Triggers from Long, Long Ago (and How I coped)

It's been a while since my last post. Sometimes I didn't write because I was doing so well. Other times I didn't write because I felt that I was doing so terribly. Since yesterday, I've been thinking about what the original intention of this blog was: self-therapy and hopefully to, in some way, encourage or help someone else as a peer.

That being said, I'm ready to write again.

I've been very triggered this past week. I won't get into all of the details of it (to avoid re-triggering myself and possibly you). In a nutshell, when I was about 8 years old. I got really ill, and my father left me with someone I didn't know. I don't remember this person ever checking in on me, and I was there several days. I was feverish and hadn't had anything to eat or drink. I kept getting sick.

I remember feeling so helpless, alone, and afraid.

Unfortunately, I've just come down with a (mild) cold with a low grade fever. Even though it's literally been a couple of decades since this incident happened, I still get triggered whenever I get a cold or come down with a bug.

At first, I was able to use a lot of self-talk. I told myself that I am an adult now. I can take care of myself. I have support. I am not a helpless child. It's 2011. I did this great grounding work, but somehow continued to listen to the fears and ended up experiencing full-blown panic attacks that have pretty much kept me up the past couple of nights and have affected my appetite (I've had to push myself to eat). I am keeping with drinking plenty...and I am continuing to tell myself that I am ok, but I continue to feel panicky.

Perhaps I wouldn't be so vulnerable if there weren't a number of other factors right now: the holidays, being in the PMS part of my cycle, and my partner is going away to see his family and will be gone for a couple of weeks.  All of these things combined were a bit too much. I need my distress tolerance skills!

Things that have helped so far: self-talk (to an extent), showing myself compassion, keeping a schedule of drinking juice, water, and having small snacks, got out for a short walk today, did a little bit of very gentle, restful yoga poses, reaching out here and on Twitter.

I also did Worksheet 1a: Emotion Regulation to deal with some of the anxiety.

Can you relate? Are there some situations from long ago that still challenge you today?

What skills do you use? How do you cope?

I found this great image here.


Thank you.

More soon. 

Don't Rob Yourself Now (Childhood Abuse & Borderline Personality Disorder)

In my Distress Tolerance DBT (Dialectical Behavior Therapy) class today, one of my classmates said that her distress this week was triggered by something she read in a self-help book. According to her, she had been doing very well, feeling stable and upbeat, and her reaction to what she read really took her aback.

The author of the book she was reading stated that children who were victims of abuse were "robbed of their childhood." All at once, her thoughts spiraled. She got angry and sad. Tons of "what if" questions ran through her head: "What if I had never been abused? Where would I be now academically? Where would I be now in my relationships with others? How much more would I be 'normal' emotionally. It's not fair. I was robbed of my childhood!"

I felt my heart begin to pound and race. I felt anger toward my parents. In the past, I'd wondered the same thing. But, in this moment, thinking about it again, my Wise Mind kicked in.  There is no way to undo the past. There is no magic time machine. There is no way to make it not have happened. It sucks. It was wrong. We were robbed of our childhoods. Plain and simple.

But, now what? What happens if we Radically Accept this? Not APPROVE of it, but ACCEPT that YES, it did happen? What if we accept how wrong it was and how it has made us feel?

I raised my hand after other patients had joined in, some crying, some very angry, all agreeing that they were hurt and upset about the abuse they endured.

"I can totally relate," I shared, "My heart is pounding in my chest right now. Racing. Our childhoods were robbed. But, you know what? My Wise Mind is kicking in, and I will NOT rob myself NOW of the life I want to have - the life I can have - that no one else can take away. I will not revictimize myself. Once around was enough, thank you."

Other patients smiled and air high-fived me. :) The doctor smiled. She reminded us all of the bumper sticker that says, "It is never too late to have a happy childhood."




Thank you for reading. More soon.

Vigil for a Nameless Cat - Using my DBT Skills in The Real World

Please note: This post contains some potentially triggering imagery. Listen to your heart, mind, and spirit as to whether you can handle reading it. I'll warn you when I am about to get to that part...

I've been hearing the word "Mastery" a lot from the doctor who runs the DBT groups that I attend twice a week, and although I started attending because I was coming out of crisis (and an intensive outpatient/partial hospitalization program), and really, I just wanted to be around other people and do the whole "misery loves company" thing...something recently switched, and I began applying myself like crazy (no pun intended).

I've been paying attention in class/group, participating, doing the homework, and really working hard to change my life and create a life worth living. And, it's been working. I also notice that I am more aware and concerned about others in the group. I listened to their stories and issues in the beginning, but I was more self-absorbed. I am not judging myself for this. There is always cause, and it's not good or bad. I'm just noticing that I now really listen to others in the group as they go around and share their struggles and successes of the week.  Rather than thinking about my own issues or what I could say to "sound smart," I give people their space and pay attention to whether it's really appropriate for me to chime in, and I try to do so humbly.

For the most part, things in my life are stable. They aren't ideal, and they aren't exactly as I would wish or hope, but there is no crisis, all my needs are met, and I feel confident in my progress and ability to make wise mind decisions - most of the time.

Please use self care in deciding whether to read on. Potentially triggering imagery follows. 

So, it was interesting to see how I would respond in a very emotionally challenging situation. I had that opportunity yesterday.  I was enjoying a beautiful day walking around downtown, visiting thrift stores, and having an iced tea in the sun.  I decided to go to another part of town that was pretty far, so I hopped in the car and was off looking for a parking space.  

I was ecstatic to see an open space, but when I began to pull up to it, I saw why no one had wanted to park there. On the sidewalk, half falling to the curb, was a deceased cat.  He had gone into rigormortis  - he had become stiff, his eyes completely wide open and staring ahead. I began to cry. I pulled my car over to the other side of the street and felt such sorrow in my heart for this beautiful, innocent being laying lifelessly, uncared for, unwatched over, totally disregarded.

I had an impulse to run into the thrift store and at least get a sheet to cover him up and give him dignity, but I felt a bit paralyzed. I was afraid to go closer. I wondered about his story. Was he someone's pet? Did they know he was gone? Would a child find the cat in this condition and be frightened? I wondered if he was the neighborhood stray that everyone fed. Perhaps he was crossing the street and got struck by a car. Maybe they were nice enough to at least move him to the sidewalk. What was his story?

I wondered how, in broad daylight, on a fairly busy street near noon, this poor kitty's carcass could be sitting there like that.

I thought maybe my eyes had deceived me. Maybe it was a toy. Against my better judgment, I looked again. He was real.

The image has been difficult to get out of my head.  I have two cats that I love more than life itself. I thought about them. It was very, very sad.

I realized that in order to regain my composure and be functional, I needed to bring my wise mind back on board asap.  I didn't want to use the distraction skill. Somehow that felt disrespectful and inappropriate. I went through my DBT (Dialectical Behavior Therapy) binder and decided to use skills from the Distress Tolerance section, including Meaning, Prayer, and Observing my Breath.

For the "Meaning" skill, I decided I would write this blog post in honor of the cat without a name. In fact, I named him "Moon," because his little spirit brightly lights the sky among the stars. This blog post is a vigil to a kitty who, regardless of his story, was called away.  I am radically accepting that, while I don't know what happened, everything has cause.  I also radically accept that his death is a part of life - albeit a part that doesn't make me all that comfortable.

Let's all take a moment for Moon.

Picture of a Cat that looks like Moon that I found here

In Memory of Moon (Photo Credit)

I cry as I wrap up this post, but I am so glad to feel my emotions and direct their energy in a positive way.

Thanks for reading. More soon.

Twitter: HealingFromBPD 
 

Does DBT (Dialectical Behavior Therapy) Work? My Story: A Case Study

I am currently attending two DBT (Dialectical Behavior Therapy) classes per week. One is an ongoing group/class that goes through the four major skill sets: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. The other just focuses on the Distress Tolerance skill set.

