Back in the land of the living (Plus On-line DBT Homework Lessons)

Hi Guys – Sorry I have been AWOL for so long. Following on from my last post, I decide I would come off Escitalopram and in hindsight came off a little too quickly. I halved the dose for nearly two weeks then simply stopped taking it, and the results were horrific. I simply have NEVER been as ill as I have been over the last month in my entire life, including the several months I spent in bed when I was 18 after contracting glandular fever. I was running a fever, constantly vomiting, horrific vertigo, dizzyness…. it was unbelievable. I had almost two weeks off work and became attached to the sofa. To start with, I was reluctant to go to the doctor as I knew he would probably tell me to start taking the tablets again – something I was determined not to do. Thankfully, when I did go, he gave me symptomatic relief in the form of Domperidone (anti-nausea) and Sturagen?? (anti-vertigo) tablets. All I have learnt from this experience is that if you ever decide to self-medicate off anti-depressants, DO IT SLOWLY. Thankfully, I didn’t have any emotional symptoms apart from becoming very weak and emotional – no urges to self harm/suicidal ideation. I suppose that is testament to how strong I have become.

In other news, I went to have a final appointment with Dr F the psychiatrist and my CPN. It’s funny. All my life I have found myself being discharged from NHS mental health teams and services and feeling pretty bitter about it; I normally feel as though they haven’t helped me and I am being fobbed off, or I feel upset and unable to ‘let go’ because of course, I have done the typical borderline ‘inappropriate attachment’. This time, it feels like it is ME driving this thing. I no longer feel as though I need the help, or want to be involved in the mental health team. When my CPN comes for her visit, I have nothing traumatic to discuss with her, only nice things I have been doing or how happy I am. I feel as though I am wasting her precious time which could be spent elsewhere, and I really don’t mean to say that in a self-pity way, I mean it more in a ‘I am happy and don’t need help’ way.

Dr F said he was fascinated by me. Fascinated by the fact that during the time I was waiting for therapy on the NHS I appear to have healed myself. Not only that, I took it upon myself to teach myself the DBT from a therapists perspective (I did this because I thought I would understand it better than simply doing worksheets). He said he wanted to put me forward for something called Service User Involvement, which involves sitting on a panel, making decisions about training and therapy within the NHS structure, giving talks about my experiences and the such like. I told him I would give it some thought – on one side it is nice to be asked as he obviously values my opinions, or another side I’m not sure whether this whole ‘chapter’ of my life is something I want to continue – perhaps I want to just close the book and move on and into recovery. Yes, I want to help people, but I am not sure doing it through helping the NHS is the way to do it.

In other news, the relationship between James and I is going from strength to strength. I love him more and more every day, and although I am mindful of the intensity a ‘borderline’ relationship can reach, I am keeping an open mind about my feelings. We had an argument which tested me a a few weeks ago; I put him on the insurance of my car, but every time he drives it, in my opinion, he drives it like an idiot. He drives too fast then slams the brakes, he throws it into the corners, he revs it when he doesn’t need to. His driving actually makes me feel uncomfortable. This situation seemed to escalate because over and over again I asked him to slow down/drive more gently (which he just ignored and then accused me of nagging). A couple of weeks ago, he had just come off a row of nights so was tired and irritable anyway, and he was driving again like a moron. I asked him to slow down for the umpteenth time, so he slammed the breaks on and told me if I didn’t like his driving, I could drive myself. I can understand that I had asked him to drive and he was doing me a favour (I was going through withdrawal at the time and the road was flickering in front of my eyes – not such a good thing!!) and I should have been grateful but surely not to the extent of him making me feel uncomfortable and even unsafe?

When we got home, he stormed off and so I just lay down on the garden bench and ignored him. I desperately wanted him to come over and apologise for the row, and I didn’t want to have to be the one to make the effort. I didn’t want to get into that trap of me always being the one to back down or apologise. Several hours passed and it became obvious he wasn’t going to make the effort so I decided I would be the one to swallow my pride, but be mindful if it happened again. I apologised to him and asked that he should talk about what happened, which he did. He explained that he was angry I asked him to drive the car when he wasn’t particularly feeling good, which he did, but then I complained about how he drove it. I explained that his driving made me feel unsafe. He replied that he was a safe driver and had never had an accident, and that although I felt unsafe, he knew how to handle the car and I shouldn’t worry. I couldn’t seem to get through to him that I FELT unsafe no matter how safe his driving was.

