Big Decisions, Avoidance, and Being Emotionally Sensitive (BPD, DBT)



As an emotionally sensitive woman who suffered for years with Borderline Personality Disorder (BPD) and is now in recovery, I have noticed a tendency to avoid making large shifts in my life.  Perhaps it’s that whole “Don’t rock the boat” mentality that comes when I think about times when I have become incredibly emotionally dysregulated after choosing to make an anxiety provoking change.

Recently, I realized that this new coping mechanism, while it has been effective and helpful in many ways, has also been holding me back from continued growth.  Here’s a recent example.

I have been enrolled in a master’s program that recently became very overwhelming. Between the intensive course load and the triggering content (subjects that opened old wounds and caused PTSD and anxiety symptoms), I began to question whether I should continue on that path.
I had all kinds of worry thoughts:
  • Does this mean I’m sabotaging if I walk away from this?
  • Does this mean I’m having a relapse?
  • Does it mean I can’t handle things the way I thought I could?
  • What will people think of me? (They’ll be disappointed, think I’m a quitter, loser, incapable, etc.)
Trigger Warning

With these thoughts mostly unchallenged, I went into full-blown panic mode.  My self-doubt was high.  Anxiety and panic attacks were coming one after the other.  I became very dysregulated.  My sleep was disrupted. My appetite vanished.  I had intrusive thoughts and felt a looming sense of despair. I was also angry and frustrated to find myself in such an emotional state after feeling very well for a long period of time.

End Trigger Warning

While I have been practicing Dialectical Behavior Therapy (DBT) skills for years and now teach them to others, the fact that I am human and sometimes stubborn (“willful” in the DBT world) means that things will not always go perfectly smoothly for me anymore than the next person.  Fortunately, an awareness of this allows me to reign things in when I do notice my heart soften toward shifting from being willful to willing.

I began to consider that the point of view that I was gripping onto so tightly and that was causing me so much distress might not be the best one for my health and well-being.  I checked in with my DBT Life Coach, Teresa Lynne, and her words to me were along the lines of:

“Debbie, even if you don’t get another day of education, you are loved, valuable, and you are giving and will continue to give so much.”

These words really helped me begin to make the shift.   The new thoughts I had after reflecting up on this and beginning to calm down nervous system and body (I’ll tell you how I did this) were:
  • Who am I doing this program for?
  • Is it necessary and worth the stress?
  • Why does it matter what other people think about my education decisions?
  • It’s my life to live, no one else’s. I don’t have to answer to anyone on this.
  • Even if people do judge me on it, what’s the big deal?

After two days of severe anxiety and feeling dysregulated, I started to feel better – but it wasn’t without a lot of effort.  I decided to attend a drop-in DBT Distress Tolerance group to talk about and acknowledge what worked as far as overcoming this episode.  I’ll now share with you what worked to help me feel better.

This is the worksheet that we fill out at the beginning of the group.  After that, each person goes around and discusses what they’ve written, allowing feedback from their peers as well as the DBT therapist.

Please note there is a minor Trigger Warning with regards to the content of this worksheet.


DBT Distress Tolerance Worksheet

As you can see, in the first column, we describe the stressful situation or event.  In my case, it was:
“Triggered by content in school and overwhelmed by workload.”

In the second column, we describe the reaction we have noticed to the stress.  Mine was:
“Severe Anxiety: GI (gastrointestinal symptoms), vomiting, loss of appetite, sleep problems, feeling distressed, muscle tension, dizzy/lightheaded, very irritable, scared, exhausted.”

In the third column, we write DBT Skills I Can Use (or have used):

I looked around the room as we presented, and I noticed that a lot of the newcomers to DBT had very long content in the first two columns and much less in the third column.  That’s only natural.  As you become more proficient in identifying which skills will help in a given situation and using them, that column will expand for you as well.

