A whole new perspective

I'm not sure what has happened with my new focus on regulating emotions. I feel a lot calmer and my head doesn't feel so overwhelmed. I think I was honestly going overboard with so many distress tolerance skills I didn't give myself time to just relax. I still swear by them but it is interesting to note the difference in being mindful of regulating emotions than constantly trying to distract myself, which has been resulting in suppression. I am not getting too excited though because I haven't had any negative emotions the last 3 days and I am almost positive that when I do I will struggle to do the skills that I am working hard on using this week. Though as time goes on I will hope to pull these skills out easily and use them in times of labile emotions. 

I received some fantastic tips from my case manager 2 days ago. I told her that I can't seem to observe and describe my emotions easily because I have a hard time picking which came first when I experience all different emotions in one hit. She could tell it was really bugging me to the point of being overwhelmed and advised that perhaps I could just choose the one that stood out the most in order to just work on that one emotion. The other tip she gave me is to write them all out on the separate worksheets (which you are meant to do) and not label which came 1st, 2nd, 3rd. It seems so silly but I have been so hung up on what came where, when that happened and how that came next, that I have lost sight of just working on any emotion that came. She said that perhaps by focusing on one, the others may come easier or I may even discover which came first. The most important thing that matters is that by working on one and radically accepting one emotion I would suppress less. So this is what I will be doing next time I need to fill out an observe and describe worksheet. I look forward to it. 

Yesterday when I was trying to think of positive experiences I could have, (a skill that is part of Emotion Regulation), I looked at a list that I got from my DBT class, written by Dr Marsha Linehan. It is surprising how even the tiniest thing can be considered as increasing positive emotions. I chose a few that I enjoy doing:

 Having quiet evenings

 Laying in the sun

 Imaging beautiful scenery

 Singing around the house

 Coming home from work

 Doodling

 Laughing

The list isn't scary (that's only a fraction of things to do out of a list of 176). It would be scary if it was climb a mountain or visit Africa but things like saving money and doodling is an achievable thing to start with and it can increase to harder things as confidence is built. It excites me to think of doing things to increase positive emotions.

Using emotion regulation skills

The last 2 posts I've written about implementing more skills from the Emotion Regulation module of DBT, the treatment for Borderline Personality Disorder (BPD). Today, when I woke, I did my usual thing and wrote a little list of skills I'd like to use today and made a conscious effort to do them even though I was out house most of the day.

To increase positive emotions I made contact with 2 of my friends (through text) that I wish to keep in regular contact with. This in itself is huge because just 6 - 9 months ago I was shutting myself off from everyone. Luckily, because I don't handle rejection very well (a day in the life of a person with BPD), both my friends responded and I had a great to and fro with a friend I thought I'd lost. I also had a couple of gaps in between jobs and so I spent those times at the beach. Again this is huge for me because I was almost agoraphobic the same amount of months ago. Not only that, I would never go to the beach even before that because I never saw the beauty in it. Even though I only spent a little time there it gave me time to experience it with all of my senses. I also shouted myself to lunch and even though up til recently I was using this as my positive experience almost everyday I decided this week that this was the one day I would allow it (long story short, I am putting on tons of weight so had to cut it back). 

To reduce vulnerability to negative emotions I put the following PLEASE MASTER skills, (see last post), in place. I built mastery by doing a bit of a strange art journal page. I'm not a fan of weaving but decided to give it a shot and love my page. Also I think I did a pretty good job today at a particular job where I knew I would be with a client that I consider difficult. I didn't need to treat any physical illness today, I balanced my eating well (ate at regular times and made good choices) and I avoided mood altering drugs. I didn't participate in exercise however I did think about it. I'm concerned that magpies and plovers will get me because they're out now but I am trying to convince myself to wear a hat if I walk (hate to because I feel stupid - a fear that I look dumb and people will talk about me if I wear a hat - silly I know). Will need to act opposite to emotion and just go for that walk with a hat. I'm working on it. 

So that's my day. I will use pictures next time I talk about my skills. It's just late and I needed to finish this post before the night was over. 

Till next time.

