Tuesday, November 30, 2010

Patience

Patience wears my grandmother's filigree earrings. She bakes marvelous dark bread. She has beautiful hands. She carries great sacks of peace and purses filled with small treasures. You don't notice Patience right away in a crowd, but suddenly you see her all at once, and then she is so beautiful you wonder why you never saw her before.

~The Book of Qualities - J.Ruth Gendler












Monday, November 29, 2010

Step 1, step 2, step...what?


We have had a request for more understanding on a certain topic, and I wanted to take a moment and cover it. I appreciate specific questions and recommendations.

So the question was, what is the first step to DBT? That is a great question and there are so many ways to answer it. However, I feel it would be most important to start from the very beginning. Before you get to DBT, or  any therapy for that matter, you need willingness. You must be willing to put a lot of hard work and effort into this. DBT is very different than standard therapy. It takes a large commitment and a lot of patience. Of course, it goes without saying that it is all very worth it. This commitment needs to be formal. My experience with this form of therapy came in the way of a contract with myself. Many have shared this approach. DBT will be way too overwhelming if you do not commit to it. You have to work the program in order for you to see differences in your life. Learning the skills haphazardly and sporadic will end up being more frustrating than good.

Once you have committed to DBT, the next step would be, analysis. You will need to start to get to know yourself in ways that you probably have never realized is possible. It is suggested to keep a record of your days. Something quick and easy, like a diary card. The information that you will want to keep track of is, how your day has gone (rating from 1-10, maybe) make brief mentions of any issues you may have had and you'll want to rate your self-injury urges, suicidal thoughts and urges to quit the program. This record should be kept on a daily basis. This information will come in handy as you start to look deeply into your habits, your tendencies, strengths and weaknesses. Take some time to assess your current situation. I have posted a series of entries regarding this assessment. Please take a look at them. July 11th-18th, 2010; July 18th-25th, 2010; and July 25th-August 1st, 2010.

What will start to emerge will feel somewhat like a jumbled mess. But it will all start to make a whole lot of sense as you become adept with the skills. The idea is, you will Observe, Describe and Participate in your own experiences. You will learn how to make these observations and put words to them non-judgmentally by practicing mindfulness exercises. These mindfulness exercises will also come in handy during crisis or distress. If you take a detectives approach to your experiences you will start to see patterns, cycles and triggers. You will be able to identify behaviors that you want to eliminate, you will start to clearly see what events precipitate those ineffective behaviors, these will be your triggers. You'll learn about your triggers too, in fact chain analysis worksheets will come in handy for this.

Ultimately, the process will take you from having a blinded awareness of yourself, to a wide, bright self-awareness that will bring change and ultimately a life that is worth living.  You will no longer stumble through life walking into one trigger after the other with ineffective living in virtually every direction. You will be able to live a life that can be virtually symptom free of your mental illness. There may not be a cure for a lot of the mental illnesses out there, but we do not have to be a prisoner to the symptoms, we can take our lives back. We can be in charge of our experiences. DBT has done that for many, and I recommend it to all. This was a really fast forward and brief introduction to the world of DBT, please stay with us and learn as we do. Share your experiences with us and allow us to share ours!

MJ

Sunday, November 28, 2010

November 28th - December 5th, 2010 - Skill of the Week:


I briefly mentioned splitting the other day and I decided to take a closer look at what this is and what can be done about it. It is also referred to as black & white thinking, all-or-nothing. I personally felt extremely validated by researching this. When we struggle so badly with certain behaviors and then we have the chance to educate ourselves and find out that the behavior is part of the package deal that is BPD, it feels as though we are given a great big hug and soothing words telling us, "It's O.K., you didn't do this." It makes it that much easier to pick up the pieces and start working on skills to reduce the behavior. I felt a rejuvenation of my energy to keep working at this.

So, I wanted first to use an illustration of what splitting can be described as, I found this in a book, I hate you, don't leave me by Jerry Kreisman, M.D.