Things have been going well. Before DBT, I felt as if I were at the mercy of my emotions and impulses. When I had a feeling, I reacted. I continually made emotional and impulsive decisions that I later regretted, and I engaged in a number of self-destructive behaviors.

While I won't say that my life is perfect or that I have it all together, I will say, I have come quite far! 

One of the mental health issues that manifested for me (and that was a red flag for my doctor in the process of my diagnosis), was a very overwhelming, terrifying realization/feeling that I did not know who I was.  I referred to it as a realization, because it was as if, all at once, I looked at myself in the mirror and was confused at who was looking back. I had become so fed up with all of the energy that I needed to expend in order to be everything to everyone - to act a certain way with this person and another way with that person.  I wondered, "If all the people I know got in one room with me, how would I behave? How would I act? Would they even know me? I don't know me!"

Image Credit


It was scary. I realized that I was like a chameleon, shaping and molding my likeness to whatever I thought the person across from me would like, approve of, and accept.  I now hold great compassion in my heart for this survival strategy that my unconscious/subconscious self was doing. As a child, I lived in a very abusive, scary, and sometimes life threatening environment.

I had to be one way with my Mom and another with my Dad in order to avoid abuse.  I was often unsuccessful, because I would act up and lash out. As I got older, I learned to "be" how I thought my Dad would want me to be so that he would love, accept, and not harm me. I think that the behavior took off from there and extended to all of the relationships and connections with others that I would have as the years went on.

As I continue in DBT, I am beginning to catch glimpses of the real ME. Not the me that I have constructed for anyone else, but the Me Me. I've caught myself, a few times, saying things like, "That's just how I am..." or "I'm sorry, but this is part of who I am..."  I don't remember saying things like this much in the past - especially when whatever it was that I was saying was in contradiction to someone whose acceptance and approval I desperately sought.

I am getting a bit more confident and independent in my thinking. I am trusting myself more. And, back to what I mentioned earlier in this post, I am putting space between experiencing an intense emotion and taking any action - as opposed to acting quickly in an attempt to relieve the discomfort, distress, or pain that I might be experiencing in any given moment or situation.

My life is radically improving. I am slowing down and THINKING before I act. I am weighing pros and cons and looking at potential consequences. I care. I am creating a life worth living, and I feel so fortunate to have found the path that I am currently on.

DBT works. It really does.

Crisis Averted! More Success Using DBT Skills (Dialectical Behavior Therapy)

A few days ago, I had the trigger of all triggers. Deep seated in my psyche are some serious fears and insecurites around abandonment and being alone. My situation is not unique. In fact, according to the DSM (the Diagnostic and Statistical Manual used by psychology and psychiatry professionals), one of the top criteria for diagnosing Borderline Personality Disorder is:
"Frantic efforts to avoid real or imagined abandonment."

Read that again: Frantic efforts to avoid REAL or IMAGINED abandonment.  My significant other recently got on a plane to visit his family and do business in England. For a whole month.  I have known about this planned trip for about a half a year, and I was doing pretty well with it all up until a few days before he actually left.

At that time, I began to notice an increase in my usual frequency of nightmares. I was waking up all hours of the night with panic attacks: heart and mind racing, sweating, feeling cold, having diarreah -- the whole kit and caboodle.

On the afternoon that I took him to the airport, my emotional vulnerabilities showed up. Now, I want to remind myself that anyone who is about to experience a long separation from someone they love will naturally experience sadness and, perhaps, some anxiety, so I know that it is normal that I felt these things.

I also felt more intense emotions that I, luckily, pretty instantly recognized as needing regulation. I felt myself escalating, having some self-harm thoughts, and feeling like I was going "out of control."

Now, this is growth...I saw a cat food can lid on the counter waiting to be recycled. My emotions were so intense that I had an impuslive thought that I wanted to just cut myself with it. Within seconds, my Wise Mind kicked in, and I thought, "No I don't; I just don't want to feel THIS way." That was my cue to start engaging in the DBT skill of opposite action.

Before that, I held an ice cube in each hand (also a DBT skill) to create an intense, but non-harmful physical sensation. As I squeezed the ice cubes in my hands and watched as the water melted down into the sink, I realized that it was helping.

I then thought about the fact that I had a choice.  I was at a fork in the road. (Mind you, this ENTIRE time, and for days afterward, my physiological stress symptoms were at a high -- tense muscles, clenched jaw, having to run to the bathroom, adrenaline rushes, heart racing, etc.)

In the past, I have gone to what I now consider extremes to feel safe and as if someone else were taking care of me (..."Frantic efforts to avoid real or imagined abandonment...").  I would allow my emotions to escalate to the point where I would vomit. Between that and the diarreah, my appetite would be low, so I would be eating and drinking less. I knew that, should I become at all dehydrated, I could go to the ER, and they would HAVE to help me. They would take care of me. They would let me lie down in a sterlile hospital bed with warmed blankets. They would put an IV in me and keep checking in on me to make sure I was ok.  I have done this scenario countless times.

 I was heading in that direction -- the thoughts were there...the physical sensations -- when suddenly,  Wise Mind kicked in: "I have a choice right now.  Yes, I can go to the Emergency Room, but what will this accomplish? Is doing this in alignment with my goals of being well, improving my relationship, and growing as a person?  My SO is gone for 30 days.  I can get as sick as I want, let my emotions get out of control, and cause myself suffering, or I can choose --right now, in this moment -- to take control of my mind and calm down."

I chose the latter, and I have to tell you -- I really am proud. That's progress!

The day after I dropped off my SO, I had DBT group. It went really well. I did my homework (the 1a Worksheet where you describe your emotion in detail), and I presented that in the group. The other group members where very supportive. The doctor said she was proud and that I should be, too: "Crisis averted."

ABC News Article ft. Dr. LeslieBeth Wish on Casey Anthony: Borderline Personality Disorder?

As someone who is diagnosed with Borderline Personality Disorder, who is doing her best to honestly share her experience and help break down negative and inaccurate stigmas about the illness (and mental illness in general), I was alarmed, disappointed, and concerned when, after watching a video by another young mental health advocate and BPD-diagnosed woman, Dani Z, where Dani referred to a recent online article published by ABC News.

Dr. LeslieBethWish  Photo Credit
In the article, a psychologist and licensed social worker in Sarasota, Florida by the name of Dr. LeslieBeth Wish, who has never met with or formally diagnosed Casey Anthony (who was charged and acquitted with killing her infant daughter), proposed the possibility that she may suffer from borderline personality disorder and/or psychopathology, claiming that:

 "[t]he main thing these issues have in common is a total lack of empathy, according to LeslieBeth Wish...'They can turn a person into a non-person,' Wish said. 'Borderline personalities have more emotional regulation problem and often use lying to get away from something and not ever feeling like they're responsible.' Wish explains that for people who suffer from these problems, separate lies can quickly become entire narratives that the teller can even come to believe as true. 'A lie begets a lie and it's easy to get trapped in telling lies to protect other lies,' Wish said. 'Does she believe her lies? She might, but more than likely she believes that she's good enough to make you believe her lies.'"

I have a number of problems with Dr. Wish's comments. To begin with, I haven't met a BPD diagnosed individual, including myself, who doesn't have an incredible amount of empathy.  I cry when I see someone else cry, because I feel so connected to their experiences and pain.  Unlike Dr. Wish, I will not generalize all people with Borderline Personality Disorder as being empathetic, and I feel that her way of presenting us in a generalized way as having "a total lack of empathy" is not only inaccurate, but irresponsible and unprofessional, especially for someone of her education level and title. If I had the opportunity to speak with her directly, I would encourage her to rethink her word choices and request that ABC news update the article.

Dr. Wish's comment that Borderline Personality Disorder "can turn a person into a non-person" is also disturbing and misleading to readers who are not familiar with the disorder. A statement like this creates fear and perpetuates the stigma that people with BPD are dangerous and completely disconnected from reality.