More about regulating emotions

Today I made a bit of an epiphany (refer to last post) where in order to regulate my emotions I need to be focusing more on the Emotion Regulation module of DBT - yeah I know, der! Because I have been having an extremely difficult time with my marriage I have been spending all of my energy on distress tolerance skills and not enough on regulating my up and down emotions. Doing distress tolerance skills is great and I am in no way going to stop doing them, however I am now aware that I need to be spending an equal amount of energy on emotion regulation skills. 

According to Dr Marsha Linehan, founder of Dialectical Behaviour Therapy (DBT) in order to regulate your emotions the goals are to: 

understand the emotions, understand the function of the emotion, reduce vulnerability to negative emotions and decrease emotional suffering

To understand the emotions experienced it is recommended to observe and describe emotion/s by filling in a worksheet or mentally go through the model shown below:

I have seen some of these models with another section called 'Vulnerability Factors' which slots in after Prompting Event. I won't go into the model too much here but will post about it separately.

The list below helps to understand the functions of emotions:
1. Is the emotion to motivate/organise action?
2. Is the emotion to self validate?
3. Is the emotion to communicate to others or to influence others?

To reduce vulnerability to negative emotions the skills are PLEASE MASTER (an acronym) and increasing positive emotions.

PLEASE MASTER skills:
Treat PhysicaL illness
balance Eating
avoid mood Altering Drugs
balance Sleep
get Exercise
build MASTERy

To increase positive emotions:
1. do things in the short term that are pleasant and possible now
2. for the long term work towards goals, attend to relationships and avoid avoiding
3. be mindful of positive experiences
4. be unmindful of worries

Letting go of emotions through mindfulness and changing emotions by doing opposite action can assist to decrease emotional suffering.

Just briefly, to let go of emotions through mindfulness notice the presence of the emotion and step back from it, experience it, don't act on the emotion, don't judge it, practice willingness and radically accept it. 

To act opposite to the current emotion you do exactly that. If anxiety causes withdrawal then do the opposite and face it. If sadness creates curling up in a ball do the opposite by doing something that is opposite. 

Of course none of the above are easy to do but by learning about them through therapy or DBT classes and practice it can be done. I hope that with this new found epiphany I can make a new goal now to focus on doing more of my PLEASE MASTER skills and increase positive emotions.

Revisiting my weekend

Unfortunately, after having set GIVE skills as one of my goals this weekend, I was not very good at following through. I spent Friday night and most of Saturday and Sunday irritable. I blasted my son over trivial things and was snappy and sarcastic towards my husband. I have spent time trying to figure out where this irritability is coming from but because I lack skills in behaviour chain analysis and struggle to sometimes get my head around observing and describing emotions I am really having a difficult time figuring it out. The only solution I had over the weekend was to try and de-escalate by distracting and self soothing as well as to stop myself carrying on (repeating myself, escalating more and more) by just shutting my mouth and literally biting my tongue. So here I am the Monday after still confused as to why I was, and still am, feeling this way. I have a few different scenarios, better known as vulnerability factors, that possibly could be contributing to this feeling of irritability. 

 1. Friday was my dad's birthday (he passed away just under a year ago and I have PTSD). 
Yet, I struggle to accept that this is the reason I am irritable because on Friday I had a great day. I felt fine. I wasn't ruminating, in fact, I was suppressing it.
2. A few things my husband did reminded me why our marriage is failing. I have days where I don't think about it (more suppressing) and days where it just smacks me in the face
3.  I have had a stressful week (by stressful I mean in my Borderline perspective I have had a lot on and I've been given bad news, all which overwhelms me). 
4. I reduced all my meal portion sizes on Friday (I have been overeating and comfort eating a lot since giving up alcohol and drugs in the last year).

With all of those things in writing I can now see where of course it would be normal for the average person (not just a person with BPD) to have these feelings of irritability after all the above situations. All anger and frustration comes from a place of hurt, sadness, disappointment and all kinds of other emotions. Suppression is also never a good thing but I guess it is just how I am dealing with things right now so I don't crumble. It's getting me by but unfortunately I do now see the consequences. 

I realise I am on the road to recovery and can't have the answers straight away. It feels like things would just be easier if I could do the skill of observing and describing my emotions as they come but because a multitude of emotions can occur so fast it is difficult to do this. As I think back to Friday when I first got cranky with my son it would have been better for me to fill out an observe and describe emotions worksheet. I did think of it, however, it requires you to fill in one sheet for each emotion. The problem is I didn't know which emotion started first and there were so many that I decided not to. This is where I think a behaviour chain analysis would have been good also. 