On mine, I wrote the following. These are all skills that I practiced prior to the group that helped me come out of the funk of dysregulation and back to a balanced emotional baseline. The two items marked with a “*” indicate that plan on doing these items but have not yet.
  • Pros & Cons Worksheet
    • for continuing this semester (I ended up dropping)
    • for continuing this particular master’s program (perhaps there’s a program with a better fit.)*
    • for getting a master’s degree at all*
  • Self-Soothing Through the Senses
    • Long, hot, aroma therapeutic shower (scented body wash, shampoo, body butter)
    • Upper Body Massage
    • Energy work
  • Engaging Wise Mind
    • Fact checking/challenging thoughts
  • Comparisons
    • Thinking about how I can get through episodes like this with more resilience and a quicker turn around time than years ago
  • Thoughts
    • Pushing away intrusive thoughts
    • Prayer
    • Self-Encouragement (cheerleading statements)
  • Mindfulness
    • Doing one thing at a time
    • Listening to guided meditation and hypnosis CDs
    • Radical acceptance of symptoms (heart rate fast, appetite, etc.)
  • Activities
    • Distracted by getting engaged in helping my yoga teacher with a project
  • PLEASE skills
    • Took medication
    • Ate even when I didn’t feel like it
    • Stayed hydrated
    • Went to yoga

Those of us who are emotionally sensitive often need to work harder and more diligently than those who are not when it comes to returning to a healthy, comfortable, balanced state of being after an upset.  As you can see, it took the practice of a number of skills to successfully convince my nervous system that I was not in danger and that it could relax.

Please be kind and compassionate to yourself when you find you are in a state of emotional dysregulation.  Begin treating yourself with the same tenderness that you would a loved one.

Soothe your nerves through activities that calm your senses and bring you a greater sense of well-being.

Know that it’s worth the time and effort.  Know that you are not alone.  Know that this, too, shall pass.

Thanks for reading.
More Soon.

5 Strategies for Sticking With DBT and Recovery (Even When Times Get Tough)


Please welcome back Healing From BPD Guest Blogger, Aeshe, from My Recovery From BPD.com:
              
               
Debbie has asked me to write on my experience thus far of participating in an Intensive Dialectical Behavior Therapy (DBT) Treatment Program.  More specifically, she has asked me to give some words of advice to others in such a program who may find themselves exhausted, overwhelmed, and in a painful storm of emotion, tempted to throw it all away.  I promise you, those feelings are sure to come at one point or another, and they can feel excruciating.  As Debbie has said to me, “Recovery is not all unicorns and rainbows.”
               Take a moment to digest that.  Recovery is not smooth sailing.  You don’t just show up to classes and magically “get better” as each module is taught.  There will most likely be many personal challenges, real-world examples and experiences of your group members that hit close to home, relapses, and very old wounds uncovered.  Oh, yes!: life keeps moving along as you go through recovery, throwing its periodic curve balls in your direction.
               The upside is that DBT and similar therapies provide invaluable tools and skill sets for weathering these emotional storms and meeting life’s challenges head on.  You’ll also be able to use the therapeutic environment as a place to practice and refine skills before using them in real-life situations.  If you’re lucky, you will also be paired with an individual therapist whom you can call in moments of distress for skills-focused phone coaching.  The key in all of this is that you commit to wellness and give yourself over to the process of recovery with every ounce of your being.
              
            In the video below I will outline five of my favorite strategies for sticking with it, even when I’m most tempted to give up on my recovery and quit the treatment program: 




Follow along with the video as I get into:

My Top 5 Strategies for Sticking With It:

1.      Take a Moment to Pause & Write Out Some Pros and Cons
2.      Use Thought Defusion to Stop the Thought-Belief-Behavior Cycle in its Tracks!
3.      Identify Your Values & Let Them Guide You
4.      Radically Accept & Assume a Stance of Willingness
5.      Cultivate Some Healthy Selfishness.  This is about YOU!

Thank you for reading and watching.
More Soon.
You can read Aeshe's first guest post here at Healing From BPD, "How I Coped When My 'Innie' Became an 'Outie': Relationships, Intimacy, and Age Regression."

and here's another post featuring Aeshe and her husband Rowan: "A Couple Shares The Challenges When A Partner Has BPD"

You can connect with Aeshe in the following ways:

Problem with Perfectionism: To "C' or Not to "C" (That is the question)


Take an emotionally sensitive woman with Borderline Personality Disorder traits (and in recovery from BPD), a perfectionist complex, and two intensive semester courses jammed into four weeks and what do you get?  This video.

I hope it speaks to you, encourages you, or helps you in some way.  I look forward to your thoughts.

I also get into the reality of being in recovery of BPD and how it is simply not a straight, easy road -- and why that is okay, too.




If you are unable to see this video on your device, click here to watch it on YouTube.


Thanks for reading and watching.
More soon.