Nowhere in the DSM - the standard Diagnostical Statistical Manual, published by the American Psychiatric Association and used by psychiatric professionals, are Dr. Wish's statement corroborated.

According to the National Institute of Mental Health, (NIMH) in order to be diagnosed with Borderline Personality Disorder, an individual must meet at least five of the following criteria:

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of unstable and intense interpersonal relationships characterized by extremes between idealization and devaluation (also known as "splitting")
  • Identity disturbance: Markedly or persistently unstable self-image or sense of self
  • Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
  • Recurrent suicidal behavior, gestures, or threats, or self-harming behavior
  • Emotional instability in reaction to day-to-day events (e.g., intense episodic sadness, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
  • Transient, stress-related paranoid ideation or severe dissociative symptoms"
Notice that there is no mention in the DSM of a lack of empathy, pathological lying, or a person becoming a non-person.  ABC, please fact-check information given to you about specifically illnesses, even if the source is a doctor, because clearly, they, too, can and do provide inaccurate information that can adversely affect others.

While I am clearly upset about this article, I do understand that Borderline Personality Disorder is still misunderstood by many, including many of those within the psychiatric profession. Strides have been made by professionals in the field, such as Dr. Marsha Linehan, who created and developed Dialectical Behavior Therapy (DBT), a program designed to specifically help those with BPD and other who have difficulty regulating their emotions. I attend DBT groups twice weekly and my doctor and I have noticed a significant improvement in my quality of life and overall well-being.

I hope this post helped you in some way.
More soon.

Making Mistakes! (We all do it.)

I was just challenged immensely on an emotional level just as I was getting ready to celebrate and share my recent success of using some of the DBT (Dialectical Behavior Therapy) skills I have been learning.

This post revolves around my recently noticing an increased ability to cope and deal with the emotions that arise when I realize I've made a mistake.

Typically, these emotions include: embarrassment, anxiety, and anger (toward myself).

The thoughts are typically along the lines of:

"I'm an idiot.
Everyone is going to think I am an idiot.
They are going to see me as incompetent.
I've screwed everything up."

The physical sensations that I tend to experience when I make a mistake are: a feeling that my face is getting hot and turning red, racing heart, clenching jaw and tight muscles (especially in my neck and shoulders).

Photo Credit
I also tend to experience a strong impulse to want to redeem myself in the eyes of the people who witnessed my mistake, sometimes lying to make myself look less incompetent or to make an excuse for why I made the mistake.

Work has been a particular struggle for me, having quit and changed jobs so many times, partly because of the inability to tolerate my perception of what others "must" perceive about me (read: She made a mistake. She's not perfect), which, by the way, is exhausting.

I recently took on a part-time job, and part of my duties are to review documents for the CEO before they are sent out. I basically look them over and correct anything that doesn't sound quite right, that is misspelled, etc.

I have done an excellent job preparing these documents. I give myself credit there. But on one occasion, I sent an email to the CEO (and a couple of other employees) that had a typo and that omitted an important word. Can you IMAGINE the level of my embarrassment, given my role/tasks at the company?

The way that I realized I made the mistake was not because I had carefully reviewed the email before sending it, but because I obsessively re-read messages that I've already sent (at work), and I found the errors at that time.  I felt the blood rush to my face. I was sure he would let me go. Others who were CC'd on the email, I reasoned, were cracking jokes at my expense and suggesting that I be fired, since I must be incompetent if I couldn't take the time to make sure my email was correct before sending it, given my responsibilities at the company.

My anxiety went from a 0-100 in about 30 seconds.  I had to get a hold of my mind. First step: I moved away from the computer. Second step: I thought about how I need to slow down and read my emails through before sending them - always.  I thought about how they may not have even noticed that I made the mistake. I thought about how they might have noticed the mistake and would respond the way I was fearing. I thought about how they might have noticed the mistake and might respond by being concerned that I had made such obvious errors, but they wouldn't take it too seriously because it wasn't something that actually would be seen by anyone else other than those emailed (basically, it caused no harm -- the email didn't go out to the entire staff or to customers, where it might cause some embarrassment to the CEO or the company.)

If you are familiar with a mental disorder called OCD (Obsessive Compulsive Disorder), you may have guessed that, in addition to my diagnosis of BPD (Borderline Personality Disorder), I also have this condition. I have made INCREDIBLE progress over the years (mostly in part to a really good doctor and her CBT - Cognitive Behavioral Therapy Group), but I still have it.

When it comes to perfectionism, the OCD symptom around this, combined with the BPD symptom of black-or-white, all-or-nothing thinking, combine to cause me a great deal of distress.

Third Step: After using my DBT skill of "Describing," I began to practice radical acceptance. I acknowledged that I had NO control over whether other people noticed my mistake, cared about it, thought about it, or how they would respond to it. The mistake was made. There was no undoing it. There was NOTHING I could do about it. 

This, believe it or not, helped me to feel better. I surrendered. What other choice was there, really?

I also extended compassion to myself, reminding myself that everything has cause: from the fact that my wireless keyboard has been sticking, to the fact that I've been rushing my emails and not slowing down to review them before sending them out, to the fact that I was punished, abused, and neglected severely as a child when I made a mistake...there is cause for everything.

I do have to admit that I fell short of behaving in a way that was completely in alignment with my goal of feeling self-respect, because I did tell a "little" lie (I know, a lie is a lie is a lie) to make myself "look better" and less incompetent.

I emailed the people I had sent the original email and made a joke that my phone's auto-correct could be so embarrassing sometimes, and I reiterated what I was trying to communicate in my original email.

I did this again today. I made the same type of mistake, and I blamed it on my phone.  I feel a bit badly about it, but my goal was to look less incompetent, and I hope I achieved this.

My goal now, of course, is to read and re-read my emails BEFORE I send them out.

I love how practicing the skills helped me to keep from making the issue worse. I love how doing so helped me to avoid escalating and continuing the self-abusive thoughts. Most importantly, I love how practicing the skills, in this instance, helped me to avoid self-sabotaging and self-harm and to set a goal to prevent this whole thing in the future.

I hope this helped you in some way.

More soon.

Celebrate Every Bit of Progress - Success with DBT (Dialectical Behavior Therapy)

Those of us with BPD (Borderline Personality Disorder), and those who know and love us, are all too familiar with how we are quick to notice, point out, and dwell upon the things we do "wrong."  As we explore in DBT (Dialectical Behavior Therapy), we learn to be less judgmental and more understanding of ourselves and others. Along the way, we make progress and we backtrack.

Let's not just notice the backtracking. Let's celebrate each and every accomplishment along the way, too!

There is a small group of us on Twitter who correspond with each other, sometimes using the hashtag #BPDFriends.  Today, this group supported me in my joy over some recent accomplishments, both big and small. It felt really good, and I thank each of you - you know who you are.

Today I shared the following tweet:

Last night, I used my #DBT skills immensely. I prevented myself from self-sabotaging and from hurting others with my words. Proud today.

Here's the scenario in a nutshell:

I woke up feeling terrible. I had my period, and oddly, I sometimes get aches and pains all over when it arrives. Yesterday was one of those days. I also had a headache and TMJ pain. It was my second day working from home for a brand new client for my brand new business. (Lots of changes! I decided to go out on a limb and try to start my own little company. So far, so good.)

I had to pull myself together to get some essential work done and submitted to the client, and I had a Starbucks date with a dear friend. I couldn't blow her off (even though I felt like crap). I'd done that too many times and made an agreement with myself that if I could show up. I would show up. I'd canceled on her too many times and didn't want to upset her.

So, I stretched a bit in bed. I let myself sleep in a little bit longer, knowing that I could afford to do so as long as I really focused when I got up.  I gave myself a little "You can do it" pep talk and got out of bed. I started to complain to myself about all the aches and pains, my period, how I didn't feel like doing anything.

