Radically Accepting Uncomfortable Emotions (DBT)



Today's Distress Tolerance DBT (Dialectical Behavior Therapy) class focused on the Acceptance skill.  When our therapist began describing how we would practice this skill, it felt very counter-intuitive to me.  What? You want me to ACCEPT the intense anxiety I've been experiencing? Heck no! I want to kick at it and scream at it and push it away. I want it gone, now!

Well, admitting that, thus far, this approach has not done much to alleviate me of the emotion, I became willing to listen and participate in the assignment. After all, if there was even the tiniest chance that I could feel better, that was motivation enough.

Below is the worksheet we used. It is from a workbook called Depressed & Anxious: The Dialectical Behavior for Overcoming Depression and Anxiety (highly recommended!):



Our therapist kept redirecting us back to ACCEPTING the emotion, rather than trying to push it away or change it (though those can be coping skills also).  Since pushing away or trying to change it haven't been working, I'm glad that there is another possible way to cope.

In the first column, you acknowledge the emotion that you need help accepting.  How I could ever "accept" feeling obnoxiously anxious, I couldn't fathom, but, again, I was being willing.

Next, you are asked to identify the judgment around the emotion. For me, it's been: "I should be able to snap out of this anxiety. I know better."

Next, you dispute the judgment. I came up with: "While I do have skills to handle anxiety, sometimes the biological aspects take a while to catch up with my Wise Mind's decision that I am safe and all is well."

Next, you allow yourself to be mindful of the emotion.  My process went like this: "I feel this anxiety. It's about being alone, with my BF thousands of miles away as I await an impending sexual harassment investigation interview."  The bottom line? "I have no control over any of this."

In the next column, you come up with some statements to reassure (soothe) yourself: "This, too, shall pass. Emotions are transient. I can still take care of myself even when I'm feeling anxious. Just this moment, just this breath."

Finally, you come with a statement of how you will accept the emotion. Even if it doesn't feel "real" at the moment, this will be the point of practice: "It is what it is. I experience anxiety, and I can tolerate it."

I have to tell you, it's been a few hours since class let out, and I feel quite a bit more at ease.  There's something about letting it go - about surrendering it to the Universe, if you will, that frees us. It's not as if spending one more moment of my life stressing and panicking about those upsetting things will change them. So why should I needlessly suffer in the meantime?

What seemed impossible seems to be having a positive effect.  

It's like Eckhart Tolle says in his book The Power of Now:

"Whatever the present moment contains, accept it as if you had chosen it. Work with it, not against it. Accept -- then act."

"Pain is self created as some form of non-acceptance or unconscious resistance to what is."


What reality or emotion are YOU not accepting in your life right now? Are you willing to try?


Thanks for reading.
More Soon.


The Impermanence of Emotions (Intense Anxiety)


Today started off quite anxiety-filled. Last night, I was awakened by the creepiest sound of something burrowing and scratching inside of my wall. My cats were mesmerized. I don't know what it was, but I was afraid.  I banged on the wall, and it would stop for a few minutes, then it went right back at it. This was at about 3 am.  When it kept going on, I'm not sure why I didn't go and sleep on the couch.  I was so tired and somehow kept drifting off to sleep - but only light sleep. As the sound got louder, I kept waking up.

This situation, the disruption of sleep and the anxiety in the middle of the night, combined with other stressors, became vulnerability factors to the intense anxiety I felt in the morning when I felt like backing out of a social commitment. The anxiety got worse as the time approached that I should go over to my neighbor's house. I was having that gurgling feeling and sound in my lower belly, and I had no appetite. I also desperately missed my boyfriend (it's day 2 of his 9 days being away).

I knew I had a choice: I could feed into the anxiety and let it completely ruin my day, or I could follow through with my plans and take a nap later to help with the lost sleep.

As tempted as I was to give into the anxiety, I used the DBT (Dialectical Behavior Therapy) skills of Opposite Action and Wise Mind to follow through.  I'm glad I did.

I mindfully chopped up the fresh vegetables for the pizza and prepared it nicely on plates with some root chips.  I then walked over to her house, and when I noticed panicked breathing, I looked down at my feet, moved one step at a time, and said to myself, "Just this moment, just this breath. What is wrong in THIS very moment? Nothing."  This helped to center me and calm me a bit.

I spent some time with my neighbor and her adorable baby.  We watched When Harry Met Sally. I'd never seen it before, and since my neighbor was appalled to learn this as a romantic movies junkie, she insisted that we schedule a time for me to come over and watch it with her. We ended up having a pretty good time. 

All the while - in fact most of the visit - my stomach was acting up. I wasn't really hungry due to the anxiety, so I just nibbled and drank my soda.  I'm not sure if she could tell I was in a bit of distress, but I decided to acknowledge that the anxiety was a fleeting, uncomfortable emotion, and rather than dwell on it and give it attention (after all, in those moments, I was in absolutely no danger), I decided to act opposite.  I presented myself confidently, played with the baby, and had lots of good laughs watching the movie.

