Getting off of SSD Social Security When You Have Mental Illness

I remember the appointment with my therapist at the time.  I met with him to discuss the paperwork that Social Security had sent me.  He needed to fill out the evaluation so that the Social Security Disability department could determine if I was still disabled and therefore eligible for ongoing benefits.

I had been on it for years, and though the monthly amount was ridiculously low in terms of being able to have a quality of life, I was very thankful that I could count on that check every month. Being that I was eligible for SSD, I was also eligible to elect private healthy insurance, in addition to Medicare, at no cost to me.  This meant I got excellent care for my mental health issues (and, from time to time, physical health), and my prescriptions and hospital inpatient visits were covered.

I had been on the program for years but had recently really tried to pull things together and work.  Though I had difficulty staying at the same job, I was getting consistently better at finding jobs and at least working at them for a couple of months.  I had to report all of my income and work attempts to Social Security, and I had evaluation requests for my doctor to fill out from time time to time.

I was kind of scared. At least Social Security was a "sure" thing - money that I could count on.  I was afraid that if I got well and improved....if I were able to keep a job..."what if" I later relapsed?  The Social Security income would be gone, and I'd have nothing. I could end up on the streets. The thought terrified me.  But, eventually, what terrified me more was the thought that in my 20s, I wasn't willing to try to improve. It terrified me that I could, out of fear, depend on the systems indefinitely and avoid getting well in order to have the peace of mind of having a government check.

I became determined to prove to myself that I can take care of myself.  I also trusted that, God forbid I should relapse to the point of not being able to work, I could reapply and have the support of my doctors.

At the point where this evaluation came up, I hadn't been hospitalized inpatient for psychiatric reasons for at least a year.  My pattern from age 18 was that I was in and out of psychiatric units several times a year. So, this, in and of itself, was a huge improvement.

I hadn't even been diagnosed with Borderline Personality Disorder yet at this point in my life.  My diagnoses were Obsessive Compulsive Disorder (OCD), Generalized Anxiety Disorder (GAD), and episode of Major Depression.  But, I was doing well!

I'll never forget how things unfolded.  I had mentioned to my therapist that I would be getting the papers for Social Security soon, and he said that we would discuss them when they came in.  I knew in my heart what I needed to do.  I knew I was getting well and that I could continue to do so, and after we discussed it and I assured him that I was clear that Social Security would end up discontinuing my benefits, that is exactly what my doctor wrote on my forms in the prognosis section: "Ms. ****** is doing very well, and there is no reason to believe Ms. ****** will not continue to improve." I felt so proud of myself when I made this choice and then submitted the paperwork to Social Security. I felt very "adult" and responsible.  My choice gave me hope in my ability and potential to continue to heal.

It's been several years since I have been off of Social Security.  There have been moments where I've deeply considered reapplying (due to repeated attempts at jobs that ended due to my own self-sabotaging BPD-behavior), but since being diagnosed with BPD and enrolling in DBT (Dialectical Behavior Therapy) classes, I have managed to keep myself together enough to hold down a part-time job and work on my writing.  I have been on the temporary state disability for a few weeks a couple of times over the years (while in partial hospitalization/intensive outpatient treatment for relapses), but then I got back on my feet again.

I live with another person, and we share most of the expenses, so this helps.  I have health insurance at the moment, so all of the things that were covered in the past are covered now.

I trusted, and it worked out.

Thanks for reading.
More Soon.


United States of Tara and My Borderline Personality

I'm bummed to learn that the Showtime Original Series, "United States of Tara," which I've been watching via Netflix, was cancelled last June.  I love this show.

Although the main character, Tara, (played brilliantly by Toni Colette) has Dissociative Identity Disorder (formerly known as Multiple Personality Disorder), and I have Borderline Personality Disorder, I love this character very much, and she reflects a lot of my own experience.

For example (I am on episode 20, which is partially into Season 2 out of a 3 seasons total), Tara has a "knowing" deep inside that there is something that happened to her as a child that she cannot recall.  It's something her subconscious has blocked from her memory (an amnesia of sorts), all in an effort to protect her psychologically.  But as the pieces and memories begin to surface, she begins to realize that something, indeed, did happen.

At this point, she hasn't figured it out yet.  I know this type of longing for answers and wanting to know the truth about my experience.  I have plenty of memories that justify the PTSD symptoms and even my development of BPD, and these are readily available memories that I can vividly recall and describe to you. But I also have a period of a few days when I was a young girl - I'm guessing around 7 years old (I don't really know), when "something" happened.  I only have bits and pieces of the experience, and the rest is repressed.

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I've considered going into hypnosis to piece together the puzzle, but then I worry that if my conscious mind hasn't revealed these memories to me, it may be too traumatic to "force" them out of hiding.

Here's what I do remember...

(Warning: Possible Trigger Alert!)


I was around 7 years old, and my Dad had taken me and his friend "P" out to eat.  When we got out to the parking lot, I told my Dad that I needed to lay down.  I was overcome with tiredness...completely overwhelmed. I remember that I could hear them talking, but I was so weak that I couldn't speak.  I was so afraid.  I heard my Dad say, "This isn't like her to just fall asleep like this."

Now, I have NO EVIDENCE that this occurred, and I always attributed my falling ill to food poisoning (perhaps that's what the adults around me told me it was), but recently, I began to wonder if my father's friend had drugged me.  I only say this because I saw an episode of "What Would You Do?" where they talked about the symptoms of a date rape drug.  The symptoms sounded eerily similar to what I remember experiencing in my body and mind as a child.  And, when I woke up at... P's father's house - a man who I had never before met, I had no idea where I was.  I remember being very frightened, having no idea how I ended up there.

For about what seemed like two more days, I stayed on P's Dad's couch, and although I kept vomiting, felt very feverish, and my skin was as red as a lobster, I don't remember EVER having a dialogue with this man.  I don't remember him speaking to me. I don't remember me saying anything to him.  I don't remember WHY I didn't pick up the phone and call my mother or Nana, or why I didn't ask where my father was.