Anyway, looking forward, I think the following post on 'coping appropriately with feelings of anger and irritability' by Debbie Corso (another person with BPD with a fantastic Blog) is a great strategy to try while I am unsure of the exact origin of the irritability. Another thing I have tried today is reading my Emotion Regulation workbook again from DBT class. Just going over the goals of the Emotion Regulation module has really encouraged me to focus more on these skills. The start of the module explains (paraphrased by me):

The goal of emotion regulation is to decrease labile emotions. In order to regulate my emotions I need to observe and describe them and understand what they do for me. I need to reduce emotional vulnerability by using PLEASE MASTER skills and increase positive experiences. To decrease suffering I need to let go of painful emotions through mindfulness and change these emotions through opposite action. 

Here I have been madly distracting and self soothing with Distress Tolerance skills, possibly to the point of suppression, where I could have been focusing more on Emotion Regulation. It's not to say that Distress Tolerance skills won't come in handy, (I love them way too much), but for this moment it makes sense if I want to regulate my emotions and moods to focus on the module specifically designed for that.

My skills for today

Well here I am posting what skills I have done for today. In actual fact I've had a good day and I'm relieved because it's the anniversary of something dear to me which could have turned into a day of mourning and ruminating. By distracting and self soothing the day has crept by without a thought to have those negative emotions and even while typing now I can just continue to distract by blogging and contributing to those out there who may have BPD like I do. Perhaps in a way I am suppressing the anniversary or thoughts of it but if it's getting me through the day then that's what I'm doing. 

One thing I do find interesting about feeling good today is I didn't feel this way yesterday. That in itself is a bit of a wake up call to me because one of my cheerleading statements that I often don't believe is 'you won't feel this sad forever'. This good feeling that I'm having today is proof right here, right now that things can be ok, things do change and emotions do really change even when you think it is absolutely not possible. I have noted also that a few times today I have thought 'well this feeling good won't last forever either' and even though that may be true I can think of ways in which to be unmindful of worries. This is a skill in the DBT module of Emotion Regulation where you can think about positives that have happened in your life and things that you are grateful for to distract from those worries.I like to also do an achievement list which I find useful as well.

So here's what skills I used today: 

 I pat the cat

Skill - Distress Tolerance (self soothe - touch/feel)

 I tidied the house up a bit 
(this is a permanent deal I have with my psychologist in order to keep my self respect in tact, to be an independent, capable adult and to ensure I am not making excuses so my husband can do it all)

Skill - Distress Tolerance (distract by doing an activity)

Skill - Interpersonal Effectiveness (FAST - a tool for maintaining self respect) 

 

 To do cleaning I had to use opposite to emotion action because I really didn't want to do it

Skill - Emotion Regulation (opposite to emotion action)

Skill - Emotion Regulation (willingness)

  Did some writing (generally everyday I write a few things I'm grateful for and a 'what was positive today' list)

Skill - Distress Tolerance (distract by doing an activity)

 I did some describing, non-judgmentally, of sounds around me
Skill - Core Mindfulness (describe)
Skill - Core Mindfulness (non-judgmental)

More tomorrow.

The last day of my 7 day challenge

Well here it is, the final day of my challenge to blog 5 skills a day for 7 days. Today when I woke up I tried to think of some different skills to put to use. I did this firstly to get used to doing all types of skills that are in DBT (Dialectical Behaviour Therapy) and secondly so you don't see a repeat of images. My main focus today was to try and incorporate more mindfulness as well as observing and describing my emotions. So, among doing my usual oil burning and building positive experiences I also did the following:
 

After work I felt a great sense of pride at what I thought was a great job. 

I observed and described what I was feeling and made sure that when I arrived home I wrote it out in the Emotion Regulation homework sheet that I received during my course.

Skill - Core Mindfulness (observe)

Skill - Core Mindfulness (describe)

 

I started a jigsaw puzzle today and did all of the edges.

Skill - Distress Tolerance (activity)

Skill - Emotion Regulation (building mastery)

 I used all of my senses to describe this jigsaw box in it's entirety without judgment.