Today I was reminded, yet again, that although those of us with Borderline Personality Disorder (BPD)  can experience our emotions intensely and have challenges regulating them, we CAN do it. It takes practice and determination. Sometimes we have to go against that little tiny voice of fear that would rather we miss out on growing and having good experiences.

I did that today.

My nervous system is still a bit shaky.  It seems that the physiological responses to anger can take quite some time to catch up with a Wise Mind, psychological decision to not feed into it. Is that your experience, too?

Have you used the skill of Opposite Action to help you get to an event that you felt like avoiding due to intense anxiety or depression?


Thank you for reading.
More Soon.


Identity Formation (and Disturbance) with Borderline Personality Disorder


Once again during DBT group this week, our therapist brought up how it's a healthy practice to pick someone on television (or in real life) who handles emotional situations the way we'd like to, and then use that inspiration as a model for our own behavior.

I recently blogged about how the character Jane Bingum of Drop Dead Diva is someone that fits the bill for me.  Since I am running dry on episodes and will soon be caught up to watch the current season, I went in search on Netflix of other shows I might like for evening self-soothing time. 
 

I came across a show from the 90s called Ally McBeal.  I never got into the show during the time it originally aired, but 6 minutes into the pilot episode last night, and I was hooked.
When it occurred to me that I enjoy watching two shows with quirky female leads that happen to be lawyers.  I joked with my Twitter followers in this tweet:


Many of you with Borderline Personality Disorder who suffer from the criteria relating to Identity Disturbance will get what I mean by this.

This past spring, I wrote a post called "Butcher, Baker, Candlestick Maker: Career issues with BPD Identity Disturbance,"about the many times I've changed jobs, professions, and school majors because I would latch on to what someone else is doing, feeling aimless in terms of having any sense of direction or desire of my own. If someone looked happy, I thought I could emulate them and be happy too.

When I realized that a decade had passed and I hadn't yet finished my bachelor's degree or committed to a profession (or stayed very long with any job), I was hard on myself.

I mentioned this in group today, and our therapist pointed out that admiring someone else and following in their career footsteps is a natural part of development. Many of us with BPD have had that process interrupted or stunted, especially if we grew up in invalidating environments


So while it may take us much longer to connect with something that feels right to us, and even if it takes years of trial and error (as it has for me), we need not judge ourselves.  For many of us, our paths have looked nothing like that of others who grew up in relatively healthy home environments where they were validated.  

So, wherever you are in the developmental process of identity formation, there is hope that one day, you, too, can watch videos about makeup artistry on YouTube without flying down to L.A. to become a certified makeup artist (which I did), or enjoy the character of Phoebe on friends without becoming a certified massage therapist (which I did), etc.

How do you discover who you are and built the life you want? One step and one breath at a time.

Thanks for reading.
More Soon.

Coping With Abandonment Issues (and I think P!nk "gets" us)


Yesterday, I had to drop my boyfriend off at the airport. (I wrote about how my fear of abandonment has been triggered, here, the other day.)

He's only going away for a little over a week, but trying to calm my inner child (and nervous system) with that bit of information is challenging.

Here's a pic I took of the walkway back to my car.  The way the phone captured the depth of the journey accurately captured how I felt in that moment.


Image I snapped at the airport yesterday
Thinking about him going away was terrifying enough. Watching him go through security even more terrifying.  Even though I have been through this so many times before, and for even longer periods of time (see my post on when he went away for a month!), I still notice my body and mind reacting in similar ways.


There is good news, though.  Now that I have a lot of practice coping with his departures using Dialectical Behavior Therapy (DBT) skills, I am able to handle these situations much better and even recover more quickly.


I notice the sensation in the pit of my stomach -- that "fear" feeling, that emptiness feeling in the evening...that scary feeling that I'm not sure who I am or how I am supposed to behave with him not around.

Last night, I used Wise Mind to acknowledge that these thoughts, feelings, and sensations are clearly components of my Borderline Personality Disorder (Emotion Regulation Disorder).  I acknowledged that while uncomfortable, I've experienced these before and have emerged feeling better.  Yes, I've experienced these before and know that they are only transient. These, too, shall pass, and I will feel better soon.

Most of what goes through my head when I have these episodes are thoughts and feelings that are just that: thoughts and feelings -- not always necessarily facts. This acknowledgment is soothing and comforting.

As I'm writing this to you, I am experiencing a dialectic: One part of me wants to scream and cry, and stomp and talk about how unfair it is that I have to go through this. The other part realizes how ineffective that would be, and that my ultimate goal right now is to feel well
.
I'm listening to the latter, but my ears are taking refuge in songs like this one, from P!nk, who really seems to get the whole BPD experience. I can actually relate to many of her songs.
This one, "Please Don't Leave Me" is particularly apt:


In addition to mood matching with this song for validation, I plan to shift to activities that are considered Opposite Action to change my mood, such as watching funny television shows and going for a walk.  