Open Letter to Dr. Marsha Linehan from Debbie Corso


For an assignment in the Positive Psychology course that I am taking this summer as part of my grad school program, we were asked to write a gratitude letter to someone who affected our lives. I chose Dr. Marsha Linehan, who developed Dialectical Behavior Therapy (DBT) and who has suffered herself as an emotionally sensitive woman.

Dear Dr. Marsha Linehan:

            For someone who has never met you in person but hopes to someday, I owe an awful lot to you, and I am forever grateful.  You came into my life a few years ago when I was at my wit’s end.  I was depressed, exhausted, and suffering from suicidal thoughts.  I found myself, once again, having an emotional crisis and being referred from the emergency room to the psychiatric clinic for mental health services.  This time, I was referred to an Intensive Outpatient Program (IOP), during which part of the curriculum was to watch sections of your video series From Chaos to Freedom and to study materials and do worksheets from your book Skills Training Manual for Borderline Personality Disorder.
            Your caring, motherly presence made me feel safe, and your background as a doctor who worked with a population who you have referred to as “emotional third degree burn victims” convinced me that you understood the gravity of my pain and validated my experience as an incredibly emotionally sensitive woman.  I didn’t understand or fully realize the power in the teachings you provided during that crisis time, but I felt incredibly comforted and excited when, after the program, I was referred to Dialectical Behavior Therapy (DBT), the modality that I learned you developed and that is based on your work that I was introduced to in IOP. This is where my real healing began.
             Each week, for nearly two years (the clinic I attended allowed you to keep taking the modules until both you and your clinical team felt you were ready to graduate), I and the rest of the group participated in 5-10 minute mindfulness meditations guided by you on CD.  Over time, these practices took me from being someone who couldn’t bear to sit still for five minutes to someone who, most weeks, looked forward to and welcomed the opportunity to sit quietly and allow my busy mind to rest.  I was inspired by the stories you would tell leading into the practices, such as your experiences with sitting meditation sometimes for a full day in Zen Buddhist monasteries.  If you could sit there for a full day, I thought, I could handle the five minutes.
            As we began to dig deeper into the four modules that you created (Emotion Regulation, Distress Tolerance, Interpersonal Effectiveness, and Mindfulness), you, alongside my DBT therapist, taught me skills that helped me tap into my Wise Mind -- skills that helped me learn to put a pause between my initial emotional reaction and any action I would take -- skills that, essentially, helped me to radically change my life.  You taught me that I don’t need to believe everything that I think -- that not all thoughts and feelings are true, but that we should still honor them because they all have “cause.”  You taught me that with hard work, dedication, and persistence with practicing DBT skills, even a serious illness like Borderline Personality Disorder (BPD) can be overcome.
            Yes, Dr. Linehan, after just a couple of years of working the skills that have been the focus of your research and practice, I no longer meet the criteria for BPD.  I realize that this would not have been possible without an active commitment on my behalf, but without the framework and guidance that you provided through the curriculum at my clinic as well as the training in your modality of DBT received by the staff who treated and worked with me, I would not have had an effective path to follow.  Because of you, I am now equipped to help my peers in the capacity of a DBT Skills Coach, was recently filmed in a documentary about BPD, have a successful blog that reaches thousands each month around the globe with the hope that they too can recover, and I have written two successful books about my experience with BPD and DBT.  Without you, none of this would have been possible.
            I am also incredibly thankful, Dr. Linehan, as are tens of thousands of other people on this planet who suffer with emotional sensitivity and/or instability issues, that you bravely “came out” recently in the New York Times, revealing after all these years in the profession and after having helped literally save the lives of countless people like me, that you also suffered greatly from mental illness as a young woman.  You shared that you essentially also had BPD and were institutionalized and thought to be a hopeless psychiatric case.  You proved the world wrong, and I believe that your choice to recently come out and share this testimony of the possibility of healing was timely and much needed.  I am so grateful that you were willing to take all of the risks involved in becoming so vulnerable within the professional community of which you are a part, the patients who are affected by your work, and the world at large.  I truly hope that it the choice has been as worth it for you as it has for people like me.
            Thank you for everything you have done and everything you continue to do.  You and your work have added much needed meaning to my life, and I hope that, should you stumble upon my work, you will be proud and gratified to know what an impact you have had on my (and countless other’s) lives.  

Thank you, Dr. Linehan.

