Sunday, January 31, 2010

January 31st - February 7th, 2010


There are three factors that need to be considered when you are wanting to have an effective interchange with others.




These three factors exist in any interaction with another human.

Think of the any situation that you have been in with another human being and those three factors have not been taken into account. It just isn't possible. Your check-out at the grocery store, you had the objective to buy groceries. The cashier was extremely rude to you, what do you do? You have to weigh the factors, ask yourself, Am I going to assert myself so that he/she does not step on my self-respect, telling yourself that you do not deserve it? Or will you be cautious in your response because you care bout what that person thinks about you when your interaction is complete? Or do you stay silent and just wait patiently until your transaction is over and you won't have to see that person again. You considered all three, your relationship with the cashier, your self-respect and your objective. In small interactions these come into play, and of course in our larger interaction they come into play.

Think of the last conflict that you had that just tore you up. You feel awful about it and you cannot shake the yucky feelings. Try and reflect on what role did your self-respect have? Your objective? Your relationship with that person? We have spoken in depth about objectives and the importance of keeping them clear in mind. Last week we took into consideration our needs versus our preferences. Gathering all of this information we are ready to decide in which order those three factors should come in order to improve the chances that we will have an effective interchange next time.

Consider this, you are being taken advantage of at work by your boss. She has asked that you stay for overtime, and since she is so sure that you will do it, although she formed it in a question or request form, you know she just assumes that you will do it. So you do. This remains consistent until you have just had enough. She seems to always ask you to do the more complicated things and now with this assumed overtime you feel really walked on. When you ask her why it seems to be that you get the extra work load, she jestingly tells you that it is because she knows it will get done if she asks you and she can count on it being done right.

These are compliments from your boss to a degree. You strive to be an employee that is dependable and you have high work ethics, yet you still feel that you are being taken advantage of. You come to the conclusion that you need to say something to your boss. This is where you would need to balance our three factors and decide which is the most important? 

Will it be more important for you to express to her how she makes you feel, perhaps making sure she knows that you do not deserve to be treated that way? Or will it be more important that you get her to quit assuming that you will do the extra work, that perhaps she can ask you to perform it, yet you may say no? Finally, is it the most important thing to be sure you and her have a great relationship when this conversation is over?

These three factors can get confusing to separate, unclear as to which is the most important.

TRY THIS: Take this example and I want to hear from all of you as to which order and why, you would put this in. Then, later on this week we will take all the input and take the example to the next level. Once we can brainstorm the order to put the factors in, then we will use a planner to use skills based on which factor is of the most importance, and so on. So please let's hear from you all.

Sunday, January 24, 2010

January 24th - 31st, 2010


We had a couple of comments from last weeks topic about the distress tolerance kits; and I really wanted to thank you. Your comments are a true contribution to the success of this group. Having a place to share your experience helps you, having a place to read others experiences helps us. Keep sharing!

Lets take on a topic with a little more depth. We have spoken about objectives and how important it is to know your objective and be very clear on what it is that you are wanting out of any given situation. There is a distinct difference between need and preference. Take a look at the following sentences, seriously look at them and reflect on how those sentences might read for you personally:  

I need to change high conflict between my husband and I.

I prefer that my husband is as committed to making changes as I am.

Here is a case of need vs. preference. If I approach resolving high conflict with my husband as needing him to be as committed to making changes as I am, I will add far more distress to my objective than I might be able to handle. This may sound silly at first, because naturally any couple would expect that their mate be as committed as they are to resolving conflict. However, first of all, needing a person to be committed vs. preferring them to be committed puts us in a very dependent position. Our happiness cannot be dependent on another person or their actions, it simply does not work. Secondly, whether or not we have the expectation of our mate being committed, we simply cannot force the actions of anyone else no matter how much we feel we need it to be that way. Understanding the difference here is pivotal. Lets say for an example that my husband is committed to making 'things better' but feels that the changes will come as I learn to deal with my mental illness better. Now there is certainly some truth to that, the more manageable our mental illness is the less conflicted our relationships will be, although his stand point of things getting better tied into my mental health only, relieves him of having to make specific personal changes. I put this in great detail like this because we need to be able to see exactly the line between preference and need.  

If I have gone through skills training and all the while I have clung to the idea that I need my husband to be committed to making changes himself, then when a conflict comes up, he resists the idea of him needing to make changes, so I then pull a distress tolerance skill out and hold pattern and I don't make the conflict worse; I will be pleased with myself. I will have reason to be motivated to keep using skills. At some point however, distress tolerance is just that. To tolerate, there needs to be healing so that we can move from tolerating distress to problem solving the distress; reduce or eliminate the distress. In this scenario I will never move out of tolerating into problem solving because I will be waiting on my husband to make some changes, ones that he does not feel he needs to make. See how it is just creating more distress by thinking this preference is a need?