Fortunately, I also have DBT group today.  I also intend to keep social plans with THREE different people this week, though the anxiety is building up inside. I know I will feel better if I follow through and spend quality time with other people.

I suppose I can even distract, immerse myself in the experience, and even be a good listener for other people instead of focusing on this passing difficulty.

I'll keep you posted.

Thanks for reading.
More Soon.

DBT Golden Nugget: The DBT Mindful Minute


Last night on Facebook, I came across something interesting that a friend posted. Intrigued, I gave it a look.  It's a short animated video during which you are lead to practice one moment of meditation.

It may not sound like much, but I honestly felt so much better even after just one minute of practicing, so I decided to pass this along to you. 

In DBT (Dialectical Behavior Therapy), there is a module dedicated to mindfulness practice, and the concepts and exercises are integrated throughout all modules of DBT. Dr. Marsha Linehan, the therapy's founder, describes mindfulness as a tool for "taking hold of your mind" (Mindfulness Handout 2, Skills Training Manual for Treating Borderline Personality Disorder.)

Give it a try, and feel free to share your experience. Notice how taking just a single moment of time for yourself can improve the moment and your mood.



Thanks for reading.
More soon.

Fear of Abandonment: When You Go Away, I Regress To a Child

 
I tried to explain to a loved one yesterday that I am heal-ING from Borderline Personality Disorder. I still meet the criteria for the disorder, and I am still symptomatic. The good news is that most of the time, I am able to apply the DBT (Dialectical Behavior Therapy) skills that I've been learning for the past two years and that I continue to learn on a weekly basis through a group class.
 
I think it may be disappointing for others, then, when I have those moments where I don't look very skillful at all. Sometimes this is true (they actually give me feedback), and other times, this is my thought or interpretation, which of course isn't accurate 100% of the time. 
 
Lately, I've been experiencing a short temper with anger. I'm more reactive than usual, and I've been saying things (and doing impulsive hand gestures) that I pretty much immediately regret. It's quite embarrassing, and this behavior is really not in alignment with the values I've discovered and the person I want to be.

What's going on?  I'm feeling STRESSED.  Those of you who have been following my blog know that I am facing a major work stressor right now. In addition, my significant has an upcoming trip for a week.
 
In June, I wrote about my mini-meltdown when he went away for a month. That post was entitled, "You've Gone Away, So Where Am I? | Identity Disturbance in Borderline Personality Disorder."  Since I more or less successfully navigated the skills to cope with the issues that came up around identity disturbance in his absence, that is not the focus of my concerns this time.
 
Even though he is only going away a week, I suspect that due to the other vulnerabilities I am experiencing right now emotionally, I am responding in a fearful, anxious way on a physical level. My nervous system is reacting. I feel scared.  The little girl inside of me who has appeared before and who has come very far in coping with fears of abandonment, has been triggered again.
 
I need to be gentle with her (me).   I need to be compassionate with her (me).  My inner child is frightened. She doesn't want to be alone during this time of stress.
 
This morning, I literally felt like acting out. I wanted to cry, beg, and plead for him to not go away, but I was able to stop myself. Been there, done that. The ticket is purchased, he has commitments, and whether I get myself sick over it and have a breakdown that upsets both of us - or not - he has to take that trip. And I have to cope with it. (Skills practiced: Wise Mind and Radical Acceptance.)
 
My goal, of course, is to cope effectively and to behave as the actual adult that I am.  I don't want to dismiss my inner child's fears and worries - they are a real part of my experience, but I also need to continue to tap into Wise Mind and choose effective behaviors that help me get through the week.
 
Realistically, I could pull myself together and actually find a silver lining to the time alone and enjoy myself. Wouldn't that be wonderful? 
 
The skills I'll be focusing on this week are:
  • Thinking Dialectically: It's not true that I'm perfectly fine when with my significant other and that I am not ok when he's away. There are shades of grey in there.
  • Effectiveness: I will focus on the behaviors that work and are effective for my short and long-term goals of maintaining emotional stability as best as I can.
  • Non-Judgmental Stance: Rather than labeling the situation, my responses and emotions to it, etc. as "good" or "bad," I will describe what I observe without any labels -- just the facts.
  • Reduce Emotional Vulnerability: I will take care of myself by eating well, getting some exercise (a nice walk here and there, some yoga), sleeping well, and doing some guided meditations to calm my nervous system
  • Distract: I have lots of little projects to get done around the house and with my writing. I can delve into these and really focus. 
  • Wise Mind: I will focus on thinking clearly and as objectively as possible, especially when Emotion Mind comes to the surface.
  • Attending DBT Group: I'll be sure to show up and go over my Diary Card and possibly an Emotion Regulation Handout 1a.
I am also going to tend to my inner child during this time. If she wants an ice cream, she's getting one. If she wants to watch something silly on television, we're going for it. I acknowledge that there is a part of me for which this fear of abandonment feels very real and scary, and I intend to love and comfort that part of me through it.