When my father finally showed up, I was very dehydrated.  What he said to me and the way he behaved set up a major trigger that I have dealt with for decades. (How can an adult be SO UNAWARE of the potential consequences that their words and actions can have on a precious, impressionable child?  How can they not know that they may scar and damage that child and that they may have to live with the effects of this well into their adulthood?!)   My father made up a concoction of Sprite soda, Alka Seltzer, Tylenol, and Pepto Bismal.  He told me that if I didn't drink it, I would die of dehydration.

Scared to pieces, I drank the concoction.  I have a lapse in memory as to what happened after that.  My next memory is being at a pizza chain called Papa Gino's with my father and younger sister, and my Dad saying, "You'll need to go to the hospital if you don't eat or drink."  When I still refused because I didn't feel well, he said, "If you don't go to the hospital, you're going to die."  I again have a lapse in memory. I don't remember if I got well on my own or went to the hospital, though I don't remember going to the hospital at all.

What I do know is that at any sign of dehydration through out my adult life (with the last time being June 11th of last year), I have always rushed to the emergency room and received IV fluids - terrified that I was going to die if I didn't.  To my father, who passed away many years ago - do you see what you've done?  I know I told you I forgave you when you were on your death bed for all of the abuse and turmoil you caused me, my sister, my mother and grandmother -- but I had no idea how long your abusive, irresponsible, horrific behavior would affect my life.

I am tired of being your victim.  Since I have been going to DBT classes and maintaining a sense of stability in most areas of my life, I realize that as an adult, I am responsible for taking care of myself.  Never again will I let myself believe otherwise.

I no longer run to the emergency room because I am now "hip" to this trigger. That's right, Daddy, I am healing.  Memories are coming to the surface.  I will know the truth, and even more importantly, I will be strong enough to face it and move on with my life, knowing that neither you nor anyone else can abuse me ever again.  It is with a a bit of apprehension and, of course, uncertainty, that I tread in these waters, but just as Tara in United States of Tara is trusting the process and pressing on as her mind unveils her secrets to her in a timing that she can handle, I, too, am trusting the process.

Even if I dissociate from time to time, I trust the process. I have the tools to ground myself and keep things from completely unraveling. I am ready.

Chameleon Phenomenon in Borderline Personality Disorder

I have another post where I talk about how many of us with Borderline Personality Disorder behave or feel like chameleons, called "Sundays Can Be Difficult for the BPD Chameleon," and this post today focuses on a specific example of the chameleon phenomenon and what I have begun to notice.

I was visiting my boyfriend at his office, and dressed in sweats, a short-sleeved shirt, and a hoodie, I began to feel very warm.  Instead of just listening to my body and the cues it was giving me, I immediately looked outside of myself, to him and others, to notice what they were wearing. Surely if they weren't warm, I must not be either...or maybe there was something "wrong" with me for feeling warm when no one else appeared to feel that same sensation.

I decided to do a reality check and asked my boyfriend casually, "Hot in here, huh?"  He responded, "Yeah, it really is."  Ah. So my body was right.

I do this with other things, too.  I've literally asked people to smell food to tell me if smelled "ok" or to feel my forehead for a temperature -- all because I don't feel secure in my own ability to determine these things and completely take responsibility for caring for myself.  I'm often afraid that if I don't get that validation or reassurance from someone else (usually someone older, but it can be a peer or someone younger), I just am not sure what I, personally, feel or think.

I came across this diagram and find it interesting.  Does it speak to you, too?

Image Credit


Thank you for reading.
More Soon.

Feeling Lonely: Just Me & my BPD

I feel lonely today, and I have fought back tears on a couple of occasions - once during a quiet moment in yoga this morning, and another just now as I began typing this.  You see, I've done a good job at isolating myself so that I don't have to try at relationships.  I had become a bit hesitant to engage in friendships since my recent one, to a woman I was very close to, ended because of my BPD-related behaviors.

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Of course, this was before I began to really "get" the skills I've been learning in DBT (Dialectical Behavior Therapy), but when I called her a couple of months ago to explain and ask her forgiveness, she informed me that she was no longer interested in being my friend. It hurt, but I can't say that I don't understand why she had finally had enough.  I only wish that she had given me a chance to show her the improved me - the one who now turns (most of the time) to practical, healthy choices instead of self-sabotaging and self-harm.  But, again, she's not interested. There's nothing I can do.  I've tried to convince myself that she's a "jerk" and that I'm better off without her, but the truth is that I love her, and I am so sad that, at the time I was friends with her, I wasn't yet ready to be a friend. I was very needy, clingy, and almost always had a crisis.  My mood was here, there, and everywhere, and I would end up in the E.R. freaking out. I really didn't know how to be there for her and constantly set up a dynamic where I was in need of her rescuing.  I can see it now, but I couldn't then.

Speaking of relationships, I've invested most of my emotional stock in my boyfriend who, while I know he loves me as a person, is also someone that I pushed far, far away with my emotional outbursts, hospital visits, and repeated promises that I would change.  The change within me really has begun to come due to a lot of hard work in DBT, but I can tell it's come too late for him as well.  I have been feeling really emotional about this lately.  I wonder if you have any idea how desperately I wish I could undo the hurt, pain, confusion, and destruction I caused around me and to the people I love, especially my boyfriend.  He has put up with SO MUCH.

Now he's deciding (for a myriad of his own personal reasons, including the issues with me) to go and live with family abroad for a few months. I'm freaking out.  I don't want him to go, and I have been dissociating and going into denial. I know that one of the reasons we have disconnected is because I suddenly began to get very triggered during intimacy with him. Not to gross you out, but I would literally throw up.  I don't know what is going on when this happens, but I've avoided sex due to the anxiety around having another episode like this. He has no idea why I became this way, and to be honest, neither do I.  Something from the past is coming up.  I've gathered from his comments and demeanor that he just really doesn't know what to do to "help" or "fix" me.  I've explained that he doesn't have to.