The thing that actually hurt the most I think, was that he appeared to be disregarding my feelings. In the end, we decided that he would not drive my car again, as we could not agree – he wants to drive a certain way, and I don’t want him to drive my car like that. Neither of us is willing to back down and the situation just needed to be diffused.

I made an effort to use the DBT interpersonal effectiveness skill ‘DEARMAN”:

Describe the situation – I told him that his driving made me feel unsafe, and I felt as though he was being disrespectful as he was driving my car in a manner that I felt was unsafe

Express your feelings – I told him that his actions had made me feel unsafe and uncomfortable, and the way he was acting was upsetting me

Assert yourself – I told him that if he was not willing to compromise and drive in a manner that I was comfortable with, I did not want him to drive my car (this was done tactfully and was a mutual decision rather than me just telling him/giving him an ultimatum and being aggressive)

Reward – This is a hard one as he didn’t really ‘get’ anything out of it other than the situation being diffused and resolved

Mindful of Objectives – At one point he turned it round and told me that my driving was unsafe. Although I am not disputing this, I told him it was not the subject under discussion. I have since, without him asking me to, made a big effort to improve my driving, especially when he is in the car.

Appear confident – Despite wanting to burst into tears and hug him and apologise for anything I had done wrong for fear of him walking away, I stuck to my guns and my principles

Negotiate – We came to a decision of him not driving my car again

Other than this one argument, everything is going fantastically. I want to be with him all the time. I think he is beautiful, and I love every single thing about him, in every single way. He is slowly teaching me about life, about relationships and about compromise, in the way it should be, rather than in the disordered way that I have previously been used to. He makes me feel safe, loved and special, without even doing anything. He is everything to me. I do feel worried that I do not spend as much time talking to people like Jen and Kim as I used to, but I know they understand. It is hard, being with James and then tapping away on my phone, I feel rude, hence our conversations are less frequent. I was particularly upset as last weekend I should have gone up to stay with Kim (and Jen was there) for a photography weekend, but I was too ill. Hopefully on Sunday I am going training with Kim, and so will get to spend most of the day with her then.

On another note, the diet and exercise regime went out of the window while I was ill. I simply was not well enough to do or think about anything. Thankfully, it hasn’t affected my weight loss journey and I am now 11 stone 2lbs. I want to get down to 11 stone 0 in the next 4 weeks so am currently doing a 4 week book camp and running at least 1 mile each day. At the end of the 4 weeks James and I go to Venice for the weekend, which I am REALLY looking forward to.

We have also been being rather homely, and have started a vegetable patch in the garden, which surprisingly, I adore. I could spend hours just staring at it. The house is coming along too, I have bought a ‘new’ kitchen (it is second hand but will be new to me) and the new boiler has gone in. The kitchen should be fitted by my Dad over the next couple of months, unfortunately he is not too well at the moment. The cancer in his prostate has spread to his hip and he is in a lot of pain with it. He doesn’t talk about it openly and I try not to think about what is going on with that.

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I have also been keeping up with the on-line DBT lessons, although my heart hasn’t really been in it as at the moment it is going through Core Mindfulness, and I do feel a little as though I have done that module to death. Here are two of my homework lessons and feedback I was given:

HOMEWORK ONE (CORE MINDFULNESS SKILLS)

Other ideas on how to tell the difference between reasonable mind and emotion mind:

If you can think about something complicated – reasonable mind
If the emotions are really intense and sudden – emotion mind
If you want to act self destructively – emotion mind
If you are manic – emotion mind
If you are emotional – emotion mind
If you are calm – reasonable mind

Describe a situation where you were in emotion mind:

I was over tired and emotional, and my mum made a comment about me not doing my job properly. I was overcome with anger and self-pity/doubt that she would criticize my work, so I snapped at her and was nasty (I let my emotion mind influence how I behaved). If I was in wise mind, I would have realized she was merely pointing out something I had missed in order that I would not miss it again, and I would taken the criticism much more constructively.