Then, DBT skills kicked in - particularly, radical acceptance. All at once, my wise mind kicked into gear, and the mature, rational adult inside spoke up. "What would you tell a friend who was describing this situation to you?"

I've been using this question a lot lately. Somehow, thinking about how I would respond to someone I care about if they came to me with the type of thoughts, feelings, and conclusions I come up with, leads me to treat myself with compassion and a higher wisdom. It's quite neat.

On this occasion, I monitored my thoughts, and then I asked myself: "How would you respond to a friend if she called you up and said, 'I don't feel like doing anything. I'm not sick, but I'm all achy. I have my friggin' period and ALLLL this work to do. I hate everything and just want to go back to sleep."

My response: "I can understand why you would feel SO overwhelmed right now. So much has changed. You've gone from unemployment to job hopping to unemployment again. You'd gotten used to being able to stay at home or roam around without any real structure, expectations, or responsibility, so naturally you are a little bit frazzled right now. Remember what one of the doctors in IOP (Intensive Outpatient Hospitalization program) said: 'Stress is the body's adaptation to change.' You are going through SO many changes right now. Just take some deep breaths, and take everything step-by-step. You'll get through this. This job assignment is a blessing, and you need to use your skills to stay focused, balanced, and to refrain from self-sabotaging. You can do this."

And, I did! :)

I worked all morning and left some time to do my makeup and have a light lunch. I then went to meet with my friend. I was honest and upfront with her about how I was feeling icky and asked her not to take it personally. We had our Starbucks, and I decided to take a couple of Tylenol to help with the pain (which it did, a lot). We went for a little walk and even had time to squeeze in a department store before I had to go to DBT group.  I am so glad that I've matured enough to be able to be an adult, in wise mind, thinking before I act and therefore preserving and growing current relationships (rather than sabotaging them.)  I won't make it sounds like I haven't backtracked or made mistakes. Just the other day I threw a complete fit in a department store because I felt my significant other "wasn't being affectionate enough," but I will not let that incident damper the light of this accomplishment.

Photo Credit


Right after this, I went to group and very actively participated. I enjoyed the guided mindfulness practice on the Marsha Linehan CD for pretty much the first time since I've started DBT.  I refrained from answering every question that the doctor asked, allowing others a chance to speak...and I learned from what they had to say.

By the end of group, the physical pain was gone. The Tylenol had kicked in.  I no longer felt nauseous. (I don't think I'd mentioned before that I had been, but I am one of those people where if the pain is bad enough - including a headache - it turns my stomach.)  I went to the grocery store and picked up a few needed items. Then, I got home, made dinner, and straightened up -- even though I still didn't feel 100%.

That friendly, wise-mind spoke up whenever I wanted to just throw a fit and "not do anything." I can still hear it now: "If we did things based on whether we felt like it or not, most things wouldn't get done." It's not that I am advocating that we don't take care of ourselves. If we are actually sick and need rest, by all means, I think we should lay down. But, I know my body and knew what this was all about.



I took a prescribed muscle relaxer for the TMJ and related/radiated pain. It helped.  I worked some more, completely messed up my computer and printer by tinkering around trying to fix something else, and voilĂ . I had another opportunity to practice DBT.

I know how terrible this is going to sound, and of course I would never act on it literally, but I became so frustrated (infuriated) about my situation, that I felt like tearing out my eyeballs and yelling at my significant other (who was patiently trying to help, by the way).

I began by "just noticing." I started to deep breathe. I then did an opposite action. Instead of screaming, I spoke softly. Instead of lashing out at my significant other, I thanked him for being so patient and trying to help. I told myself I'd work on the issue for 20 more minutes, and if it wasn't resolved, I'd take a break and watch some TV to cool down.

The problem was resolved in 20 minutes. During those 20 minutes, when I would feel myself escalate, I identified the emotion and accompanying thoughts I was having:

Thoughts:

"This thing is broken forever.
I'm an idiot because I f*cked it up.
I'm never going to fix this.
I'm not going to be able to get the project done for the client.
I hate myself.
I hate everything."

Accompanying Emotions:

Fear
Sadness

Hopeless
Hateful
Angry

Mind, you I went from calmly working to having all of those emotions and thoughts...literally in minutes. But, I noticed it and took hold of my mind.  The DBT groups are working!!! :)

I noticed how quickly I went from 0-100.  I noticed that my thoughts were exaggerated and a bit irrational. I was able to identify, from my wise mind, that I was operating primarily in emotional mind. That's when I was able to begin practicing the skills and preventing self-sabotage, self-harm, and hurting my significant other with my words.

This was a long one. I hope it has helped you in some way to understand something about yourself or someone else.

More soon.

Be Like a Baby - DBT Mindfulness Skill

A few weeks ago in my weekly DBT (Dialectical Behavior Therapy) group, the doctor asked us all to place one hand flat on the table and leave it there. About 30 seconds later, she asked us about our experiences - specifically, she asked if we started to describe the experience.
I certainly had. My mind is quick to think, analyze, and describe, pretty much all of the time. I rarely get a break from the constant stream of thoughts.

When I placed my hand on the table, I had the following thoughts:

"My hand is on the table.
The table feels cold.
I feel the pressure of my hand against the table."

When we went around the circle, it turned out that all of the other patients had the same type of experience.  Describing is a good skill for staying grounded and in the moment, but today we were going to learn a new skill: Being in the present moment, or Being Mindful.

The doctor suggested that we think about how a baby experiences the world before he or she has any concept of associating words with things. When a baby feels the table, the baby is fully immersed in feeling the table.

This can be a little bit confusing to "get" at first. In fact, it took me a few weeks of random opportunities to practice touching tables and similiar activities before I began to get it. Now, when I place my hand on a table with the intention of practicing this mindfulness activity, I simply place my hand on the table. If thoughts come in that want to describe, I watch the thoughts float away like clouds in the sky, and I am totally immersed in the experience, just like a baby.

A beautiful baby in the present moment. Photo Credit
The doctor suggested that we "just observe like a baby - with no words - just BE the experience." She also suggested that we keep our eyes open during the practice.

If you practice, you will "get it" too, and, if your experience is anything like mine, you may experience a moment of bliss when you fully connect to the moment without having to put names or descriptions on anything.

Another example that we were given as a potential practice assignment is around mindful eating. The suggestion is to eat a raisin as if you are an alien who just came to this planet and had never seen one before. I have yet to try this, but doesn't it sound fun? If you have done this or something similar, please do share your experience. Others (including me) will find it very interesting.

Mindfully Eating a Raisin   Photo Credit
Some other thoughts from the class:

Mindfulness is the Quality of Awareness or Presence.
Part of being mindful is to do one thing at a time.

What has been your experience with Mindfulness Practices? What are your successess and challenges around this particular DBT skill?

Thank you for sharing.

More soon.

Easily Influenced? A Borderline's Struggle with Identity

I'm not sure if other people with BPD (Borderline Personality Disorder) feel this way or can relate, but I am pretty easily influenced.  I might hear a strong opinion that radically differs from the one I had been holding until that moment and be swayed completely.  I am not trying to say that I am gullible, an idiot, or totally brainless. I do mean to say that my sense of self and identity is not really strong as it is for most other people.

I also mean to say that many of us with BPD have a tendency to shape-shift, if you will, to become like whoever it is that we are talking to at the moment, trying to impress, or who we like and want to like us back.

When I was in high school, if someone asked me what kind of music I liked, (and my musical taste was and is quite eclectic and varied), I think my mind would do a split second assessment of what I though that person must like (based on their clothes, hair, makeup), and I'd respond with the type of music I thought would impress them or give us something in common.

For example, if I met this girl, I'd say I liked goth music. :)


Photo Credit
Have you ever done anything like that?  I have found that sometimes this trait can have positive results.
 
I've been feeling a bit depressed lately, and I reasoned that if I could get myself around some smart, positive people, perhaps their words and actions would influence me in a positive way.  It worked.
 