Let's switch it. Lets say now that I have gone through skills training and I have realized that I prefer my husband to be committed to making changes too, but I understand that my need is that the high conflict to be reduced, I will work with my husband at this up until the point that he feels he is no longer responsible for any changes. Instead of going into distress tolerance, I move to problem solving. I make that shift because I know that I would like my husband to make changes, but I also understand that he may not feel the need to. Therefore it has now become fully my responsibility to fall back on my need, and that is to reduce high conflict. At this point however, it looks as though I will need to be doing it without the continued assistance of my husband, but if I had stuck to the idea that I needed him to be committed to changes, then I would have never seen the cue to problem solve for myself. I would still be sitting back tolerating distress and waiting . . . Granted this particular situation is far more complicated than just these few paragraphs. Naturally, no one wants to be faced with a situation where their partner feels they have less changing to do than you. Also, in the defense of some of our mates, they really feel as though they are just as committed but perhaps they are also at a loss for skills.

In conclusion, being clear on our need vs. preference we open up options. Confusing the two we are blinded to options. Certainly, some of those choices that come from those options are not choices that we may want to make, but they are there and since they are, then we need to be able to utilize them.

Next week we will discuss three things we will need to be sure to have weighed and balanced before we move forward in problem solving.

TRY THIS: Make a note of what you believe to be your needs. Then ask yourself, is this really a need? Discuss with yourself the possibility that it  may be a preference. Share what conclusion you came up with. If you aren't sure, comment about your situation and see if we can offer insight. Next week we will move forward.


Sunday, January 17, 2010

January 17th - 24th 2010


Keep up practicing the mindfulness exercises!! If anyone has an idea for a mindfulness exercise please share it with us all. We can always use new ideas.

Distress Tolerance is quite a challenge at times. Especially since it is a skill that is used when we are in, well . . . distress. Distress can turn to extreme suffering in a blink of an eye. There are so many skills we have either attempted to use, or have used by the time we get to distress tolerance; that often times we are exhausted and not in a frame of mind to retrieve data.

Last week we discussed the importance of keeping the objective clear in mind. Distress prevention will have caused us to make firm our objective, weighed the difference between preference and need. Perhaps we would have listed the pros and cons over our objective and have written it down so that we can easily access it.

Now, lets say we have come up against an event, a trigger. The first step is to breath. Breath and attempt a mindfulness exercise. I say attempt because at times while in distress we may not have the time to sit down and do a full fledged exercise. However, if we are practicing these mindfulness exercises when we are not in distress, then we will be very capable to spend a moment and do an abbreviated version of an exercise as soon as we are aware we are in distress. Again, I mention aware, because this too will take practice becoming aware in advance enough of a crisis that we will have a moment for a mindfulness exercise and enough of a moment to relect on our options and make a choice on how we should proceed.

After this exercise, no matter its length and even if it was just followed breathing, reflecting on your choices on how to proceed  is where your distress tolerance skills come into play. You will want to get comfortable with a variety of tolerance skills so that you have options. Some skills will only work in certain environments where as others will be able to be used no matter where you are. If you have too many skills listed for your options, and yet you have not become familiar with any of them in-depth, then you will find that you will chase yourself in circles trying the skills. There is a strong caution against looking in your workbooks under distress tolerance and trying them one after another while you are suffering, this can cause frustration, and if none of them do their jobs in relieving the distress then you will set yourself up for resentment towards DBT skills and therefore add to the struggle of implementing DBT in your life. Of course some of you out there do not have workbooks, you may be learning these skills on your own and of course the caution still remains, avoid having too many distress tolerance skills to choice from if you are not fully familiar with each and every one of them to use during distress.

I invite you all to share a specific skill that has worked for you, or perhaps share your observations of a skill that didn't quite work that well for you. We can all learn of from each others successes and failures. Of course as some of you are all very familiar with is that failure is 100% effective if we have failed well.