The world of a [Borderline], like that of a child, is split into heroes and villains. Like an emotional child, the [Borderline] cannot tolerate human inconsistencies and ambiguities; he cannot reconcile good and bad qualities into a constant coherent understanding of another person. At any particular moment, one is either Good or Evil. There is no in-between; no gray area....people are idolized one day; totally devalued and dismissed the next.
Normal people are ambivalent and can experience two contradictory states at one time; [Borderlines] shift back and forth, entirely unaware of one feeling state while in the other. 
When the idealized person finally disappoints (as we all do, sooner or later) the borderline must drastically restructure his one-dimensional conceptionalization. Either the idol is banished to the dungeon, or the borderline banishes himself in order to preserve the all-good image of the other person.
Splitting is intended to shield the [Borderline] from a barrage of contradictory feelings and images and from the anxiety of trying to reconcile those images. But splitting often achieves the opposite effect. The frays in the [Borderline's] personality become rips, and the sense of his own identity and the identity of others shifts even more dramatically and frequently.

Thursday, November 25, 2010

What rhymes with recovery?


I woke up one morning and I saw two little pink soft-gelled pills setting on my bedside table. They were oval and the size of jelly beans. I wondered where they had come from. There next to them, in beautiful handwriting a note read, "Cure".


I had no choice but to gobble them up as fast as I could get them into my mouth. I didn't even waste time with water, I choked them down without hesitation. With a hard gulp, I began wondering how fast it would be until they started working. I was eager. I perched myself on the edge of my bed staring out of the window. I saw the sun, the trees, the grass; all without every really seeing them. I recalled at that moment a phrase my mother used to say to me, "A watched pot never boils..." It made me realize that if I sat there waiting to 'feel' different, perhaps I wouldn't notice the difference. I anxiously rushed into the shower. I knew I had to get moving and divert my attention somewhere else until the cure would set in.


I forced my way through over half of the day before my anticipation turned into anxiety. My head started to spin and swirl with fears of never being cured. I was terrified that I would be this way for the rest of my life. What sort of life would that be anyways? It wouldn't be. Not at all. Especially not a life that I want to participate in. I wanted to scream, "When is this CURE going to WORK???"My day dragged on into the evening and finally with a feeling of relief, it was time for bed. I laid my head on the pillow and realized that there was no way I was ever going to fall asleep on my own. There was a mixture of anger and grief pounding inside my head. Both of which would keep me awake all night long if I did not do something about it. I took a sleeping pill. Angrily I swallowed it down with water. Within 20 minutes I was off to dream-land.


When I awoke, at first it was difficult to get my bearings at all. I couldn't recall which day it was. Was I waking up from a nap, or had I slept through the night? What time of day was it? I laid in bed blinking while my room came into focus. My mouth was dry. Really dry. I looked to the left and caught sight of my drinking glass on my bedside table. Total recall came crashing down on me, I had taken the "cure" pills yesterday. It was morning, and I was waiting for my cure to start working. I laid perfectly still because it also occurred to me, that I may very well be cured already. It may have taken effect as I slept. How was I going to know? 

OK, so in reality? There never were any pills. There isn't any pill that will cure Borderline Personality Disorder. We can take medication or try a new therapy and spend a lot of anxious hours just waiting for the cure to set in, but in reality there is no cure. As of yet at least. Seriously, google it. There just isn't a cure. But the idea here is, once we have headed down the road to recovery, how do we know when it is working? As it went with the above illustration, she laid in bed unmoving, wondering how she would know if she were cured...again, in reality there may not be a cure, but there is recovery, which is just as good. But how will we know when we are well on our way to recovery? First and foremost, we must embrace recovery and what that means. Finish this sentence..."For me, recovery looks like..." This is very similar to our mission statement or our purpose. But secondly and more importantly, to know we are on the road to recovery we have to move, we have to go about our day, we have to experience our life, we have to move to the participation part of D.B.T.

D.B.T.: Observe (become aware of yourself, your triggers, your body, your sensations to yourself in your environment), Describe (put words to your experience) and then Participate. How else do you ever expect to know whether your recovery is working or not? Remember, we are doing these three "one-mindfully" and without judgments. This means that although a quick cure would be easy whereas hiking through recovery is not so easy, we will be practicing our mindfulness skills and we are actively identifying our judgments and reducing them. Instead of things being good/bad, they are effective and ineffective. Your target behavior is not bad, it is simply ineffective for a productive life. Your choice to walk out on your job was not you being bad, it was an ineffective choice. Removing those judgments helps you to move into the participation phase of your recovery. This phase will look different for everyone.