Skill - Core Mindfulness (describe)

Skill - Core Mindfulness (non-judgmental stance)

 I looked up cheerleading statements that are best suited for me for times when I desperately need to reflect on them. I looked on Pinterest for ideas and I looked through previous DBT homework sheets. I typed the ones I liked then rewrote them in pretty colours.

Skill - Distress Tolerance (Improve the moment - encouraging/cheerleading)

 I decided at the end of the day to take a vacation. I've had a pretty busy week so I took a book to bed and had an hour nap.

Skill - Distress Tolerance (Improve the Moment - vacation)

Skill - Distress Tolerance (Improve the moment - by reading I was doing one thing at a time)

So there you have it - 7 days of using 5 skills per day. I had fun. It taught me a lot and I really do hope I encourage you to try some yourself.

The next thing I blog may not be a challenge but I certainly look forward to posting again soon with something creatively different. Until next time. 

 

My Bad Mood

I was in a bit of a bad mood over the weekend. It’s almost as if I woke up on the wrong side of bed both Saturday and Sunday. Everything my husband and son did irritated, annoyed and frustrated me and it triggered off thoughts of hopelessness, worthlessness and being unlovable so on and so on. Disappointing, however I dealt with it the best way I knew how. 

During the weekend whenever I felt irritable I tried so hard to remember that it could potentially turn out worse and that I could really put more dents in my already weak relationships with the boys. I said to myself to try and take breaths and just allow time before speaking and to use my GIVE skills (be Gentle, act Interested, Validate them and use an Easy manner). Unfortunately it didn’t work completely but I am almost positive the GIVE skill was in the back of my mind all weekend and I think this might have been the thing that kept me from completely losing it. I also had to take myself away from the situations quite a lot. I didn’t create a scene about it, I just went into my room and closed the door (which normally means I’m meditating). I tried so hard to figure out why I was feeling the way I was and I really couldn’t work it out but it gave me a chance to just cool down. I also tried to work out what emotions I was feeling and I was able to figure it out eventually and it then reminded me of a situation which had possibly created this irritability. In brief, I saw my sisters and niece on Friday night, something happened where I snapped instead of being interpersonally effective so I went home feeling disappointed in myself and couldn’t sleep until 4am. It was such a small thing but I had to ask my psychologist if this tiny event could possibly have caused this bad mood and she agreed it could have triggered things off, especially the lack of sleep. She did want to remind me though, because I was so disappointed in myself for not using skills, that I am going to have days like this for no apparent reason or for good reason and that it’s ok. It’s how I deal with the mood that’s the key. 

Thinking back now I could have done things differently by telling my husband and son that I was in a funny mood and even though I didn’t know why, that it had nothing to do with them. To make my husband feel like he was helping, (because he usually tries to help with really bad advice), I could’ve asked for a cuddle or a cup of tea. My psychologist was still really happy with how I dealt with my bad mood because I de-escalated it to the best of my ability and the bad mood hadn’t caused a huge fight or falling out because of that. 

All in all, a little bit proud of myself, even though a fraction of disappointment is still lingering. I was able to really have insight into what emotions were happening and why and I was really thinking hard about the skills that I could put in place. I wish I did more but I’m still happy it ended where it did. As I say in almost every post, these skills really do work and the more you practice the better you get and the more you see improvements in yourself and in relationships.

Using skills on a work day

With the DBT skills I find huge importance on practicing them daily even when I’m fine and not the least bit distressed. I choose to do this because I know that when I get distressed it is extremely hard to get myself out of feeling this way. When that happens for me it can easily lead to the urge of self harming or ideations of suicide (symptoms of the Borderline Personality Disorder that I have). This is why I do practice the skills daily – to make it such a habit in my life that when the time comes where I’ll desperately need them they’ll be there. 

Recently I have found it difficult to do a lot of work and have knocked back quite a few jobs. With the help of my psychologist I have slightly improved in this area and now I am working more hours in a day than I have in 8 months. Sometimes it can be a challenge to find time to practice DBT while at work.

This post is to demonstrate that you can find time during a work day to do many skills on the way to work, during work, at lunch time and after work. The idea is to have a plan so I stick to it as to not lose the practice time. I am lucky enough to only have jobs that go for 1 or 2 hours then I have a gap and go somewhere else for another 1 or 2 hours. Sometimes lunch breaks are the best time to practice.