I'll keep you posted on how it goes.

Do you have a difficult time when a loved one goes away, even for a short time, such as on a business trip?  How do you cope?

Thanks for reading.
More Soon.


UPDATE The author of this blog no longer meets the criteria for a BPD diagnosis and is in recovery. Join her online DBT informed course (live each week with Q&A) at www.emotionallysensitive.com

DBT Distress Tolerance Skill: Prayer

This week in DBT, one of my fellow group members went over her Diary Card. She shared that she used the skill of Prayer, a Distress Tolerance Skill that falls under the "Improve The Moment Section."

Imagery
Meaning
Prayer
Relaxation
One thing at a time
Vacation
Encouragement

(Above list from page 165 of what I consider to be the essential DBT Bible: Skills Training Manual for Treating Borderline Personality Disorder by Dr. Marsha Linehan)

It's interesting, because I had just received an email from Amanda Smith of My Dialectical Life (a DBT-skill-a-day email subscription), just days before, in which she also shared that she had recently used prayer as a DBT skill to cope.

Up until now, I've honestly been very hesitant to talk about this particular skill since it can be a 
sensitive issue for many. But, since two other BPD sufferers recently opened the doors by sharing their experiences, I felt safe enough to blog about this with my dear readers.

I personally do not have a particular religion that I identify with.  I was brought up Catholic and sometimes consider myself a mix of Christian - Buddhist - Agnostic - Atheist.

I think many people with Borderline Personality Disorder can understand my ambiguity around this.  One of the criteria for having BPD is:

Identity disturbance: Markedly or persistently unstable self-image or sense of self 

I found an in-depth elaboration of this on PsychCentral:

There are sudden and dramatic shifts in self-image, characterized by shifting goals, values and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with borderline personality disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of a meaningful relationship, nurturing and support. These individuals may show worse performance in unstructured work or school situations

Not unlike my struggle to discover and commit to a career path or job has been an issue with my having BPD, a religious preference or decision has been also. I do have a hope that there is a supreme being or a supernatural force at large in the Universe. I am comforted by many spiritual things. Other times, I feel anger or fear toward teachings I've received and don't want anything to do with any of it.

I've also met other people with BPD who have a strong faith and consider this their anchor, like the woman who shared in group this week. When our therapist asked her what she meant when she said she "used Wise Mind from a religious perspective," she said that in considering her religious views while angry with another person, she was able to become compassionate and have empathy for their imperfectness.  She said that this helped her dissolve the illusion that they were a villain and that she was a victim. Our therapist said that it sounded like she was able to reduce judgment and be as effective as possible with this perspective.

I do think it's great that Western medicine is respecting the importance of religion and/or spirituality for some patients in their recovery process.

What about you? Do you ever use the DBT skill of prayer?  Do you have a faith that helps you get through difficult times, or are religion and spirituality not a part of your life?

Thank you for sharing and reading.
More soon.

DBT Diva: DEAR MAN Skills

Today in DBT group, we covered the Interpersonal Effectiveness "DEAR MAN" skills.
 
As you can see from the image above, the acronym stands for:

 

Describe
Express
Assert
Reinforce
 
(stay) Mindful
Appear Confident
Negotiate
 
(From Interpersonal Effectiveness Handout 8: Guidelines for Objectives Effectiveness: Getting What You Want, from Skills Training Manual for Treating Borderline Personality Disorder by Dr. Marsha Linehan)
 
Our group therapist asked us if there is a role model that we look up to in terms of someone who exhibits these skills and who we would like to emulate - in real life or in fiction.
 
My instant response was yes: the character Jane Bingum on Lifetime's "Drop Dead Diva."  Jane, a savvy, quirky lawyer is played by the talented actress, Brooke Elliott.  The premise of the show is a bit fantastical: a beautiful, super slim aspiring model named Deb ends up in a car accident and passes away. Once in heaven, she manages to get herself back to earth, but ends up in the body of plus-size attorney Jane. 
 
Watch Drop Dead Diva
online through Amazon
Upon reading the description one day on Netflix, I thought, "This is probably total cheese, but it also seems very non-triggering. I guess I'll watch an episode."  I've been addicted ever since.
 
The show is, for the most part, lighthearted, non-triggering, and...there's that word again...quirky, and I love it.
 
As Deb navigates through the world as a mix of her former self and Jane, we watch a woman discover who she really is.  
 
I love watching her implement the DEAR MAN skills, and I hope to one day exude the confidence that her character so eloquently displays.
 