Yesterday, I went to get a much overdue hair cut.  Due to my budget at the moment, I go to one of those in-and-out quickie hair cut places.  In the past, it's been hit or miss for me in terms of finding someone who is competent and cares enough to cut my hair the way I request. I recently got lucky. 
 
I found a stylist who not only cuts my hair beautifully for $15, but she also shares her bright, positive, encouraging spirit with me every time I sit in her chair.  And, she takes her time. About a month ago, I was very concerned to see that she had stress written all over her face. Her eyes were puffy and red, as she'd obviously been crying. I asked her what was wrong.  She shared with me that she and her husband were losing their house and needed to find an apartment by Sunday (and it was already Tuesday).  I worried for her. In fact, I let my hair grow out all raggedy and didn't go back for a while because I was so sad to see her that way. 
 
The experience made me realize that she is human.  We all experience a wide range of emotions, and just like I can't expect myself to have a constant baseline of "happy," I can't expect others to either.  I can't expect to be all-or-nothing or "completely happy" or "completely depressed."  It's difficult for me to get it sometimes, but there are shades of gray in-between.
 
I finally went to get my hair cut again yesterday.  My stylist seemed happy again. She told me that a huge weight had been lifted off of her and her husband's shoulders and that, although they now live in a tiny apartment, they are very happy and have stopped arguing. She had a brightness in her eyes again. And, this time, she detected my stress.
 
"You seem SO stressed," she said, "It's written all over your face."  I told her I was, indeed, stressed.  I didn't get into all of the details (I had SOME boundaries, lol), but I did tell her that I was having a difficult time holding down a job.  I was on the verge of tears and felt SO DEPRESSED. I even felt a heaviness in my body.
 
Photo Credit
My stylist encouraged me to DISTRACT myself whenever I wasn't doing anything proactive with regards to my goal of securing and keeping a job.  Wow. (She doesn't know, of course, that I have Borderline Personality Disorder, and my hunch is that she probably doesn't know about DBT. So, I wonder, do people who don't have this disorder naturally tend to do the skills we learn in DBT? Any thoughts on this?)
 
Distraction is one of my favorite DBT (Dialectical Behavior Therapy) skills.  The idea is to distract yourself with activities and thoughts that make you feel better and that help prevent you from acting impulsively or destructively when there is nothing more you can do in that moment to change your situation.
 
She also suggested being grateful and speaking positive things about myself and my situation. I started doing it, and it began to work.  Her influence on me was positive.
 
After I left, I got into my car and began speaking positively. Out loud. At first, I still felt really crappy and heavy, but the more I did it, the better I felt. I practiced doing the "half smile" DBT skill (are you familiar with this one by Thich Nhat Hanh?), and I said, aloud:
 
I choose joy.
I choose happiness.
My new job is coming within the next couple of weeks. I will love it. They will love me. I will be happy.
I am happy.
 
It felt kind of fake and phoney at first, but I just kept going with the practice. I kept repeating those four lines all the way home, and, I have to tell you, I felt like a different person when I woke up today. I didn't feel heavy.  I didn't feel deeply depressed as I have been for weeks.
 
It took a perspective change. It took an acknowledgment that I could change my mind and state of being by changing my thoughts and choosing to focus on the positive, and it all began by realizing my highly influenced nature and choosing to be around someone who would positively affect this trait.
 
I hope this helps you in some way.
 
More soon.


Dr. Marsha Linehan, DBT Founder, Comes out as having Borderline Personality Disorder (BPD)

Tomorrow, the weekly DBT (Dialectical Behavior Therapy) group that I attend and that has been helping me signficantly in my walk with Borderline Personality disorder delves into the skills of Interpersonal Effectiveness. I am really excited about this, because I think that my lack of skills in this area have been a stumbling block in my ability to maintain important relationships, including friendships and a long-term job.  The excitement comes from a feeling of readiness to grow in this area and, well, to keep a job.

I look forward to sharing more with you as I learn this particular set of skills. The doctor who leads the group mentioned that there are no accompanying video lessons for this section of the manual.  I have mixed feelings.

The videos we watch in class are by Dr. Marsha Linehan, who, up until last week, was known to me and thousand of others enrolled in DBT classes or therapy, as an incredible doctor who took the time to create a set of skills to help people with Borderline Personality Disorder (and other disorders or mental states of being that interfere with emotion regulation). She named these skills DBT: Dialectical Behavior Therapy.


Photo Credit: Dr. Marsha Linehan
 As of last week, we still knew her as a genius doctor, but we also came to know her as "one of us."  In a New York Times article that came out on June 23, 2011, journalist Benedict Carey reported that Dr. Linehan revealed to a group of her friends and colleages at a presentation at Institute of Living in Hartford, Connecticut, that she was treated as a young adult for severe mental illness and lived in a locked psych ward, primarily in isolation, for about two years.

The signficance of her decision to reveal this personal information cannot be undervalued. Dr. Linehan's disclosure stands to inspire and bring hope to so many of us living with conditions like Borderlie Personality Disorder (and our loved ones), because her disclosure brings us HOPE.  Hope is something that we often are lacking or desperately seeking, so to receive it in such a large dose as we did last week: seeing a successful Ph.D. doctor come as far as she has, be as successful as she has, be as stable as she has -- to have TRULY created a "life worth living" (one of the phrases she repeated encourages us with in her DBT skills), brings incredible hope.

Thank you Dr. Marsha Linehan.  I'll miss your videos during the Interpersonal Effectiveness section of my DBT group, but I'll be making the rounds again to the other sections right after.  All the while, I'll be thinking about how, if you accomplished what you did, there is so much more hope for the rest of us than we had previously imagined.

More soon.

New York Times Article on Dr. Marsha Linehan

DBT Distress Tolerance Skills

Photo Credit: Sarah Cardwell
I am a bit overwhelmed with my own emotions right now.  I have been caught up and in my own internal drama as I work hard to not let it consume me.  Yes, I am working VERY HARD to use my DBT (Dialectical Behavior Therapy) skills to help me through this rough patch.  I am working hard to learn from my past mistakes and overreactions...my tendency to go into black-or-white catastrophic thinking and to fall into a role of feeling/being victimized.

I have been having a lot of anxiety (which affects my appetite and sleep, which causes more anxiety), so I have given in to taking a couple of additional tablets of Ativan.  It is prescribed to me as 0.5 mg at bedtime, but the label says "May take an additional 1-2 tablets on occasion for extreme anxiety." I almost never utilize it, but I would categorize my current state as being in extreme anxiety, and I want to feel better, so I have gone ahead and taken it.

Before doing so, and in the meantime, I have been practicing my skills today. It hasn't been easy. At all.  But now I fully understand why our doctors and therapists recommend practicing the skills when we are doing well and feeling stable. It really does seem to help them to be more effective when used in "crisis mode."

Today I really felt like I needed to focus on skills that would help me take control of my mind, so to speak.

I  used some Distress Tolerance skills, particularly Distracting (during which you do the best you can to allow your Wise Mind to ACCEPT the current situation while you distract yourself.)  According to Dr. Marsha Linehan, the word's respected leader on Borderline Personality Disorder research and treatment, Distress Tolerance skills such as Distracting can be used "for tolerating painful events and emotions when you cannot make things better right away" (Linehan, 1993, Skills Training Manual, 165).

ACCEPTS breaks down to:

Activities (I cleaned the house. Every single room. I also did the laundry.)
Contributing (I consider getting online and posting this as contributing to others out there.)
Comparisons (I compared my current situation to what could be worse and realized I am blessed.)
Emotions (I haven't done this yet. It is when you do things like watch movies or listen to music that evokes the type of emotion you WANT to feel in the moment. I will watch something funny tonight in hopes of feeling the emotion of happiness or joy.)
Pushing Away (As my head started filling with TONS of negative thoughts, I literally stopped in my tracks and repeated the word "NO!" as I envisioned putting the emotions away in a box while I cleaned the house. Funny, but it helped.)
Thoughts (This is where you focus your thoughts on anything. Counting to 10, counting colors in a painting, watching a tv program.  I decided to listen to some talk radio to hear what other people who aren't in crisis are thinking about.)
Sensations (Recently, in DBT class, we practiced holding ice in one hand. The other day, while at the ocean (the Pacific Ocean is VERY COLD), I went in up to my ankles/shins to experience the same thing - a distraction caused by a sudden, intense, non-harmful change of sensation. I haven't practiced this skill today, but I may do the ice cube later.)