Before arriving at work I:

 

 Eat a healthy breakfast

  Spend time observing my breath (about 20 minutes)

        Pray

 

 Do one thing at a time getting ready

While driving to work, (while being mindful of driving), I:

  listen to relaxing, calm music if anxious or loud pop music to lift my spirits

 encourage myself by saying “I can do this”, “I have done much worse than this and have gotten through”, “I only have to get through 7 hours, not 10 like I have before” etc.

At work I:

 

              half smile (if work is not going to plan, in meetings, at people I may not wish to be                    around, even on the phone to someone)

         try not to be non judgmental 

           do one task at a time (being mindful not to juggle many jobs at once)

                use GIVE skills (be Gentle, act Interested, Validate the person, use an Easy                                        manner)

At work, (during lunch/break between 2 jobs), I:

             might ask a friend to join me and maybe shout them their meal or;

 shout myself to something special (a piece of cake or an unusual juice)

go to the park/beach/nice location

observe things around me non judgmentally

After work I: 

continue to use GIVE skill with family at home

go for a walk

                give myself permission to have a vacation to relax from my day at work (after                        dinner and usual tasks are completed)

Just doing all of those things above in just one day covers about 13 DBT skills. I vary them pretty much on a daily basis but I have a plan at the start of the day. It doesn’t take too much time out of my day to do these and it certainly doesn’t interfere with my work. I believe this sets me up for having easily accessible skills for when things do go awry or if I have to deal with difficult situations that could possibly occur at work/on my way to and from work.

More on Skills When Incapacitated

A couple of days ago I wrote about using skills when incapacitated. It made me think how true it really is that no matter if you are lying down, curled in the foetal position, desperate for release or even when disassociating you can always try to reach out to a little bag of tricks that could get you through without even leaving your lounge/bed. I thought it might be handy to write some tips and who knows maybe a print out of these tips could help you get by or at least lift your depression just slightly. 

SKILLS TO GET YOU BY EVEN WHEN LYING DOWN

·         read

·         play games on your mobile phone

·         pat the cat/dog

·         think of pros and cons of you tolerating your distress and not tolerating your distress (if possible write these down)

·         describe something in the room non judgementally (if possibly grab it so you can describe how it feels and smells as well)

·         observe your thoughts and feelings, letting them go

·         half smile

·         listen to calming music (I have a collection sitting right near the stereo)

·         think different thoughts by listing/naming things such as:

-          dog breeds

-          fruits and vegetables

-          scientific words

-          occupations

-          countries

-          famous people

-          cartoon characters

-          plants/trees

-          boys/girls names

-          product names

-          authors

-          names used in the Bible

·         counting with each breath (e.g breath in 1, breath out 2, breath in 3, breath out 4 etc)

·         when someone is talking to you try to consciously use GIVE skills (be Gentle, act Interested, Validate them and use an Easy manner) – yes you can do this while incapacitated it just takes extra extra effort

·         look at a book with beautiful images (again this is something that I have handy)

·         use imagery

·         observe your breath

-          on each inhale count 1, 2 then on each exhale count 1, 2

-          on each inhale say to yourself ‘breathing in’ and on each exhale say ‘breathing out’

-          concentrate on the little ridge underneath your nose on each inhale and exhale

-          on each inhale say to yourself ‘calm’ and on each exhale say ‘relax’

-          put your hands on your stomach and feel the rise and fall of each inhale and exhale

·         pick up the phone and call someone you know that will listen, they don’t need to give you advice, they could just be there and say ‘uhum’ and that could be all you need to feel a little better

·         rub hand cream into your hands, observing everything you are doing (I have this nearby also)

·         pray

·         take the observe breathing a step further and actually do this for a full 20 minutes ensuring you are lying on your back with your arms by your side, palms up and legs extended out in front of you relaxed

SKILLS TO GET YOU BY EVEN WHEN LYING DOWN (with a little help)

If you are completely incapacitated ask someone to help you with the promise to pay them back. My advise however, would be to, in your own time, achieve this little step yourself which in itself will feel rewarding

·         light some candles or burn essential oils

·         have a cup of chamomile tea

·         brush your hair (get your helper to help you get up not to brush your hair for you)

·         do a puzzle

·         write down 5 things you are grateful for