In warmth and sincerity,
Debbie Corso

Attention Clinicians: People With BPD Need Validation, Non-Judgment, and Compassion (Borderline Personality Disorder)


What I am about to write in this post will come as no surprise to those of you who suffer from Borderline Personality Disorder (BPD), but it may be helpful for those who treating you or who have careers ahead of them that will allow them to do so.

Starting with its very name, the diagnosis is often misunderstood, stigmatized, and feared, and the patients who bear its name on their records are often lumped into a group of manipulative, untreatable consumers of the psychiatric system.  As a person who no longer meets the criteria for a BPD diagnosis and who has substantial contact with others around the world who have BPD or have overcome it, I am here to tell you that I have been catching promising glimpses of hope that this is all starting to shift.

I was invited to speak on Friday at the Berkeley Cognitive Behavior Therapy Clinic by Dr. Patricia Zurita Ona, with whom I connected with last year around the time that I was getting ready to release my book Healing From Borderline Personality Disorder: My Journey Out Of Hell Through Dialectical Behavior Therapy.  She invited me to speak to a group of twenty students at the doctorate level of psychology on Borderline Personality Disorder and Dialectical Behavior Therapy.  I was nervous but happy to do so.
It's tough to see in this pic, but that's me,
joining the group  at Berkeley CBT Clinic
via Skype, projected onto the wall.

Thank you Rich for this closeup of the screen.


As an advocate for my community -- those suffering from BPD, those on the road of recovery, and everyone in-between, I believe that it is essential the we encourage, educate and inspire new psychologists entering the field about working with the BPD population.

As part of my preparation for the presentation, I asked many of my readers via this site's Facebook page to chime in on the following question:

What would YOU like me to say on your behalf? ....

Hello Dear Ones, Tomorrow I'll be doing a presentation in front of a class of students who are working to become psychologists (and I believe psychiatrists, too) at the Berkeley CBT Clinic here in California. This is a group of enthusiastic, new practitioners who are entering into the field wanting to help others and make a difference. They have also likely been exposed to stereotypes and stigmas associated with Borderline Personality Disorder and may be nervous or hesitant to work with our population because of this.

If you could tell them one thing to encourage them in a direction that reduces stigma and helps create an atmosphere of hope and healing for those with BPD as they set out to start their careers, what would you say? I'd love to share your responses with this group tomorrow, and I'll let you know how it goes.
♥ Debbie


Their responses moved me, as many were so raw, vulnerable, and willing to be incredibly open.  I've selected some to share with you here, but you can read them all the Facebook page if you'd like.








The above answers, as with all of the rest of those posted by my readers, were shared with the students.  They all received a link so that they could review the entire thread.

The doctoral students asked me a number of questions, such as "When did you finally commit to DBT and why?," and "What advice do you have for a provider who is feeling burned out?"  I was really impressed with their interest and commitment to providing excellent care.

After the presentation, I received this kind tweet from the program's director, Dr. Patricia Zurita Ona:




And the next day this one from one of the clinicians, Charlie:



It is my pleasure to be doing this work, as I believe it really does many an impact and a difference lives of all of my connections around the world who have BPD, their loved ones and families, and those who treat them.

Years ago, I never imagined I would be in a position to do this, so please have hope that your future is bright, too.

Thank you for reading.
More soon.

If your organization is interested in having Debbie present in person or via Skype, click here.

Making BPD Stigma Free: For Me, My daughter, and YOU (Guest post by Joyce Savage)


Please welcome Joyce Savage from Make BPD Stigma Free. In this guest post, she shares her mission as well some personal notes from her own experience.
My name is Joyce Savage.  My mission is to increase awareness of Borderline Personality Disorder and reduce the stigma surrounding it.  That’s why I created my website.
I was not properly diagnosed until I was 35 years old:twenty years of unnecessary suffering later.  In my experience (and that of many others with BPD), not receiving a timely diagnosis can lead to damage can be done that can’t be undone or that takes an awful lot of work to undo.  Families can be ripped apart.  Many lives can be lost.
My understanding is that BPD can be hereditary.  I wanted to make sure that my daughter, who was showing possible BPD traits, didn’t slip through the cracks like I did.  I can’t just sit back and do nothing.
What I do at my site, Make BPD Stigma Free, is search for blog posts, articles, etc. on the topic of Borderline Personality Disorder from around the world that touch me and that you may never come across otherwise. I collect them all in one place for you to easily find. 
I try to have a little bit of everything on my site – something for everyone – things for people with BPD or those who think they may have it, loved ones of BPD sufferers, etc.  
I have information, statistics, some videos, poems, polls, and so much more.  I also have some humour because we sometimes need to laugh or else we’ll cry.  And we’ve all had enough of that.  I especially love the jokes that only those of us with BPD would get!
I feel so alone a lot of the time, like no one can possibly understand what I’m going through.  It’s so hard for people without BPD to understand what it’s like.  I believe they can, but usually only to a point. My goal is to help change this.
During this journey, I am working on writing a book about Borderline Personality Disorder.  I’m not sure what it’s going to be like.  I’ll find out as I write it and it comes to me I hope you’ll follow me via social media to keep updated on this project.I look forward to reading your comments on my site.  I’d like to know what you like about it and what you’d like to see, and I’ll do my best to provide it.
Thanks for reading. Follow my blog in my journey to wellness and  recovery.  I hope you will learn more about BPD along with me.