I chose to write about this today because I realized that I was going about my life the past few days thoroughly enjoying a symptom-free week and it became painfully obvious to me that there are so many borderlines out there that are not experiencing these types of weeks yet. YET being the key word here. I thought of the statistics of borderlines and treatments and I read a bunch of articles and although I did get a  bit of really good information about the polarized thinking borderlines tend to gravitate towards. (It is called "splitting" it was fascinating. Really it was, I felt extremely validated in some of the experiences that I have when I have a better understanding of what my brain is doing during that time. The article sort of reads like stereo instructions, but with a little diligence and a quite room I am certain many will find it helpful too). I didn't want to bore anyone with stats. Experiences is what will help to keep us all motivated. I need your experiences too.

Anyways, I wanted to reach out to people today to encourage you to be kind to yourself, don't expect a quick-fix, but the miracle of living a symptom-free life is a reality for everyone of us. Don't let go, not today, not any day...

MJ



Tuesday, November 23, 2010

Don't tell me I can't have what I want!



Longing studies archeology. She is at home in the future as well as the past. She collects mirrors and antique necklaces. The lamps in her living room have embroidered shades, silk with beaded fringes. She takes long walks in the early autumn evening when everything looks dark green and purple and brown and deep blue, and the windows of the little houses shine yellow from the lights inside.

Longing speaks the language of dreams. She is a dancer and an actress. She knows tides and currents and pirates. She has swum in all the oceans, and traveled to places that the rest of us have only visited in our sleep.

Although I have met Longing many times, it is not easy to describe her appearance. She dresses herself with an awareness of where she is going and who will be there. It is more than the costumes though. Even the gossip columnist who notices everything could not quite remember Longing's height or the color of her sea-filled eyes. If you must see her, invite her to a concert. She is especially fond of the music of stringed instruments.

~J.Ruth Gendler ~ The Book of Qualities












Your desire need not be unattainable. . . 


Longing, 


I cordially invite you to attend a symphony in your honor. The highlight of the evening will be a beautiful piece entitled, "Life Worth Living", by my solo-harpist. This event proves to be enlightening, I am certain you will not be the same as when you arrived. Assuredly you will transform from my deepest desire to my greatest of accomplishments. 


Sincerely, 


MJ

Sunday, November 21, 2010

November 21st - 28th, 2010 ~ Skill of the Week:


Living in the moment. Not, living for the moment. Living in the moment. Living life using the value of each moment in the moment in which you are experiencing it. Sounds tricky, right? Well, honestly it is. I am not going to kid anyone here. Mindfulness is one of the most difficult skills to master. This is the case because mindfulness is intrinsically connected to effective living. They embody one another. When all else fails, you have your mindfulness. 

I know that sounds crazy, but seriously consider this: Let's say you have fallen flat on your face, you attempted a distress tolerance skill and it failed miserably and you engaged in target behavior. The consequences of your target behavior is staring you dead in the eye, you have two choices...A) ignore it and continue to spiral down or B) become mindful of your experience and use it. Of course, ideally mindfulness, if used on a regular basis, will help prevent us from engaging in our target behavior. We have many steps along the way to use our mindfulness exercises. I like to think of my skills in categories of Green, Yellow and Red. Green-light skills are used as preventive measures. Mindfulness is done in this category. Then there is your Yellow-light skills, which are used when your internal alarms begin to be activated for whatever reasons, mindfulness is done at this stage too, sort of as a distress tolerance skill. Then we have our Red-light skills, which are used in crisis - in a way our skill is telling our bodies and minds to STOP! Mindfulness is used here too. This is where I say, "When all else fails, you have mindfulness" because you can use mindfulness during crisis. It is very difficult to teach yourself, and at that point you would just be using it as damage control, but it can be done there. Then, finally, mindfulness is used to get our butts up and pushes us to Fail Well

Saturday, November 20, 2010

Despair the opposite of despair???


In a lot of ways I am really blessed. I have to admit that, sometimes it gets a little overwhelming and I forget those things, and that is why gratitude is so important. If I could make a suggestion to everyone, with or without a mental illness, it would be to set up a specific time on a regular basis to remind yourself of what you are grateful for.