The good news is, he says that he has seen a huge improvement in me since really getting into DBT. This is a lot coming from him, as he would always say to me, when I relapsed: "all that therapy, psychiatrists, therapists, emergency rooms, groups -- and you're still the same year after year."  I don't hear that anymore. I take that as a very good sign of progress.

Thanks for reading.
More Soon.

Practicing the "Radical Acceptance" DBT Skill in Baby Steps

There is an enormous relief that comes with practicing the "Radical Acceptance" DBT (Dialectical Behavior Therapy) skill.  When you embrace a situation, emotion, or feeling without trying to change it -- when you accept it with 100% of your body, mind, and spirit, you can gain a sense of peace that isn't otherwise possible.

Before I go on, "acceptance"  does NOT mean "approval." It doesn't even mean that you like the situation, emotion, or feeling that has taken place or arisen.  An extreme example of "Radical Acceptance" is if someone were to say, "I accept that I was abused as a child," and she truly felt and believed this with all of her being.

This person is not saying that she approves of the fact that she was abused, that she likes that it happened, or anything like that.  She is simply fully acknowledging that no matter what she does, says, or hopes for, we can't go back in time and change the past. What has happened has happened. As painful, unfair, and horrible as it was, the fact is, she was abused as a child.  She is accepting reality.

Most of us have to start off practicing this skill in baby steps.  I have a tiny example to share with you that happened today.

I decided to try to sleep less in order to not go down the road of depression and so that I would have more time in the day to work on productive things. Somehow, last night, I forgot to set my alarm.  I eventually woke up on my own, of course, but an hour later than I had planned.

Unfortunately, the first word out of my mouth as I jumped up in bed was "F#ck!"

I then took a deep breath and realized, fully, that getting upset wasn't going to give me that hour back.  I radically accepted that I slept past my intended time and that I could still have a positive, productive day if I just got started then and there.

Something to notice about my example is that there was "cause" for me getting up late.  Dr. Marsha Linehan, the founder of DBT Therapy, often talks about "the laws of the Universe" and how everything "has a cause."  In this case, my forgetting to set the alarm caused me to not wake up on time.  I am finding that sometimes examining the cause(s) behind a situation help me to radically accept it.

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Have you ever used radical acceptance?  In what situation(s)?

Thanks for reading.
More Soon.

Using Distraction DBT Skill for Dissociating & Distress

I have been having more episodes of dissociation lately.  There is one topic in particular that triggers me - my boyfriend is planning to go away for a while.  Almost every time he begins to discuss the particulars, I sense myself drifting off. Sometimes I don't sense anything and realize it after a few minutes have gone by.  I sort of just go into a deep stare into outer space, and though I can hear the sound of his voice, I can no longer make out his words.  My thoughts take me somewhere else.  It's the strangest thing.
Image Credit

I know that my brain dissociates as a self-care mechanism, but I'd like to reduce the impact of these episodes and their frequency so as to not have them disrupt my life (as they have in the past).

What I began to do today, as we sat down to lunch together and he brought the topic up, and I felt myself beginning to disengage and disconnect, is use the DBT (Dialectical Behavior Therapy)  Distracting Skill of "Thoughts."

From Dr. Marsha Linehan's Skills Training Manual:

You can distract yourself "with other thoughts:  Count to 10; count colors in a painting or tree, windows, anything; work puzzles; watch TV; read."


What I chose to do was name the different attributes of my boyfriend's shirt:blue, buttons, pocket on the sleeve, pocket over left side of chest, stitching near the collar, etc."  It actually helped me to stay grounded.  I could feel a strong pull to escape mentally and not hear what he was saying, but I continued to hear what he said.  I didn't feel as emotionally charged by what he was saying, though.



This was an interesting experience, and I plan to use this skill a bit more to see if it continues to be effective.  It felt very "grounding" to me.

Thank you for reading.
More Soon.

Boredom & The Borderline (BPD & Self-harm)

As a person with Borderline Personality Disorder, I can attest - boredom, or being idle, truly is "the devil's playground." It seems that when boredom hits me, it's much more intense than it is for other people, and I desperately feel the need to feel something - anything.

I've heard a theory that, since many of us with BPD came from unstable, often erratic backgrounds, our nervous systems are more sensitive, especially around emotions.  We have grown so accustomed to being on guard and needing to survive in scary and sometimes life-threatening situations, that the ordinary calm that most people experience on a daily basis can feel very foreign or unfamiliar to us.  It can feel uncomfortable, and at times, intolerable.

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Possible Triggers Follow...

Some people with BPD self-harm when they feel this way. The most common ways are cutting and burning, though there are so many behaviors that could be classified as self-harm.  I choose to speak on these because I mentioned that when people with BPD feel bored, they sometimes feel very desperate to feel anything.  This includes creating physical sensations and pain in the body, and it works.  The dangerous thing is that the person could unintentionally hurt herself with an infection...or worse.  People self-harm because they get something out of it - it meets their need in a given moment when they are feeling very emotional.  One of the goals of DBT (Dialectical Behavior Therapy) is to help us learn new, effective skills - think of it as an emotional tool box that we get to fill with all new ways of responding when we feel extremely emotional, bored, or desperate -- ways that don't hurt us or cause us to throw our whole life down the drain over a transient, passing emotion.

Sometimes I get so bored that it seems like it would take way more energy to practice my skills than to wallow in the torturous feelings I experience.  In those times, I become numb and sedentary, which often leads to feelings of depression and anger.

I'm finding that the best thing to do is to get busy - especially with something that will allow me to feel like I've accomplished something. It doesn't have to be anything big, either - I can just go and clean the bathroom or vacuum the rug. At least I'll be using my time in a way that gets something done.  And, truth be told, I usually feel better after I complete the task, and one thought leads to another as far as other things I can do to stay out of trouble, if you will.

