Friday, December 29, 2017

DBT 101: Do What Works


Doing what works is a cornerstone to effectively using your DBT skills. However many wonder, "What happens when doing what works feels like failure?" - What does that mean? What does that look like? And, more importantly, how do we work with it?

Simply put, doing what works is when you are faced with a distressing situation you choose the course of action that will get you closer to what you want and not the choice that will get you further away from what you want. When faced with a reaction to a conflict, you can either react in a way that feels better, but by consequences, gets you further from your desired outcome. OR - you can choose actions that while they may not feel better in the moment, will, in fact, get you closer to what you want.

For example, you are in a conflict with your mate. He says something unkind and you react by "putting him in his place" - they call it righteous anger. Telling yourself, "I have every right to be pissed off right now!" - Which may very well be true. However, putting your mate in his or her place, may not be the action that gets you what you want.

Chances are, having that righteous indignant response, will get a load off your chest, and for many borderlines, it will give us that release of tension and emotion that we seek. What it will not do is give us resolution, or peace. It will not draw your mate closer to you and it may not bring forward any sort of healing.

Let's face it, most mental illnesses that have been controlled by skills and hard work, the only time they rear their ugly heads is in interpersonal situations. When you are interacting with others. While there is an occasional issue of fear and anxiety that may still creep up on you while you are shopping in a busy store, most of the symptoms of our mental illness after years of learning and educating ourselves, have dulled to the point of being able to cope quite easily in a lot of circumstances. The ones that pose the largest threat to our mental health at this stage of the game are the actions and reactions from our environment that are completely out of our control. Our skills do not cover the actions of others. Not completely anyways. We may influence others, but we certainly do not control them, nor would we want to.

So, interacting with family, loved ones, friends, mates, children, etc... these are the areas that revive those weaker mental health areas. Most families go through phases once mental illness is addressed. The person that is sick has a realization period where they get to know and understand what it is about them that is struggling and in a lot of ways, why they struggle. Their loved ones often times go into protective mode, or triage. Where they address the symptoms and live in a constant state of waiting for the other shoe to drop. But once learning to live with a mental illness takes hold of a family, there next comes a period of time that feels comfortable, less climactic and a new challenge emerges:

How to live without a constant state of crisis on the horizon?

Support persons learn during this period to trust the person with the mental illness a little more and realize that it is no longer necessary to be "on call" at any moment. Newly found freedoms exist at this stage.

The next stage can be more challenging than the first. This is where skills have been learned and decisions have been made. Changes have been affected and the quality of life is improving for the person with the mental illness. What about our loved ones, our support persons, our mates? Well, in a lot of situations they find themselves unsure how to proceed. No longer are they "the glue that holds it all together" - no longer do they need to be worried about the fall. They aren't too sure of their role and all this time and energy has been spent on the other person, the one with the mental illness, learning new skills and educating themselves. If the loved ones and the support persons did not spend the time learning and educating themselves too, an imbalance can occur.

This imbalance is tricky - hard to navigate. Many times, this imbalance causes conflict and strife. To the one with the mental illness, it can be frustrating and overwhelming, because after-all, they are the ones that climbed what seemed to be the impossible mountain to mental health, a state of mind that many take for granted. Yet, in all of their efforts and their fight to have a life worth living, their family, loved ones or mate, did not learn the skills and they find themselves being the very hurdle to happiness and peace in the environment.

How do we react?

We do what works.

Not retaliating or putting them in their place. We validate. We understand that our loved one does not have the same skill set as we do. We have empathy for the role changes and pattern changes that our lives together and the journey that we have been on has created. What it really boils down to is this, our loved one is not purposely creating an environment that is difficult. It is a perfectly caused product of the journey we have been on together. What each of us does with it at this point is what matters. How will we react? Will we condemn our loved one for not having the skill or will we patiently wait while they learn it? Will we condemn ourselves for struggling to cope with this new phase of life? If at times doing what works steps back a few paces and pulls us out of the environment, like say spending the day in seclusion from time to time, may not be the failure that it feels like.

Sure, at the beginning of this journey we spent many, many days in bed. Unable to remove ourselves from the protection of our comforter. Or perhaps we were housebound for a time. If we choose what works to cope with our environment and that choice is staying in our room, even at this late stage of healing, it does not mean we failed. It does not mean we are starting over.

It does mean that we are choosing the lesser of the two evils, in that, staying in the room or out of harm's way from the changing circumstances, we are putting into practice all that hard work of growing and learning.

So pat yourself on the back if you have found yourself here and do not quit the journey: keep on learning and growing, and this too shall pass!