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

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

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

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

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

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

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

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

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

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

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

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