Some distress tolerance ideas I personally have used is opposite action. Finding something that will elicit the opposite emotion of which you are experiencing. If I have time, I use a movie or a book to accomplish this. Movies or books can help your mind to let go of the ruminating thoughts that are causing more distress. If I have less time, I will listen to music for a moment before I have to start to interact with my environment again. The key is to find a skills that will work in all types of environments. For example, if you are out shopping and you get into a conflict with your mate or perhaps your friend, you need to prevent an outburst or episode, obviously stopping and watching a movie is not an option and equally absurd would be for you to find a bench and sit and read a book. So you will need to find a skill that will work to reduce the distress in that moment. Granted this can be really challenging. I do not have hard and fast answers. The skills I found to work for me, may not work for someone else. But trying them, working out exercising them, this will help you to determine which ones work for you and which ones do not. This suggestion to try new ones, coupled with my caution of having too many to choice from would mean that you try new ones, one at a time, not several of them in a rapid succession. This is where each of your comments would really help, the more experiences we can share the more options each of us will have.

Some others that I have found to be useful, especially in times where there isn't much time before I have to interact with my environment is a worry bag, or 'issue' bag. It is something small and portable. I have index cards in a baggie. I have labeled my baggie and I quickly jot down my reason for the sudden burst of distress and put it back into the baggie. I take some deep breaths, count them in and out and I carry on with whatever it is that I am doing; knowing that I will return to the information on that card at a time I have pre-designated. I personally look at my baggie of cards the next morning after I have had time and rest. Some of you may be familiar with this skill but know it as the worry corner. It is the same idea.

'On the go' distress can be the most challenging to deal with. Especially at the beginning of your recovery. It is really important to get an idea of what type of things calm you. Perhaps something you feel in your hands will bring relief, maybe a scent or small action like blowing bubbles. Chewing gum, writing a card to someone, playing SUDOKU, crosswords, mp3 player, etc. All of these things can be small and portable.

TRY THIS: This week each of us will prepare a portable distress tolerance kit. Put several things that will bring you immediate relief together and place them in a container that you can take with you places. Try and make it as personal as possible. I ask that after you have prepared this kit, please share with us all what you have added to your kit, and maybe a brief comment on why. ALSO: Find 2 skills that you can try this week for times of distress that are not on the go. Ask a friend or loved one what helps them to calm down and relax. Do your homework and I can't stress it enough, share your ideas with us all!


Sunday, January 10, 2010

January 10th - 17th 2010


We need to take another week to really get the idea of mindfulness and how it relates to our daily activities. For those of you that are advance DBT students, you know that an extra week of mindfulness practices is as good as gold.

During the course of this week however, I want us to pay attention to our objectives. When we are interacting with the world around us we have objectives.  When standing in line at Blockbuster you have the objective to pay for your rental and get home. If the line is long and  the people you are standing in line with are rude, you may want to revisit your objective and reconsider it. Perhaps renting a movie isn't worth the possible irritation of staying in your environment. If you decide to remain with the same objective, then the only option you have at that point is to keep clear in mind your objective and tolerate until you have reached it.

Granted, renting a movie at Blockbuster is an unlikely place that you will find yourself needing to take a peek at your DBT notebook and pulling a skill out in order for you to tolerate your experience. However, for some a simple interaction like that can create much distress. For most of us though, it is the bigger things in life that we need to spend time reconsidering our objective and then perhaps reinforcing it or make alterations to it as the need may be.

Either way the above example has some merit to it. The wait in line will be much more tolerable if we clearly see the light at the end of the tunnel. In larger things in life, getting through a rough conflict, that light may seem so faint. The only way to make that light brighter is to reinforce your objective. If it is wise mind justified, then keeping that objective close at hand, frequent reminders of it will light up the end of that tunnel very brightly.

Practical ways to keep your objective clear in mind are as simple as jotting it down in a notebook you can carry on your person or in your car, maybe sticky notes. Something that you can see easily on a daily basis until that objective has been met. Another way to keep that objective close, is to set aside a time each day to meditate briefly on it. For really large objectives this one with the first suggestion can be really helpful. I have found that when I am trying to endure through reaching my goal or objective I have taken a journal approach. Scribble down some of my barriers, list things I have done thus far to reach that goal. Keeping it near, fresh and clear can go a long ways in tolerating. It also affords us an opportunity to make choices.

TRY THIS: take a specific objective you are working for. Write it down and list the ways you have thus far been able to tolerate while you are reaching for it. Look at those steps and ask yourself, 'Is there another way I can look at this step to help me to get what I want?' you might be surprised to find that instead of just coping while you reach your objective, you might just be able to enjoy the learning experience of achieving your objective!

Sunday, January 3, 2010

January 3rd - 10th 2010


Thank you for the comments, I encourage this to be a way to communicate our lives with DBT; and communication isn't much if it isn't going both ways. So keep the comments coming!