I am going to focus on some of the Taking Hold of Your Mind skills that we learned in DBT this past week. These include Observing, Describing, and Participating, as well as being Non-Judgmental, One-Mindful, and Effective.  I hope to share more with you about this soon.

I have an appointment in the morning with my therapist and may be going back into the intensive outpatient (IOP) program again for a little longer.

Thanks for reading. I really hope this helps you on your journey.

More soon.

Anxiety, Lack of Appetite, and Wise Mind

I am writing this so that I can stay in Wise Mind.  Wise Mind is something you learn about in Dialectical Behavior Therapy, or DBT.
Wise Mind Handout Credit: Marsha Linehan

Here's what it's all about:

Suppose we have two states of mind: The Emotional Mind and the Reasonable Mind. If we lived in the Emotional Mind all of the time (and I tend to spend a lot of my time there), we can get into a lot of trouble. If we spend all of our time in the Reasonable Mind, we'd be quite boring and emotionless. (Think of character Data on Star Trek.)

In DBT, we are told that somewhere in the middle is the Wise Mind - a balanced combination of the two minds.

The section of class where we covered this the most was Mindfulness.

I am feeling particularly anxious and fearful. Because of that, my appetite is lacking. Remember, everything has a cause.  Because I have fearful past memories that are being triggered around eating, lack of food, and losing weight, what other people might see as an ordinary lack of appetite after having a stomach bug and going through anxiety - as something that will pass and the appetite will come back, I end up seeing as a very scary, catastrophic experience.

I decided to become mindful and noticed that I was operating almost entirely from the Emotional Mind:

Thoughts include(d):

I am scared. (feeling)
I am afraid. (feeling)
I am anxious. (feeling)
This is very bad. (judgment)
This is dangerous. (thought)
I am in danger. (thought)

The first step into entering Wise Mind was to just notice what was going on in my head: feelings, judgments, and thoughts, and not giving any of them too much credit. This alone started to calm me down. I reminded myself that I am not my feelings and that judgments and thoughts aren't necessarily TRUTH.

I did something that is difficult for us borderlines - I remembered other times when I have been through this and emerged feeling well. I am getting better at doing this. I think it just takes dedicated practice.

I thought about the reasons I might be having those feelings: quitting/losing job next week (with thoughts about loss of structure and income), long-term relationship in peril (with feelings of guilt, remorse, and fears of abandonment and rejection), physical health has been suffering lately (stomach bug, difficulty sleeping, lack of exercise, and now the lack of appetite), and I realized that I had legitimate reasons to have emotional reactions. I also realized that being scared, afraid, and anxious won't help with any of these except to motivate me to continue to get help and stay on track with plans to keep my mood and health stable.

Judging the situation as "bad" isn't helpful either. While I also wouldn't label it as "good," it just is. It is the fact of the matter - the present situation...so I can go ahead and give it a negative label to make myself feel worse, or I can say, "I recognize this situation. It's uncomfortable. I sense I'd rather not be experiencing this right now. But, I am experiencing it. This is not good or bad. This is my present experience."

As far as the thoughts of this being dangerous - sure it would be if I didn't care, made no effort to take care of myself, or wasn't reaching out for help. But, I remind myself that I do care. I am doing the best I can to take care of myself right now with the tools that I have. I have reached out and will be in an intensive therapy program next week to get some in-depth help with getting back on and staying on track.  So, actually, I am not in any real danger.

Do you see how just breaking things down, identifying them, and being reasonable about each item can help you feel better and deal with things more clearly? I feel like this exercise was very therapeutic for me, and I hope you also learned something or got something of value out of my sharing it.

Have you ever heard of the Wise Mind/Emotional Mind model before? Have you used it to help you through a difficult situation?  I'd love to hear your thoughts.

More soon. 

What Gets YOU Through?

It's been a while since I've posted, and I think it's due time. Without getting into the details of what's been going on just yet, I'll give it to you in a nutshell and then focus on what's happening in the now.

Anyone who has Borderline Personality Disorder (BPD) or knows someone who does knows that one of the more common criteria of signs of this disorder is "frequent crises" ("Borderline personality disorder," 2010.)  I can relate to this. About once every 6-7 months, I end up in the emergency room with symptoms such as diarrhea and vomiting that become so intense due to anxiety and dramatization, that I end up needing IV fluids for re-hydration.  Again, I won't get into the details now about my insights as to why this happens, but I will get into it in a future post.

I ended up in the ER yesterday with one of these episodes. I was deeply troubled and very badly triggered by some very unsafe situations going on at work. Not so much on a physical level, but on a mental health level.  I wish I had kept myself together like an adult and made rational choices that I could be accountable for - like quitting and moving on and knowing that I had made the right choice.

I wish I had tried harder with my DBT (Dialectical Behavior Therapy) skills that I have been working so hard to learn and practice. But I ended up going full force into crisis mode, less than 24-hours after my significant other of many years - my first and only real, mostly stable relationship, expressed in a way like he never had before, how his feelings had unfortunately shut down for me. He was tired of seeing me self-sabotage -- one job after another, one relationship after another, financial issues, etc.  He was tired of my crises - my issues with appetite, running to the hospital and getting IVs, etc. He expressed that he cares for me so much but didn't think he could take much more. He had said this many times before, but I had unfortunately not taken it very seriously and sometimes let it go in one ear and out the other, because hearing it and considering he might leave me was just too painful.

But there was something different about this conversation. He asked me to look him in the eyes and know that he really could not take this anymore, and that it is getting close to the point where we might have to go our separate ways. I was and partially still am in denial. I freaked. I panicked. I cried. I felt sick. I begged him to give me another chance, but everything I said in my desperate plea not to be abandoned and to have him know that I do realize where he is coming from and only wanted one more chance to prove that I won't take him for granted -- he said he was tired of hearing it and had heard it so many times. I begged him to let me know if the situation was hopeless or if there was any chance at all, but he didn't want to answer.

I had to put some DBT skills into action PRONTO. Whether the diarrhea and lack of appetite I was experiencing were anxiety or a stomach bug and anxiety combined, I needed to calm down and care for my physical health and condition before I could deal with this incredibly intense, overwhelming, and terrifying emotional situation.

I pulled out a piece of paper that a licensed psychologist at the hospital helped me come up with before I left yesterday.  Here are some of the things that I wrote down to keep in mind, read, and repeat:

  • I don't need to think about this right now.
  • Just this moment, Just this breath.
  • Keep Breathing.
  • I am okay. Look at the evidence.
  • That's too much for me right now.
  • I want to show you I can do this.
  • Listen to a meditation CD.

For the last one, I listened to (and have since listened three more times to) a CD called Time for Healing: Relaxation for Mind and Body, by Catherine Regan, PhD. I am not sure where you can find this CD - a former co-worker gave it to me. But, I highly recommend it. The first track is a progressive muscle relaxation exercise, and the second track is a guided imagery meditation of walking through the countryside.

image credit:: mindbodysmile.com

Other things I am doing to stay on track is to imagine that I am the adult taking care of my inner child while she doesn't feel well.  I came up with a plan where, even though I have no appetite, I have a light snack and a full glass of fluids every 2 hours or so.  It's been going well. What I've had is hardly anywhere near what I'd eat on a normal day, but on a normal day, I don't have stomach problems and a come-and-go fever. So, I need to take it easy on myself, do the best that I can, take good care of my mind-body-spirit, and trust that each day I will feel better and stronger.

