Sunday, August 1, 2010

August 1st - 8th, 2010


Failing well.

Some may find themselves asking, "OK, seriously how can one 'fail' in a good way?"

This is common, I know that when I first heard this expression, it both touched me (anticipation that soon relief would come from the guilt and shame from my failure) and frustration (if failing was so easily written off, why am I working so hard at not doing 'it' again?)

The reactions are varying. So let's take a look at the skill of Failing Well.

When you are in DBT programs further along enough to really take a stab about Program Solving, it becomes clear right away that part of having a 'plan' is fully understanding the relapse process and ways in which you can prevent relapse and ways in which you can deal with relapse.

We'll start with relapse triggers. The following is a list of experiences that can potentially send you down that 'slippery slope' of relapse. It goes without saying of course that your first line of defense for a relapse is to have skills that you can use at any point down that 'slippery slope'; however please be realistic with yourself, no one is perfect and these skills will not work 100% of the time, and we need to be prepared for that too. Having said that, here is a list of possible relapse triggers:

  • Coping with negative emotions: Having something in life, your everyday experiences be something that although it is not a full-blown 'trigger' to your underlying trauma or depression you are still having to use emotions like; anger, frustration, fear, anxiety, tension, boredom, grief or loss. Again, although these emotions on any given day may not directly be the product of an obvious trigger, however through your experiences with your mental illness, you have trained yourself, inadvertently, to process these emotions in an ineffective way.

  • Coping with negative physical states: Perhaps you have physically injured yourself and are not as mobile as you are accustomed to being. Or maybe you are hungry or tired, this is a nasty spot that the cycle can begin. Why? Because here you are unsuspecting. Your alert system to possible triggers is in rest mode no doubt, or at least the volume is turned way down. So if something does come up, you risk catching it too far into the trigger, and you possibly lack the insight to reach for skills. No one can be poised and ready to attack any trigger, all the time. So the key here is in understanding that you are more vulnerable when you are suffering physically.

  • Enhancement of positive emotional state: This one seems odd at face value, I mean, whats wrong with pleasurable activities? Aren't we working hard to experience more joy out of our life? As much as this may be true, this possible relapse trigger is referring to 2 possible scenarios. 1) perhaps you have just come home from a fabulous vacation, you have had freedom and celebrations, fun and joy. You may have even been able to take a bit of a break from the constant 'working' you do with your mental state. The heaviness of your 'normal' life, may be too much to cope with after a vacation like that. So again, of course it would be silly to consider not going on vacations or planning an event that would carry this type of enjoyment, but rather be aware the possible relapse risk that is associated with 'coming down' off of a vacation or enjoyable event. 2) searching out this pleasure, joy, fun, freedom or celebrations in an effort to relieve your suffering to a degree that you lose sight of the basis for reducing suffering, which of course are skills. Enjoyment and relaxation are part of skills, they are not THE skill. It can present a relapse risk if you are uneven in your distribution of positive emotional states.

  • Coping with interpersonal conflict: During or after a disagreement, hassles or fights are serious relapse triggers. Especially if the disagreement or fight appears to have no resolution. The unfortunate nature of this possible relapse trigger is that it goes fast. There usually tends to be hardly any time between the fight triggering the beginning of the relapse and a full-blown relapse. Again, no one is perfect and the key lies within the understanding that this a high relapse risk.

  • Minimizing: When you are struggling with a relapse on the horizon, minimizing can present a significant problem. It can be the force that shoves you down that 'slippery slope' at warp speed. If you start to reason that a little slip-up isn't that bad, that the potential negative consequence of engaging in your target behavior isn't totally detrimental. Of course we know that it isn't the end of the world, but keeping vigilant to not engage will help us to never minimize the effects of engaging in that target behavior.

  • Testing personal control: Having control over your life is probably one of the highest ranking desires in making a life worth living for yourself. After-all, the loss of personal control is what is making life so miserable. However, once again an off-balance of weighing this need for control with the reality that certain things will be outside of our control and we will have to accept, can and will send us towards a relapse. So you would want to be mindful of not testing this personal control, like going to high-risk places or thinking you can "do it just once". Somehow you know that you can do it differently, or have a different result this time.

  • Social pressure: This one is simple to write, yet not so simple to execute. Associating with 'toxic' people is harmful and will most likely trigger you into a relapse.

  • Not using the DBT program: When we become lax and do not practice or use the skills, or we procrastinate in using them, or even avoid going to therapy or group; we are increasing the likelihood of a relapse.

Alright, so grasping what each of these possible relapse triggers would look like on a personal level will help you on a large-scale for when you do relapse. Understanding these vulnerabilities will help you first-of-all, to reduce the chances of a relapse, but secondly and more importantly it will help you to see the 'failure' for what it was: A human reaction to a very difficult experience. Your mental illness is a very difficult experience, and learning to examine deeply, the triggers in your world will dramatically increase your ability to pick-up the pieces in the after-math of a relapse and dust yourself off and say, "Alright, I see here, here and here where I can help myself the next time"  Then you will able to Fail Well. Yes you did in fact fall flat on your face, but you also can keep going and be O.K. with that, ready to start over. Next week we will look at the relapse cycle, and get an in-depth look at how failing well keeps you going.

GROUP ON MONDAY AUGUST 2nd, 2010 - 2p.m. PDT

Last week we discussed a bit about cue-controlled relaxation. However, we have a need to revisit that material this week too, so we hope to see you all there!

To attend the group join the forum here and meet with us!

MJ ~

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