Jane is articulate at communicating her thoughts, especially at the workplace (Describe), she communicates her feelings (Express) but is also willing to hold them back when expressing them would be inappropriate or potentially hurtful to others, she stands up for what she believes and gently presses her point of view when she isn't being hear (Assert), and she describes potential consequences of not getting her way (Reinforce).
 
She stays mindful of what her objectives are (Mindful) and doesn't allow herself to be swayed by obstacles, in court, especially, she carries herself in a professional, controlled, and effective way (Appear Confident). Even with all of this going for her, she is not completely black or white. She realizes that sometimes she needs to give a little in order to get what she wants (Negotiate).
 
How about you?  Is there a person in your life, on TV, or in a movie that is the epitome of what you strive to be?  Do you emulate them in any way?


Thanks for reading.
More Soon.
 
 
 
PS - Want to take an online class with me to learn DBT Interpersonal Effectiveness Skills like DEAR MAN? Click here to learn more.

New Book Coming Out on Borderline Personality Disorder and Dialectical Behavior Therapy

Dear Readers,
It is with great pleasure that I share this press release with you. Please join me in my excitement:



DBT Golden Nugget: But I Can't Wait!


I've noticed something about myself that gets me in trouble from time to time: I don't have much patience.  It's very difficult for me to sit with waiting for something when the outcome is unknown, or, more precisely, when it is not guaranteed to go in my favor.

I like things to be resolved, answered, and completed pretty much right then and there.  Unfortunately, I've also learned that most people don't work this way, this expectation sets up more opportunities for errors, and once the issue is resolved, I only experience peace for a short amount of time.  I'm quickly then aware of something else that I want resolved right away.

I'm currently dealing with a number of important, intense, and stressful life issues that are not being resolved on my timeline.  It's frustrating, to say the least.

One of the skills that can help when we feel this way is the DBT skill of Radical Acceptance.  When we radically accept something, we see the situation as "it is what it is."  We accept that we have to wait.  We accept that we don't like waiting.  We accept that despite not liking the wait, we still must wait.

A good example of using Radical Acceptance is when you don't like how the weather is on a particular day.  Perhaps you prefer bright skies and sunny warm weather, but instead, Mother Nature has decided that today will be a cold, wet day with skies so dark that it seems like 24 hours of night.

What are your options for coping with any distress you may feel as a result of today's weather?

You could:

  • Complain about how lousy the weather is
  • Wish the weather were different
  • Radically accept that the weather is like this today
  • Radically accept that you perceive the weather as unpleasant, but it is what it is for now
  • Use Wise Mind to acknowledge that this too shall pass -- nothing is permanent, not even the weather

Which approaches do you think will be most effective in coping with your distress?  How can you apply this approach to other areas of your life that are uncomfortable, such as waiting anxiously for a result or answer?

I'll contemplate these answers with you.

Thanks for reading.
More Soon.


One Thing at a Time... (DBT: One-Mindfully)



It's actually been over two years now since I started DBT (Dialectical Behavior Therapy) to treat my diagnosis of Borderline Personality Disorder.

DBT skills have become wonderfully integrated into my daily life. I practice them so naturally now that they have truly become a part of me. Well...but not all of them.  There are some skills that haven't quite "taken."  I suppose I became frustrated when, early on, these particular skills seemed to frustrate me more than bring relief, so I left these on the back burner while I practiced others that seemed more effective for me a the time.

As I am currently experiencing a crisis that has me sitting with more questions than answers, I am turning to being in the moment ("just this moment, just this breath," reminding myself of Eckhart Tolle's quote of how all we ever can really cope with this moment), self-soothing (watching upbeat, quirky comedies on tv, nice warm showers, cuddling with my cats), using Wise Mind to differentiate facts from emotional reactions, and Pros and Cons.  

These are all, in and of themselves, highly effective DBT skills for me.  But since I am going through this stressful time, I'm wanting to increase the number of tools in my DBT toolbox.  I am returning to some of the skills I've found challenging in the past, reasoning that if the skills I currently use are very effective, there's a chance that if I work through my resistance and be willing rather than willful, there are potentially other skills that can also be helpful.

Once skill in particular that I want to work on, given that reminding myself that I only have to cope with this moment has been very comforting and effective, is "One-Mindfully."

In Dr. Marsha Linehan's book, Skills Training Manual for Treating Borderline Personality Disorder, the ultimate DBT bible,  she describes being One-Mindfully as a mindfulness skill that allows us to take hold of our mind:

"One-Mindfully
  • DO ONE THING AT A TIME. When you are eating, eat. When you are walking, walk.  When you are bathing, bathe.  When you are working, work.  When you are in a group or a conversation, focus your attention on the very moment you are in with another person.  When you are thinking, think.  When you are worrying, worry.  When you are planning, plan. When you are remembering, remember. Do each thing with all of your attention.
  • If other actions, or other thoughts, or strong feelings distract you, LET GO OF DISTRACTIONS and go back to what you are doing - again, and again, and again.
  • CONCENTRATE YOUR MIND. If you are doing two things at once, stop and go back to one thing at a time" (page 113, Mindfulness Handout 3).

My DBT therapist told us that the opposite of mindfulness is multitasking.  She said that the point of practicing being one-mindful is so that we are not missing out on our own lives.  Instead, we participate totally in them. This reminds me of the John Lennon quote "Life is what happens to you when you're busy making other plans."  It's really profound when you consider it.

One of the challenges of being one-mindful, though, is not liking the present moment and allowing the past and future to get in the way.

I have to admit something.  As much as I believe that it is much more effective to do one thing at a time, I am almost constantly multitasking. It's not because I think it's a good way to get a lot of things done either.  It's just that it seems if I don't overwhelm my mind with a number of tasks at once, I don't distract myself from the possibility of feeling empty or emotional.  Because feeling empty usually frightens and concerns me, I try to "fill up" by doing multiple things at once.

If I'm at the computer checking email, I have multiple browsers open and keep switching back and forth, refreshing Facebook, Twitter, and Pinterest.

If I'm cleaning the house, I'm calling my mother or sister to chat with them while I'm doing that task.  If I have a sink full of dishes, I turn on talk radio to distract my mind with that instead of just being with my own thoughts.  I guess I'm afraid to do that sometimes.

Tonight, though, I decided to try to do something one-mindfully.   I mentioned earlier that I like to watch  upbeat shows.  I like to watch feel-good movies, too.   I selected a movie, and JUST watched it.  For a full 90 minutes, with the exception of a restroom break, I sat there and paid attention.   I didn't drift off and lose track of the plot.  I connected with the characters because I followed them closely.  I didn't have my iPad propped up, alerting me to every new tweet, Facebook message, email, text, and comment.  

I survived!!!

It actually felt good to JUST watch the movie one-mindfully.  I'm smiling now as I write this, because I was truly terrified that I might not be able to tolerate this exercise.  The fact that it was a success gives me hope that I can continue to apply this skill to further reduce my suffering, to regulate my emotional distress, and to suffer less.

If you're wanting to try to use the One-mindfully skill but aren't quite ready to do it with a 90 minute movie, there are some smaller, but very powerful ways you can practice, such as:

  • Mindfully make and drink tea. Just MAKE the tea. Notice all of the sensations and every movement involved in each moment to prepare the tea, wait for the tea, pour the tea into the mug. Steep the tea. Hold the warm mug. Feel the steam on your face. Sip the tea.  Now focus on just DRINKING the tea.  Be sure that you've already read this so you can put it aside and truly be in the moment while you practice.
  • Mindfully take a shower. I like to joke that the shower is where I solve the world's problems - or at least go through my entire day or what I anticipate my night will be like.  But try JUST SHOWERING. From the process of disrobing, to adjusting the water, to stepping in, to feeling the water on your skin. Every step of washing your hair, using the soap, and just standing under the water flow.  Notice how it feels to turn off the water...to reach for the towel, to dry off. To get dressed again.  Allow the bathroom to be your sanctuary for this mindfulness exercise.

I plan on practicing both of these exercises this weekend. Will you give them a chance, too? What other activities can you do one-mindfully?   


Thanks for reading.
More Soon.

I'm Going to Massachusetts (in my mind): DBT Improve The Moment "Vacation"


There are times when we become very aware that the only way we will navigate the rough surf of an emotional crisis is to literally take things moment by moment. It doesn't mean that we have to suffer through each moment. In fact, we can consciously and mindfully escape a moment or two here and there.

In DBT (Dialectical Behavior Therapy), one of the Distress Tolerance skills recommended for coping is "Vacation," one of the Crisis Survival Strategies under "Improve the Moment." 
Improve the Moment skills can be remembered by the following:

Imagery
Meaning
Prayer
Relaxation
One thing at a time
Vacation
Encouragement

(from page 165 of Skills Training Manual for Treating Borderline Personality Disorder by Dr. Marsha Linehan)

I've been going through a tremendous amount of stress lately -- stress that would have previously, no doubt, landed me in the hospital. But, with the implementation of my DBT skills and therapy, I am working through this crisis, moment by moment.

When I looked at the IMPROVE skills tonight, "vacation" caught my eye. A vacation sure does sound good. Unfortunately, as is the case for many people, it is not realistic for me to take a real one right now.  But, when practicing a "vacation" in the context of DBT skills, it doesn't require that we leave the room we are in.

In fact, I practiced the DBT skill of vacationing tonight, combined with imagery, relaxation, and one thing at a time.  How?

It all started when I began to fantasize about what it might be like to move back to New England some day.  I miss the rituals that happen during each holiday and the change of seasons. I miss the four seasons (except for Winter, though in New England, even winter has its beauty).  I miss thunderstorms in the summer and leaving your windows open all night because it's warm enough.

As I sat in my California living room and  reminisced about these positive memories from my childhood home, I began to noticed that I felt soothed. A warm feeling came over me.  It was so nice to be focusing on the bright side of a place that holds so much darkness for me. So, I focused on it.

A song popped into my head. It's by James Taylor, and it's called "Carolina in My Mind."  He wrote it when he felt homesick in Spain, and it's a great song for visualizing.  I closed my eyes and listened to the melody and words. In my mind, I went to Massachusetts.  It felt good.  I visualized the aspects I've shared with you. I became relaxed. I focused on just this exercise and let outside distractions melt away.  

I, in effect, had myself a mini vacation tonight.  It felt good.

See if you can take a little vacation of the mind with James Taylor's imagery-filled folky song. See if you can tell which decade this song is from.




Thanks for reading.
More Soon.

That's just *YOUR* Story: Mind Reading (Distorted Thinking Style)


I recently wrote a post on the 15 Styles of Distorted Thinking.  It's important to acknowledge when we have been operating in one of these styles and to further acknowledge when we are telling a story that we've created in that mindset.


Years ago, I went to massage therapy school - more so to learn the spiritual aspect of mind-body, which is probably why I better remember those courses than the ones on anatomy.

One of my teachers in a mind-body-spirit class repeatedly taught lessons during which he would often throw in the phrase, "No, that's YOUR story."

He would talk about how he would often get into conversations and notice that people would make assumptions and create stories to explain what others must be thinking and feeling or to explain their actions.

This is an excellent one of the fifteen styles of distorted thinking:

"Mind Reading: Without their saying so, you know what people are feeling and why they act the way they do. In particular, you are able to divine how people are feeling toward you" (page 26 Thoughts & Feelings: Taking Control of Your Moods and Your Life).

Let's say you were recently called out on an error you made, and several coworkers had overheard your boss.  Later that day, you see some of your coworkers standing around in the snack area laughing and sipping coffee together.

You go back to your office and think, "They're all such jerks. Talking about me and laughing behind my back. They didn't even invite me to have a coffee break with them. I'm the 'outsider' now for sure."

Does this assessment lines up with reality?  Can we really know what others are thinking without asking them or without their telling us?

Wise Mind asks:


  • Do you know for a fact that your coworkers were talking and laughing about you?  Did you actually hear something to this effect?   ☐ Yes       No 
  • Were you available when your coworkers gathered for a break?   ☐ Yes     No    Not sure
  • Is it a fair judgment to consider all of your coworker, who you liked this morning, suddenly be 'all jerks?'     ☐ Yes       No     (This is actually another form of distorted thinking called Polarized or Black or White Thinking, for example, people are either "all good" or "all bad." If you tend to put people on a pedestal only to kick them off, this post on "Splitting" is for you. )

It's so easy to forget that sometimes a thought is just a thought or a feeling is just a feeling. Neither are always facts. Reminding ourselves of this the next time we begin to write "our story" can save us much unnecessary suffering.

The next time you get upset over a situation like this, run through some fact checking questions with your Wise Mind, and ask, "Is this an accurate picture of what happened, or could this possibly just be 'my story'?  Could this by my Emotion Mind talking?  Am I attempting to mind read?"

Many people with Borderline Personality Disorder, as a learned survival mechanism, "read people," as I wrote about in my post "The Psychic Borderline..." but it's important to remember that our perceptions and interpretations can be skewed by Emotion Mind and one of the Distorted Thinking Styles and that grounding through Wise Mind can help us gain clarity and direction in such cases.


Thanks for reading.
More Soon.

Lashing Out in Anger When We're Hurting (Anger and BPD)

{via}
The next time you're feeling sad, guilty, remorseful, or even angry at yourself for lashing out a loved one, consider this:
1.) We all have those moments when anger gets the best of us.  It's important to remember to try our best next time to be more skillful. What we say and do matters.  That is because WE matter. And so do other people. Words can be so powerful and have a long and lasting impact. Let's choose them wisely and carefully.
2.) Dr. Marsha Linehan, founder of DBT (Dialectical Behavior Therapy) says that "everything has cause." The fact that you lashed out was not random. There were circumstances, vulnerabilities, interpretations, and so many other variables that happened before that moment.

If you recently had an incident like this, take a look at Emotion Regulation Worksheet 1a.  This form helps walk you through your reaction and helps you to understand the contributing factors to how you reacted.  It also gives you the opportunity to extend compassion to yourself and to reflect on how you plan to cope the next time you are faced with a potentially angering situation.

Emotion Regulation Worksheet 1a
from Skills Training Manual for
 Treating Borderline Personality Disorder

Click to enlarge

3.) Anger is a common emotion to all humans. It's how we handle it that matters. Emotion Regulation Handout 4 lists some prompting events for feeling the emotion of anger:

  • "Having an important goal blocked or prevented
  • Having an important or pleasurable activity interrupted, postponed, or stopped
  • You or someone you care about being attacked or hurt physically or emotionally by others
  • You or someone you care about being threatened with physical or emotional pain by someone or something
  • You or someone you care about being insulted
  • Losing power
  • Losing status
  • Losing respect
  • Not having things turn out the way you expected
  • Experiencing physical pain
  • Experiencing Emotional Pain
  • Not obtaining something you want (which another person has)"
    (The above list is from page 29 of Dr. Marsha Linehan's Skills Training for Disordered Emotion Regulation, in press).  Dr. Linehan also wrote Skills Training Manual for Treating Borderline Personality Disorder.)
4.) If your anger is "justified," meaning that any of the first four, bold bullet points above are the reason for your anger, Dr. Marsha Linehan suggests using problem solving to deal with the situation.  And whether or not the anger is justified, you can practice Opposite Action by:

  • Gently avoid the person you are angry with (as opposed to attacking them)
  • Take a time out and breath in and out slowly
  • Do the OPPOSITE of other angry urges
    (above modified from page 50 of  Dr. Marsha Linehan's Skills Training for Disordered Emotion Regulation, in press).
She also recommends doing the Opposite Action to anger wholeheartedly by:

  • Trying to understand or empathize with the other person, seeing the ordeal from his or her perspective
  • Change your posture so that you are more relaxed. Try half-smiling. 
  • Change body chemistry by breathing slowly, running or doing something else that is high energy and non-violent


Which of these skills do you think will be most helpful to you the next time you feel the onset of anger?
What do you currently do when you get angry?
What do you do that helps you from making the situation worse?

Thanks for reading.
More Soon.

Crisis Averted using DBT PLEASE Skills

I'm proud of myself. Today I experienced a medical issue that, when I last experienced it about a  year and a half a go, landed me in the ER in a state of panic.  It's a good thing I did go the first time.  Doing so lead to a test the next day that showed I can sometimes be sensitive to sugar (or a lack thereof).  I don't have a diagnosis around this. It just tends to happen if there are certain vulnerability factors, namingly stress, the weather is very hot, and if I haven't eaten enough.

Today all of the elements were there to brew the perfect storm.

As I was driving home from a fun day out in the warm California sun, my calves began to feel very heavy.  It was a very familiar feeling - the first thing I noticed when I had the episode over a year ago.  I then had a sudden onset of extreme hunger (again, same as before), and finally, just as in the first episode, my hands began to visibly tremble.

Initially, my nervous system reacted in panic. I decided to pull over and use my skills to avoid a medical and mental health crisis.

Once pulled over, I took out one of my energy bars, which I now carry in my purse at all times.  This is the type I had with me today.


I ate it, quickly but calmly. I also drank some water.  I knew that my body needed more sugar, fast.  Fortunately, there was a frozen yogurt place on the same street. I waited until I felt a little bit more calm, then I went in, got a small serving of frozen yogurt in a cone, and returned to my car, AC blasting, to eat it. 

Anxious thoughts that I should go to the ER popped up.  I countered with Wise Mind and assured myself that this was something I'd been through before,  that I knew how to take care of myself, and that I needed to slow down my mind. 
I thought about my day -- how it was hot, I'd been running around, and I hadn't eaten enough. It all added up.  I needed to eat, and my body would find equilibrium.  I felt more calm. I trusted that if I could stay in control of my emotions, I could rationally monitor my health and make reasonable decisions.
It took about 20 minutes, but the trembling subsided.  

I'm proud that I was able to use the skills in such a scary situation!  I was all alone, and part of wanting to go to the hospital was to have people around me taking care of me. The little girl inside of me was frightened, and I managed to use my DBT PLEASE skills to take care of "us."

The DBT PLEASE skills are on Emotion Regulation Handout 14 of Dr. Marsha Linehan's Skills Training Manual for Disordered Emotion Regulation.  I am also showing you Handout 9, which talks about Reducing Vulnerability to Negative Emotions: How to Stay Out of Emotion Mind (including PLEASE).
Specifically, paying attention to number 2 on the list would have prevented my Emotional Mind episode and the ensuing feeling of panic and anxiety.


Nonetheless, Wise Mind skills worked to help avoid a crisis.  DBT works!


Which PLEASE skills have you been implementing? Which do you need to work on?

If you find these worksheets helpful, I strongly recommend Marsha Linehan's book, Skills Training Manual for Disordered Emotion Regulation.  It is an essential part of DBT practice, a therapy that Dr. Linehan founded to treat Borderline Personality Disorder, and it is effective at helping people with many other conditions as well.

Thanks for reading.
More Soon.

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