Monday I have an appointment with my psychiatrist. We are going to come up with a rational, "Wise Mind" plan on how to proceed with leaving my current job and take a look at the meds I am taking for anxiety. I am looking forward to this appointment. But, until then, I will do my best to live in the moment...to deal with the anxieties and fears as they come up...and to continue to take care of myself.

Thanks for reading. If you have any comments, questions, thoughts, or suggestions, please DO share.

Talk soon.


References/Resources:

Borderline personality disorder.
(2010, November 15). Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001931/

Identifying Triggers with BPD - A Personal Experience

Caution: This blog post is about triggers and talks about some major abandonment issues.

Our household has been a bit stressful lately. We decided to adopt a second cat to keep our first cat company while we are at work and just so that he would have a playmate. Unfortunately, our resident cat is being very rough with our new, sweet, gentle cat, biting his throat and making him cry.

The situation, and my significant other's response to it, has set off some major triggers for me. Triggers are situations that cause you to experience your own trauma again. They are very personal, and anything can be a trigger for anyone.

The reason that this particular situation is troubling to me is because when I was in my early teens, my mother decided that it was too difficult to deal with my behavior and voluntarily gave me over to social services. While I forgive her now, many years later, and many apologies later, I'll never forget the look on her face when she dropped me off and said, "Take her. I don't want her." It hurt so much. I tried to look brave and tough, but it must have been written all over my 13 year old face that I was devastated, embarrassed, and afraid. She was warned that if she left without talking it out with a counselor, she would be charged with child abandonment.

She stayed, talked to a counselor, and then she left with my sister and grandmother. My sister told me years later that she was scared into submission to my Mom, afraid that she too would be "given away." While I choose to do my best to move on and forgive, I don't know if I will ever forget the hurt, rejection, and humiliation of that moment when my Mom left me there.

The trigger for me this week was that my significant other repeatedly said, "We need to get rid of Smokey" (our resident cat) "He's got to go."  My heart sunk. How could anyone turn like that on the cat we've had for a year? Yes, the cat has always been a little standoffish, but this has been his home. We rescued him and gave him the life of Riley. Then, we thought we were doing something nice by bringing in a friend, but Smokey feels threatened and jealous and is acting out. I agree that the level of aggression that he shows toward our new cat, Piper, is too much, but I want to try any and everything before giving up on Smokey and making him leave.  I feel like all of my garbage from when I was 13 is being kicked up as I think about how sad it would be if Smokey ended up in a cage at the Humane Society. How scared the poor thing would be. I would probably wonder about him for the rest of my life. I don't want to give up on Smokey.

In all fairness to my significant other, I can understand why he has reached this level of frustration. I know he loves Smokey, but he is VERY concerned about Piper (as am I), who came to us with known medical problems and who should not be stressed. My SO has been experiencing insomnia because he worries so much about Piper getting hurt, so he keeps checking on him. He is a major cat lover, and it breaks his heart that he thinks one of the cats has to go, and that if he had to pick, he would pick Smokey. He has loved Smokey so much. They've been inseparable. But, losing sleep night after night while monitoring the two cats together or hearing them cry and scratch at the door if separated have taken their toll.

I called our vet today and asked what else can be tried. Perhaps a mild tranquilizer to help Smokey deal with the stress of the changes?  I'll let you know what happens.

As you can probably tell, something that happened for me is that I really identified with the cat.  I transfered all of my stuff onto the cat, and I re-lived my pain from years ago. It has affected my appetite big time. I'm going to hypnosis on Monday (which always helps with this), and I will give you an update on how it goes.   I feel so scared though - the part of me that is afraid I will be abandoned (my inner child) is on red alert.

Please keep both kitties and my SO and I in your good thoughts as we figure out what's best for everyone.

More soon.

Encouraging Those With BPD & Anxiety

Today was particularly challenging.  I have been in somewhat of an existential mode (which is interesting but can get really scary, really fast for me), and I have been experiencing some rather intense anxiety attacks (heart jumping out of chest very fast, racing thoughts, crying spells).

I know that there are some reasons why I feel overwhelmed and worried, and I also know that after some reflection, my mind is also reacting to 'perceived dangers' - things I am afraid may happen or that may be happening, but that aren't actually solid facts.

I ended up feeling the need to reach out for help today. I felt like going to the emergency room (which I have done so many times in the past), they always end up diagnosing me with anxiety/mental health issues after me being there for about 12 hours. I usually end up pressuring them to give me an IV, because I have a major fear of being dehydrated (since I was in the past), and when when I am anxious, I tend to eat a lot less and, well, I just worry.  I decided, even in the midst of the intense panic and the fact that I desired to have an emergency room team reassure me that I am alright (yes, I have the insight to understand that this is what I, personally, tend to do), to I called the psych department's crisis line and talk it through. It was time for a reality check.

I spoke with a counselor (who I happened to know, which made it less scary and less embarrassing). I talked about all of the symptoms I have already mentioned here and how I have been going through a huge abandonment fear (people with Borderline Personality Disorder often fear and dread - more than anything else, being rejected and abandoned. I am no exception.)

I was really, really hurting and suffering in those moments. I cried out. I wailed. I felt desperately afraid. The counselor helped me to ground myself. She had me take several slow, cleansing breaths. Then she had me look around the room and notice the windows and doors. She had me crack the window and describe what the air felt like on my skin. She then asked me to describe everything that I saw out the window. I quickly calmed. I realized that I had been in a trigger-reaction mode, and by simply bringing myself to the here and now, things felt less intense. I felt less scared, and more in control.  Thank you, dear counselor. I also send thanks to my therapist who picked up the phone yesterday to talk me through it, and to my dear friend and my love, who both helped me today.

Today, I used the DBT (Dialectical Behavior Therapy) skills of:

Taking hold of my mind
Being present in the moment

and the Anxiety Skills of:

Accepting the symptoms
Reminding myself that it would pass
Doing a guided meditation CD (3x!) -- what are some of your favorites?

General Self Care:
Reaching out to others
Resting
Making sure I had something to eat and drank lots of fluids

May your inner voice guide you to the best ways to care for yourself, in the best of times, and in the most challenging of times.

More soon.

Dealing with Intense & Difficult Emotions and Intrusive Thoughts



Sometimes we just need to be held and know we are loved




















It's been a rough couple of days emotionally - really intense. I know things will be fine, but I have been frustrated by the repeated visits of uncomfortable and unwanted thoughts. Something that has helped in the past is the Emotion Regulation Worksheet 1a: Describing Emotions from the DBT Skills Manual from Dr. Marsha Linehan.



What do you do to deal with repetitive intrusive/unwanted thoughts?

Click to enlarge
This worksheet is supposed to help with reflecting on the trigger of the emotions and thoughts and to slow us down in our responses and actions.

More soon.  

Desperately Seeking Sanity - Or at least some stability

Love this image: Mood Swings :)
Mood Swings. Need I say more? I swear my boss must think I am bi-polar after my little performance today. I actually at one point had thought I might be - the type with rapid mood swings...but my doctor assessed that my mood swings are actually triggered by a combination of Borderline Personality Disorder, Anxiety, and the poor diet that I eat when I am very anxious.

I think that mood swings are one of the more frustrating symptoms.  I can't even express how much I long to experience some consistency in mood. I'm not even talking about having a couple of days in a row of consistency. I'd love to experience some consistency over the course of a single day.  Perhaps I should keep a mood journal to see if I notice a pattern in anything (conversations, situations, foods) that may trigger a change in mood. Perhaps being mindful of it will help me discover something that can be of help -- because right now, it feels as if I am on a roller coaster, and I am at the mercy of it.  I can be feeling fine for an hour or two, and then BOOM.  Can you relate? How do you handle it?

