When We Know Too Much

Yesterday, I had the distinct pleasure of being a guest on Moments of Clarity, a Mental Health themed radio show based out of Florida. If you’re so inclined, you can listen to the episode here.

A big theme in our discussion was the ways in which having an intellectual understanding of a topic can actually work against us in recovery. More than that, it can serve as a defense mechanism to protect us from having to do the real hard work of feeling. But how can that be? How can having the ability to step back and intellectualize a situation possibly be a negative in the healing process?


We like to think we know an awful lot. Scratch that, and let’s just leave it at we like to think a lot. Full stop. Sometimes, what we think about the specifics can obscure our view of the whole situation. For example, did you notice how you can see me and my messy living room reflected in the whiteboard above or were you focused on the equation? A stretch of an analogy? Maybe you’re right – but my high school physics teacher would give me an A for effort, I think.

This is a topic with which I am intimately familiar. Surprisingly enough, knowing “too much” is one of my ingrained and most frequently used defense mechanisms. My husband and I recently began couple’s counseling and, at our first meeting, we were both called out by the therapist on our tendency to over-rationalize and over-analyze a situation, to the detriment of actually engaging with it. We take our “knowledge” of what’s happening and use it to avoid understanding the impact of our actions on each other and getting in touch with the emotions we are both having in a given moment. The fact is, we both struggle with emotional intimacy and our tendency toward intellectualism protects us from having to “go there” with each other. Through our experiences growing up, we both learned that exposing emotions was a surefire way to be berated, targeted, and even placed in physical danger. This has been a major hindrance in our ability to communicate and connect, not just with each other, but in general. The habit of stepping back and demonstrating an intellectual understanding of a situation has saved us (up until now) from needing to get to the emotional truth of the situation – which is what any relationship of depth needs to survive.

My marriage is not the only place I have struggled with connecting with my emotions. When I was in the psychiatric unit in January of 2017, I held firm to my identity as a mental health professional for the first three days I was there. In my mind, because I was familiar with the skills being taught in the group therapy sessions, I could not learn anything from them. I knew DBT and CBT and mindfulness techniques. I knew how they applied to life in general and recovery in particular. I understood the nuts and bolts. This mentality prevented me from considering my particular situation, the events which lead to my hospitalization, the immense emotional and psychological pain I was in. I was essentially hiding behind my “book knowledge” in an attempt to save myself from the pain of actually accepting where I was at that moment in my life. In reality, I was in one of the scariest and most vulnerable positions I’ve ever experienced – suicidal and hospitalized with the shambles of my former life crumbled at my feet. It was not until I was willing to at least consider that the things being taught had relevance to my life that I was able to take the first tenuous steps toward recovery. But this has been a slow moving progression.

Vulnerability is the most important component of mental health recovery – allowing yourself to be vulnerable enough to honestly report your symptoms, allowing yourself to be vulnerable enough to open up and actually do the work of therapy, allowing yourself to be vulnerable enough to ask friends and family for support – and I’ll tell you a little secret: historically, I suck at vulnerability.

You’re reading the words of a woman who once completed an entire grocery order gently inching the cart along while on crutches just to feel less at the mercy of an injured knee. You’re reading the words of a woman who once chose to babysit her little brother a day and a half after a gal bladder removal surgery because she was too stubborn to admit that, yes, she needed to be in bed recovering. You’re reading the words of a woman who spent years in therapy happily giving step-by-step accounts of traumas with a steadfastness and sincerity that prevented the therapist from digging any deeper. You’re reading the words of a woman who sucks at emotional anything.


The deadbolt was set and locked for this gal! No one was getting in in any meaningful way, and demonstrating an intellectual understanding of mental health meant I didn’t need to expose the messy, emotional truth. 

Over the last two years, though, much to my initial horror and chagrin, my walls of intellectualism have been slowly eroded. It started in the hospital with that tiny step of considering my current situation and the idea that I did, actually, stand to benefit from applying the skills being taught. I unlocked the deadbolt, but the door was still solidly closed. It continued in the partial hospitalization program, where I had a therapist who was obnoxiously good at calling me on my bullshit. Every time I’d say, “I’m fine” or I’d try to minimize symptoms, this woman would actually dig deeper and get me to admit that this or that was bothering me. I’d never experienced a therapist who didn’t take my words at face value before. I was thrown off kilter and, as a result, accidentally cracked the door open a little bit. Then, I started working with my current therapist, and holy cupcakes did my entire paradigm shift!

This was not an over night transformation – in fact, the first year I was meeting with her was crisis stabilization and trust building. I didn’t realize we were building trust at the time, but we definitely were. Once the foundation of trust was laid, this magician of a professional actually got me to feel things. Things I had never felt. Did you know that you can feel an emotion strongly enough to get physically sick? Cause I sure as hell didn’t. Until I did when we were talking about shame one week. Did you know that you can feel anger so intense that your ears ring and your vision blurs? Because I was rather concerned when this started happening in session one day. Now, once a week, I open the door just enough for her to see my face. But, slowly but surely, the door is opening wider and wider.

I’ve learned that simply saying, “that time I watched my mother get beaten was really jacked up and should never have happened.” has been a brilliant coping mechanism I’ve developed over time to prevent myself from feeling the terror, the anger, the sadness, and the shame that I disconnected from when that event (and many like it) happened. What I’ve learned through this journey I’ve been on is that there is true strength in vulnerability and that healing comes only when you allow yourself to feel the things you blocked out. You cannot truly heal from trauma until you’ve processed it, and that necessitates feeling your feelings without judgement. You cannot grow in emotional strength until you are willing to let the intellectual strength take a back seat for a few.

Sometimes, we “know too much”, and, while it’s an effective defense mechanism, it is shutting off an entire section of our lives if we hide behind it.

The effects of this process are no longer limited to therapy, either. I am finding myself increasingly willing and able to be open and honest about my needs in my personal life. I’m slowly learning how to connect with my feelings in a meaningful and productive way that I’ve never felt before. I’ve learned that there is value in intellectualism, but there is just as much value in getting in touch with the emotional side of things. And that connection is worth all of the hard work and discomfort that comes with it.


Can you relate to this post, or am I some weird outlier? If you can relate, have you considered this before? Have you addressed it? Do you plan to address it?

Agree, disagree, indifferent, confused – I’d love to hear your thoughts, whatever they are! Drop a comment below, or Tweet me @paradichotomy. You can also find me on Facebook  and join the conversation over there! Thanks for reading!

Frustration in Recovery – Changing Your Perspective

Earlier this week, I had a… “heated discussion” with a friend of mine. We were arguing so intensely that it nearly cost us our friendship. The conversation ended with insults, “Goodbye”, and being blocked on Facebook Messenger.

I was devastated that I’d lost a friend, but I read back over our conversation and was convinced that everything I’d said was true. I couldn’t understand his reaction and the more I thought about it, the angrier I got. Why couldn’t he just accept what I was saying? Why would he feel the need to minimize my feelings and completely negate my thoughts so harshly? 

The next day, the two of us spoke on the phone. We started off with apologies and then processed what had happened. As it turns out, we were talking about two entirely separate things and assuming we were on the same page. Both of us were so adamant that we were right because we both were – about the topics we were arguing. The problem was, we were not arguing the same topic.

During that conversation, we both lost perspective. We lost the ability to step back in the moment and ask for clarification. We lost our mutual respect for each other in our need to prove our respective points.

It got me thinking about how a lack of perspective in general can impact our lives. And, in a more specific sense, our recovery. Living with mental health diagnoses can, by default, make things like perspective difficult. Our brains are working against us most of the time, and perspective is a frame of mind.

Recently, I came across my intake paperwork for the Partial Hospitalization Program in which I was enrolled at this time last year. If you’ve ever received mental health treatment of any form, you know that clinicians set goals and projected outcomes of said treatment. Frustration and embarrassment and shame slammed into me all at once as I realized those goals, set for me a year ago, were almost identical to my current treatment objectives.

It’s been a year and I’ve accomplished nothing. I thought, disgusted with myself. The spiral continued (as it tends to do when you don’t challenge your thoughts.)

I thought of how incredibly different my life was just a year and a half ago. Before the hospital. Before losing my job. Before needing to leave school. Before the months of intensive treatment. Before the medicine. Before the foodstamps and medicaid. Before all of it.

And then, I started comparing. I compared where I am now, to where I was then. I have a job but it pays substantially less. I have less treatment, but I still need treatment. I have correct diagnoses, but that just means more meds, more appointments, more possibility for future crises. I am not in school. I am not financially self-sufficient. I am not better. And I never will be. I told myself all of that, in rapid succession. Naturally, I spent the rest of the day feeling like complete shit.

When I compare my life now to my life prior to the PTSD symptoms and the manic episode, I feel discouraged. I feel frustrated and angry and pathetic. Because it seems like so little progress has been made. I’m still no where near where I used to be. And that is beyond infuriating.

This line of thought fuels my self-hatred, my self-doubt, and my lack of faith in recovery. It leaves me stuck in complete despair, soaked in tears and ready to put my fist through a wall. I’m not being over-dramatic when I say those things, either. I’ve literally sobbed and wallowed and punched and screamed and cursed.

These feelings are natural, I think. And valid. I don’t imagine that they are dissimilar to the feelings of someone who’s suffered an impactful physical injury. I refuse to minimize the sense of loss and anger that come with losing capabilities or dreams or simply the life you were living. It is tragic and unfair to be moving through your life, in the only way you’ve ever known to live it, and have that way of life ripped away in what feels like an instant. I believe that grief is natural in such circumstances. Comparing your progress in recovery to who you were before the change is normal. Sometimes, for me anyway, where I was feels like the only real bar by which I can measure progress. But I’ve realized recently my perspective is wrong. And it needs to change.

I’m comparing two entirely separate things. Two wrong things.

What I need to compare is where I am now to where I was a year ago. That is when my mental health took a sharp downturn, and that is the period from which I am recovering. When I look at it through this lens, there is simply no denying that immense progress has been made. Tangible progress. Objective progress. No longer are the hours of my days punctuated by body shaking, vision blurring, muscle tensing panic attacks. Horrific flashbacks to childhood and my marriage are no longer daily occurrences. More often than not, I get more than a few hours of sleep a night. I am not the person I was before I went to the hospital, that’s true; but neither am I the person who left the hospital. I’m not the person who entered a partial hospitalization program, nor am I the person who was discharged from that program. I am not the person who met with crisis counselors in March, nor am I the person I was when I first started meeting with my current therapist.

Do I still have panic attacks, flashbacks, and nightmares? Yes! I do! And they are just as exhausting and brutal as ever.  But they are less. Am I symptom free on the Bipolar front yet? No, I’m not even on the right medications for my particular “bipolar brain” yet, so I still have hypomanic and depressive episodes (thankfully, the medications do, at least, seem to hold off full-blown manic episodes), but I’m working with a competent psychiatrist to get those medications right. Am I where I want to be? No, I’m not. But I’ve come a hell of a long way.

I’ll be honest here. I’m always going to wish that I could go back to the Sheila I was before all of this stuff happened and my brain freaked out and the chemical make-up of my mind shifted. I’ll always hope to one day be “that person” again. But the truth is, the events leading up to my hospitalization were a turning point in my life. A switch was flicked which cannot be unflicked. Living with bipolar disorder, I will need medications of one form or another for the remainder of my life. PTSD is incurable, though the symptoms can be managed over time. There will always be the possibility of those symptoms being triggered again, though. I am not the same person I was before I went to the hospital, but one things for sure, I’m not the same person I was a year ago, either. And that is significant and encouraging.

Do you ever struggle with perspective in recovery? Is there a distinctive “turning point” in your life that you know has changed you forever? Do you struggle with comparing past you to present you in your journey? As always, I’d love to hear your thoughts! Please drop a comment below or Tweet me @paradichotomy.

Thanks for reading!

A Reflection on Advocacy: I am not a Hypocrite (and Neither are You)

I was going to write a different post for this week. I had one planned out on exploring the ways in which trauma physically impacts us, and I was going to toss in a review of a fantastic book on that topic. But then I saw three or four separate Twitter conversations with advocates wondering whether or not they were hypocrites for calling themselves “Advocates” while struggling with their mental health. This is a topic about which I am incredibly passionate.

If you’ve been following the blog for a while, you know how I roll – calling myself “Flexible” with subject matter and posting times would be a kind understatement. Sometimes, I simply free write in this public journal of mine; sometimes, I do intense research and carefully craft each word. Sometimes, I plan out elaborate posting schedules and then abandon them weeks later (OK, every time I’ve come up with an elaborate posting schedule, I’ve abandoned it. Schedules aren’t my thing, especially not elaborate ones. This “once a week” thing seems to be working for now, but who knows what will happen in the future!). OK, I digress.

Let’s get on with this month’s super flexible, free-write post.

Be real. 2017 was a rough year for many of us. I am no exception to that statement. New Years Day 2017 marked my admittance to a psychiatric unit and I spent the entire year trying to get stable. And I’m still not there. And that’s OK.

I’m a huge proponent of transparency. Here at Parallel Dichotomy, I like to call it “radical honesty.” I firmly believe that this openness is important both in recovery and in advocacy. For me, these two topics are inextricably linked.

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I know that that is not the case for everyone; in fact, there are many people living with mental health diagnoses who do not feel driven toward advocacy at all, and I completely understand that. The need to keep your own business just that is completely OK. I know that many of my family and friends believe I should do the same and simply don’t get why I blog about “this stuff”. Isn’t it private? Wouldn’t it be better to wait until I’m “better” to reflect? Isn’t it important to recognize those components of my life which should remain private and keep them that way?

Now, I completely respect those who wish to keep their mental health struggles private. But the idea that we must do so bothers me. I challenge the core assumption of such statements. Shouldn’t the truth of living with mental illness be a private matter? For me, in my situation and by my convictions, the answer is a resounding “No.” Mostly because I know that those caveats will never be met.

The truth is harder to swallow than the seven different medications I have to take every day, but it must be spoken loudly and clearly. I have Bipolar Disorder and Complex Post Traumatic Stress Disorder. I will never be “cured.” These things will never “go away.” There is no surgery to remove them. There is no vaccine to eradicate them. There is no antibiotic to clear them up. That’s not what mental health recovery is about. Recovery is about learning to cope with and manage our diagnoses. And for me, personally, it’s also about sharing the things I learn through that process to help educate others- both those living with mental health diagnoses who may benefit from the things that I am learning, and those who do not live with those diagnoses, but seek to understand what it’s like to live with them.

I did not ring in this year at a hospital (thankfully), but I did come out the gate swingin’ as I’m adjusting to a new medication during a depressive crash following a hypomanic episode.


Medication changes always seem to hit me hard. Some of it is psychological – I know that things are different and I can trick myself into believing that every new feeling is a side effect. This, I understand, is common for many of us. Some of it is legitimately physical, though, too. Dizziness, tiredness, nausea.

Regardless of the root, my reaction to new medication is still always strong and uncomfortable. Sometimes, the side effects ease off and I adjust; sometimes, my psychiatrist decides that we need to end a medication and start a new one. I’m still not on the “right” meds. When I am, manic episodes won’t happen and my depression will be under control. Finding the correct combination of medication is a massive jigsaw puzzle. There are over 1,000 possible combinations of medications out there, and every single human brain has a differences in chemical composition. My treatment team and I are still working to find the chemicals to balance my imbalances and make my life a little more stable.

In moments like these, I sometimes question my “right” to be an advocate. Am I being a hypocrite for spreading education and hope for recovery in mental health while struggling? I don’t think so.

I’m not “out of the woods” yet, but I’m further along than I was. I began blogging about a year ago, while I was still in the partial hospitalization program to which the inpatient unit discharged me. I was nowhere near “stable.”

I was ashamed and I was nervous to talk to anyone about what had happened. After some encouragement from amazing friends, though, I decided to start chronicling my recovery process, and it’s become as much a part of my recovery as therapy. For better or worse. I didn’t think of myself as an “advocate” at the start, but I did think of myself as someone who was doing what little I could to spread understanding and fight stigma in my own little corner of the world.

I had many friends and family who could not understand how I had found myself in such crisis. They could not connect “bipolar” with “Sheila,” despite the fact that I had, in fact, been living with symptoms of Bipolar Disorder since I was 19 years old. But they didn’t know that, and neither did I.

Personally, I could not understand how I had unwittingly made the jump from mental health worker and Social Work student to mental health patient. Being naturally inclined toward writing, though, and with all of the free time that came with losing my job, I figured telling my story may be worth something to someone. Did I think that that story would have reach beyond my immediate circle? No. I did not. But I felt compelled to share the process.

Since starting this blog, I’ve heard from people that reading my stories of triumphs and difficulties have inspired them to feel less ashamed, to get help, to go to the hospital, to continue taking their medications and going to their appointments. This is meaningful to me, to my own recovery. And I feel the same encouragement and inspiration reading and watching the work of other advocates. This inspires me to continue sharing, because, at the very least, I know that there is some sort of good, however small, coming out of the hard times. I’ve learned a hell of a lot about myself this year through therapy and treatment, but I’ve also learned a hell of a lot through talking with other advocates. The mental health community on Twitter has helped me challenge my internal stigmas. Hearing the insights others have gained in their own recovery has compelled me toward my own insights. Showing up with honesty and openness helps everyone living with mental illness, because it does help challenge the 2-D stereotypes and over-simplifications of mental health diagnoses so prevalent in our society and it also shows all of us, at all stages of recovery, that growth and healing are possible.

I am here, right now, coming out of the depths of a depressive episode with new IMG_20180105_185305_044.jpgchemicals coursing through my veins and brain, and I am writing about it.

Society knows that mental illness is hard. Society knows that those of us with mental illness live our lives in a different way than those who do not have mental illness. These are facts. Advocacy, to me, is accepting that, validating that, and then flipping the script. Showing that, yes, my life is different; yeah, I have to take a bunch of pills and go to therapy and meet with a psychiatrist and manage my schedule and avoid some of the things that many take for granted for the sake of maintaining wellness. But I’m also a human. I have good days and bad days. I have hobbies. I have likes and dislikes. I struggle with some of the same things every other human being struggles with. I am living my life, and attempting to do so to the best of my ability, just like every other human on this planet. By sharing both the struggles and successes of my journey, I’d like to think that I’m painting a full picture of living with mental illness instead of just perpetuating stereotypes.

Many of my family and friends struggled (and still struggle) to understand my drive to do this. It’s one thing to reflect on one’s experiences and struggles after the fact. People do that all the time with all kinds of life experiences. Especially writers. But I’m not waiting until after the fact. And I have refused to do so since day one of this project. Since starting this blog, I have had 3 hypomanic episodes, I’ve had too many med changes to count, I’ve attempted suicide, I’ve been to a crisis stabilization house. I still get manic. I still get depressed. I have flashbacks. I have nightmares. I have insomnia. I have paranoid thoughts.

I am not my illness, though. My illness does inform a portion of my life and it always will, but it’s the things I do and learn along the way as I move through life that define me as a person. And it’s sharing those things that define me as an advocate. It’s the balance. It’s the honesty. It’s the journey. All of it.

Am I less of an advocate for being symptomatic? No. I am not. And neither are you.

Top 3 Ways to Care for Yourself as a Caregiver

When someone you love has a mental health crisis, or is diagnosed with a serious mental illness, it’s natural to want to help. But not everyone takes on the role of primary or secondary caregiver. If you have, though, first and foremost, I want to say thank you. The support and care you offer is lifesaving and you are a superhero, truly. You may not take care of me, personally, but I guarantee I have traits in common with the person you do support and care for. I also recognize that it’s far too easy for you to push your own needs to the side and focus entirely on helping your loved one. This can place immense strain on you, as a caregiver, and strain on the relationship. But, as someone who cares, the last thing you want is compassion fatigue. It’s very important for you to take care of yourself, even when caring for someone who is chronically ill.


This is me trying to smile through a rough time. I know this because… well, I remember taking the picture for one, but also because of the bags under my eyes and the way my “smile” looks more like a slight grimace and does not reach my eyes. This is what I look like when my nights are plagued with nightmares and ensuing insomnia.

I have a friend who, upon seeing a photo like this, will immediately reach out and listen to anything I have to say. I’m writing this blog post for that person; for the one in my life who has literally walked through every single step of my recovery with me. I’m also writing it for the handful of people who have been other sources of support. The people who have tag-teamed to come visit, to check in, to do everything in their power to help. I can’t imagine how exhausting taking care of me must be.

I struggled enough with self care as a professional caregiver, but at least I got to leave my clients at the end of the day and come home. There are people in my life who, in the last year, have gone so far above and beyond any reasonable expectation of anyone, even someone considered family.

To you, I know that you are not going anywhere, and I know that you will continue to show up and support me. And I am so far beyond thankful for that support. There are no words. I wish I could repay you for your unending support and care, but there’s no way. Nothing would be enough. At the very least, though, I can consolidate some solid information on self care for caregivers in a place I know you will see it. And that’s why I’m making this post.

The truth is, I have spent the majority of this past year having a hard time. I’ve had moments of full blown crisis and also persistent stretches of struggling and intense pain. I’ve had slip ups with unhealthy coping mechanisms. I’ve had moments of being so “stuck” in depression that I can’t admit that I’ve made any progress at all. I’ve had hypomanic episodes. I’ve been suicidal. I’ve been angry. I’ve been depressed. Honestly, I’ve been on a massive roller coaster. To the people strapped right in with me, holding on tight and going along for the ride, I’m begging you to please read this, and then apply it.

The last thing I want, as someone who loves you as much as you love me, is to be a source of pain for you. I’ve done some research on how you can take care of yourself (because I know you’ve been busy all year doing research on bipolar and PTSD and medication and warning signs and crisis management and probably have not gotten around to looking this stuff up for yourself). This list is a consolidation of information from the National Alliance on Mental Illness (NAMI) and the Family Caregiver Alliance. I will link both at the end of this post. That said, here are three ways you can take care of yourself while caring for loved ones with mental illnesses.

It's a long journey..jpg

Understand and Recognize that Caring for Others Affects You

It’s OK to say it. Those of us with mental health diagnoses can be exhausting. Believe me, I know. I exhaust myself. I annoy myself. And you show up for me consistently and without question in those moments and in every moment. I can only imagine how exhausting and annoying I can be to you. (Even when you tell me repeatedly I am not.)

Let’s look at the documented effects of care-giving on human bodies. Feeling responsible for the well being of another person has some very tangible impacts on your body and mind. It can cause:

  • anxiety
  • lack of sleep
  • headaches
  • tension
  • nausea/upset stomach
  • lowered energy
  • depression
  • poor eating habits
  • poor exercise habits due to exhaustion and lack of time

That’s a hell of a list, isn’t it? Not everyone will experience all of this, but it’s important to check in with yourself around which of these effects may be present in your life. You are not betraying anyone by taking stock and being honest with yourself. Neither are you being selfish to consider your needs. Which is exactly what you have to do once you’ve identified the effects your role as care-taker is having on you.

It's OK to be Stressed.jpg

Look, I can be stressful. Seriously stressful. Anyone with a mental illness can be. Think about it for a minute, if you’re spending your time talking your suicidal friend into getting help, reminding your loved one to take medications (or finding yourself needing to “gently convince” that loved one to take their meds and stick with their treatment plan), holding your sister while she has a massive panic attack for the fifth time in a day, or listening to someone process traumas, you’re doing something amazing and very important, but you’re also probably feeling pretty perpetually wiped out and tense.

Now that you’ve taken some time to consider what, specifically, is affecting you in your specific role as a caregiver, figure out which situations provoke the most stress.

It’s likely there are certain situational stressors that you need to consider. Is it difficult for you to be out in public with your loved one while they are symptomatic? Is it hard to be in social situations with your loved one, consistently worrying they may become symptomatic? What situations cause you the most stress? It’s important to know triggers so that you can either avoid these situations or be prepared with fortified coping skills prior to the event.


Take Time for Yourself

Hey caregiver. Yeah, you. I can hear you. Right now. “I can’t.” “There’s no time in my day.” “I’m fine.” To that, I give a skeptical, “Mmmhmmm.” When I tell you, “I’m fine”, you dig. You dig deep. I’m flipping the script in this one. I know it can seem hard, especially if you have more people to take care of in your life than just your mentally ill loved one.

You need time in your day where you are not a “caregiver” of any form. Not for your loved one with mental illness, not for your other family members, not for coworkers, not for other friends. There are a lot of good suggestions on how to do this. Let your lunch break be your lunch break. Don’t text people to check in and make sure things are getting done, or to make sure that your loved one is OK. Think of the things that you enjoyed doing before becoming engrossed in the caregiver role and work them back into your schedule, slowly but surely. If you liked to knit, give yourself ten minutes at the end of the night to knit and only to knit. If you liked to exercise, get in a fifteen minute cardio workout somewhere in your day. If you like to zone out to Food Network, don’t feel obligated to also listen to your loved one and talk them through a rough time. Set standing, monthly plans with friends and loved ones who do not require you to be or do anything caregiver-like. According to my research on this topic, it’s easier to plan your busy life around if these are scheduled in advance, but spontaneous ones are fine, too!

When you are doing these things, resist the urge to worry. Try to be present, instead of preoccupied with what might be happening in the mind of someone else. You are not being selfish for taking time to recharge. In fact, you are setting yourself up to be a more effective caregiver. We all know the airplane mask metaphor, and we all know it’s true (no matter how much we try to deny it).

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Take Care of Your Own Health

If you’re going to insist on taking care of my health (or someone else’s), make sure you’re tending to your own as well. It’s essential if you want to be effective as a caregiver. Truly. How can you do this? Remember how I said that I was going to flip the script on you? I wasn’t joking. Because many of the same things you try to remind me to do to improve my mental health are the same things you need to do to care for yourself. Take your own advice!

Tend to your physical health by:

  • Eating well – don’t put off your nutritional intake to care for others. Don’t skip meals out of obligation. Try to avoid stress eating unhealthy, processed food every night for comfort.
  • Exercise – it increases endorphin levels, decreases the physical symptoms of stress, and can serve as some of that very important “you” time.
  • Avoid alcohol and other drugs – I know you’re stressed. And I know all too well that mood altering substances can feel like stress relief. But these things won’t actually help the situation. Caregivers are at an increased risk of developing problematic substance habits, just like those of us with mental illness. It’s important to be aware of this.
  • Get enough sleep – Oh yes, sleep. It needs to be a priority. Unwind before bed. Set up a bed time ritual. Practice good sleep hygiene.
  • Practice relaxation techniques – I don’t care if it’s yoga, meditation, guided breathing, progressive muscle relaxation. Find 10 – 15 minutes a day to work this in. Relaxation and mindfulness are powerful tools. Use them.

In addition to your physical health, protect your mental wellness also.

  • First and foremost, avoid feeling guilt. There are going to be times you do feel annoyed, overwhelmed, and maybe even resentful of your role as caregiver. In those moments, you may well immediately start some negative self-talk. You may think “If I was a good person, I wouldn’t feel this way.” This is not true. You are a good person, you are simply human. These feelings are natural. Notice them, accept them without judgement, and validate them. What you are doing is hard. It is physically and mentally draining. You are working your ass off to support someone who, especially when symptomatic, is not able to do much to support herself or himself. Cut yourself some slack. Seriously.
  • Second, notice the positives in your day. It can be hard to find positives when your loved one is in crisis, or even having a hard time. Often, when someone having a hard time, it can cause anxiety that a full blown crisis is just around the corner. You’ve got a lot going through your mind every single day. When you’re “in it” with someone with a severe mental illness, when you’re along for that same roller coaster ride, you can find it hard to see the positives, too. Just like those of us living with our illnesses. NAMI suggests keeping a journal and writing down a few good things about your day, every day. This might seem silly, but it really can help shift your mood and ease your tension.
  • Third, and perhaps most important, find support. NAMI has in-person support groups in most states, but if you can’t make it to one of those, that’s OK. You can ask others for help, too. Are there others who could help you by being secondary caregivers? Can you ask someone to tag team with you occasionally? Can you reach out to other friends of yours and build your own support system? You don’t have to go into details at all if you’re not comfortable doing so – but you can ask friends to help you with making dinners, help you organize paperwork, or clean your house. Even just asking friends to make those standing, self-care plans with you, like nights out to dinner, a trip to the movies, a hike, or whatever you like to do can be an immense source of support and strength.

“You are not weak because you need support. You are not a failure for being overwhelmed. You are not pathetic for needing some help.” These are things you tell me almost every day. And guess what? They are true for you, too.


That’s my list. I know it’s not much, but I hope it’s something. Thank you so much for all you do.

Here is the link to the Family Caregiver Alliance and here is NAMI, I hope you’ll spend some time digging around these sites and researching further ways and resources to care for you, just like you spend time researching ways to care me, or for your loved one living with mental illness.


As always, I’d love to hear your thoughts! Did you find this article helpful? Drop your thoughts in the comment section below, Tweet me @paradichotomy, or jump over to Facebook! Speaking of Facebook, Monday, January 1st at 8 PM marks the one year anniversary to the hour of me checking myself into the psych ward (accompanied by my strongest support and caregiver). I’ll be doing a livestream at that time, reflecting on the year, the blog, and what “stigma” and “advocacy” mean to me. I hope you’ll tune in and join the conversation!

Thanks for reading, all! Happy New Year!




Self-Respect Effectiveness – Keeping Respect for Yourself

Welcome to the third and final portion of our DBT Interpersonal Effectiveness series! In the past two days, we’ve covered the techniques of Objective Effectiveness (DEARMAN) and Relationship Effectiveness (GIVE). Today, we’re going to look at the specifics of the FAST technique, which focuses on maintaining your self respect in conversations, conflict, and relationships.

Have you ever felt pressured in a conversation (or a relationship in general) to compromise yourself to keep someone else happy? I know I have. In the past, I’m ashamed to admit, I’ve compromised some of my most important beliefs and convictions to satisfy other people. This happened frequently in my marriage, for one, but has also occurred in other very important relationships in my life.

Setting boundaries and maintaining those relationships while also maintaining my values and beliefs has proven difficult, but I am slowly getting better at in, in large part due to these communication tools. Bullet points and silly acronyms aside, DBT is incredibly valuable and, I believe, relevant to everyone, whether you’re in recovery or not.

Some relationships, though, are simply unhealthy and toxic.

You can usually tell if a relationship is unhealthy based on whether or not you are able to maintain your values, the majority of the time, without being shamed or given a guilt trip. What are your values?

Sometimes, even that question can be difficult to answer. I couldn’t quite articulate most of mine when I was first asked to think about them. But when I was in the Partial Hospitalization Program, I was given a list of over 200 core values and simply asked to circle the ones that most resonated with me. If you need help identifying your core values, here’s a list of over 500 of them!

Once you’ve identified those values, you’re ready to step into the realm of using FAST.

By now, I’m sure you know the drill – it’s bullet point time. (I know, I hate them, too. Stick with me, though, because I wouldn’t be writing this if I didn’t think it was valuable knowledge.)

First, the questions to determine if you want to use FAST in any given situation:

  • Regardless of outcome, how do I want to feel about myself after this conversation?
  • What do I have to do to feel that way about myself?

Want some examples of when you use FAST? Here they are!

  • When you want to hold firm to your morals, and leave the conversation feeling that you did
  • When you need to respect your own values and beliefs over other people’s judgement or thoughts on those convictions

OK! Bullet points out of the way!

It’s Christmas Eve and if you’re like me, you may still have some wrapping to do… or all of your wrapping… or shopping… so let’s get FAST out of the way quickly. (See what I did there? Do you?)

Fair – While it is important to be fair to the other person, it is also important to be fair to yourself. Don’t forget to validate your own feelings, along with the feelings of the other person. Validation is a two way street, and even if you’re not getting the same respect you’re giving, you can still be there for your own feelings and give them the acknowledgement they need while also remaining civil.

Apologies – As in NO apologies. Unless you have done something to wrong the other person, don’t apologize. Don’t say sorry for making a request. Don’t say sorry for having an opinion or disagreeing. Don’t say sorry for existing and living your life in a way with which the other person may not agree. Keep apologies out of your body language as well. You have nothing to look ashamed for if you are simply making a reasonable request, setting a boundary, or sharing a different opinion. Nothing at all.

Stick to your values – Your own values. You are not required to invalidate your integrity or morals for anyone. No matter the threats; no matter the judgments, hold your ground. Your integrity is important, and if you compromise it, you will feel shame and guilt afterward which may follow you for a long time.

Truthful – Don’t lie. Don’t minimize or maximize your feelings or the situation. This one can sound a little tricky, but part of sticking with your values and morals is integrity. This can include not exaggerating or making up excuses for your own actions in a conflict, but also not making up excuses for the other person’s behavior.

That’s FAST! I’ll be honest, I’ve struggled immensely with this one. I tend to over apologize and make excuses for the actions and words of other people. I’ve compromised my values based on threats by other people. I’ve invalidated my feelings in order to validate the feelings of others. I’ve had a skewed view of what constitutes healthy give and take in a relationship.

A long while ago, I wrote a post on that topic called Are Your Relationships Healthy?, and in it, I share a tool called the “Relationship Report Card.” If you’re confused as to whether or not your relationship is healthy and respectful or unhealthy and damaging, I suggest looking through that older post. It really helped me figure out which relationships required each of the three techniques we’ve covered these past three days.

I hope you enjoyed this triple header of a series. I know I enjoyed reviewing the skills and getting them out there for you beautiful humans! I’d love to hear your thoughts and any questions you may have! Be sure to drop a comment below, Tweet me @paradichotomy, or take a look around the blog’s Facebook page!


If you’re celebrating, Merry Christmas from Parallel Dichotomy! If you’re not, I hope you are having a wonderful weekend and have been safe and well this holiday season.

In all seriousness, this time of year (Whether you celebrate the holidays or not) can be really rough. If you’re struggling, please reach out to someone.


***********GIVE, Interpersonal Effectiveness, and all DBT skills were developed by Marsha Linehan. I am not a professional therapist and these skills are not meant as a substitute for therapy. I’m simply sharing things that I have learned and found helpful along the way.

Relationship Effectiveness – Maintaining Important Relationships

Have you ever played an RPG video game? If you have, you know that you have a choice of reaction in each conversation in which your character engages. My favorite of these video games is the Mass Effect series. I loved playing through the entire thing three times. The first time, I played it exclusively being nice and polite to everyone I met, the second time exclusively “renegade”, not giving a single fuck who I pissed off, and the third time a combination of both.

In DBT and life in general, the goal would be the third option. Boundaries are important, but so is being an active, positive participant in your important relationships. The people that you care about deserve your full attention in conversation just as much as you deserve theirs.

Sometimes, giving that attention and remaining positive is very difficult, though. Let’s be real, conflicts occur in every relationship at some point. When you have a disagreement with someone you love, how can you resolve it in a way that saves the strength of the relationship.

We talked about Objective Effectiveness yesterday. Just like it’s important for us to protect our rights and boundaries in a relationship, it’s important that we respect others’ rights and boundaries, too. Have you ever gotten upset at someone you love and walked away, slamming a door on the way? Or maybe someone has refused to do something you request and you’ve said something like, “If you really loved me, you’d…” If these communication styles become a pattern, the relationship may become damaged beyond repair and you may lose someone you care about deeply. But that’s not the goal, right? The goal is healthy communication.


You know, nice, respectful, kind communication like this. (This is my “little” brother and I, we love each other and we are joking around in this picture. It’s New England for “I love you.”)

In the spirit of avoiding shouting matches with loved ones this holiday season, let’s talk about how we can interact with those people, even through disagreement, without hurling accusations, making threats, or trying to get them to either do or not do something out of a sense of guilt. I think, to an extent, we are all guilty of this at one point or another. We’re in a bad mood and we take it out on someone we love, or someone we care about does something that triggers our fear of abandonment or control and we flip out. I know I am. Our pasts frequently impact our present, and our emotions can feel all consuming. The question, then, is how can we be in relationship with someone without requiring everything be dependent strictly on our thoughts, feelings, and emotions at any given moment? How do we tale the power away from our emotion mind and give it to the middle ground, wise mind?

Guess what? There’s a DBT acronym for that! (OK, there’s a DBT acronym for just about everything, so I guess that’s not a huge revelation.)

For this particular skill set, the acronym is GIVE. Let’s get those bullet points out of the way again so that we can get to the meaning of GIVE. (How seasonally appropriate is that sentence?)

Remember how I said that each section of Interpersonal Effectiveness has associated objectives and questions to help you determine if it’s the right choice in any given situation? Here they are for GIVE:

  • Regardless of the outcome (if I get what I want out of this interaction), how do I want the other person to feel about me when we’re done talking?
  • If I want to keep this relationship, what do I have to do?

In what instances is GIVE most applicable?

  • When you want to act in such a way that the other person is not driven away and continues to like and respect you
  • When you need to balance your short-term goals (like conflict resolution) with the long-term goal of preseving the relationship
  • Simply wanting to improve and maintain a positive relationship with someone

Easy enough, right? Isn’t that our goal in any important relationship? Let’s get right to the specifics of how to achieve those things.

Gentle (be nice, be respectful)  – Don’t attack, don’t make threats, don’t judge, and don’t sneer. If someone you care about is upset, don’t tell them that their feelings are “stupid”, don’t tell them “you should…” or “you shouldn’t…”, express any anger you are feeling with words only. Stick to “I statements” instead of “You statements”. (Don’t say “You’re making me feel angry”, say, “I am angry right now because I feel I am not being heard.”)

Interested – be an active participant in a two way conversation. Listen to hear and understand, not to reply. Listen to the other person’s point of view and their perspective. Respect the other person’s boundaries, too. If they say that they need to have the conversation at a later time, agree and be patient with them.

Validate – with both your words and actions, show that you understand where the other person is coming from, even if you disagree with them. Try to see the situation from the other person’s perspective, then say something that shows that you understand. (Example: “I hear you saying that when I said [x], you felt [y].” “I see that this conversation is difficult for you.”)

Easy manner – If you’re both having a hard time, check in with your body. What are you feeling physically and how can you calm any tension? Try to keep your body language relaxed. Throw in some humor if appropriate. Try to keep your emotions in check. If you’re asking for something, uses a “soft sell” instead of a “hard sell”. Don’t demand, don’t be rude, don’t manipulate.

That’s it! That’s GIVE! Like all Interpersonal Effectiveness, this one takes practice and mindfulness, but going into the holiday with this in the forefront of your mind, I hope, will be helpful. It can be hard, especially if emotions are running high, but you and I know that close relationships are worth the hard work of preservation.

As always, I’d love to hear your thoughts! Do you find this information helpful? Drop a comment below, Tweet me @paradichotomy, or hop over to Facebook and join the conversation there! Speaking of Facebook, I spent some time doing a live stream answering some of the questions I’ve received through the blog email and Let’s Talk tab! If you missed it, don’t worry! You can watch it here! If you have questions, please email me at paralleldichotomyblog@gmail.com, hit up the Let’s Talk tab, leave them on the Facebook page, or Tweet them to me, as I’m already prepping for the next live stream. (The next one will come with more warning, I promise.)

Finally, be sure to check back tomorrow for the final installment of this triple header! Tomorrow’s post if all about maintaining your elf respect and values in communication and relationships. Very important information. You won’t want to miss it!


***********GIVE, Interpersonal Effectiveness, and all DBT skills were developed by Marsha Linehan. I am not a professional therapist and these skills are not meant as a substitute for therapy. I’m simply sharing things that I have learned and found helpful along the way.



Objective Effectiveness: Getting What You Want

Welcome to day one of three – a DBT triple header on Interpersonal Effectiveness! While I planned to share this information back in August, I thwarted my own intentions, not only in the blogosphere, but, well, with everything. I think that the end result may have been for the best, though, as I can’t think of a more relevant time to share some skills for holding boundaries, maintaining relationships, and keeping your self respect than the three days leading to the “most wonderful time of the year.” (I recognize that not everyone, some of my readers included, celebrates Christmas, but there are many reasons we find ourselves around family and friends this time of year, and to be completely honest, my family does celebrate Christmas – this is a crash course/ reminder for me as much as you.) Even if you don’t have any holiday plans coming up, good news – this stuff is effective year round!

Now, I did manage to write the introduction to Interpersonal Effectiveness back in August, and I have linked it above for your convenience. But I never got the chance to break down the three areas I was hoping to explore in this overview series. No time like the present, though, right? (No Christmas pun intended.) Speaking of presents, though, I am sincerely apologetic for not getting you the techniques for “getting what you want from people” out in time for your Christmas list writing. Actually, that’s not what this approach is for, but there are going to be a lot of bullet points and I know that that is dull as hell, so I’ve got to squeeze in the mildly funny stuff where I can.


Holiday Cheer or… something.



OK! Back to DBT Interpersonal Effectiveness. We’ll be looking at three techniques over the next three days.

The first technique is called D.E.A.R. M.A.N. (Heretofore referred to as DEARMAN, because I don’t want to type all those periods.) If you remember from the original post, there are different types of relationships and different objectives in the dealings within those relationships.

Each of the techniques we’re going to looking at relates to those different types of relationships and the different goals you have within those relationships in the moment.

Each also has associated questions and goals to help you determine if it’s the right fit for what you’re trying to accomplish. For DEAR MAN, you need to go into the situation with a very clear idea of your objectives in the conversation. Here are some good questions to ask yourself before jumping into using this effective communicative approach:

  • What specific result or change do I want from this interaction?
  • What do I have to do to get that result? What will be effective?

Now that you’ve asked yourself those questions, it’s important to know not only why you would want to use this technique, but also why it’s ok to use this technique. It can be really hard to hold firm in boundaries with people. DEARMAN is a little hard hitting. I know that I struggle with this communication tool, because I always feel like a massive jerk when I use it. That said, it does have it’s place. When should you use is? Here are some concrete examples of important goals you have every right to work toward in your relationships:

  • Protecting and receiving your legitimate rights
  • Saying “no” to something that you do not want to do or find unreasonable
  • Getting another to take your opinion seriously
  • Conflict resolution

OK. How are you holding up with the bullet points? I’m already feeling my mind and eyes glaze over a little. Let’s take a quick break. We’ve all been in situations of feeling like our boundaries are being violated. When your relationships are based in a pattern of blurred boundaries, it can be hard to even recognize that you need to stand up and protect your own well being. If you’ve been following the blog since the beginning, you may have a vague recollection of me mentioning something called the “personal bill of rights”. It’s an excellent place to start. If you need a refresher, here they are. IMG_20171217_122024_196 (1).jpg

As you may have deduced, my ever intelligent readers, this is my own copy of these. The highlighted ones are the points that really stood out to me while I was in the Partial Hospitalization Program. All are applicable and different ones may stand out to you. Please ignore my highlights and stars. 

Reading that list, do any jump out at you? Did you read through that list and think “Wouldn’t that be nice?” or “Wow! It never even occurred to me that that was possible!”? If you had that experience, then DEARMAN is going to feel simultaneously uncomfortable and like one of the greatest things you could possibly have in your toolbox.

OK, let’s rip the band-aid off and get the last “list” portion of this post over with. And that, of course, is the meat of DEARMAN. You’re probably wondering what, exactly, does the acronym stand for? I’m so glad you asked!

the DEAR portion is action based (what you do in the conversation.)

Describe the situation. Stick with facts only. Tell the person exactly what you are reacting to. (EX: “You said that we would get together this weekend, but then didn’t respond to my texts to make concrete plans.”)

Express your feelings and opinions. Don’t assume the other person knows how you feel. (EX: “I feel hurt and disrespected and devalued.”)

Assert yourself by asking for what you want or saying no clearly. Don’t assume the other person will figure out what you want. Remember that other people cannot read your mind. (EX: “I would really like it if you would text me back, even if something comes up and you have to cancel plans.”)

Reinforce (reward) the person ahead of time. Explain the positive effects it will have on the relationship. If necessary, also clarify any negative consequences. (EX: “I really like hanging out with you. Our friendship would be stronger if we communicated better.” or “You’ve done this a few times, my time is valuable to me. If I think that we have plans and you don’t tell me we don’t, I’m setting aside time that could be used for something else. I would prefer to use my time wisely, so I need to know if we are getting together so I can plan accordingly.”)

OK, so, that’s the DEAR portion of tonight’s broadcast. What are you thinking and feeling? Do you feel like you are able to do this more often than not in your personal life, or do you feel like this is an area in which you need some practice? Or, like me, have you completely shut down due to anxiety at the mere thought of using something like this? “Assertive” and “Sheila” have not traditionally appeared in the same sentence. I am growing exponentially in this area, though, and that is due, in part, to the Interpersonal Effectiveness skills I’ve learned. So, I promise you that this stuff works!

Let’s hit the MAN breakdown and then we can get to actual application and conversation.

MAN is about how you approach the conversation.

Mindful Don’t get distracted and don’t get off topic. Keep your mind on your goal, and on the reasons you are justified in advocating for yourself. Check in with yourself. This will help you stay calm and collected and effective.

Appear confident. Try not to look at the floor or stammer or whisper. Try to avoid saying things like “I don’t know” or “I’m not sure”. Both your tone of voice and body language should convey confidence.

Negotiate This one may seem to counter some of the other points in this strategy, but make sure that you are aware of the areas of give and take going in. Don’t compromise in a way that pushes past your boundaries, but be willing to be flexible within your boundaries. Be willing to give and take a little. Offer solutions to the problem, and ask the other person if they have any thoughts on possible solutions. If you’re saying no, offer to do something else that you are comfortable and/or able to do. Focus on what will work for both of you, but maintain your boundaries.

Alright! That’s the breakdown of DEARMAN.

We all know that holding boundaries can be difficult, especially within ingrained relationships with well-established dynamics, but it is never too late to start holding them. If people in your life are not respecting your personal, legitimate rights as a human, or if you find yourself feeling “Required” to say yes to things that you do not feel able to do (or even things that you do not want to do), you have a right to assert yourself.

DEARMAN is an incredibly assertive technique. But there are still certain ways of implementing that will get you the best end result.

In my personal life, I have someone who will ask the same question repeatedly and try to guilt me into giving the answer he’s hoping for. This has been a pattern in our relationship for over ten years, and, only after learning about DEARMAN was I able to begin to break it.

Do you have a current situation in which someone is violating your boundaries and space? See if this might apply to that situation.

First, I tried to ignore these requests/ threats from this person. When that didn’t work, I tried what’s called the “broken record” response. He would ask, and I would say no. He would guilt, and I would say no. He would start verbally attacking me, and I would say no.

This is where describe comes in. Remember, that’s just facts. So it’s not saying something like, “Are you deaf? I said no!” or “You’re obviously refusing to hear what I’m saying.” Instead, it’s simply, “You’ve been asking me to do this for days, and I’ve told you no several times.”

Then, I expressed feelings. In my situation, I said, “I’m feeling very frustrated by this and I cannot continue this conversation.” It’s important to keep it short and assertive and, no matter how upset you are, to avoid personal attacks. If I’d personally attacked this person, I would be getting pulled into his heated emotions and it would then become a shouting match and all of my interpersonal effectiveness would be out the window. I did not say, “You’re so fucking defensive and aggressive about this! I can’t stand you!” because he would have responded with something like, “Oh, I’m aggressive? You’re the one who can’t {x,y,z}” Can you see how that would have gotten us off topic?

Following that, I asserted myself. I said, “I’ve said no, my answer is not going change. Please don’t ask me again.” Again, I kept it short and to the point. And I did not personally attack him. I did not yell “Shut up and listen to me!” or anything to that effect.

Finally came the reinforcement phase. I said, “We are talking in circles. I know that my answer isn’t going to change and I think that this conversation is becoming frustrating for both of us, so we need to end it for now so that it doesn’t turn into a fight. We can talk more tomorrow and try to come up with something that will work for both of  us.” I didn’t threaten to never talk to him again, I didn’t yell at him. I held my ground in a Mindful and Assertive way and was willing to negotiate within the realm of my own boundaries.

This technique takes practice, but if you move into the holidays knowing that you will be interacting with someone who does not respect your boundaries, you can mentally prepare for that and be ready to hold your ground. You can even practice a sort of “script” ahead of time, if you feel that that would be helpful.

And remember, ultimately, you are not required to interact with anyone who is treating you poorly, violating your boundaries, or abusing you. You can refuse that engagement, especially if you know that you are especially emotionally vulnerable. (Which, I think, many of us are around the holidays.) If you know that a conversation will result in heated conflict, try to ignore it. If not, though, you can break out these skills. If it’s someone with whom you tend to argue, they will be blown away by the calm, firm, assertive manner in which you are approaching the conversation, I promise.

Alright! That’s part one of Interpersonal Effectiveness! I hope you found it helpful despite all the bullet points!


Here’s a cat picture for your time!

TOMORROW – pop back in the GIVE technique, which deals less with assertiveness and more with maintaining the important relationships in your life. This technique is a fantastic reminder of the best ways to listen and speak to those you care about in a way that keeps the relationships strong.

As always, I’d love to know what you think! What are your thoughts on DEARMAN? Drop a comment below, give this a like and/or a share, or Tweet me @paradichotomy. You can also hop over to the Facebook and join the conversation!

***********DEARMAN, Interpersonal Effectiveness, and all DBT skills were developed by Marsha Linehan. I am not a professional therapist and these skills are not meant as a substitute for therapy. I’m simply sharing things that I have learned and found helpful along the way.




Guest Post: Living With Borderline Personality Disorder

Welcome to Parallel Dichotomy’s second guest post! I’m so happy to be hosting Kelsey’s thoughts on Borderline Personality Disorder and the stigma attached to it. I’ve been hoping to run a piece on BPD for a while, as I truly believe it is one of the most stigmatized diagnoses in the world of Mental Health. As a professional, I heard the term tossed around as a warning. “This client is borderline so you need to have incredibly strong boundaries.” or “This client has borderline, so take what they say with a grain of salt.” These comments always struck me as somehow unfair, but I’ll admit that the stigma seeped into my own professional and personal perspective.

Like many, I was just as susceptible to societal stigmas – at least, until I was diagnosed with Bipolar Disorder. I never stigmatized depression, anxiety, or post traumatic stress because those things I “understood”, even before  I had my own experiences with them.

Still, the specifics and the truth of other mental health diagnoses were completely lost on me.

As a teenager, I thought that schizophrenia was “the worst possible thing someone could have”, and Bipolar was a close second. My fear of these diagnoses followed me well into my 20s and into my professional perspective. I was completely unaware of BPD until I started working in the mental health field, and my perceptions of that were, unfortunately, shaped by the unfair opinions of bosses and colleagues. And those opinions, I am sure, were informed by the views of their bosses and colleagues.

Ultimately, all of this stigma comes from the older wording of the diagnosis, which includes words like “manipulative” and “attention-seeking.”

My perspective on mental health diagnoses truly began to shift when I was admitted to an inpatient unit and, subsequently, diagnosed with PTSD and Bipolar. I’m ashamed to say that it took me that long, especially as someone studying and working in the mental health field. But, I suppose, better late than never. If you missed last week’s post on my psych ward, please feel free to check it out! It was truly the turning point in my life, wherein I shifted from “professional” to “advocate.”

Because I do not have the experience of living with BPD, I did not feel qualified to write on the topic. Nor did I feel that it was “my story to tell.” I am so thankful to Kelsey, host of The Brave for allowing me to share a portion of her story in this space.

So, without further ado, let’s get to Kelsey’s wonderfully written story of being diagnosed and coming up against the stigma around such a diagnosis first hand.


I had to fight for years to get a diagnosis of borderline personality disorder, and everyone I met along the way kept asking me why I wanted to be diagnosed with “such a thing.” Doctors, nurses, friends and strangers alike all asked me if I was aware of the huge stigma BPD carried, of the judgments and prejudices from society and mainstream media. In my quest to be diagnosed, I learned a lot about BPD through the eyes of others, and every single word uttered was horrifying to me, but most shocking of all was the conclusion that people with BPD are “manipulative.”

I spent months reading books and blogs, watching YouTube videos and talking to people in the hopes of educating myself about the disorder. I saw myself in almost every symptom, making me a “classic, quiet borderline.” Some books and websites were compassionate, reassuring and validating, but the majority made me feel like I was some super villain and that I ought to be avoided or even exiled for my… personality.

When I finally got my diagnosis, after a tidal wave of emotions was witnessed firsthand by a crisis team, and after my second serious suicide attempt in a matter of weeks, I was fully ready to hand back the diagnosis with a not-so-polite “f**k you!”

For months on end, nurses came into my house and upon looking at my history, made their mind up about me in an instant. All of a sudden, I wasn’t Kelsey, a 20-year-old with a mental health issue. I was… Kelsey, a 20-year-old woman who acts like a child to get what she wants. Kelsey, a burden to everyone around her. Kelsey, manipulative and deceitful. Kelsey, who might not actually be suicidal at all but uses it because she knows it’ll get her the help she thinks she needs.

I heard firsthand how my behaviors were manipulative or attention-seeking, and I stopped reading books on BPD because almost all of them told me I should be avoided. My self-esteem and self-worth plummeted to an even lower level than I thought possible, so much so that I even bought books for my favorite person on “how to live with a borderline.” Naturally, she was disgusted by this book and threw it straight in the trash. Naturally, she saw how offensive and harmful these books were to anybody with BPD.

One night at a friend’s house, I came across a website for men who were “in recovery” from their relationships with “a borderline.” We all laughed and joked at how ridiculous such a site was. Then we found an article called “How to Train Your Borderline,” and once again, we laughed and joked at the absurdity of such a piece. But months later, I still look back at that article and I can’t help but think – is this how the world really views us?

I didn’t want to be diagnosed with BPD for any other reason than I wanted targeted treatment. After years and years of my doctor sending me away because he didn’t know how to deal with a person in crisis, I wanted to finally be understood by medical staff. Instead what I got was a “one size fits all label” that branded me as untrustworthy, aggressive and manipulative. I couldn’t help but notice that since my diagnosis, nurses would no longer be sent to my home by themselves but instead in sets of two. I know I have a particularly paranoid mind, but that spoke volumes to me about how I couldn’t be trusted. Since my diagnosis, any self-harm or suicidal thoughts have been brushed off as cries for help or mere symptoms of my disorder.

I spent years asking doctors what was wrong with me, why I was so emotional, why my mind instantly turned to suicide if something even slightly scary happened in my life. When I was tired of searching for answers about myself, I turned to other people who I believed could “save me.” I was in a string of unstable, abusive relationships because I needed to feel loved, despite the violence or the abuse I received. I turned to alcohol and gambling. Little did I realize that everything I turned to was actually a symptom of my BPD. I fought for years to get this diagnosis so I could access correct treatment and targeted medication, and while my medication has changed to suit my disorder, the treatment I have received by medical professionals has left me feeling more broken and more abandoned then ever.

I recognize that BPD is one of the most difficult disorders to treat for a number of reasons. We tend to engage in fast and fleeting relationships, be it romantic, therapeutic, or friendship. We may experience “black or white” thinking, meaning we “spilt” on people very easily, putting them in a mental box labelled either “good” or “bad.” At our worst, we may “test” people to see if they will abandon us. Without even recognizing it until afterwards, I test people on a daily basis because I am so scared of them leaving me. My previous therapist cut our sessions short because I told her I was suicidal, to which she replied: “I will not waste my time treating someone who doesn’t want to be here.”

I do understand why my diagnosis makes me a harder case to treat, but don’t I deserve the same treatment, the same level of compassion and understanding as any other person with a mental illness? There are many therapists out there who flat-out refuse to treat people with BPD because we are considered to be manipulative and mentally draining. None of my actions are manipulative by choice, and everything I’ve ever said or done is out of an uncontrollable fear of abandonment or desperation. I also do not intend to be so intense or mentally draining, even though I can clearly see that’s how I am being perceived. And believe me, as much as you might loathe me, I can assure you I hate myself than you can even imagine. I already feel like society’s castaway and the most unworthy and unbearable of people. So when you dedicate yourself to the profession of psychology, try to be aware that not all of your patients will be a “quick fix.” You chose this field because you want to help people. That should mean all of us.


There you have it! I’d love to hear your positive and compassionate feedback. Let’s all send Kelsey love and not perpetuate the stigma any further. Do you live with BPD or love someone who does? Share your thoughts in the comment section below, or Tweet them to me @paradichotomy. Make sure to hop over to Kelsey’s blog, too, and take a look around!

If you’d like to write a guest post for Parallel Dichotomy, please email me at paralleldichotomyblog@gmail.com or drop a message through the “Let’s Talk!” tab.

Thanks for reading! Be sure to tune in Friday, Saturday, and Sunday for the Interpersonal Effectiveness triple header! Hopefully it’ll give all of us some techniques for navigating all the people we’ll see over the holidays!

5 Unexpected Things I Found In The Psych Ward

If you’re familiar with my story, my journey into true mental health advocacy began in the Two West Psychiatric Wing of Dartmouth-Hitchcock Medical Center in January of this year. This, it seems, is a bit taboo to talk about. No one can seem to understand why one would willingly share that a hospitalization occurred. No one seems comfortable talking about it. In conversations with friends and family, more often than not, if it comes up at all, it’s referred to as, “You know… when you were struggling” or “Well… in January…” or simply an awkward and hasty “When you were in hospital…” with an unspoken plea for an immediate change of subject.

No one asks what it is like to be on a psych unit, but you can see the curiosity beyond the silence, the unasked questions in the awkward pauses, and the speculation in the avoidance. With the year rapidly coming to an end, and eleven months of reflection under my belt, I’ve decided to answer the question people don’t ask. Not because they don’t want to, mind you, but because it’s awkward. Psychiatric Hospitalization is mythical in out culture. From horror movies to historical documentaries, what people believe happens beyond those locked doors is infamous and ingrained. Rather than challenge those beliefs, people tend to avoid asking any real questions and then engage in an impressive dance of cognitive dissonance and denial. (Really, there’s an interesting response by those not in crisis.) 

But, what’s it actually like to be in a “psych ward”? 

For me, at least, it was nothing like I expected. I went in completely unaware of what I was walking into, but I definitely held some of those same preconceived notions. As such, I was understandably terrified.

I don’t think anyone expects that a psychiatric unit would be “fun”, but I also think that there is a lot of misinformation out there. A collective idea that a psychiatric ward is the worst possible place you could end up.

My feelings on my own experiences are mixed, as are the feelings of many others who have had the unique experience of an inpatient mental health hospitalization.

Still, my experience was nothing like the depictions you see on television or read about in books. I’d like to share with you 5 of the things I learned about psychiatric hospitalization during my seven day stay at Dartmouth.


There is a “special section” of the ER for potential psych admits.

My best friend took me to the hospital. After speaking to the secretary and an intake nurse, and after my name was called, we were lead through the “standard” portion of the emergency room to a back wing. It was sectioned off and had two or three exam rooms, I think. Only they weren’t exam rooms. The room I found myself in was set up like a therapist’s waiting room. Two arm chairs. No bed. An open door with a security officer sitting in the hallway. I wish I’d taken a picture of the “quiet room,” as it was called. Had I known that this blog was in my future, I would have. As it is, I only took one picture while waiting to be admitted:


Because… what better time for a selfie? Am I right?

In the background of that picture, though, you can sort of see the “soothing” grass-land trim that traced the entire room. On the side opposite us was a mural of a lake. The colors were all blues and greens and beige. Except for the black security camera in the corner, of course. I waited, along with my best friend, for over 7 hours in this room. I was interviewed, I had my blood tested for any potential physical causes for my symptoms, and, ultimately, I was told that I would be admitted if I agreed. And agree I did. Through all of the terror, uncertainty, and honestly muddled and confused thoughts, one thing was clear in that moment: the professionals knew I needed it, my best friend knew I needed it, and, on some level, I knew I needed it. Despite some of the other points in this blog post, it was the right choice and it saved my life.


Inpatient Units in Hospitals are Based in Psychiatry, not Psychology.

This one really took me by surprise, even though “psychiatry” is pretty clearly implied in the term “psychiatric unit”. I was expecting a few days of intensive therapy. I was expecting that I would be required to talk with a therapist frequently. In this particular unit, however, there was absolutely no individual therapy. The focus was strictly on medication and skills to cope. There was no “processing” the events that lead to my hospitalization (except when one nurse attempted, but the effect was adverse, not positive*). Unless you wanted to talk with a Chaplain (I did not), one on one conversations with professionals were non-existent. The experience of being in a psych unit is not about laying yourself bare and sharing your feelings, it is about crisis stabilization and, in theory, securing follow-up services for all that emotionally messy stuff. (I say “in theory” because I unfortunately saw first hand that that is a luxury not everyone can access).


Group Therapy Actually Helps.

While individual therapy was not available, there was Group Therapy. A lot of it. CBT groups, DBT groups, Art Therapy groups, Mindfulness groups… in fact, I was essentially in one group or another from 9 AM to 4 PM every day. Again, these were not “share your feelings” groups, they were skills based. They were recovery based. They taught truths applicable to every single person in the room, regardless of what landed them in the hospital to start with. I found these groups incredibly helpful, as they allowed me to detach from my specific situation enough to absorb the knowledge being taught. It was in these groups that I learned the majority of the “bumper sticker wisdom” that actually helped me begin what has proven to be a turbulent but persistent journey toward wellness and recovery.


“Voluntary admit” is a loose term.

When one “voluntarily” checks oneself into a psych unit, one may be under the impression that walking out the door at any minute is an option. One would be incorrect. If you verbalize a desire to harm yourself or another, the option is completely off the table. But even if you are not suicidal or homicidal, the process of leaving is, well, a process. Yes, with much fighting and a complete lack of suicidal ideation, you can check yourself out Against Medical Advice, but you can only do that once you’ve met with a doctor. That doctor has to tell you that you are doing so against his advice, and you have to sign a paper stating that you met with him and that you understand that. There was a girl on the unit while I was there who decided to check herself out. It took a day and a half after she stated that she wanted to leave for her to actually leave. The typical stay on a psychiatric unit for stabilization is only 2-3 days. I went in with the plan to discharge in 3. Then it became 5. Then 7. Had I asked to leave at any point before the treatment team agreed, I would have been denied that request as I was struggling with suicidal thoughts. So, while I voluntarily admitted myself, and I did voluntarily stay, knowing that leaving was not an option sort of took the “voluntary” out of “voluntary admit”.


No one there was “crazy”

On this point, many will disagree – even in the mental health community. I know many advocates who are the first to say “I’m completely nuts!” But I am not that kind of advocate. I am a human who lives with chronic medical conditions which happen to be of the mental health variety. I don’t deny my illness, but I also don’t consider the term “crazy” to be very helpful in the dialogue against stigma. And, while I certainly felt crazy, I quickly learned that no one on that unit, myself included, was. Not the young man with Schizo-Affective Disorder who would pace and talk to himself, not the young woman who was so anxious she physically shook for four days straight and had a trembling voice the entire time, not the girl who had flashbacks just like me, not the old man who had been on the unit for months after a suicide attempt and was receiving Electro Convulsive Therapy, not the kid who was so depressed it took him three days to speak and five days to crack the slightest hint of a smile, none of them. And not me.

A funny thing happens on a psych ward. You’re terrified at first, but then you realize that the “gig is up”, so to speak. If you’re on a psych unit, there is no room to pretend you’re OK and all pretense goes away. No matter the struggles each person on that unit was facing, those who had been hospitalized before comforted and encouraged those of us who had not. We all found things to talk about, and even laugh about together. I’m still friends with some of the truly wonderful people I was lucky enough to meet in those seven days. That week changed my life for the better, even though there were undeniably triggering, frustrating, and upsetting moments. It was in the psych ward that I first began to realize that I was not “crazy”, I was simply struggling. (This has been an area in which I’ve needed frequent reminders, but, as I learned in group therapy, “relapse is part of recovery” and “recovery is a process, not an event.”)

BONUS FACT: The psych unit is not even close to a cure all. You will not leave feeling “healed”, but it is a fantastic first step toward true recovery if you are in crisis. Despite my mixed feelings, it was a necessary and helpful resource for me.

There you have it! Now, I want to acknowledge that I was at one hospital at one moment in time. This article reflects my subjective experiences and not the experiences of everyone. It is also important to note that I checked myself in of my own volition. I was not psychotic or brought in by police or EMS personnel. Many in our community have had these experiences, and they can be traumatic. I am not seeking to invalidate that trauma, simply sharing my own experiences. Even with my relatively positive stay, I had some distinct realizations around the lack of Trauma Informed Care (*read more about my adverse nurse experience here) as standard practice on the unit. Let me be clear, psychiatric hospitalization is the absolute last situation in which I want to find myself ever again, unless, of course, I need it. In that case, the hospital is the first place I want to be.

I hope you enjoyed this week’s post! Next week, Parallel Dichotomy is going to be a busy place! On Monday, I’m hosting a wonderful guest post by Kelsey, host of the blog The Brave. In this post, she shares her experiences with the immense stigma surrounding Borderline Personality Disorder. You don’t want to miss this honest and informative piece, believe me! Following that, we’ll have a triple header – three straight days of new posts, starting on Friday, covering the three sections of Interpersonal Effectiveness. I’m running this series in quick succession close to the holidays because… well, what better time to know how to effectively engage with people with whom you may not quite see eye to eye. It’s my blog-mas gift to all of you, my beautiful readers!

Thanks for reading! As always, I’d love to hear your thoughts, be it your experiences with hospitalization if you’ve had one (or more), or, your reaction to reading this as someone who’s never been hospitalized. Drop a comment below, or Tweet me @paradichotomy. Also, feel free to jump over to Facebook, give the page a like, and join the conversations happening over there! Finally, if you found this insightful and helpful, please feel free to share it!

6 Ways to Survive the Winter

It’s snow secret that winter sucks. It brings a blizzard of unwanted feelings to those of us who suffer with depression. While the title of this post may seem lighthearted and rings like a sleighbell, don’t be sled to the wrong conclusion. “Winter Blues” are a slippery slope that can easily become an avalanche and bury us.

OK, done with the puns. Seriously, whether caused by Seasonal Affective Disorder, heightened sensitivity to change in seasons common with Bipolar disorder, a Depressive Disorder that gets worse as the days grow short and cold, or simply bad associations with “the most wonderful time of the year”, winter depression is a very real experience for millions of people each year, and it is a serious topic.

I live in New England, and winter is the time of the year for increased symptoms for those of us living with mental health struggles. I am no exception to this rule. The days are shortened and it’s often dark only an hour after I get out of work. It’s cold and windy, and often the roads are slick with snow or completely frozen, making travel difficult or impossible. Staying indoors is more appealing than it is in the warmer months, and the blankets and comfort of a bed are even more alluring than normal. All of these facts contribute to a lack of motivation and an increase in depressive symptoms for me, and many others.

IMG_20171126_201542_316 (1)

This is my cat, The Lord Commander Jon Snow, refusing to come inside despite the fact that he’s clearly miserable. Don’t be like Jon.

Winter is here in northern Vermont, and, much like my beautiful cat’s namesake in the Night’s Watch, I’m bracing myself for the coming onslaught and trying to prevent myself from joining the legion of the walking dead.

In the past, I’ve simply fallen into the helplessness and hopelessness of the winter months. I always know it’s coming, but I never take steps to preempt any of the difficulties ahead. I’m usually resigned to the fact that winter is also Depression Season for me. This year, though, I’m trying something new. I’m planning ahead. In the spirit of trying to survive the next 5 months without falling into a deep hibernation, I have some specific strategies I intend to use this winter that I’d like to share with you. This is a strategy list I’ve been compiling these last few weeks. I’m hoping it’s helpful to all of us.


Isolation is Bad

For me, it is far too easy to cut people out of my life. At the height of depressive episodes, I’ve gone longer than a week without leaving my apartment save one trip to the store for toilet paper. This did not even occur in the winter. And we all know it’s far easier to stay inside when it’s cold, snowy, iced over, and dark outside. This winter, I am forcing myself to make plans with friends I know will make me keep them in an attempt to stay ahead. It’s key to have friends and/or family that you know will hold you accountable for keeping the plans that you make. Personally, I’m connecting with friends who also struggle in the winter, and making a sort of “Accountability Buddy” system. We are all aware that winter is the hardest of the seasons for all of us, and that we need to make sure that we see each other frequently to avoid falling into the trap of a near-complete lack of meaningful human interaction.



Get Light Exposure When You Can

Letting light into our lives is important when battling depression, and I don’t just mean the metaphoric light. Actual, real, UV rays like we get from sunlight are very important in combating depressive episodes. Some people use light boxes for this. But light boxes can be expensive. I certainly don’t have the disposable income to get one. So, my plan is to go outside. I know, I know. It’s cold and miserable. In the area of Vermont in which I live, at least a few times a year we get “frostbite warnings” which advise all of us chilly citizens not to be outside with any exposed skin for longer than 15 minutes at a time to avoid getting frostbite. Around February, negative temperatures are common occurrences. I believe that the lowest temperature I’ve ever seen is -35 fahrenheit  with a wind chill factor of -50. So, I don’t say “go outside” lightly. My plan is 10 minutes in the morning, 10 minutes on my lunch break, and 10 minutes right after work. A minimum of 30 minutes of light exposure is recommended, so that’s my goal. If going outside is too intimidating of a task, or it really is just too cold, I’ll sit by windows as often as possible. In my understanding, anything helps.


Find a New Hobby or Build on an Existing One

Personally, I need activities to occupy my time and mind when I am home, especially when my daughter is with her father. I enjoy playing guitar, reading, and writing. As you can see, mine are pretty exclusively indoor, but there are fantastic outdoor hobbies one could have to get through the winter and get that light exposure and fresh air – snowboarding, skiing, snow shoeing, snow sculpting, etc. These things do not appeal to me, but they may to you, so I’m listing them. This winter, I’ll likely be focusing on expanding on my current hobbies rather than picking up a new one. While I love watching sports and sci-fi, I’m going to try to limit that and focus more on the hobbies that engage my mind. I know that staring at a screen and getting sucked into a new show tends to fuel my desire to isolate, and is therefore counterproductive. Whatever your current hobbies, though, make sure you have at least one or two you can focus on, or, if you don’t have any, pick something you’ve always wanted to learn to do and give it a go!


Make Plans for Spring/ Summer

When the winter has really got you down, think about what’s to come. When I’m depressed, I try to remind myself that it will pass. It always does. I’m going to apply that same philosophy to winter in general. When the days are dark and cold and miserable, I’m going to think of all the things I’ll do once it’s warm and light again. My favorite parts about the warmer months are hiking, bonfires, swimming, taking day trips, and going to Boston. Planning for these things builds a sense of excitement and anticipation. It’s also a fantastic distraction technique. Googling places which I can visit in a day, trails I can hike and explore, and planning nights full of barbecue, bonfires, and laughter with friends and family will, in theory, help keep my mind off the dreary cold.


Find Someone to Help

If you’re so inclined, find somewhere to volunteer. Helping others and positively contributing to our respective communities can increase our sense of self worth while also providing a tangible distraction from our own depression and getting us out of the house. Honesty time: I’m not sure if I’m going to use this trick. I’ll likely have my hands full with work, my daughter, and the rest of the techniques on this list, but I can see the potential in using it as a coping skill, which is why I’m adding it to the list. Look into local nursing homes, food shelves, soup kitchens, youth mentoring programs, or hospitals for volunteer opportunities. Or even just be there for a friend or family member who’s struggling as well. If you choose that option, though, be sure to do so with healthy boundaries in place.  


Find Comfort

Winter is cold. Once you’ve gotten your sunshine for the day, it’s actually really beneficial to your health to stay warm. (And not just to avoid hypothermia or frostbite.) After the tasks of the day are done, indulge in those comfy blankets, put the heat up if you can, if you’re lucky enough to have a wood stove, sit next to the fire with a nice, warm cup of tea. Find some comfortable fuzzy socks. Curl up with a book or a favorite show. Everything in balance. Music is a huge part of my life, so, while I’m in comfy clothes and blankets and relaxing with tea, sometimes I like to listen to music instead of watching or reading something. I have a playlist specifically for when I’m feeling depressed. It has upbeat, positive songs that also validate my feelings. One of my go to albums when I’m having a hard day and I want to get out of my head is “Positive Songs for Negative People” by Frank Turner. He populates my depression playlist, along with Indigo Girls, Modest Mouse, Alanis Morissette, Third Eye Blind, Goo Goo Dolls, Bastille, Linkin Park, and The Lumineers, among others. (Judge away if you’re so inclined. I like it, and that’s the point – find the music that lifts you up and listen to that.) The idea is to find things that comfort you and use them! 


  • Don’t ICE-OLATE
  • Keep those days merry and bright (with light)
  • Slide into a new hobby or brush off an old one
  • Think of The Most Warm-iful Time of the Year
  • Help dig out a neighbor
  • Chill out, stay comfy!

OH! And don’t turn a cold shoulder to my winter pun-derland.

There it is! Six ways you can beat the winter blues! Do you have any strategies that didn’t make the list? Please leave them in the comments below or hop over to Facebook or Tweet me @paradichotomy. Let’s share tips and tricks with each other to make sure that we all enjoy this winter as much as possible or, at least, survive it!

NOTE: This list is preemptive. If you find yourself in a rough situation, check out these other tips for getting through: Top 5 Ways to Get Through a Bad Situation (Without Making It Worse) and Grounding Techniques. And, of course, if you’re worried that you or a loved one may be at risk of self harm, call 911 or reach out to the National Suicide Prevention Lifeline at 1-800-273-8255.