Some DBT skills that I have found helpful in coping with boredom are:


  • Mindfulness: Sitting with the emotion and not trying to fight it. I'd really like to be able to tolerate peaceful, low-key times -- even if they are sometimes boring.
  • Build Mastery:Work on tasks that allow me to accomplish something
  • Improve the Moment:Put on music, light a candle, pet my cats

I hope this helped you in some way.  What do you do when YOU get bored?


Thanks for reading.
More Soon.



How To Change Your Emotions [If you WANT to]

Today in DBT (Dialectical Behavior Therapy) class, we covered the Emotion Regulation Skill of "Opposite Action."  In this post, I summarize what I got out of the video we watched by Marsha Linehan. No copyright infringement intended. Just passing along knowledge to better process the material myself and to help others.

How to Change Emotions [if you WANT to]

If you're experiencing an emotion that is not serving you or standing in the way of your goals or effectiveness, Dr. Marsha Linehan prescribes a 3 step system to help:

1. Every emotion has an action, and it's different for every emotion.


2. Change the emotion by changing the action.


3. It doesn't always work.  Changing your action doesn't ALWAYS change your emotion. Opposite Action will work when the emotion is not "justified" by the situation.


Elaboration on "justified":

Justified seems like such a subjective term. Our therapist/group leader said to think about it as "justified in terms of the laws of the Universe." For example, if there is a tiger in the room and you get afraid, that is a biological response designed to help you get out of harm's way.  No amount of opposite action will take away that fear (and with good cause!).  However, if the next day you were sure there was no tiger in that same room but felt too fearful to enter, the opposite action of entering the room would help reduce your fear. You would essentially be training your brain and letting it know that the room is now safe (this is known as "exposure therapy.")

The video went on to explore a couple of emotions in more detail. 

Fear

According to Marsha Linehan, "Fear is justified when a situation threatens your life, health, or well-being."  If it does not, it is not justified.

Anger

Anger is justified when you have an important goal blocked or when you feel a lot of pain.  Our therapist pointed out that even when anger is justified, it doesn't always serve you or work for your good, so you may want to reduce it anyway.

The natural response to anger is to attack.  The Opposite Actions to anger are:

  • Gently Avoid (leave the situation without causing a scene)
  • Be Decent, and if possible, be a little kind
    • Try to be empathetic - think about what the other person might be thinking/feeling. This is more effective at getting what you want than getting angry and acting in anger.
We have an intern doctor assisting our group leader, and she gave an excellent example of how she used Opposite Action to counteract anger that came up inside of her.  She was working in the E.R., where emotions are heightened and people obviously do not feel well. A confrontational nurse was rude and angry with her, and she decided to respond to the nurse in a very soft, kind voice (genuinely). She felt that this disarmed the nurse emotionally and that she (the doctor) kept her own cool.

Effect of Intense Emotions Being Reduced

Once you reduce intense emotions, you can think more clearly, allowing you to make appropriate, effective decisions.

"Do it [Opposite Action] All The Way"

Dr. Marsha Linehan also emphasizes that if you are going to practice Opposite Action, you must do it "all the way"if you want to experience results. She gives the example of a woman who is afraid to go to parties because she is fearful that people will criticize her and be mean to her. If the woman shows up at the party in order to practice Opposite Action, but she keeps her head down and doesn't make any eye contact with anyone, she is only making a half-effort, which won't be effective. She also needs to be looking up and being willing to engage. In this way, she is giving the full effort of body and mind in the Opposite Action attempt.


I hope this was helpful for you.
Thanks for reading.
More Soon.



"Opposite Action:Changing Emotions You Want To Change (Dialectical Behavior Therapy Skills Training Video)"  Dr. Marsha Linehan DVD 







DBT Skills for Dissociation

I put my DBT (Dialectical Behavior Therapy) skills to work today. Unfortunately, I experienced a panic attack and a couple of episodes of dissociation. The panic attack happened during a group exercise at the gym.  My impulse was to run from the room to "safety," but I used Wise Mind to remind myself that I was safe already.  I focused on my breathing and paid deliberate attention to the instructor, using both the Mindfulness and Distract Skills.

Later in the day, I went for a walk with my boyfriend. He's getting ready to make some big changes in his life, and they include moving away for three months. Sometimes the thought of it is too much for me to handle. I get really stressed, and from time to time dissociate.

Disconnected.  Image Credit.

Today, as we were on a beautiful walk, he began to discuss some of the financial issues around his plan to go away for three months, and suddenly, I didn't hear him anymore. My surroundings became surreal, and I didn't feel like I was in my body. Once I realized it, I felt a bit shaken up and anxious. I let him know  that the particular topic was too much for me in that moment and that I was dissociating. I'm not sure he knew exactly what that meant, but I described it as being "checked out,"  and "disconnected," and that anything he said when I was having an episode would go in one ear and out the other.

I suggested we talk about something else, and I used the new conversation to ground myself.

I am feeling particularly unbalanced today because I am experiencing PMS, and my menstrual cycle is set to begin any hour now. I am giving myself compassion by self-talk/ Self-Soothing and Non-Judgment. I used Opposite Action to get myself out of the house today twice - once for the gym class and the other for the walk.  I made sure I ate even though I've had a low appetite today ("PLEASE" skills), which is in stark contrast to yesterday, when I wanted to eat everything in sight.

The plan now? A little nap with my cats, and then cooking up a light dinner later...followed by TV.

It's good to know that even on the days that we feel really "off"or "crazy," we can still stay in control of our emotions and actions.


Thanks for reading.
More Soon.

Sometimes I Act Like a Little Girl | Borderline Personality Disorder

Some interesting insights tonight as well as some big question marks.   Netflix recommended a television series to me called "United States of Tara." In it, Australian actress Toni Colette brilliantly plays a woman who is diagnosed with Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder. While this disorder is quite different from Borderline Personality Disorder (BPD), which is my diagnosis, watching a few episodes has me thinking about times when I, as a person with BPD, shift into different parts of myself.



While Toni's character, Tara, is portrayed as someone who completely dissociates (disconnects from herself) and whose body is taken over by a number of unique personalities (one of them is even left-handed, and she and all of her other personalities, or "alters,"are all right-handed), when I experience a shift in my sense of self, they are all "parts of me." For example, there is "Little Girl Me." I haven't experienced feeling like and behaving like her in quite some time.  Up until about 8 months ago, she showed up pretty much daily.

Little girl me likes to talk in a cute, childlike voice, stomp and pout when she doesn't get her way, and she uses her charm and cuteness appeal to, most of the time, get her way. It's a mix of conscious and subconscious efforts, but unlike Tara, I remember everything that happens. Also, the main person this side shows up around is my boyfriend. There is a variation of her, "The Child Me," who has shown up when I was desperately afraid of being alone or abandoned. This part would show up at the crisis clinic begging to be admitted or for someone to take care of her in some way. She would also show up at the emergency room.  In retrospect, this part of me would have a shift in body language and tone of voice, and I would even dress a bit younger - all to elicit help and rescuing from "real" adults.  I didn't completely realize it when I was doing it, and again, I didn't feel like I was someone else - just me, younger. Perhaps this is regression?

Usually, during the episodes, I'd have some awareness that I wasn't behaving like a "normal" adult. Sometimes my boyfriend would say, "How old are you?" and I remember that I would stand there, feel confused for a little bit, and then I would literally need to count my age up from around 6 years old all the way up to my current age. I didn't really know what "grounding" was, but this seems as if it were an innate knowing.

Little Girl Me and Child Me have caused some drama in my life as well. For example, when it came to intimacy with my boyfriend, because I was Little Girl Me so often, he didn't want to be romantic with me, as he said he felt "wrong" about it - as if he were taking advantage.

The more I think about it, the more amazing it is that I've been slowly letting that part of me go. The more I've come to realize that I am responsible for myself, my behavior, and the way I treat others no matter what mood I'm in or what "part of me"shows up, the more I've realized the value of grounding and using DBT (Dialectical Behavior Therapy)skills.

As a result, I've been more present, more accepting of the now, and more accepting of the fact that I can't go back in time and change the past. I think a part of me thought that if I desperately clung to behaving and being like a child, I could somehow undo the pain and difficulties that I had when I actually was a child. I think part of me thought that this was the only way to get my needs met and to get others to rescue me. This is the part that was very unconscious. I didn't realize that this was my motive.  I just know that a day or two after some big crisis that I'd created, the Adult Me (true self?) would come on board, feel embarrassed and ashamed for my childlike behavior, and I'd apologize to people - only to have the cycle repeat itself again and again.

Wow. I've been living as my authentic self more and more. That's kind of exciting. That's not to say that the other parts of me aren't there or never come on board, but it's so rare. I'm much more in control now, have less crises and have been getting more comfortable in my own skin.  I never thought this would be possible.

Thank you for reading.
More Soon.


UPDATE: Learn the skills that helped me ultimately overcome these behaviors. I teach an online class where I share everything I learned to help me overcome borderline personality disorder and learn to love myself, be myself, and be in healthy relationships with others. Check out DBT Path for emotionally sensitive people today!

Practicing Radical Acceptance & Non Judgment (DBT Skills) With the Weather

Lately I've been wanting to apply the DBT (Dialectical Behavior Therapy) skills of Radical Acceptance  and Non-Judgment to the moodiness that I often experience at night.  It's been challenging. Today, Life gave me the opportunity to see how to put the skill into practice. 

I love warm weather and sunny skies. I also enjoy an occasional rain or thunderstorm. The weather in San Francisco lately, though, has been pretty much constant rain -- and I am not exaggerating. A storm has been passing through and for days, when you looked out the window, it seemed as if it were dusk.  Rain has been pouring from the skies, dancing and pounding on the roof of our house and, when I braved it to go to work and essential appointments, on my car top.

When I heard the forecast and learned that this would be going on for days, I realized that it wouldn't do me or anyone who had to deal with me any good to complain or wallow in misery over the weather. Clearly, I have no control over it. In fact, whether I radically accept it or not, it's going to happen the way Mother Nature intends. So, to reduce suffering, which is a key goal in DBT, I chose to not fight "what is." I decided to accept reality.



I thought about how cozy this week would be with my two cats and I on the couch, all snuggled up with the heater on. I thought about how nice it will be to fall asleep and wake up to the sound of rain on the rooftop. You could say I was using the "Coping Ahead" skill. It all worked. I have indeed been enjoying the things I envisioned.

There was a time when I would have gotten very judgmental about even the weather. If I had gone down that road, my state of mind and feeling of contentment (in general) would likely be in a different place. We don't have to like the rain in order to accept it. We don't need to judge the rain and make it "bad" or "terrible." We don't have to like the fact that it's cold and dark outside and we'd rather be outdoors in the warm sunshine...but we can accept that this is the way it is and that the storm will pass.

It's the same with emotions. When the mood changes come tonight (I predict they will only because it's been happening so consistently at around 7 pm each evening), I will try to apply the example of the rain storms to the difficult, unpleasant emotions I experience in the mood swings. Instead of making a strong, black & white, "negative" statement to myself (when I get moody, I often say to myself, "I hate EVERYTHING," only to follow up with, well, not everything.)  We'll see how it goes.

Thanks for reading.
More Soon.

We Are Not Monsters | Borderline Personality Disorder

A tweet from a twitter friend today confirmed that I needed to write this post. She came across a BPD hate website, apparently written by ex-lovers of people with Borderline Personality Disorder. Although I haven't personally read the site (nor do I want to), as a person who lives with, copes with, and who is healing from the diagnosis, I feel it's time to speak up.

We're not all monsters. While the media sometimes portrays us as such, the truth is we are human beings who are extremely sensitive emotionally, and we do often have some extreme behavior patterns. For many, it's a combination of life-sabotaging, impulsive choices or literal physical self-harm. The people I have met in my ongoing DBT (Dialectical Behavior Therapy) groups, while they experience these symptoms and behaviors, are also very vulnerable and desperately seek to be liked, approved of, and cared about. They want to be in relationships with others but the dichotomy of this desperate desire and a fear of being hurt and rejected causes confusion and overwhelm. The result is acting out in ways that have, up until now, seemed to serve to get our needs met.

That being said, it's not to say that living with someone with BPD is an easy ride. It can be really difficult. It depends in large part on where the person is in his or her recovery and treatment. Each experience is very individual.  Several years ago, I was so different than I am now. Even up until last year, I made incredibly desperate attempts to seek attention from my significant other and friends, only to push them away both emotionally and physically.

Winona Ryder plays a young woman with Borderline Personality Disorder in
"Girl Interrupted"


I've spoken carelessly and said hurtful things. I've acted in ways that made people who cared about me feel helpless and sometimes hopeless.

I didn't do it from some narcissistic place, a feeling of entitlement, or because I deliberately wanted to make anyone else suffer with me as I surfed the emotional ups and downs and emptiness that I experienced (especially when circumstances were "drama-free" for a while -- then I'd unconsciously stir something up just to feel something). The truth is, I was living very unconsciously. I didn't know any better. It's not an excuse. It's reality.

And even when sometimes I did feel that I was a bit off, I desperately clung to old patterns and old ways that seemed to work to get my needs met. I didn't have the tools, knowledge, or support that I have now. These things make a huge difference.  If I were to behave in the same ways at the level of maturity I've begun to reach through DBT, something wouldn't be quite right. I take things day by day, sometimes hour by hour. I have my ups and downs. I slip up sometimes, and most of the time, I move forward and progress toward a healthier mind and life.

I'm much more conscious now. But, the person you love, care about, or treat who has BPD may not be "there" yet in terms of consciousness.  He or she may not even be trying yet. This can be discouraging for the both of you. Remember that you didn't do anything to cause your partner's distress.  There are all sorts of reasons and often years worth of a history filled with trauma and crises when a person ends up with this diagnosis (there may be instances where this is not the case, but I haven't come across any).

If the person  you love isn't ready to acknowledge his or her diagnosis and get the proven treatment so that he or she can recover, you can't expect much to change. But, if he or she takes that step and truly invests in his or her recovery, you will see improvements over time. At least that's what I've observed in my own life and with others around me who have Borderline Personality Disorder.

Going online and venting about difficulties is fine - that's your prerogative and right. Perhaps you find it healing.  The one thing that I would urge is to refrain from bashing someone based on their mental health diagnosis. Remember that each person is doing the best they can, where they are at, and with the tools they currently have.


Thanks for reading.
More Soon.



"Girl Interrupted" movie on DVD



"Girl Interrupted" book by Susanna Kaysen



Blank Global Assessment Functioning Form (AOQ)

Some of my readers have asked for a blank copy of this Global Assessment Functioning form, so I have uploaded a blank one here for you.  The clinic where I attend DBT classes has us fill one of these out every week before class.

Here is one that I recently filled out:

You can click the image to see one of my
recent AOQ forms (filled out)


We are also asked to fill them out before meeting with a therapist or psychiatrist. They have named the form AOQ. I believe it may stand for "assessment of quality [of service]" but I am really not sure.

A few of my twitter friends have mentioned that they'd like to use this form as a tool to be mindful and that they plan on bringing it to their next therapy session.

Here's a blank copy:



Click to enlarge. Blank AOQ/Global Assessment
of Functioning form

I hope it is helpful for you in some way. If you find a practical use for it or think you will use it, I'd love to hear from you.

Thanks for reading.

More soon.

Moodiness & Mood Swings | Borderline Personality Disorder

I hate it when I feel this way.  For those of you who are in DBT (Dialectical Behavior Therapy), you probably, like me, recognize the word "hate" as being very strong and extreme. When I've used it in the past with my psychiatrist, she said, "Why don't you try describing how you feel with a less intense word?"



Alright...I feel extremely irritated, agitated, and annoyed. This mood, unfortunately, tends to show up most weekday nights at around 7 pm.  By then, the structure and errands of the day are winding down. I've made dinner, eaten, and cleaned up the kitchen. I'm usually sitting on the couch, surfing the net, playing with my kitties, and waiting for my favorite television shows to come on.

That's when the feelings of emptiness creep up. I notice that I am bored and extremely discontent. I have no real reason. I think about all of the things going right in my life and all I have to be thankful for.  It then makes even less sense that I would continue to feel so irritated and even angry...but I do.

I mentioned to my therapist  how this aspect of moodiness is especially difficult for me. She suggested using the DBT skill of Radical Acceptance. Of course this had crossed my mind, but I am not really "there" yet with this particular issue.  I haven't been able to come to terms with and accept this deep dip in mood that feels so incredibly uncomfortable and upsetting. It doesn't last forever, but each time it visits, it feels as if it will.

One of the things I've learned is that many of us with Borderline Personality Disorder  (BPD) tend to forget that emotional states are temporary. It may be hard for us to recall a time when we felt similar and then got though it. Knowing this, I have deliberately reminded myself, whenever I deal with extreme, intense, emotional episodes, that I have been through this before and made it though.  It really helps. It feels very unnatural at first, but a with anything, time and practice have made it easier. The frustrating part about this mood is how regularly it occurs.

So, right now, all I really feel up to doing is noticing and describing this particular mood and the mood swings, using Wise Mind, improving the moment, and self soothing. It is still way too difficult to imagine radically accepting this. I'm doing best I can with what I have and where I am in this moment.

Thank you for reading. More soon.

Sensory Overload: Reigning In Emotions Using DBT

I went on a beautiful walk with my boyfriend today. It wasn't very warm out, but we were dressed for it.  I enjoyed the feeling of moving, since I'm trying to be less sedentary and more active. I enjoyed the sights and sounds.  At one point though, I began to notice that I felt disconnected - I was experiencing dissociation.  It felt like my physical body was still making the movements of walking, and I felt the gravel surface beneath my walking shoes, but my mind was somewhere else entirely. I felt separated, and not whole.

The state I was in felt kind of strange. I tried to redirect to my breath and the feeling beneath my feet, but neither were really grounding me, and I was becoming anxious.  All the while, my boyfriend had no idea that this was going on. (I don't know if you're like me, but when I feel like I am "freaking out" on the inside, I worry and assume that others can see it on the outside...interestingly, rarely is this the case.)

I wondered why this was happening. There were so many pleasant things coming in through all of my senses, that I wondered how I could be feeling distressed. And then my answer came: too much stimulation at once. Even though it was positive, I am learning as I progress through DBT (Dialectical Behavior Therapy), that my nervous system may be a bit more sensitive and heightened than others' might be, and I can experience "sensory overload," if you will.



I decided to reign in my emotions using DBT skills. I became mindful. I focused, as best as I could, on one sense at a time. I allowed my eyes to focus only a few feet ahead at a time, looking at details of branches on trees and new spring blossoms.

I then focused on the sound of the water crashing against the rocks. Occasionally a car would drive by, and I'd need to integrate that sound into my mindfulness practice. At some points, I had to radically accept that more than one thing was successfully getting my attention at once. Noticing that, describing it, and radically accepting it were still all in alignment with my mindfulness practice.

And, you know what? I felt better. I continued on and finished the walk that I intended for myself, and it was enjoyable. I guess you could say that I also used the "[be] effective" skill.  All in all, yet again, using DBT skills helped me significantly and aided me in preventing a crisis reaction.



Thanks for reading.

More soon.

Jealous, Insecure Inner Child at Work | Listening To Her Concerns

It started out with physical sensations.  My neck and shoulders hurt. My jaw had a sharp pain right at the hinges. I felt a headache coming on. It was all out of nowhere, really, but it was all very familiar.

Usually I would get these symptoms if I had spent all day hunchback over the computer keyboard, but today was different. I actually went out and got some sunshine. I went on a nice work, went to the gym for a class, and I did some work around the house.  So, it was unlikely that the physical stress symptoms (as  I've come to know them) had anything to do with my posture or from lack of movement.

This week in DBT (Dialectical Behavior Therapy) class, we talked about how in the course of the life of an emotion, there are times when we may notice physical symptoms first and then have to trace them back to their source.  For most of us, it's usually the opposite: We'll get stressed or angry about something, notice that, and then later notice a headache or feeling fatigued.

Other times, like with me tonight, we'll notice the symptoms and then say, "Ok, what I am holding onto? What am I stressed about?"

I decided to get mindful. I laid on the couch and closed my eyes. I did a body scan and was surprised to notice how very tight I was clenching and holding my muscles all over, especially in the area where I was experiencing the most pain, tension, and discomfort (neck, shoulders, face, jaw).

Slowly, one at a time, I released tension from each part, saying, "I release this tension in my shoulders," and I'd slowly drop my shoulders, noticing how far up they had been and how far down they were coming to relax.  I did a trick my therapist taught me that helps relieve jaw tension: I pushed my tongue against the backside of my upper teeth. I felt my jaw ease a bit. I did this throughout my body, and the tension began to melt away.  This activity is called a "body scan" meditation.  If you can find a CD/MP3 of someone doing a guided body scan, I highly recommend it. I find them very relaxing and effective.

Here is a good one that I just found on YouTube:


Video can also be downloaded from LifeLight

With the distraction of physical pain subsiding, I began to drift off. I had about 2 hours of blissful napping before I woke up feeling refreshed and restored - and ready to cope with the issue that was stressing me out.

I'm feeling very jealous and insecure. Although I have been dealing with inappropriate behavior at work from male staff, I have been the only female in the group for a long time. It turns out that another woman was hired.  The men describe her as attractive, young, and brilliant. She's 3 years younger than me, European, and she graduated from a prestigious, expensive, well-known school.  I'll meet her tomorrow. I'm nervous as heck.



There are so many things going through my mind. Having heard all these wonderful things about her, I wish my reaction could have been one of excitement. I wish I would have thought that she must be as wonderful as they are all saying. I wish I looked forward to meeting her. (Hey, she could be another chance to have a friend, or at least a work buddy.)

But, instead, I got jealous and insecure. Although I say that I want the attention off of me at work, I only mean the negative, inappropriate, offensive attention. I felt kind of special being the only woman at work. I guess this role made me feel special in this place.  Perhaps this is an issue of a fear of losing a part of my identity -which I am working so hard to discover, build, and grow in - disappearing.

But, when I use my Wise Mind, that doesn't seem quite right. It's probably my inner child - that scared little girl who likes to be the center of attention...who loves to be the pretty girl in the room...who loves to be treated special...she's afraid that she's going to lose all that because there's a new girl in town.

The more and more I write about this and process it, the more I realize what an amazing opportunity this is to grow in a number of ways as I continue my work in DBT. I have the opportunity to regulate my emotions, reactions, and impulses to this situation that is causing me a bit of distress. I can to mindfully observe the whole thing and proceed with Wise Mind.

I may even get to connect with a bright, friendly colleague at the workplace.  I feel badly that I harshly judged her, with no basis and not even knowing her, but I release that. It was just a defense, coming from a place of fear. I don't have to start out not liking this person that I don't even know.

I can grow.


Thank you for reading. More Soon.

No Longer The Victim | Protecting My Inner Child (Sexual Harassment at Work)

Today at work my boss made some really inappropriate comments to me in front of other staff members. It's been ongoing lately, and it is really upsetting.  I like my part-time job. It's my source of income, and I enjoy the work. I don't need this kind of stress.


Years ago, in a situation like this, I would likely have reacted very impulsively and become "out of control" emotionally.  I know this because it did happen years ago, and that was my reaction.






This time, I wasn't going to allow myself to be victimized again. I won't lose my mind, I won't let anyone make my work life so uncomfortable that I don't want to go to work, and I will not let anyone violate me. Those days are over.  I have a responsibility and commitment to protect my inner child now that I am older. I am an adult, and I now have an toolbox full of coping skills and ways to advocate for my rights.


I decided to call my boss on his behavior, professionally and firmly and to make it known to others in the company that this type of behavior will not be tolerated. I don't need my boss saying demeaning things, especially in front of other staff. It sets a precedence, and I will not be treated that way. I don't want others thinking it's ok for them to be treated that way either.


It's been a while since we covered Interpersonal Effectiveness in  DBT (Dialectical Behavior Therapy) class, so I had to consult my trusty binder. 


The sections I focused on today are:


"BUILDING MASTERY & SELF-RESPECT



  • Interact in a why that makes you feel competent and effective, not helpless and overly dependent

  • Stand up for yourself, your beliefs and opinions, follow; follow your wise mind. "
from   Skills Training Manual     by Marsha Linehan   (c) 1993 The Guilford Press


The questions under Self-Respect Effectiveness from the same manual are:

" 1. How do I want to feel about myself after the interaction is over?
   2. What do I have to do to feel that way about myself? What will work?"





The old me would have run to everyone who would listen and tell them my story, from the position of a victim. In the past, I would have worried a lot about getting my boss upset or causing him not to like me if I stood up for myself. I would have worried about losing my job. 


Now I am staying in Wise Mind, focusing on setting and maintaining boundaries, appropriate work behavior, and standing up for myself when it feels necessary to do so. I want to feel good about my choices and responses.


Last week and today, I've chosen to communicate in firm, professional emails, and I have only discussed the matter with my significant other and other employees who were directly exposed to the harassment. (Oh, and I tweeted...)







I am going to continue to consult my DBT Binder and also share tomorrow in my group therapy session. 


Sexual harassment is difficult for anyone to endure. As a person who experienced sexual exploitation as a child and who was not protected by the adults around her, I have carried a burden for many years. I am just beginning to heal from those times. It's probably going to be a long process. In the meantime, I do not need to deal with grown men in the workplace triggering my old wounds. The law protects me against it.  


I hope this serves as an encouragement to anyone who has ever been through or who is currently going through this type of situation...or maybe you know someone who is.  There are appropriate ways to take care of this situation while taking care of you. 




Thanks for reading. More soon.

DBT | Practicing the "Non-Judgmentally" Emotion Regulation Skill





I had the opportunity to practice the DBT Emotion Regulation skill of Non-Judgment today in a tangible way that actually made sense. I've been under a lot of stress lately, and for days, I've been fantasizing about just spending a weekday lazing around, hanging out in bed, and not even leaving the house.


The thoughts that came up with this desire/fantasy were generally very judgmental. Even though I only work part-time and do have the flexibility to call in and say that I'll work form home, I still judged myself, my motives, and what the possible outcome of my choice to follow through could be.


Some of the thoughts were:


"If you stay home and do what you're thinking, you're giving in to depression."
"They'll get mad at you, and you could lose your job."
"You shouldn't waste your day away."
"Why do you think that you're so special that you can do this?"
"What do you do all week that you should rest all day? You're not even active."
"If I break my routine and do this, I might feel crazy."


Well, this morning, I awoke feeling very tired. 


I got up, checked my email, had a little bit of breakfast, and played with my cats. I was so tired. 


Outside, the weather was very wet, and the sky very dark. This was definitely a day conducive of a cozy, napping marathon with my kitties.


I acknowledged the judgmental thoughts that began to come up again as I considered staying home and resting. Then, I wondered how I might view the situation if I removed the judgment and practiced my skills.


Image Courtesy of StarinYourOwnLifeStory


According to the "Mindfulness Handout 3: Taking Hold of Your Mind: 'How' Skills" worksheet that I have from DBT (Dialectical Behavior Therapy) class, Non-Judgmentally means:

See, but DON'T EVALUATE. Take a nonjudgmental stance. Just the facts. Focus on the "what," not the "good" or "bad," the "terrible" or "wonderful," the "should" or "should not."

UNGLUE YOUR OPINIONS from the facts, from the "who, what, when, and where."

ACCEPT each moment, each event, as a blanket spread out on the lawn accepts both the rain and the sun, each leaf that falls upon it.

ACKNOWLEDGE the helpful, the wholesome, but don't judge it. Acknowledge the harmful, the unwholesome, but don't judge it. When you find yourself judging:

DON'T JUDGE THE JUDGING.


(I am not sure where the hospital where I attend my DBT group sourced this worksheet. No copyright infringement intended)




Keeping these guidelines in mind, I laid out the facts:


1.) I want to stay home and have a low key, restful day with naps
2.) The weather is conducive for the kind of day I'd like to have
3.) I have the option to work from home if I wish
4.) I feel tired and want to rest
5.) I might feel differently from having changed my schedule




Somehow, just looking at the facts of the situation without attaching any judgment allowed me to feel so much better about the situation. Suddenly, I wasn't some lazy villain trying to "get away with something."  Suddenly I wasn't a "horrible person" who didn't deserve to have this kind of day.


In fact, I even ended up developing some positive judgments that made me feel better:


"It's ok to stay home. It's not harming me or anyone else."
"It's ok to pamper myself in this way."
"Doing this is a form of self-care that has no real harmful side-effects or consequences"

"I am going to enjoy this day as it unfolds."


I hope that my own personal example of applying the Non-Judgmentally skill has helped you. Of course, your own personal situation and circumstances will vary, but I am excited for how you might apply it the next time you find yourself judging. I hope you feel as liberated as I did in this example.


Thank you for reading.


More Soon.

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