Today, before I went to work, I decided that I would 'fake it 'til I made it' and be positive and upbeat even though I have been feeling under the weather. Do you ever set this intention and then take it overboard to where you think others may see that you are obviously 'faking it'?

Of course I am not a mind-reader, and I really have no idea what other people are thinking unless I ask them (and even then, there is no guarantee of getting an honest response - and besides, it's often not appropriate to ask for this kind of feedback...i.e.: boss gives you a weird look after you behave in a very hyper way when the day before you looked like a banana slug struggling to truck along..."Boss, what are you thinking? Are you judging me? Do you think I am bi-polar or something? Do you know I have mental health issues?")  Could you imagine? I have to laugh at myself sometimes.

Because it's clear to me that I won't solve this tonight, I decided to do some 'self-soothing' skills, which we are taught in DBT (Dialectical Behavior Therapy).

According to the handouts in my DBT binder, the way to self sooth is to think of ways to make yourself feel better, in the moment, though one or more of your senses. Here are some of the many examples given (this page is labeled "by Marsha Linehan, (c) 1993 The Guilford Press, Skills Training Manual):

"Vision: Buy one beautiful flower. Make one space in a room pretty. Light a candle and watch the flame.

Hearing: Listen to beautiful or soothing music (I've been doing this tonight...finding that the Beatles are doing the trick. My imagination ran a bit wild while listening to the songs on YouTube. The advantage to this is that they also show footage from that time period, so I imagine what it must have been like to be young in that era. Fun!). Pay attention to sounds of nature.

Smell: Use your favorite perfume or lotions, or try them on in a store. Light a scented candle. Boil cinnamon.

Taste: Have a good meal. Treat yourself to a dessert. Chew your favorite gum.

Touch: Take a bubble bath. Put clean sheets on the bed. Pet your dog or cat (I did this - actually danced around with him to Oladi Oblada. :) )

Even if our moods are not consistent, we can find ways to brighten periods of our day by focusing on creating soothing experiences for our senses. I hope you find yours, and please feel free to share!

More soon.

The author of this letter has since RECOVERED from Borderline Personality Disorder and no longer meets the criteria for a BPD diagnosis. There is HOPE for you and your loved one. Recovery happened through a commitment to DBT. Debbie now teaches the DBT skills that helped change her life over at DBT Path (http://www.emotionallysensitive.com) where you can take online Dialectical Behavior Therapy Classes from anywhere in the world. You *can* overcome this disorder! Visit DBT Path to learn more.

It's the Little Things | Every Day Pleasant Life Activities for Adults

In DBT group, we have a handout called "Adult Pleasant Events Schedule." It is a checklist of 197 little things we can do each day (we are encouraged to pick at least one daily or make up our own) to make life more enjoyable. There are 3 pages total.

Here is Page 1:












Page 2:












And Page 3:



At the bottom of the sheets, it notes: "From Skills Training Manual for Disordered Emotion Regulation" by Marsha Linehan (c) in press Guilford." It seems that this manual is FILLED with great resources for people with BPD and their care providers.

It really helps to have this list handy or to come up with ideas - events and things that you know will boost your mood, and then to do them - whether you have Borderline Personality Disorder or not.

I tweeted today that it makes me feel happy to have a kid's food like peanut butter and jelly, a grilled cheese sandwich, or a string cheese. Just a little thing, but it is enjoyable for me.

Last night I tweeted that an old-school Bee Gees song was relaxing me and helping to make the night mellow. I included that I figured people would think I was "lame" for choosing that song, and someone responded back and said that nothing is lame if it helps. I have to agree. If you aren't hurting yourself or someone else in any way, and it helps, go for it!

Today I did a few pleasant life activities:

Met with a friend and we caught up on each others' lives. We sat in the sun, which was a bonus.

Had a peanut butter and jelly sandwich for lunch.

Treated myself to the Light Caramel Frappuchino at Starbucks (low-cal and low-sugar). As I parted with my $4 for the drink, I reminded myself to enjoy it slowly and that I could fork over a few bucks now and then for the pleasant experience. Yumm!

I blasted some music in my car while driving to and from work and sang along with reckless abandon.

I set goals for work to help me stay focused, and I enjoyed the feeling of confidence most of the day.

I think that some of these items are on the list, but see how many you can identify for yourself, and try to do at least one tonight/today. Feel free to share if this exercise helps you or if you have any activities you particularly enjoy or recommend.

Go do something pleasant!

Thanks for reading.
More soon.

Triggers When You Have BPD or PTSD | Polarized Thinking

A number of things come to mind that I could write about today.  I think I will talk about triggers.

I have a personal trigger where I have a very difficult time accepting criticism. It's not because I believe I am perfect and don't deserve it, but as someone living with Borderline Personality Disorder, I want everyone to THINK that I am perfect and don't deserve it.

I somehow get so caught up in the game that I, at least briefly, experience the delusion that I am convincing others that I am perfect. I can do no wrong. I am perfect. As a child, I was always the teacher's pet. Come to think of it, I was in high school and college as well. Didn't make me very popular, as you might imagine.

As an adult, I have been frustrated over the past few years in the work force. Why? Because I don't know it all. I am not perfect, and I make mistakes.  I suppose this is true of EVERYONE, but they say that how you interpret something is what matters. So, I decided to look deeper.

Why is making a mistake such a big deal for me? Why does it terrorize me?


For me, making a mistake means that my boss will see I am flawed. Rather than looking at the one small mistake, acknowledging it, learning, and moving on, I become immediately defensive. Not because I want to be rude. Not because I don't think I am in the wrong.

I just feel so immediately naked and vulnerable once she sees that I have messed up. Years worth of childhood rejection and abandonment pop up and mock me in that moment.  I become afraid that she is now beginning her plot to fire me. "We can't have imperfect people here making mistakes. All of the good things you have done, your potential, and all the ways you have contributed - none of it matters. You made a mistake. You are worthless. Goodbye."

While I realize that it is highly unlikely that this thought goes through my boss' mind, in the moment that I am caught making a mistake and/or criticized, something inside me on a visceral level believes that she is thinking this. And, I become paralyzed with fear. I say something to defend myself or explain why other peoples' miscommunication is to blame. Then I realize how obvious it is that I am doing this and feel as if I've dug an even deeper hole. It's pure madness.

With Borderline Personality disorder, in my case and with many others living with BPD, black-or-white, all-or-nothing thinking is a major issue.  We see in extremes. We tend to see people as either Good or Bad. It's difficult to see shades of gray or colors. I am working on this, but as of the moment, I don't usually catch myself in the act and only realize that I have been thinking this way in retrospect.

In this particular situation that I have been describing, my thinkings is that I am either a perfect employee or a worthless one.

I am now looking through my binder from DBT group for the section on black-or-white thinking. According to this handout that I am looking at, this type of thinking is also called "Polarized Thinking: Things are black or white, good or bad. You have to be perfect or you're a failure. There is no middle ground."

I can totally relate to this.

The worksheet goes on to give a "Rational Comeback" to "Polarized Thinking." I am not really sure where the worksheet was sourced from, but the pages on top are 26 and 40-41 (no copyright infringement intended:)

"Listed below [is a] rational correlative to the ....distorted thinking style...Use it as a reference when you are having problems with a particular distortion...

Polarized Thinking: No black and white judgments. Think in percentages.

The key to overcoming polarized thinking is to stop making black or white judgments.  People are not either happy or sad, loving or rejecting, brave or cowardly, smart or stupid. They fall somewhere along the continuum. They are a little bit of each. Human beings are just too complex to be reduced to dichotomous judgments. If you have to make these kinds of ratings, think in terms of percentages: "About 30% of me is scared to death, and 70% is holding on and coping...60% of the time he seems terribly preoccupied with himself, but there's the 40% when he can be really generous...5% of the time I'm an ignoramus, the rest of the time I do all right."

Tonight I will practice being more compassionate with myself and thinking about integrating more shades of gray and color in my thinking. 

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