Feedback:

Mybpdstory,
Emotion mind occurs when you make judgments or decisions based solely on how you feel. However, keep in mind that emotions themselves are not problematic. We all need emotions to live healthy lives. The problems associated with Emotion Mind develop when your emotions control your life. This trap is especially problematic for many because Emotion Mind distorts your thoughts and judgments and then these distortions make it hard to formulate healthy decisions about your life. Your example is an effective example of just that. The balancing counterpart to Emotion Mind is Reasonable Mind. Reasonable Mind is the part of your decision making process that analyses the facts of a situation, thinks clearly about what is happening, considers the details and then makes rational decisions. Obviously rational thinking helps us solve problems and make decisions every day. But there again, as with emotions, too much rational thinking can be a problem. So here too a balance is needed in order to live a fulfilling, healthy life. But for people with overwhelming emotions, balancing feelings and rational thoughts is often hard to do. The solution is to use Wise Mind. Wise Mind results from using both Emotion Mind and Reasonable Mind together. Wise Mind is a balance between feelings and rational thoughts. You can develop Wise Mind by using the mindfulness skills. Remember that part of what these skills did was to help you recognize and separate your thoughts from your emotions.  So you’ve already been using both your emotion mind and reasonable mind. And by practicing those mindfulness skills even more, it will become easier to lake healthy decisions based on a balance of what your emotions and your rational thoughts tell you. Keep up the nice work.
moderator
Sharon
HOMEWORK TWO (CORE MINDFULNESS SKILLS)

Consider and describe which “what” skill (observing, describing, participating) is your strength and which is your weakness.

Which of the “What” skills do you have most difficulty with? This is the one to practice the most! Describe your practice of the skill.

…………………………………………………………….

I find observing the easiest skill to do out of the three `WHAT’ skills, perhaps because it is the one that requires the least effort and I can be a lazy person. Describing is possible, but takes a larger amount of concentrated effort, something I struggle with as I often am able to observe the fact that my thoughts have gone off on a tangent.
I find participating the most difficult, mostly because I am constantly thinking of what other people are thinking of me at that point in time. This is where I think the DBT skills will come in useful, being able to change my thoughts from `What are people thinking of me right now’ to focusing on what I am doing and blocking those conflicting thoughts out. By observing and describing the fact that I was thinking of what people must think of me, perhaps I will be able to slowly reduce the fact that I am doing it.

Feedback:

Mybpdstory,
Consider the multitude of ways that you are distracted from being fully present in the current moment in your daily life. It is often a rare thing to be completely present. Even when we feel like we are particularly calm or focused, there are often multiple thoughts flitting in and out of our minds or distracting physical sensations. All of these distractions remove us from the present moment and scatter our focus. Participation is practicing what you are learning, actually working at making changes. The skill of participating as mindfulness skill is a very difficult skill, especially for many people who have lots of emotional stuff going on inside of them lots of  the time. The concept of participating is the idea that your throw yourself into the moment. In a way, it is like shifting gears, going with the flow, and really working to put your attention to what is going on in the immediate environment. It is one thing to show up in your body, but it is another thing to show up with your mind. It can be effective to show up for the party, movie, meeting or event even though something really stressful is going on. You can practice shifting gears to show up for the immediate moment or situation and perhaps shift gears again when you go back to worrying about what is stressful. At the very least, notice how you feel when you are worrying, ruminating, stressed out, and under emotional threat, and possibly shut down to the world around you. Using the skill of participating means keeping your eyes open to what is going on around you, listening, feeling and being touched by the things that matter. When you put yourself out there, into the world, you risk being vulnerable. Engaging, interacting and participating in the world helps connect to people in meaningful ways, find people that share similar struggles and feel more real. When people have extremely stressful situations, they may be able to mitigate the stressors by being present to the things that could be enjoyable despite being stressed out. Sometimes trying to participate doesn’t yield immediate rewards, and therefore takes a lot of effort. Simply participate in the now if the moment calls for you to be here now. Let go of worry thoughts such as “How do I look to others?” or “Am I doing it as well as so-and-so?  Keep up the nice work.
moderator
Sharon

I hope you guys are all doing well. I’m sorry I have been so appalling at keeping up with the blog, I promise to do better. I want to show you all that there is a way out of Borderline into recovery, and I have found it. Finally, I want to thank Dying to be Me for this very kind award:

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2 comments

  1. I’ve recently stumbled upon this amazing blog and it inspired me to create one of my own…so thank you! I think I may have to copy you in completing some of Linehan’s homework and posting it online….what a great idea. It’s so easy to get stuck in emotion mind and I think that concept has been one of the most helpful from my time in DBT.

    1. Thank you for your lovely comment. I wish you all the best on your journey. Keep Safe xxxx

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