We've recently discussed taking a detectives approach to our lives, observing ourselves and putting those observations to words. Describing our experiences with a non-judgmental point of view. These skills, if practiced, become vital in making effective choices. As a part of an effective life, you will notice that there are ample opportunity to step back from our experience and start running a commentary in our minds. What is that I notice about what is happening to me? How does that impact the way I am feeling about it? Asking these questions and sticking it out long enough to get answers from yourself, is what the DBT text-book refers to as participating in your own experience. A recap: Take a non-judgmental view on your experience, observe it, describe it and then participate in it.

The participation can be effective or ineffective. Either way, you are still participating. Of course we all desire the participation to be effective. In order to improve our chances of effective participation we do all of the aforementioned steps, mindfully; this will ensure that we will have effective choices to pick from. 

It seems reasonable to consider: what would it look like for me to non-judgmentally observe, describe and participate mindfully in my own experience? This will look different for everyone. That is why when describing the 'wise mind' to beginners of DBT I often reiterate to them that deciding on how much logic and how much emotion is needed in any given situation depends solely on the person. For me, dealing with a member of my distant family may include 80% logic and only 20% emotion. Whereas for you, perhaps you don't have the same triggers when the 'fam' comes to visit; therefore you can have a healthy dose of emotion, say 60% and then the remainder would be 40% logic, enough to keep your wits about you and keep your mental illness at bay. Or in some cases where mental illness isn't even a factor their balance between the two logic and emotion will be different yet.

In order to determine what your recipe is, you do not need to have an extensive list of circumstances and the ratio of emotion/logic. Rather you simply need to know how to balance what your body and mind needs. The only way to get the general idea of what your basic recipe is, is to practicing being mindful. Once you get your basic recipe, you then can tailor your 'wise mind' for any given circumstances.

The most basic mindfulness practice is breathing. As you become more skilled, try out other forms of exercises. In fact you can get books on the practices, or you can dream up your own. We will also cover a variety. The idea is anything that gets you focused on what is happening to your physical person in the moment you are in, now. How does the chair feel under you? the floor - is it hard flooring, carpet? What noises do you hear? What sensations is your body experiencing? ~ So on. So start with breathing. Count them in/out, or say in/out; anything to get you focused on your physical body and it inside of your environment. Leaving behind what is distressing you, or simply the demands on you. Take 5 mins and do these exercises regularly. This will help you to balance yourself and with balance and practice you will begin to see a picture emerge. This picture will give you insight into what wise mind looks like for you at baseline. Once you can clearly see what wise mind looks like there, you can start to compensate for too much or too little emotion or logic based on how far off of baseline you are getting.

Believe it or not, mindfulness is ultimately the skill that will be your temperature gauge so to speak. When you practice mindfulness during distress or during baseline, you will build knowledge about yourself and what that self needs emotionally or physically. Once mindfulness is on board as a skill; when you turn to your bag of tricks it will include so many new skills.

TRY THIS: set yourself in a calm, quiet room. Sit comfortably in a chair or on the floor, or even lay down on a bed. Close your eyes and breath deeply. With each breath in count, 1. Breath out, 1. Breath in, 2. Breath out, 2. Keep doing this, if you find that you have lost count, start over at one, but do not stop breathing or break the concentration, keep your eyes closed. After you have done this for 3-5 mins. open your eyes and ask yourself, What did I notice? Was I anxious? Afraid? Did I have a hard time concentrating, did my mind wander? If it did, where did it wander to? You do not need answers to these questions per say, they are for you to get an idea of the experience for you. Practice.

Mindfulness for when you are in distress: whatever you are doing, notice the rising emotional temperature and tell yourself, I notice I am getting elevated. Then, if you are washing dishes start talking to yourself about washing dishes, 'my hands are in water that is hot, luke warm, cold. I feel the slimy soap and when I touch a pan it feels rough. I am holding a spoon, it is oval-shaped with an odd reflection.' Keep describing everything you notice about what you are doing until you can feel the distress reducing. Your description should include what every one of your senses is doing. What do you smell? Feel? Taste? This may seem odd, but no matter what you are doing, you can do this exercise. Whether you are driving, walking the dog, laundry, shopping.

Try these practices out, do them often over the course of this week, I will send out reminders to practice via Twitter. So if you aren't yet signed up to receive those, you might want to do so. No matter how ineffective mindfulness practices may seem at the time, there is always something we can learn about ourselves and overtime you will see the impact it will have on you and your ability to dial in on what you really need in the moment, you might be surprised!