Sunday, January 17, 2010

January 17th - 24th 2010

THIS WEEK:

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!

MJ