point of this post is to figure out what DBT skills to use to stay regulated so I can be the shoulder to lean on my friend needs right now.

MINDFULNESS

I need to be aware of which emotion I am experiencing. I will do this with OBSERVE, by checking in regularly with myself, and through my meditation practise. Then I will DESCRIBE the emotion and how it is affecting my body, thoughts and behaviours. I will be NON-JUDGEMENTAL towards my thoughts, my emotions and the feelings and emotions of those who are grieving. I will do this by putting myself in their shoes. I will let my friend know that t’s ok to feel whatever way they feel, let her express her feelings without judgement, argument or criticism.

INTERPERSONAL EFFECTIVNESS

This is a time to use the relationship effectiveness skill GIVE

·         Be gentle

·         Be interested

·         Validate

·         Have an easy manner

I will smile at my friend and her family and be MINDFUL in my conversation.

EMOTION REGULATION

I really need to reduce my vulnerability with PLEASE, take my medication, go to yoga (even though this friend normally comes with me). Absolutely no drink or prescribed drugs…! I must endeavour to get the right amount of sleep. I will continue with my healthy diet and stick to my meal plans.

I will try to INCREASE POSITIVE EMOTIONS by going to my meditation group tonight. I will notice how I feel in my body, what’s passing through my mind, what I am doing, how I am behaving.

DISTRESS TOLERANCE

DISTRACTION is my best bet here, in particular focusing on others, in particular my friend. I will focus on her and concentrate on her needs. This will help direct my thoughts away from the difficult emotions which accompany death

I am AWAKING OPPOSITE EMOTION by listening to my favourite music, calming and soothing music.

PRAYER is helping me too to not make the situation worse. I am also bringing my friend and her family into my meditation.

I self-soothed by taking a really long hot shower this morning which gave me the strength to go see my friend after.

Finally RADICAL ACCEPTANCE is greatly needed. Death is the ultimate test for this skill. I hate that he is dead, yet I must accept it. 

DEARMAN Success with Therapist

Love this Meme!

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

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

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

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

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

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

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

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

Kind regards

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

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

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

DISCOVERING VALUES Individual Therapy

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

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

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

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

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

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

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

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

FACTORS REDUCING INTERPERSONAL EFFECTIVENESS

Get out of my head!

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

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

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

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

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

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

Mr. Worry!

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

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

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

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