Let’s Make BPD Stigma-Free!

- Joyce Savage

You can follow Joyce at:

You can also read my weekly newspaper at:  Make BPD Stigma Free Newspaper

More content also coming soon at Google+  

New BPD Documentary: Behind The Scenes Sneak Peek!

I recently blogged about why I agreed to be in Tami Sattler’s documentary on Borderline Personality Disorder in this post.  I also promised to bring you behind the scenes photos and information on the project since many of you, my dear readers, expressed in interest in such things via my Facebook page and Twitter feed.

I was nervous and excited in the days leading up to filming.  I’ve been invited to be a part of a number of projects over the years, but fear and not feeling ready has held me back.  This weekend was a HUGE step, as I independently navigated the city streets of San Francisco and went to film on location in Sausalito. 

Here is a photo of me with producer Tami Sattler before we really started talking. Interesting body language, with both of our heads tilting in opposite directions. (Tami is a licensed therapist, so I’m sure she’s noticing this as well as she reads this post.)  Tami’s vision is to bring awareness to BPD – what it is and what it is not.  She seeks, as I do, to break down stigmas and help professionals to understand that while Borderline Personality Disorder is a serious mental illness, it is also treatable.  People can and do get better.  In fact, I am not the only subject profiled who is in recovery, but I’ll get to that in a bit.  She also wants to reach those who are suffering to let them know that, no matter where they are on their path, there is hope.  I’m sure you can see why I found this project to be such a good match!

20130531_105111 

As time went on, Tami and I had a very relaxed experience together.  I progressively felt at ease sharing my story and answering her questions, even the ones that took me back to darker times in life, as I recently wrote about in this post about when I was twenty-three and highly symptomatic and suffering.

20130531_105051

Filming was fun and exciting.  It wasn’t a big time Hollywood production, but a serious, independent film with a professional staff.  You can see a tiny bit of Paul, our camera man filming me here.  I wish I had gotten a pic with him, too!

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One of the most fun parts of the film was when we took a walk down to the water in Sausalito.  It was so beautiful, and it helped me to open up about additional questions that Tami had for me.  The second pic of she and I by the boats is one of my favorites from the day.

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I reflected on what it meant to be a part of this project and posted this on my Facebook wall the night of the shoot:

FB healingfrombpd

Another subject of the film, Teresa Lynne of Essence Happens is also in town from Georgia and was filmed today telling her story of recovery from BPD. Teresa now dedicates her life to coaching others with BPD as well as their family members. She also works with people in recovery and  those who have no diagnosis at all and are seeking life coaching. I’m actually one of her clients!  I’ll have some pics of her and I together in the coming week (as well as a collaboration video), as we’ll be trekking around San Francisco together this weekend.  But in the meantime, she was smart enough to get a photo with Paul, so here’s that image:

Teresa Lynne Essence Happens

I want to give a HUGE shout out to all of my readers who chose to invest in this film.  While the project is funded primarily by producer Tami Sattler, she did put up a KickStarter page to help raise some capital. In exchange, backers are given tickets to screening events, and depending on their level of contribution, can have their names in the credits.  You can check out the page and watch a section of the movie that covers another subject who goes by the name “Presh,” for Precious.

This project is something we envision being distributed widely, and we think that even the Sundance Film Festival is a realistic possibility.  The anticipated release of this film in Summer 2014.  I’ll, of course, keep you posted along the way.

So excited to share all of this with you.

Thank you for reading.
More soon.

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