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. 

Opposite Action: DBT Skill

I did NOT feel like writing tonight, which is exactly why I decided to do so anyway. Today I had DBT Group after work. DBT (Dialectical Behavior Therapy) is the leading treatment for Borderline Personality Disorder.

Every week, we meet together in a group led by a psychotherapist who guides us on a brief mindfulness meditation, followed by a brief check-in about how we are doing. We also check in about any self-harm behaviors we might have engaged in and if anyone is feeling unsafe (or having suicidal thoughts).  Next we usually watch a video from Dr. Marsha Linehan, the founder of DBT.  We then go over some worksheets as the doctor teaches us a new skill. It will be our homework to practice the skill throughout the week and report back as to how it went.

Today, we talked about Opposite Action.  I took some notes so that I could fill you in...

This is pretty much verbatim of the video (I jot down notes very quickly.) No copyright infringement intended. Just trying to share this work with those in need.






1.) Every emotion has an action. (It makes you want to do something.)
2.) Change the emotion by changing your actions. (Actions change emotions.)

3.) It doesn't alwys work. (Opposite Action will work whenever the emotion is NOT justified by the situation.)









Breakdown:

1.) Every emotion has an action. Here are the examples that were given on the video and by our doctor in group of typical (re)actions to common emotions:

Afraid --> Run, avoid
Angry --> Attack (physically, verbally, psychologically)
Sad --> Withdraw
Shame --> Hide

2.) Change the emotion by changing the action. In other words, do the opposite action that you normally would do.

3.) Determine if the emotion is "justified" by the situation. A better way to think about it is whether the emotion is proportionate to the situation.

I will use my own example. I am feeling irritable.

1.) Irritable --> My typical behavior is being short/rude to others, tensing up, and complaining.
2.) Instead of doing my typical behaviors, I am doing the opposite: finding at least one way tonight to reach out in kindness to someone else, relaxing with a good tv show, and using this experience of irritability constructively by writing this blog, instead of complaining.
3.) I don't want to get into the exact reason for my irritability tonight because I don't want to focus on it, but in being honest with myself, it is disproportionate to the actual situation that is irritating me.

I hope you found this somewhat helpful. If you have questions, I will try to answer them to the best of my understanding.

More soon. 

Today's Visit with The Psychiatrist

I am quite lucky to have a psychiatrist that really gets me. I feel that she understands, has compassion, and actually listens. At least most of the time. I mean, we're all human.

I had an appointment with her this morning, and I revealed to her some anxiety that I have been experiencing. I haven't had much luck sticking it out with my past few jobs, all with what I consider to be good reason, but even she agreed that my current situation is unhealthy and that she, herself, wouldn't last 5 minutes in the environment that I've described. And I didn't even exaggerate. Not even a little bit.

I have been working for the past half year for a psychiatrist. Yes, interesting. Up until recently, I have been able to (at least I think I have) conceal the fact that I suffer from any type of mental health issues. I have been able to go to work, do my job, deal with my own insecurities and anxieties, and all has pretty much been well. I only work 5 hours a day, part-time, so this has helped to make working, in general, more tolerable for me.  If I am having a particularly difficult day, I tell myself -- I can keep myself together for the next 5 hours. 4 hours...etc.

The interesting thing about the doctor that I work for is that she also claims to be a psychic. This can get very interesting at times. She is a legitimate doctor with her license and all. She treats patients all day. But, in my estimation, as someone who has her own issues, the woman has some issues of her own.  She tells me that she channels her alien-being friends all day and that they advise her. Then she advises her patients accordingly. The fact that she is writing scripts and treating people is a bit scary to me.

She sometimes tells me very personal information that her clients share with her, and it makes me uncomfortable. To boot, the stuff is often about issues that trigger me, and I have had to, more than once, go to the restroom and ground myself so that I didn't totally spin out into dissociation and anxiety.  She tells me things about sexual abuse and things of that nature.   Not only do I not want to hear these things, but I feel bad for her unsuspecting clients who trust all their very personal stuff with her. It's not right, and my psychiatrist has urged me to consider reporting her for it. 

The thought only fuels the anxiety I already feel. My stomach has felt like a rope has been tightening around it since last night. My appetite has been down, and my heart has been racing. I know it's just the anxiety. It's just from being triggered. My mind is trying t stay in "wise mind," but the physiological effects of the stress and worry linger and taunt my nervous system.

The job itself isn't that bad at all. I rather enjoy it. I answer the phones, type up documents, greet visitors. Nothing too fancy. I make just enough money to make ends meet, and I have time to go to DBT group and take care of other things that are going on in my life. She pays me rather well, which makes it hard to walk away...especially that as I scan the want ads, I don't see anything paying as much, and I do have a bottom-line survival salary that I continue making ends meet.

I feel somewhat challenged by the situation -- I have to figure out how to behave like an adult. How to handle the situation responsibly. How to figure out how I will take care of myself from all perspectives, including financially - without making any impulsive moves or irritating her enough that she just lets me go.

My doctor recommended doing repeated reality check with myself for as long as I choose to stay in the position. "She is crazy. She is crazy" is what I am supposed to repeat to myself if she comes up with one of her wacky psychic visions.

I am STRESSED about this, but I know that in the past, things have always worked out for me. So although I am filled with anxiety and I know I need to practice my DBT skills, I am going to do my very best to try to relax this afternoon and evening. I have DBT group after work tomorrow, so that's a very good thing. We're talking about emotion regulation. Another good thing.

Thanks for reading, more soon.

Sundays Can Be Difficult for the BPD Chameleon


 Sundays can be a bit difficult in terms of my BPD symptoms.  In reality, Sunday means that the weekend is winding down and that my boyfriend and I go back to work tomorrow - just as we do every week and have every week for as long as we've been together.

The scared, little girl inside of me, a part of me that I am learning to nurture and learning to set boundaries with so that she does not "run the show," so to speak, sees Sunday evening as a threat. She feels anxious and uncomfortable.  The routine, once again, will change, and the man in her life - who she often clings to and sees as a source of constancy and normality, will go off to work, "leaving her alone" in the big, cold world. 

She felt secure all weekend, by his side, doing their usual, typical weekend things: running errands, enjoying lunch at a favorite hot spot, taking a nap or too.  Now, they will be apart. All week. Except for after work.

For the typical person without BPD, it may be difficult to understand why I, or anyone with BPD would take something so "normal" and feel so threatened by it. 

For me, it is a few things that I believe come together to cause this anxiety, but mostly, it is my struggle with identity.

I have described myself to doctors (which ultimately led to my diagnosis last year), as a chameleon.  While I have some things about myself that I know are a part of me, I have a survival mechanism in me where I have learned to mimic those who I am with and to "read" them so that I behave in ways that they find acceptable - essentially so that they will accept and like me and not reject me.

This may sound manipulative, and to a degree, it is. But for SO many years, I did it unconsciously. Now, I am much more aware, can catch myself doing it, and can be compassionate as I work toward figuring out who I am - not who I think others want me to be. It is exhausting to "be one way" all weekend only to shape-shift to be "someone else" at work for my boss and co-workers.

Every Sunday, things change again.

No doubt, the survival mechanism to be like a chameleon stems from childhood, which was rocky, uncertain, unstable, and often scary.

Now, it doesn't serve me, and it is one of the things I am working on in DBT (Dialectical Behavior Therapy) Group.

I am off to try to enjoy this night by doing some things that I find fun - including watching Celebrity Apprentice. I'll write more soon.

May your Sunday evening be less stressful, less anxiety-filled, and my your heart be filled with more peace.

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