What I felt I wanted to share today is OPPOSITE ACTION. Now there is one for you. I can't speak for anyone else, but I have a real hard time with this skill. By the time I need to engage in opposite action my brain is so jumbled that I cannot really make effective choices to begin with, let alone make a concentrated effort to decipher what the opposite action to what I am experiencing would be! What does one do?

Thursday, November 18, 2010

Loving yourself ... enough to change the world.





AJ and I were sitting in a waiting room at a children's mental health center. We are getting help for our eldest son, he is depressed. What we are doing for him, getting him help, is what I understand to be our job as parents. And, we are happy to do it. Eager in fact to do what is needed to help him feel better about himself and the world around him. 

So here we are, sitting in the waiting room. I often wonder if other people notice the interactions that I have with my children as much as I notice the interactions that they have with their own children. What I noticed in that waiting room was amazing. The room was drab and lifeless, completely unappealing to myself or many adults let alone children. We were separated by a partition with sliding glass from the receptionists, who although they were behind the glass we could still make out, generally, what they were saying. The glass provided hardly any privacy. There were signs all over the office, haphazardly placed with scotch tape on the glass, walls and doors. Signs telling us that we are not allowed food or drink in the waiting room, that we are not allowed to open the window and that we are not allowed to use their phone. A lot of "please don't" and not a single "please do". The chairs for waiting were placed all along the walls leaving a large open space in the center of the room where they have one tiny table with a tiny toy. I have yet to see a child play at that table. So if you can picture this, with the room set up the way that it is, everyone waiting to see a therapist is sitting there staring at one another. Just waiting...no music...just muted sound from behind the glass. 

Tuesday, November 16, 2010

The "F" word...

Forgiveness is a strong woman, tender and earthy and direct. Since her children have left home, she has embarked on an extended walking tour, visiting ruins and old monuments, bathing in rivers and hot springs, traveling through the small towns and large pulsing cities, tracing the current of sorrow under the stories she hears. Sometimes the city authorities and officials don't want her within their gates. If the people want her there enough, she always manages to find a way inside.

Forgiveness brings gifts wherever she goes. Simple ones, a three-stranded twig with leaves turning yellow, a belt she wove on an inkle loom, a little song that grows inside you and changes everything. She brought me a silver ring from the South with a pale stone, pink with a hint of brown. When I had asthma, she taught me how to breathe.

~J. Ruth Gendler -The Book of Qualities

Be kind to yourself.
MJ

Sunday, November 14, 2010

November 14th - 21st, 2010 ~ Skill of the week:



I think that it is really important to spend more time on ourselves. No, this isn't being selfish, really it isn't. We are progressively learning things about ourselves that really will make a difference in our recovery. 

This week, lets focus on the axiom that is D.B.T. The idea that two opposites can and do exist at the same time. This is true in the statement, "I am doing the best that I can AND I need to do better." I personally believe that this statement should be affixed to everyone's mirror (or equivalent) as a constant reminder of not only what D.B.T. is, but also to validate themselves. This is a hard road, no question. At times it feels like it is uphill at a near 90 degree angle for as far as the eye can see. These times are the most critical to understand that you are in fact doing the very best that you have, and staying humble and real, you will also remind yourself that you can and will do better (timeline appropriate anyways). It is absolutely unreasonable to think that someone who has just started to address their mental illness will be skilled enough to identify their triggers and place a skill over the top of one and use it effectively 85% of the time. That is unreasonable for a lot of D.B.T. veterans. But that is reasonable for those out there that have been in recovery for 5 years+. Of course I say that with the disclaimer: that is relative to each consumer. No two persons are the same and skills will not come to each the same and at the same time as the other. OK, having said that, moving on...the axiom of D.B.T. - Wise MindTry and think of Wise Mind as a mathematical equation. 

Saturday, November 13, 2010

Do Ostriches go: "gobble gobble"?

SO, this is how I feel lately...but there is one thing that I am certain of. And that is my life is DBT. Or at least I strive for DBT to seep into every aspect. So I plan on fighting back.Gratitude

What am I grateful for? Well, there are lots of things. Here are just a few: