… Yeah, But What I’m Feeling Really Sucks!

Welcome to the fourth and final part of this series! If you’re new, I’ve been giving a quick overview Emotion Regulation, which is one of the four “pillars” of DBT treatment. If you haven’t yet, or if you need a refresher (it’s been a minute since I last posted on Emotion Regulation, I know, more on that later), I strongly suggest you read part one: Emotion Regulation – What is That?!, part two: What Am I Feeling? (And Why It Matters?), and part three: OK, I Know What I’m Feeling… Now What? before continuing here. If you’re all up to date, then read on, Macduff*!

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Ahhhh… the return of the Rat’s Nest! It just wouldn’t seem right to finish this series up without it. Besides, untangling the Rat’s Nest happens to be the best way to tie up this topic! (See what I did there?) The final portion of Emotion Regulation is “Decreasing Emotional Intensity”. There are some specific tools and tricks to greatly reduce the negative feelings we don’t want and, in some cases, even get rid of them completely. As with everything else in DBT (and any therapy or healing work) there is no instant gratification, there is no “EASY button” (Am I dating myself? Yes, dear reader, if you are younger than twenty-five, you likely would consider me “old.” There. I said it so you don’t have to!) While there is no “quick fix”, there are some things we can each practice which, over time, will allow us to feel much more in control of our emotions. We can take the driver’s seat again and move from Emotion Mind to Wise Mind.

If you’ll indulge me, I’d like to run very briefly through the things we’ve already covered. I promise to be quick. We’ll just rip off the redundancy Band-Aid rather than pull out the sutures of “shit you’ve already read” one by one.

Remember how this series started? With the simple idea that emotions are neither good nor bad, they are simply information. The only time any emotion can get us into trouble is when we avoid it or deny it so long that we believe it is “unmanageable” and that we have no power over it. This is the case for most of us, at least at first. If you learned that anger is “bad”, you’re likely walking around with a lot of inhibited anger that is messing with your relationship to others as well as yourself. Eventually, that anger is going to boil over and you are either going to explode at someone else or take it out on yourself. If you’ve struggled with suicidality before, you may start to get nervous when you feel even a little sad or isolated; if you’ve experienced panic attacks from social anxiety, you probably tense up the minute you start to feel the slightest bit uncomfortable in a crowd. You tell yourself “I CAN’T FEEL THIS. THIS IS DANGEROUS.” over and over until you’re trying to avoid anything even remotely associated with that emotion at all costs. And every time that cycle repeats, those pesky, maladaptive shortcuts in your brain that tell you you must avoid those feelings are reinforced. We then find ourselves in a predictable and entirely unhelpful self-fulfilling prophecy. We believe that something is too much to handle, and thus it becomes too much to handle. We start to view our emotions as some massive, unstoppable force outside of us, when, really, no emotion is outside of our control. We just need to learn the tools to manage it.

This is the part of the post where I digress quickly to give the same disclaimer I’ve given in every post in this series: DBT is not about minimizing your struggles and it is not a suggestion that you can just wave your Positive Thoughts Wand through the air and let it shower you with the mystical power of the Sparkles of Optimism and be magically free of all of your struggles. This is work. It’s taking the time to learn the tools and practice using them until it’s easier for your brain to fire neurons that say “This sucks! Here’s a healthy coping skill!” than it is to fire the neurons that say, “Hey you. Yeah, you. This sucks. You know it sucks. There’s nothing you can do. Let’s make it suck more!” (Because, really, that’s what our negative coping skills do in the long run – they make our lives, both internal and external, worse.)

OK, so we’re using tools, not shooting Care-Bear Rainbows of happiness out of our… abdomens. Great! What kind of tools, you ask? Fantastic question! That brings me nicely to telling you what Tool Number One is! (See, I’m responsive!) Step one to Emotion Reg. is identifying emotions. Really taking the time to name, specifically, what we’re feeling. You may say, “I’m angry.” But “angry” is a really broad emotion – are you livid or are you irritated? Are you seething or are you peeved? See the difference there? It’s important to recognize, as much as we can, our specific emotion. Especially when it comes to healthy coping.

Think about it – if you are someone who has come to believe, through experience, that “anger is bad”, you’re going to have a visceral reaction to anything that feels even remotely like anger. But naming it, saying, “I’m irritated right now.” can make it feel much less threatening. Remember, “If you can name it, you can tame it.” You’ve got to separate the individual wires from the tangled Mess of Uselessness before you can figure out what’s what; which ones to keep and which ones to toss. Looking at the box, that original heaping mess of wires, controllers, headphones, yarn, speakers, screws, power chords, and component cables, was incredibly overwhelming at first.

When I started this series, I knew that the Rat’s Nest would be a really useful metaphor, but man did I put off this post! In part, because this post required the sorting and organization of all of the chaos that was in that little cardboard box. I don’t think I need to draw too bold a circle around how perfectly that avoidance also fits with this topic. But finally, despite not wanting to, I sat down and I did it. (For you, Reader – I did it for YOU!)

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As I sat on my living room floor slowly tracing wires through loops and freeing them one by one, I did so while watching what is probably my absolute favorite series of all time – The X Files. I can quote just about every  episode at this point, but I never get tired of watching it. Why do I mention this here? Because it was a healthy little dose of self-care. Which is essential in Emotion Regulation.

It’s hard work, and it can feel completely overwhelming, especially at first. If you are one of the 99.9999999999% of us who grew up being told, somewhere in your life, to stuff one emotion or another, actually digging into your feelings, being curious, sitting with them, and working through them is very difficult. Take care of yourselves! Do something you enjoy! Take breaks! Just don’t avoid the work all together, because, as I said, that’s where we all tend to get into trouble.

Over time, and with practice, identifying and acknowledging emotions gets easier. Then you can move into some of the skills for decreasing vulnerability to negative emotions and increasing positive emotions. That’s where we dump the whole box of wires out and look at it. We see how complex and tangled it is, but we can start making it neat and manageable, one wire at a time. In part three of this series, we checked out some specific skills to decrease that negative vulnerability and ways to increase positive experience. If you’re living with depression, or any mental health diagnosis, or you’re just here to learn how to better manage the emotional suckiness of any kind, it’s so important to remember that this is a process, not an event. You can’t snap your fingers and have the wires miraculously untangled. It’s not going to happen. If you go into the process thinking that it will, you’re going to get frustrated and give up before you even start.

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TA-DA! Separated and manageable! 

That photo is a portion of the Rat’s Nest, no longer tangled, with each item easily identifiable. For those wondering, this amazing feat took two and a half episodes of The X- Files to complete. I didn’t sit down expecting to be done before Scully introduced herself to “the FBI’s most unwanted.” I probably would have thrown the box and my computer had I expected that of myself. And then I would have spent hours telling myself how stupid and worthless I was for not accomplishing the impossible – because depression and anxiety are just neat like that. All that to say – have reasonable expectations of yourself and be gentle. I’ll say it one more time, because it really is that important: this is work. This is hard fucking work. But it’s worth it.

OK, we’re now in that dreamed of world. The wires are separated and organized! I’ve thrown the cardboard box into the recycling bin so that I may never lay eyes on it again! I know exactly what I have, and I know exactly what I don’t need!

Now that’s done, what next? What do I do with all the crap that I know I’ll never use again? What do I do with the broken chords? Say we’ve finally pulled apart and named our emotions, and the broken ones are the one’s that we really don’t want anymore – the ones that really suck? Because, let’s be honest, while anger and sadness and loneliness are, like all emotions, simply giving us information, they are uncomfortable to feel long-term. In life, we’re going to feel them from time to time. That’s a given. But a lot of us have felt them for so long with no tools to properly interact with them that they’ve become this constant thing. Those shortcuts in our brains are well-worn and comfortable. Emotion Reg. is about learning to pull a Robert Frost and cut through the underbrush to make a new, better path. Eventually, that path will be just as used as the old one, but at first, it takes commitment and dedication to our recovery process to blaze that trail. We’ve been stuck in a feedback loop of all that junk for way too long and the mass of negativity and pain needs to go!

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Remember in part two, when I was first talking about the Rat’s Nest and I said that for some godforsaken reason there was an actual spool of yarn tangled and mixed with all the wires? I wasn’t exaggerating. The only way to get it separate was to cut it.

So, what do we do with the emotional yarn? The stuff that’s just tangled up and preventing us from the untangling process? We flex those healthy coping muscles and we forge the tools we need to cut through it. As with anything in DBT, the number one approach is mindfulness. What does that look like? DBT is big on steps, so here is the step by step guide to mindfully managing negative emotions:

OBSERVE YOUR EMOTION

Note it’s presence: name it and acknowledge it.

Step Back. You know what it is, but you also know that it is within you, you are not within it.

Get unstuck from the emotion. Untangle it from the other wires. Hold it out and away.

EXPERIENCE YOUR EMOTION

This is where we have to sit with it for a bit. This is the uncomfortable part, but it’s worth it, I promise.

Think of it as a wave, it’s come, it’s washing over you, it will recede.

Try not to block or suppress the emotion. It’s not going to hurt you, even if it’s uncomfortable. It’s not a danger to you.

Don’t try to get rid of the emotion or push it away. Feel it.

BUT…

Don’t try to keep the emotion around, either.

Don’t hold onto it.

Don’t amplify it.

Do you ever find yourself “spinning”? You start to feel depressed and then you put on depressing music and focus on your depressing thoughts and just let them build? I know I have fallen into this trap more times than I can count. There is a difference between feeling and acknowledging a difficult emotion and torturing yourself with it. Don’t torture yourself.

REMEMBER: YOU ARE NOT YOUR EMOTION

You do not necessarily need to ACT on your emotion.

Remind yourself of times you have felt DIFFERENT.

When we’re in super emotion mind and engulfed in negative feelings, it can seem like we’ve never felt anything different and we never will. This is a lie we subconsciously tell ourselves. Actively remind yourself of a time when you were not angry or upset or lonely. This can help prevent that spinning.

PRACTICE LOVING YOUR EMOTION

Don’t judge your emotion (or yourself for having it).

Practice WILLINGNESS – don’t refuse to engage with your emotion.

Radically accept your emotion – “I’m really hurt that my friend cancelled our dinner plans. I’m disappointed and I feel rejected.” If you feel rejected, you may start to tell yourself some lies like, “My friend hates me.” “No one ever hangs out with me.” “I don’t have any friends because I’m a loser.” Remind yourself that just because you feel a certain way right now does not make it the Truth, and it does not mean that you will always feel that way. Remind yourself of times that your friends have not cancelled on you. Accept that you feel disappointed, and accept that that feeling does not need to consume you and send you spiraling.

Some automatic thoughts associated with emotions simply don’t serve you. They are junk and you don’t need to keep them around. You need to challenge them and then toss them.

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In the Rat’s Nest, I found a bag of screws and washers, specifically for some piece of furniture somewhere that I no longer own. I found phone jacks. I found a strand of USB Christmas Lights (that I used to love) with a cut wire, and I found headphones with only one ear bud.

While not actively screwing up my process of untangling (unlike the yarn), some of the things I found in the Rat’s Nest are simply not necessary for me to keep around. I don’t need to hold on to any of these things. I’m sure that we all have emotional stuff that we just don’t need anymore, even if it used to serve us (like those USB Christmas lights). This is where the really hard work comes in. And this is the section of Emotion Regulation that, if you practice it, will have the biggest impact in your life. You need all the other stuff we’ve talked about first, just like I needed to dig through the mess that was the Rat’s Nest first. But what do you do with the things that you know you don’t need, that you know are not serving, but that you feel attached to?

As backwards as it may seem to someone who hasn’t been living with challenges around managing emotions, our negative emotions can feel like a safety net. They are familiar. It’s easy to sink into them. Sure, now you can name them, you can be mindful of them, you can tolerate them, but how do you actually change negative emotions? 

You use the power tool of DBT. You Act Opposite. This is not easy and will make you incredibly uncomfortable at first. (At least, it did me.) What does “Acting the Opposite” mean? Exactly what it sounds like. Here’s another DBT list for you:

FEAR

Do what you are afraid of doing… OVER AND OVER AND OVER.

APPROACH events, places, tasks, activities, and people you are afraid of.

Do things to give yourself a sense of CONTROL and MASTERY.

When you are overwhelmed, make a list of SMALL STEPS you can do; then DO the first thing on that list.

GUILT OR SHAME (when these feelings are justified)

Repair the transgression: Say you’re sorry; make things better if possible.

Commit to avoiding that mistake in the future.

Accept the consequences.

Let it go.

GUILT OR SHAME (when these feelings are unjustified)

Do what makes you feel guilty or ashamed OVER AND OVER AND OVER.

Approach; don’t avoid.

SADNESS OR DEPRESSION

Get ACTIVE. Approach; don’t avoid.

Do things that make you feel COMPETENT and SELF-CONFIDENT.

ANGER

Gently AVOID the person you are angry with rather than attacking; avoid thinking about them. Don’t ruminate.

Do something NICE rather than mean, passive aggressive, or attacking.

Imagine sympathy and empathy for the person rather than blame.

 

THAT’S THE LIST I WAS GIVEN in Partial Hospitalization as examples of Acting Opposite. These are only examples, and they are only methods to prevent yourself from suffering too greatly with your emotions. Obviously, this is a simplified list. Fear is different than Phobia, for example. Working through a reduction in vulnerability to a Phobia is best done between you and your treatment professionals. For unjustified Guilt or Shame, this is only for activities. For example, you may feel unjustly guilty about taking an hour for yourself to read or watch TV. This is the situation in which you would approach until you no longer feel guilt or shame. This is not meant for trauma survivors (like myself and many of you wonderful readers) who may feel deep shame as a result of their trauma. Again. that is something that needs to be worked out with proper supports in place to prevent any re-traumatization. This is more of a springboard. A place to start.

And nothing needs to be set in stone. My ideas of Acting Opposite when I’m depressed, for example, change depending on circumstance and severity. If I’m moderately depressed and trying to summon the strength and motivation to go to work, I will drag my ass to work. That’s Acting Opposite. One really bad days, it means dragging myself out of bed and into the shower. Maybe forcing myself to wash a couple of dishes. Maybe it’s just making myself get off my bed for five minutes and walking around my apartment before crawling back into bed. You know you. Do what you know you can, then do just a *little* bit more. Overtime, you’ll thank yourself. Because the hold your negative emotions have on you will diminish.

Living with a mental health diagnosis (or diagnoses) means that many of these struggles will be present in our lives, in some form, for a long time. Possibly forever. But wouldn’t it be cool to be able to say “Yeah, I see you, but you’re not running the show!” Even if we could only say that 50% of the time, wouldn’t that be a hell of an improvement? I know it would for me. That’s why I work to apply the skills from this series to my life every single day. Sometimes I fail miserably – sometimes the wire I’m tugging is just too knotted and it’s time to take a break and try a new angle in the morning – but that’s OK, because everything is progress. Everything is a little step toward recovery.

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NOTE: I AM NOT A THERAPIST, PSYCHOLOGIST, PSYCHIATRIST, OR MEDICAL EXPERT, and this series is not intended to be used in place of professional treatment – I’m just sharing some tools and approaches I’ve found useful in my own recovery. If your current providers are not using DBT and you are interested in learning more, I highly suggest bringing it up to them. It’s well worth it. 

AS ALWAYS – I look forward to hearing your thoughts! Leave ’em in the comment section below, find me in the Twittosphere @paradichotomy, or pop in on Facebook! Peace and love, all. Sorry this post was such a long time coming!!

*RE: “Read on, Macduff” I’m aware that the actual quote is “Lay on, Macduff”, I’m playing off of our pop-culture misquotation, not the original Shakespeare. Also, this is not an invitation to kill me in battle. Please don’t do that.

OK, I Know What I’m Feeling… Now What?

It’s the beginning of the week, and that means we’re jumping into another resource/skills-based post! If you’re new, I’m currently doing an introductory series to the Dialectical Behavior Therapy skill of Emotion Regulation. If you haven’t yet, please feel free to read part one and part two before continuing here.

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If you haven’t noticed by now, I’m a fan of metaphor. You remember the Rat’s Nest? Let’s stick with that imagery. That huge mess pictured above is really absolutely no help to me whatsoever. Even if I know what chord I need, and I know for a fact that it’s in there. Yes, knowing the specific chord I’m digging around for is a starting point, but I’m still in for an incredibly frustrating time if I have to dig through that tangled mess every time I need a chord, right? The question is, how do I separate out what I need and prevent it from getting tangled again? (No, this blog is not going to suddenly become full of house organizing tips, I’m the last person you want telling you about that stuff!)

As you may imagine, separating and organizing all those chords is not a one step process. It takes time and a whole lotta work! Would you look at that box and expect me to “just organize it” in the space of a few minutes? Of course not! (Well… I hope not, anyway. You’d be out of luck, there. It’s physically impossible.) So why do we all seem to demand such a miraculous feat of ourselves when it comes to mental health recovery? Honestly, we go to a hospital for a few days, or we go to therapy once a week for a few months and we get frustrated that we’re not “finished” with all the untangling and differentiation yet, we berate ourselves for not being “better”. That is incredibly unfair. All we can do is take it one step at a time. So, what’s the next step? Now that we recognize that our emotional rat’s nest is a complete mess, what do we need to do? You may think “start untangling”, but that’s not it. (We’ll get there next week, I promise.)

First step is simply to make sure that we’re not tossing in more chords and speakers and yarn! To accomplish this, I took everything out of the Rat’s Nest. It was quite overwhelming:

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But, by taking it out and having it out in the open, I ensured two things: first, that I would not toss any more assorted electronic accessories into the snarls of rubber and wire already present; second, that the mess was undeniable now: in my hands, on my floor… there was simply no ignoring it or shoving it out of sight and out of mind anymore. I had to look at it, I had to feel it woven between my fingers. Yup, this is going to be a big job. 

Now, in Emotion Regulation terms, getting the mess out of the box and knowing that, in the future, only properly wrapped, zip-tied, easily identifiable chords will be placed back into that box represents increasing positive emotions. I feel good about that knowledge. Taking everything out of the box and knowing that never again will I toss a spool of yarn into a box or chords just to make my life more difficult represents decreasing vulnerability to negative emotions. If the junk that I don’t need is out on the floor for me to see, in the light of my stylish yet affordable floor lamp, it’s not going to blindside me next time I need to dig something out of there. And those two skills are the next step of Emotion Regulation!

Let’s start with Decreasing Vulnerability to Negative Emotions. After all, that’s probably the one that seems most difficult, right? (It definitely felt that way to me.) If you’ve ever been to any form of group therapy or a twelve-step program, you may be familiar with the term HALT – in other words, stop and think if you are Hungry, Angry, Lonely, or Tired. For me, this has been a very helpful little prompt. I know that if I am any of those things, I am very likely in “Emotion Mind”, which places me at risk for using some maladaptive coping techniques. The idea with Emotion Regulation is to get out of Emotion Mind and into Wise Mind, which simultaneously honors and acknowledges what you’re feeling and uses Reason Mind to react in a balanced way. OK, I’m a little worried I’m venturing into text book territory here. This is not a class room, and I am not a teacher. I just had to give a little exposition to make sure we were all on the same wave length. There are quite a few DBT skills I could go into here for decreasing vulnerability to negative emotions, but the most popular skill is called “PLEASE MASTER.” It’s a decidedly lackluster acronym, in my opinion; and it’s one of those “way easier said than done” things. But it did help me shift my thinking, which is why I am sharing it with you. Initially designed and presented by Marsha Linehan, the creator of DBT, in her book Skills Training Manual for Treating Borederline Personality Disorder, here it is:

PLEASE MASTEr

Treat PhysicaIllness – Take care of your body. See a doctor when necessary. Take prescribed medication.

Balance Eating – Don’t eat too much or too little. Stay away from foods that make you feel overly emotional.

Avoid mood – Altering drugs – Stay off non-prescribed drugs, including alcohol.

Balance Sleep – Try to get the amount of sleep that helps you feel good. Keep to a sleep program if you are having difficulty sleeping.

Get Exercise – Do some sort of exercise every day; try to build up to 20 minutes of vigorous exercise.

Build MASTERy – Try to do one thing a day to make you feel competent and in control.

(Like I said, the acronym is not exactly what one would call “inspired”.)

But that’s neither here not there. If you’re anything like me, you look at that list and say, “Well yeah, if I could do that shit, I’d be way better off! But that’s where I struggle! I can’t just make myself do these things when I feel like crap!” I know. I get it. It sounds impossible. But, again, this is all about baby steps. If you’re not a fan of this technique, that’s totally cool. I’m just sharing it because it has truly been helpful to me in my own recovery. So, how did I start tackling this list? The same way I started tackling the Rat’s Nest. I pulled it out and put it in the open.

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Yup, really. Right on my bathroom wall. I see it every time I brush my teeth or wash my hands.

It’s my multiple-times-daily reminder to do healthy things that will benefit me in my recovery, or, if I’m not doing them (believe me, there are more days I “miss” applying some or all of this list than there are days I “hit” it, but I’m working on it!), at least I can check my mood against this list and see what may be contributing if I’m having a hard time. A group facilitator at the hospital told us all to “check our lens” every time we went to the bathroom. She chose the bathroom because, like it or not, it’s something we all have to do multiple times a day. “Checking your lens” is essentially what I’m describing. Checking my feelings against how I’m doing on wellness goals, reminding myself, even if my lens is “narrow” (i.e. tunnel vision, focused on the negative self talk and the lies my depression and anxiety like to throw at me), that it will pass. That there are environmental and physical factors at play that will not always be present. That I can ride it out. I chose to post this list in the bathroom as a sort of homage to that group facilitator. You can do whatever you’d like with it.

ALRIGHT, so that’s one way to REDUCE vulnerability to negative emotions. What about INCREASING positive emotions? That sounds more fun, right? It certainly did to me.

Here’s a funny thing about our brains. When something amazing happens, we remember it. When something terrible happens, we remember it. When something mildly annoying happens, we remember it. But when something mildly good happens? We tend to forget it. Here’s a little story to illustrate:

I wake up for work. My alarm goes off as scheduled. My coffee maker kicks on automatically and I have a cup on my way out the door. My car unlocks and starts without issue. As I’m driving to work, I hit a traffic jam. I realize I’m going to be late. My phone properly connects to BlueTooth, I call my coworkers to give them a heads up. They assure me it’s nothing to worry about, and they’ll see me when I get there. I get to work twenty minutes late because the traffic jam was truly terrible. I accomplish all of my work tasks. I drive home without incident. A family member asks me how my day was. I say, “It was terrible! I was 20 minutes late to work this morning!”

I carried the stress of being late to work with me all day, because I am not usually late to work. All of the things that went “right” in my day are so routine, I don’t even consider them positives. Can you relate to that?

Now, again, this isn’t a post on inspirational, magical thinking to use the power of positivity to poof your depression/anxiety out of existence. Just a reminder that our default setting is not to be mindful of positive events. But, we can nudge our minds a little in the direction of focusing on positive events when they happen. And that act, in and of itself, can increase our general happiness over time. If you live with anxiety and depression, though, you know that even when things are going well, it’s really easy to slip into worrying about when the positivity will end and things will go to hell again. (Hey PTSD friends, I’m looking at you, too!) When this happens, the principles of mindfulness also apply. Refocus on the moment. Try not to get caught up in the past or present. The flip side of that is to be UNMINDFUL or your worries. Distract yourself from thinking about when the positive experience will end; distract yourself from thinking about whether or not you deserve the positive experience.

YEAH, sure. OK. Noooooooo problem. All those deeply ingrained negative thoughts, I’m just gonna shove them away with positive mindfulness. Yup. I’ll buy that. Okey-Dokey. Absolutely. That makes perfect sense. 

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Seriously, though. That’s not what I’m saying. Remember everything in DBT, and in recovery in general, is a skill which needs to be used and used, frequently and often, before there will be any major change. It’s basically re-wiring our brains to diminish the maladaptive thoughts and negative coping skills that get us into trouble and then, over time, to increase our ability to form adaptive thoughts and positive coping skills. This takes work. This does not happen over night, or even in a few months. BUT, you can take the first few steps toward getting there any time.

The best way to start anything in life is to begin where you are. In the short term, what can you do to increase pleasure in your life? The goal here is to pick a few things that you truly enjoy and make time for them each day – even if it’s only ten minutes. I enjoy playing my guitar. I do it for a minimum of ten minutes a day. During those ten minutes, I am enjoying myself. I am experiencing positive emotions. What’s something you’re good at? What’s something you enjoy?

Ahh… but you’re depressed and you don’t enjoy anything at the moment. What then? Loss of joy is sort of a hallmark of depression, right? It can be overwhelming to even consider something that you might enjoy doing depending on how deep in the abyss you find yourself. This is a valid point. This is also the part of the post where I share yet another resource I’ve found helpful. Beautiful humansperson, I present to you the The Adult Pleasant Events Schedule. I know, it sounds corny (or maybe even slightly taboo), but it’s really just a list of prompts of things that adults find enjoyable – everything from needlework to sightseeing, watching sports to, yes, sex. I promise you you will find something on this list that is at least moderately fun. I found it very refreshing because it is a pretty comprehensive list. Most of my experience in therapy hasn’t really touched on the fact that adult people enjoy adult things. This list does not shy away from that fact; it embraces it outright. And I’d like to give you the same challenge that my DBT group facilitator gave me – pick seven things* from this list and commit to doing one a day for the next week. Like I said above, even if it’s just ten minutes a day. I did this exercise, and the impact on my over all emotional state was impressive.

*Some activities on this list (like gambling, spending money, drinking, and sexually-based activities) may be a specific “problem area” for you. DO NOT CHOSE AN ACTIVITY THAT WILL DECREASE YOUR OVER-ALL WELLNESS. That would defeat the point of the activity. I’d also like to reiterate that I am not a therapist, doctor, psychiatrist, or psychologist. I am sharing techniques from my own, personal recovery process that I’ve found to be helpful, and that I hope you will find helpful as well. Beyond the disclaimers, go forth, dear reader! Have a fun week!

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As always, I’d love to hear your thoughts, questions, complaints, or tangential observations on this series or the blog in general! Please lemme know in the comment section below, and feel free to hit me up on Twitter and Facebook as well! If you decide to take on the seven day challenge, I’d be really interested to hear what activities you chose and how the experience was for you! please feel free to share that, too!

ALSO, I’m wicked excited to be able to share with you all that I am OFFICIALLY a contributor to The Mighty Site! Please feel free to check out my first Mighty article 5 Things I Learned Living with PTSD and Bipolar Disorder

8 Self-Care Techniques for an Impending Mixed Features Episode

OK, it’s transparency time. Transparency is essential to fighting stigma and helping those who may not live with a mental health diagnosis (or diagnoses) understand a little bit of what we face daily. The truth is, sometimes living with Bipolar Affective Disorder is absolutely no fun. This has been the case for me these past two weeks. See, I’m trying to get in a groove with the scheduling for posts on this blog. I’m on track to do that for next week, at least. I have caught an expanded vision for this blog that really excites me, and I’m so looking forward to putting it into action! But, I missed the mark this past week and the week before, and the depression that caused me to miss that mark also tells me what a failure I am and that I will never be able to make this space line up with my vision. Then, the more manic symptoms tell me that I don’t have to. Whatever I do, everyone will love it, and everything I touch will turn to gold because I’m freaking unstoppable. (One symptom of mania is grandiosity, and in me, it tends to take the form of making ridiculous plans and just assuming that everything will come together because, hey, how could it not with how amazing I am.) I’ll be honest, even typing that makes me feel like an arrogant jerk. I hope you’ll forgive me.

I assume if you’re reading this, you’re at least a little familiar with the basics of depression and a Manic episode (links provided in case you’re not). I’d like to briefly describe my experiences with each before getting into the meat of this post. Depression is an aching in my bones. It’s the searing knowledge that nothing has ever been right and nothing will ever be right, but the simultaneous numbing of all pain receptors. It’s feeling my whole body slowly petrify. It’s being unable to get out of bed some days and also being unable to even muster the energy to care. It’s running my fingers through my hair in exhaustion and realizing only then that I’m a greasy mess who hasn’t showered in days. Then, there’s (hypo)mania. When everything is perfect and I am amazing and I can do no wrong. It’s unrestrained energy and excitement. Now, that might sound fun, and it is – at first. I’m charismatic and I can probably get you just as excited as I am about [insert Amazing, World Changing, New Idea here]. But then, things get pretty overwhelming. The best analogy I can come up with is when you go on one of those super-fast, spinny rides at the fair. At first, it’s thrilling; then it starts to make you sick and you wonder when it’s going to stop. It’s being so energized you can’t sit still. It’s having so many ideas flying through your brain that you can’t grab just one. It’s jumping between ten tabs on your browser, all on different topics, and only being able to stick with any one long enough to read a sentence or two, but trying to make sense of what you’re reading anyway. Trying to blend the sentence fragments into a coherent reading experience, then getting frustrated that you can’t make it make sense.

Then, there is the dreaded Mixed State. And it truly is a beast. It’s hard to explain, really, even for me. The technical definition is that you have symptoms of Mania and Depression at the same time or in rapid succession. Try to imagine that for a minute. It’s being depressed but energized. It’s having fantastic ideas of things I want to accomplish all while depression screams in my face that I can never accomplish anything. It’s being hyper and hopeless at the same time. It’s wanting to do nothing but sleep all day, but being unable to sleep at all. It’s pacing the kitchen at 4 AM, crawling in my skin, with quick snapshots of everything I’ve ever done wrong in my life flickering before my eyes, and being simultaneously unable to break the train of thought and unable to focus on just one event or memory. It’s sensory overload on every level. It’s just a big collection of suck.

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Well, here we go! (Resigned to the coming battle)

Were it not for my meds, I have no doubt I would have been in a full-blown Manic with Mixed Features episode these past two weeks. Meds, thankfully, muted the effects a bit. But the basic symptoms were still present, if less severe than they have been in the past.

All of that to say, today is supposed to be a post about self-care. What steps can we take to practice self-care while in the midst of a Mixed Episode? That’s the question of the week!

The first, most important part of self-care with BPAD is pre-episode, daily management. Being aware of subtle changes in your mood, following a schedule, taking a PRN sleep aid the first night you can’t sleep, within the first two hours of trying to sleep and realizing you can’t. Eating well, even when you’re not hungry. Reaching out and connecting with people, even when you don’t feel like it. Taking all of your meds as scheduled. And so on. This is the “do as I say, not as I do” part of the post, I admit. I’m still working on getting a handle on the whole “schedule” thing, I hate my PRN sleep pill because it makes me groggy all of the next day, and I’m not even going to touch the eating thing. That said, I recognize that these things are important and I am working on it!

Alright, you say, preemptive management is good, but what do you do when you’re already barreling toward a Mixed State or in one that hasn’t reached red alert crisis levels yet? Agitated depression, paranoia, no sleep, racing thoughts are here or right around the corner… what can you do?

  • Stick with your meds even though you probably have no interest in taking them. I set alarms in my phone and I know, no matter what, I have to take them when the alarm goes off. This can help minimize the impact of your symptoms on your overall day to day life and prevent the need for a hospitalization or a full-blown crisis situation.
  • Reach out to a friend/family member/treatment team person. Maybe this feels absolutely impossible. But if you’re aware that your mood is spiraling, asking someone you trust to check in every day can be the difference between a rough few weeks and a very dangerous situation. I have a really good friend who calls me four to five times a week and helps me keep track of things. Remember other people have their own lives, though, and you can’t count on them for everything because they have their own stuff going on. But even a 10 minute phone call every other day can go a long way. IMG_20170429_030324_285.jpg

Yes, I’m using a picture from Disney Land. The sword is a metaphor, though. Sometimes we need help. Friends are great at helping. Let your friends help. ❤ 

  • Keep crisis lines saved in your phone. Really. If it’s 4 AM and you’re feeling unable to handle the chaos in your brain, having a support you can call no matter the time of day can be immensely helpful, if not life saving. Keep them in your contacts and use them.
  • Make sure your friends and family know what to look out for. This article may be helpful to share with your family/ friend support system. The fact is, once the episode becomes full blown (whether traditional mania or one with mixed features), we don’t really have the ability to realize what’s going on or what we’re doing or feeling. If you live with BPAD, you know that. That’s where an extra set of eyes (or two, or ten) can really come in handy. Someone outside of you who can help keep tabs and manage things is essential.
  • Avoid alcohol and mind-altering drugs. This is essential. I understand the temptation, that need to do something, anything, to stop feeling what you’re feeling. But it’s just going to make things worse and less manageable for you in the long run. If this is a big struggle for you, take care to avoid triggers during this time. Don’t hang out with friends you drink with. If it’s a REALLY big struggle, have a friend or family member go to the store with you if you need to go so that you don’t convince yourself that buying that bottle of wine on the shelf won’t hurt. Really, it will. I promise. Drinking is going to make things much worse for you. IMG_20170429_040108_636000.png
  • What’s in your Kit Bag? “Kit Bag” is a term I learned from a friend to refer to a sort of “emergency self-care kit”. If you don’t have one, I highly recommend making one now. It doesn’t have to be an actual bag of tangible things. It can just be a list. When you’re recognizing mixed features but they are not yet full blown, it’s time for self-care central. What people, places, and things make you feel most at peace and in control? Hot showers? Mindful cooking? A favorite movie? Calling a friend? Seeing your therapist? Come up with your list and use it! Some people also do have a tangible bag with things like a DVD of said favorite movie, a bottle of favorite bubble-bath, some beloved recipes, notes of encouragement and love from family and friends, etc. Find what works for you and do it.
  • Challenge you’re thinking. If you’ve ever done Cognitive Behavior Therapy, you know that negative self talk and distorted thinking can overtake us at any time. You also know that there are ways to challenge these thoughts. My favorite method is the one that feels the least threatening – I think of one fact that suggests that my negative thoughts are not 100% true, 100% of the time. I say “least threatening” because, as backward as it may sound, my negative self-talk and distorted thoughts are pretty thoroughly ingrained in my mind, and I’m so used to them that the idea of getting rid of them is sometimes more scary than the thought of continuing to live with them. So challenging them outright is always difficult and sometimes impossible. But, I’m also a very analytical person, so finding one fact, one event, one moment in time, that demonstrates that my negative thoughts are not 100% true feels pretty manageable to me. By doing this, over time, you do start to fight against the entire thought. But it’s all about baby steps.
  • Finally, if you are truly in crisis, get to a hospital. Have a safety plan in place with your supports. Set limits. If you cross the line on those limits, it’s time to go get the next level of help. Look, no one likes hospitals. Especially not psych units. I know. I get it. But I also promise you your future self will thank you for going.

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Literally me checking into the psych unit. Taking a selfie was maybe not rational, but, honestly, I was pretty thoroughly irrational at the time. Really, though, it’s OK to need help, and sometimes we do need that “higher level” of support. There’s no shame in that! 

So, that’s my little list. The fact of the matter is self-care while heading for a mood episode of any form is a tricky proposition, and preemptive planning with your support team is the best way to manage it. But if you, like me, are living with some of the symptoms, but they are muted enough to not require hospitalization, self-care can really help you ride it out. It’s going to suck, there’s no getting around that, but having good self-care techniques and good supports can be the difference between a crappy couple of weeks and a crisis requiring hospitalization. It does require a certain awareness of mood and an understanding of what is happening, though. Which is where the friends and family come in. In the week heading into this episode, on three of my phone calls with my friend, she noticed that I sounded “in a fog”. This was a big cue to me that things were not well and that I was heading for a bad time. So, self-care kicked into overdrive.

Self -care is going to look different for everyone, of course. And I feel obligated to mention that Mixed States are often the most dangerous types of mood episodes, because being depressed but energized tends to facilitate making and carrying out a suicide plan. So, please take care of yourselves. And, not to beat a dead horse, but IT’S OK TO NEED HELP at whatever level is necessary.

If you’d like some specific techniques for getting through a particularly difficult time, check out my list: Top 5 Ways to Get Through a Bad Situation (Without Making It Worse).

What are your go-to emergency self-care techniques? Do you agree with this list? Disagree? I’d love to hear your thoughts in the comment section of this post! You can also Tweet me and find me on Facebook. Thanks for reading!

 

What Am I Feeling? (And Why It Matters?)

Welcome to Part 2 of my Intro to Emotion Regulation resource series. If you haven’t yet, check out part one (linked above) for a broad introduction to the topic.

In my living room, there’s a skinny, overstuffed closet. It’s become kind of a catch-all. It’s a disorganized, cluttered, precariously stacked mess of all of the things I don’t need in my day to day life (and some things I may never need again). At the very bottom of this Leaning Tower of Useless Crap, there is a bent, crinkled, water stained cardboard box filled to the brim with various electronics chords I’ve collected over the years. Affectionately (sort of) called The Rat’s Nest, this flimsy box houses a massive ball of boom box power cables, skinny wired head phones that no longer work, chords to long-since-corrupted and discarded laptops, USB Christmas light strands, component cables of all shapes and sizes, and for some God forsaken reason, an actual spool of yarn, among other things. I only know these details because a few weeks ago, I actually needed a chord that I thought might be in there. Thus began what would become an infuriating 40 minutes of following each individual wire, looping, twisting, untying, and looping back, all in what turned out to be a fruitless search. (The wire needed was, of course, in the back of the closet, free of the box, completely untangled and ready for use, but such is life.)

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Dear Readers, I present to you: The Rat’s Nest (or, Sheila’s emotional mess incarnate).

I think of emotions like The Rat’s Nest. When you first think about them, they seem pretty straight-forward, if sometimes unpleasant and challenging. It’s just a big ol’ box o’ wires, right? But when it comes to untangling those wires, identifying what each one does, and sorting through them to create something a little more manageable than that enmeshed mess, things get a little more complicated. STEP ONE of Emotion Regulation is literally just identifying your emotion(s): observing them and describing them, and then learning what they do for you. 

To stick with The Rat’s Nest metaphor, it’s figuring out what each individual wire is and what it’s for. Because, just like with my stupid and unnecessary mess of chords, if you can separate your emotions, sort them out, and identify their function, then you can use them to help you, rather than being overwhelmed by the mess and not knowing where to even start. And you can toss the wires you no longer need, or that no longer serve you.

The first time I was exposed to Emotion Regulation was at the Partial Hospitalization Program I attended after being discharged from Full Hospitalization. Another patient there had a phrase he repeated several times: “If you can name it, you can tame it.” It may sound like a silly bumper sticker platitude, but for me, it really sums up the first step to Emotion Reg. You’ve got to know what your feeling before you can even start to do anything about it.

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Yes, I’m THAT Blogger who does an impromptu photo shoot in my kitchen at midnight to embellish my post and get my point across. Don’t judge me! (OK, you can totally judge me. I can take it. Judge away.) I call this series: “Sheila tries to express basic human emotions while slightly over tired and VERY over caffeinated.”

SURE, you can name the basic emotions. You might even be really good at saying, “God! I’m so freaking angry right now!” or “I’m so sad, nothing matters.” But let’s dig a little bit deeper there, alright? Say that ANGER is every single component cable in my Rat’s Nest. Well, for component cables alone, I’ve  got the old school red, yellow, white to red, yellow, white; the red, yellow, white to PS1 connector cable; the newer red, blue, green to red, blue, green; a wicked old school red, yellow, white to cable connector, and a Python component cable with all the colors you could ever want for your video entertainment needs. (No, this isn’t a plug for Python cables… see what I did there?)

Silly puns aside, if anger is the broad name given to all of my component cables, you can see how that’s still confusing and hard to differentiate. If I told you to go into my Rat’s Nest and get me a component cable, but I didn’t tell you which type, that would be an incredibly daunting task, right? But what if I told you “I need you to grab the Red,Yellow, White to Red, Yellow, White cable.” OK, realistically, if I ever asked you to get anything from The Rat’s Nest, you’d be well within your rights to kindly tell me to fuck off. But let’s pretend that’s not an option: you’re somehow my indebted servant or intern or something, and you have no choice in the matter. Even though you still have to untangle the mess, at least you know specifically what you’re looking for. That makes it much easier.

Similarly, screaming “I’M ANGRY!” in every situation wherein anger is the “root” emotion can make it awfully hard to actually understand what you’re dealing with. Are you Furious or are you Humiliated? Are you Annoyed or are you Seething? (No, this isn’t an SAT vocab boost, I promise.) Think about it, though. Annoyed is very different from Seething. Differentiating and naming your specific emotions can, in and of itself, help you get to the bottom of where that emotion came from and what it’s telling you.

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Which brings me to my next important point: Emotions are just information. You do not need to react in any predetermined way. If you feel depressed, you do not need to isolate; if you feel anxious, you do not need to self-harm; if you feel angry, you do not need to lash out. Our emotions get us into trouble when we think that we have no control over them, or when we try to avoid and ignore them because of our fear of them.

But here’s the kicker, when we avoid emotions, we reinforce the idea that avoidance is the only real option. Over time, our avoidance urge becomes so strong that it starts to act on anticipation rather than a precipitating event. Let me give you a quick example: you have a really stressful day. You feel like you need to “decompress”, so you open the fridge and crack a few beers before bed. By the time you go to sleep, you are stress free and feeling fine. Later in the week, you have a less stressful day, but it’s still been a little rough. You remember how alcohol helped you relax after that last bad day, so you drink a few more beers. Over time, this continues, until, “Holy shit! I have a stressful day coming up – that huge presentation I need to give – well, I’ve got to loosen up a bit to be able to sleep. I’ve got to be loose for the actual presentation.” Before you know it, your brain is now home to the super exciting short-cut “stress, or anticipated stress = drinking.” The idea has been repeatedly reinforced and, before you know it, you feel completely incapable of sitting with any stress at all. You’ve got to drink it all away. Your avoidance response becomes seared into your unconscious. Now, this isn’t your fault. It’s natural to want to avoid pain. But wouldn’t you agree that that is not the way to live your best life? Needing a drink or two (or six or seven, because, let’s be honest, tolerance to alcohol builds pretty quickly) every time you’re stressed or thinking about being stressed is not healthy – physically or emotionally. The truth is, we all have to learn to sit with our stress. And then, over time, learn skills to alleviate it in a healthy way.

When it comes to learning Emotion Regulation, it’s important to interact with our emotions through a lens of positive assumptions. We tend to view certain emotions (like anger, sadness, and fear) as being “bad”, being “the enemy”, and being “the root of our problems”. We assume that our emotions are threatening and that we need to stuff them down so that they don’t make us do something harmful or take over our lives completely. But the fact of the matter is that those core assumptions, those attitudes we hold toward emotions, are flawed. Changing our perspective of emotions, and viewing them in a more positive light, can help take some of the power away from them right off the bat. I’m not sure how to make this list of positive (or just realistic) assumptions pretty or interesting, but they are truly invaluable in this process, so I’m just going to list them for you. (Sorry if this is where the post seems to get dry, but reading on is worth it, I promise. And there’s a pretty, inspirational quote picture waiting for you! Isn’t that what the Internet likes?) Anyway, here:

1) Your emotions are important. They exist to give you information about yourself and the world around you. Don’t minimize them by avoidance!

2) You have to experience and acknowledge your emotions. Avoiding them will just cause more problems over time.

3) The more you try to avoid or escape your emotions, the more powerful and consuming they will become. Yes, really.

4) Feelings are simply another way we experience the world. They are a form of sense, just like taste, touch, smell, sound, and sight. 

5) Feelings are always right. It’s OK to feel whatever you are feeling in a given moment. We can have automatic negative or false thoughts in reaction to emotions, and we can have go-to behaviors that can be harmful or maladaptive, but the emotions themselves do not cause these things. They are always giving us necessary information, and honoring our feelings is key to on-going health and wellness.

6) Before you can move on to a different emotion, you have to sit with the one you’ve got currently. This isn’t Mario Bros. You can’t just hold A and slam B to jump over this stuff. Your emotions are not a Piranha Plant and they will not eat you or drag you down a Warp Tube. You can sit right next to them, acknowledge them, and learn from them without being threatened.

7) Feelings do not need to be acted upon. Feelings can increase the chances of you acting in a certain way, but just because you feel happy doesn’t mean you need to laugh. Just because you feel overwhelmed doesn’t mean you have to turn to self-harm or substance abuse or isolation.

8) You are separate from what you’re feeling. Your emotion is a part of you at any given moment, but it is not “you”. You are not angry, you are feeling anger. Who you are is not the same as what you are feeling in the moment. (Even if the moment is very long and it seems to consume you.)

9) The automatic thoughts attached to your emotions are likely not giving you the most useful advice if you are in “high-arousal” (high depression or anxiety: feeling your heart beat fast, muscles tighten, that “I need to do something fast, RIGHT NOW! to get rid of this terrible feeling!” thought loop we’ve all been stuck in) Your thoughts will tell you avoid, avoid, avoid!! But, again, this will not help you in the long run.

10) As much as it sucks, Emotion Regulation can’t be learned overnight. It takes practice, hard work, and consistency to master. As my case manager at the PHP program said, “These skills are simple, but they’re not easy.” Be gentle with yourself, but keep moving forward. Keep practicing. Over time, those unhealthy shortcuts in your brain will fade and you’ll have brand new, freshly paved roads leading to healthy coping skills and a better overall life.

11) Emotion Regulation is not about insight. If you’re anything like me, you can analyze the crap out of every situation imaginable. You can think about it intellectually. You can consider the angles. But that won’t necessarily help you out here. There was a fantastic quote in one of the books we read from in Morning Group at the hospital (I know, that sounds corny as all hell). But this quote stuck with me so much, I wrote it down in my journal. It’s from a passage called, “Let Life Reveal Itself to You” from the book Journey to the Heart by Melody Beattie:

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Sometimes we get so caught up in needing insight – thinking, if we can just dig up that treasure chest of understanding and clarity, all of our problems will be solved.  This is not the case. Emotional Regulation is about constant practice and application of the behavioral skills you need to, over time, create healthier responses to overwhelming emotions. It’s not a journey to the temple to meditate for a month and find complete serenity. It’s not a quick fix. Don’t over-think it. As the Nike advertisers would say, Just Do It! and then do it again, and again, and again until it’s your “new normal.”

12) Emotion Regulation skills are a process. Again, there’s no magic “on” switch that’s going to get thrown overnight and allow you to wake up screaming “I’m cured!” This, like everything else in life, is a process and not an event. As we dig deeper into specific skills next week, you’ll see that there are many tools available. Some will work better than others for you. I have my favorites, and you’ll have yours. Some will not work well for you the first time, but may be just what you need the second or third time. It’s a whole lot of trial and error.

Again, on paper, these skills are simple and straight forward, but putting them into practice is not easy. It involves literally reprogramming your brain. Pulling apart each individual wire to make everything you keep useful, and to ensure you’re able to get rid of the things that are not serving you and are just cluttering things up.

THE SINGLE MOST IMPORTANT THING, THOUGH is to “simply” be mindful of your emotions. Name them. Avoid the urge to avoid them. Again, in instances of depression or anxiety, avoidance can be everything from isolating yourself from the people who care about you to suicidal ideation or action. It encompasses the entire spectrum. At the core, though, all maladaptive behaviors are about avoidance of emotions we can’t or won’t tolerate. It’s completely understandable if you’re feeling depressed or anxious to want to get rid of all that grossness immediately. You are not wrong for having the urge to use substances, self-harm, lock yourself away from the world, or even consider suicide. I want you to hear that loud and clear: YOU ARE NOT WRONG. You are not bad. You are not a failure. You are not pathetic. You are not weak. You are none of those. This is not a condemnation. This is not a “you SHOULD do better” post. This is simply an introduction to the idea that there are other, healthier alternatives which, over time, will help decrease your suffering and aid in recovery. I also want to reiterate that I am not an expert in this. I’m working on learning this stuff, too. I’m in my own recovery process. But, in my experience, this stuff works. And it works wonders.

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And I leave you with this handy Emotion Vocabulary Card. What are YOU feeling?

I hope that you found this post informative and helpful. Part Three of this series will be posted next Monday! 

What are your thoughts on all this Emotion Regulation stuff? Do you think it could be helpful? Do you think it’s a load of crap? Do you have questions or parts you don’t understand? Leave all your thought in the comment section below! If you found this post helpful, please like and share it, and, if you enjoyed reading this, take a cruise around the rest of the blog and feel free to subscribe! 

FINALLY – Let’s get SOCIAL! I love to chat about pretty much anything and everything – TWEET ME or catch me on FACEBOOK  for general updates on Life, the Universe, and Everything! And in case you missed it, I’ve started a Patreon! I’m REALLY excited about the growth happening with this blog and some wicked cool collaborative projects I have coming up! Patrons will receive exclusive content, early access to blog posts, further materials on the resources discussed here (with some really fun art work by a secret guest contributor who’s kind of a big deal in the world of internet comics) and lots of other wicked cool perks as they become available! I’m also holding my first 50 Patrons, regardless of donation amount, in a special category – when physical goodies arrive, you’ll get some freebies, even if you only back me for $1/ month as a personal thank you from me to you!  

Mental Cleanse Challenge – G.L.A.D./ What’s Not Wrong?

Day two of the Mental Cleanse Challenge for me! My goal for self-care today is one of my favorite techniques to keep a running reality-check of my current situation. It’s a great way to combat the negative thoughts that can bombard me when I’m depressed. It’s quick and relatively easy, and it’s a wonderful little journaling tool to focus, at least for a few minutes a day, on the positives that are happening. (No, I’m not saying that positive thinking can eradicate depression or anxiety or Bipolar or PTSD or any mental health struggle – we all know that’s a metric shit-ton of bull.) But this self-care tool does help you counteract negative self talk and distortions. Depression tells us we’re failures and we’re not accomplishing anything with our lives. Anxiety tells us everything is wrong and we can’t possibly function as normal humans. In my struggles with Bipolar Affective Disorder, the swings can make it hard to keep track of what’s what. Sometimes, I’m untouchable and everything is “great” (though, objectively, everything is not great and I’m in for a manic episode if I’m not diligent with my treatment); sometimes, I feel so depressed I’m not even sad, I’m just numb, and I know that nothing will ever get better and I’m doomed to live life disconnected and emotionless (ahhh, the lies of depression). With PTSD, I can get so stuck in my past or so anxious about the future that it’s tricky to stay in, or even really see, the present.

This technique has helped immensely, in all of those areas. I learned it while in the Partial Hospitalization Program, in a DBT group. I look forward to doing it each day. I wanted to share it with you as a part of this challenge, as it is one of my go-to, ongoing self-care tools and I thought it may be helpful to some of you out there in Internet world, too!

So, what is this G.L.A.D./ What’s Not Wrong trick I use? G.L.A.D. is adapted from the book The Mindfulness Toolbox by Donald Altman. (Gotta cite the source.)

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This is my journal. I like laying it out with “What’s Not Wrong?” on one page and G.L.A.D on the other, but you could just as easily put them on the same page, reverse positioning- whatever you like – you do you! 

It’s really simple. Take a minute or two out of your day, every day, to write down one Gratitude, one thing you Learned, one small Accomplishment, and one Delight you experienced. (See what they did with the acronym there? Clever, right?) As for the “What’s Not Wrong?” portion, challenge yourself to think of at least one thing that is not wrong in your life right now. If you’re really struggling, it could be something as basic as “I’m breathing” or “There are shoes on my feet” or “At this exact moment, I’m warm.” If you’re not struggling as much, feel free to broaden the scope: “I have a good job.” “I have a home.” etc. Usually, I’m somewhere in the middle of those two. But, again, it’s about being in the absolute present moment if you’re really having a difficult time.

My entry for today is as follows:

What’s Not Wrong?

I got Katie to school on time today; I’m starting to figure out solutions to the “no income” issue; I’ve been writing every single day for over a week.

G.L.A.D.

Gratitude: I’m grateful for the community of advocates I’ve connected with on WordPress & Twitter – they uplift and encourage me and let me know I’m not alone.

Learned: I learned that I can push back my phone bill for a few weeks! This is also another thing I’m grateful for!

Accomplishment: I made some phone calls, which made me anxious, but I did them anyway.

Delight: My coffee was on point this morning! Perfect ratio of coffee:milk:sugar.

 

There you have it! My self-care tool of the day. Do you think that using the GLAD/What’s Not Wrong journal might be helpful to you? DO you have a different journaling technique to reflect on the positives and small victories of living with mental health diagnoses? Do you think this is a load of hippie-dippie new age crap? Whatever your thoughts, I’d love to hear them! Tweet, Facebook, or Comment below!

Self Care Service Stop: Self-Love is NOT a Bad Thing

It may come as a surprise to you, but occasionally, I have to google synonyms to words in order to make my writing a bit more interesting. Today, as I sat at my computer with my notebook at my side, I set out googling synonyms for “self-love”, in an attempt to create a catchy title for the weekly self-care segment I’m developing. Much to my surprise, the synonyms that appeared on my screen bombarded me with simultaneous guilt and uncertainty and a sort of righteous anger.  Pompous. Self-indulgent. Conceited. Self-absorbed. Egotistical. Meglomaniac. NARCISSISTIC.

I stared at the screen for a moment. Had I typed it wrong? Had I clicked on some anomalous site? Surely, these cannot be reflective of our culture’s view of self-love! So, I switched tactics. I googled “Self-Love definition”. Here’s what that search revealed:

Merriam-Webster Dictionary
Self-Love n. Love of self

  • Conceit
  • Regard for one’s own happiness or advantage

Dictionary.com
Self-Love n.

  • The instinct by which one’s actions are directed to the promotion of one’s own welfare or well-being, especially an excessive regard for one’s own advantage.
  • Conceit; Vanity
  • Narcissism

Vocabularly.com
Self-Love n.

  • An exceptional interest in or admiration for yourself
  • Feelings of excessive pride

Now, there were, of course, sites which offered the definition I had in mind when I initially searched for synonyms of Self-Love. Sites like Oxford English Dictionaries, which took the time to specify that Self-Love is generally viewed as desirable and not narcissistic. And there were articles about Self-Love as a positive component of Self-Care and the importance of being kind to yourself, but I can’t help but feel that that does not negate the overwhelming negative connotations of Self-Love we seem to carry in our collective cultural mind.

Either consciously or unconsciously, I believe that many of us view Self-Love as a negative. How could we not? The above are the definitions and synonyms most commonly associated with the term. In addition, antonyms of Self-Love include words like humbleness. Altruism. Humility. Unselfishness. Are these not things to which we are told to aspire? No one wants to be seen as “selfish”. But “altruistic” is a virtue, right? Whether you’ve actively looked up these definitions or not, there’s simply no way that this perception doesn’t spread through you and dig its tendrils deep into your brain.

From day one on this little planet of ours, most of us are ingrained with the idea that selfishness is a negative trait – a character defect, if you would. When you grow up with that mentality, how can you possibly love yourself? We judge our worth on the light we bring to others rather than the light we have ourselves. I think of it like a candle: if our flame is about to extinguish, we cannot focus on lighting others’ candles. Because sooner rather than later, our flame will go out and we will not have light for ourselves or to give to others.

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Personally, I have always struggled with the idea of Self-Love. In the CBT group in which I participated after discharge from the hospital, I learned a lot about “distorted thoughts” and “negative core beliefs.” One of my most pervasive negative core beliefs is, “I’m not worthy of happiness”, or, “Others are more worthy of happiness than I am.” In CBT, you get “homework,” where you walk through different cognitive exercises, often actually on paper, to challenge these distortions and negative core beliefs.

One assignment was to consider a negative belief you hold about yourself and list “evidence or experiences that suggest that the core belief is not 100% true all of the time.” You want to know what my list included? My “evidence” that I am “worthy of happiness” comprised of things like: I support others. I help people. I am good in a crisis. I put others first. I care about others. I’m empathetic. I am a good employee. Do you see a pattern emerging? Even any sense of positive self image (or self-love) I hold revolves around the traits considered antonyms to Self-Love. That’s how deeply embedded the tendrils of cultivated “unselfishness” are in my mind, my soul, to the deepest levels of my core essence, my Self.

So, how do we make the jump to Self-Love if we have internalized it as a negative term? What can we do, each day, to challenge that warped perception that our value lies only in altruistic self-sacrifice and selfless giving to and caring for others?

The answer lies, I believe, in embracing a certain level of “selfishness.” Now, I don’t being flipping a switch and being cold-blooded, dog-eat-dog, I’m-only-out-for-myself-and-fuck-everyone-else kind of selfishness. I mean a pure, reality-based selfishness that says, “I have the right to exist. I have the right to set boundaries. I HAVE THE RIGHT TO BE HAPPY.”

What does this look like? Anything. We are all individuals, with unique values, perceptions, wants, and needs. And we all have the right to our personal wants and needs.

In the therapy groups which I attended, I was exposed to The Anxiety & Phobia Workbook, which is, truly, a fantastic resource full of coping skills and exercises to help challenge your thinking and improve your quality of life. One of the best parts of the book, in my opinion, is The Personal Bill of Rights: 

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  1. I have the right to ask for what I want.
  2. I have the right to say no to requests or demands that I can’t meet.
  3. I have the right to express all of my feelings, positive or negative.
  4. I have the right to change my mind.
  5. I have the right to make mistakes and not have to be perfect.
  6. I have the right to follow my own values and standards.
  7. I have the right to say “no” to anything when I feel I not ready, it is unsafe, or if it violates my values.
  8. I have the right to determine my own priorities.
  9. I have the right to not be responsible for others’ behavior, actions, feelings, or problems.
  10. I have the right to expect honesty from others.
  11. I have the right to be angry at someone I love.
  12. I have the right to be uniquely myself.
  13. I have the right to feel scared and say, “I’m afraid.”
  14. I have the right to say “I don’t know.”
  15. I have the right not to give excuses or reasons for my behaviors.
  16. I have the right to make decisions based on my feelings.
  17. I have the right to my own needs for personal space and times.
  18. I have the right to be playful and frivolous.
  19. I have the right to be healthier than those around me.
  20. I have the right to in a non-abusive environment.
  21. I have the right to make friends and be comfortable with the people around me.
  22. I have the right to change and grow.
  23. I have the right to have my needs and wants respected by others.
  24. I have the right to be treated with dignity and respect.
  25. I have the right to be happy.

There you have it! The personal bill of rights and my view on “selfishness.” In truth, you are worth just as much as every other person on this earth and you do not need to perpetually place your needs on the back burner. I’m learning, slowly but surely, that the more I establish boundaries that protect my right to be treated with respect, my right to express myself, and my right to feel comfortable in my environment without owing anyone an explanation, the more I have to give others. Protecting my space and my self-worth has slowly but steadily been refilling my tank. Helping others is a wonderful thing, but sometimes you have to help yourself first.

When I first read Personal Bill of Rights, two really struck me: Number 15: I have the right not to give excuses or reasons for my behaviors; and Number 20: I have the right to be in a non-abusive environment. These kind of blew my mind at first.

What Right do you find most relevant to your life? Do any of the Rights listed rub you the wrong way? Do any of them make you sit back and say, “Wow! I never even considered that before?” I’d love to hear your thoughts via Facebook, Twitter, or in the comment section below!

Top 5 Ways to Get Through a Bad Situation (Without Making It Worse)

There’s a lot of information out there about preventative measures for relapse into a mental health crisis. There are also great resources on what to do in a crisis situation. But what do you do when you’re just having a really hard time? What if you’re feeling completely overwhelmed, but you’re not posing any threat of serious harm to yourself or others?

I’ve learned a lot in the past few months about distress tolerance skills. These tips and tricks have been immensely helpful for me in my recovery. Tonight, I’d like to share with you my Top Five skills for dealing with negative, overwhelming emotions.

NUMBER ONE

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If you’ve been following my story, you know that I live with Complex Post Traumatic Stress Disorder. Included in the PTSD gift basket are things like dissociation, panic attacks, and flash backs. Each of these events are about as fun as getting your tooth drilled without Novocain (this happened to me once at the hands of a very incompetent dentist, so I feel justified in making the comparison). You may have heard of different variations on this particular grounding technique, but my favorite method is this: look around the room you’re in and pick a color. Now, find five different shades of that color, or, if you can’t find different shades, just find five different objects of that color. Once you’ve done this, find five things you can touch. If you can, physically reach out to objects around you. Are they hard or soft? Are they smooth or rough? Are they warmer or colder than your hand? Etc. If you cannot manage to reach out, consider things you can feel without moving. What does the fabric of your shirt feel like against your shoulders? If you’re sitting – what does the chair or couch or bench feel like against your thighs and back? If you’re standing, what does the floor feel like against the soles of your shoes? How does your hair feel against your ear or neck? And so on until you’ve hit five. Finally, what are five things you can hear? This one really helps bring me back to the present, because you have to really focus to find five unique sounds. It can be challenging, and it may take a few minutes of intense listening, but I have yet to be in a place that I could not, with concentration, find five different noises. If you are still not grounded after going through these steps, repeat. In my experience, this is nearly 100% effective when I need to get back to the present and back to my center ASAP.

NUMBER TWO

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Sometimes, you’re so overwhelmed by your emotions tolerating them feels impossible. Everything starts to close in and your anxiety or depression seems to be consuming your entire being. When I’m really overwhelmed with depression, it feels like there’s a gaping hole in the middle of my chest and everything “good” about me is seeping out. It physically hurts. When I’m overwhelmed with anxiety, it seems as though the entire world is folding in on me and it’s suffocating. How can you sit with such intense emotions? Often, the mere thought of being “in your body” anymore seems impossible. You almost wish you could just crack your rib cage open and shrug off your skin and muscles for a few minutes to get some relief. These intense feelings tempt many of us to revert to old, unhealthy, maladaptive coping techniques, such as: self injury, binge eating, or substance abuse. In these moments, sometimes the best thing you can do is remember that the discomfort is temporary and find some way to distract yourself until the intensity of the feelings decreases a bit. It’s important to note that there is a difference between distraction and avoidance. Avoidance is complete neglect of your feelings, unwillingness to get curious about the causes of your distress, and, in the long run, it is not conducive to mental wellness. Distraction, on the other hand, can provide a healthy, temporary reprieve from those feelings until the intensity has diminished enough for you to sit with them and consider what may have triggered you. I’ve found it very helpful to keep a list of easy-access distraction techniques on me at all times. I keep mine in my smartphone, but I have friends who carry theirs on actual pieces of paper in their wallets. Some people I know also have a list posted somewhere in their house. Whatever method you feel will work best for you is the one you should use. When you’re not in distress, compile a list of short distraction activities you can utilize. My list includes playing a few rounds of Galaga or Tetris on my phone (10-15 minutes maximum), doing dishes, playing the “Wikipedia game” (pick two completely unrelated topics, start at one, and click links in each article to see how few clicks you need to get from the first topic to the second), and going outside for 5 minutes of fresh air and a change of scenery. Your distraction list will be unique to you, but it’s important to choose activities that will take a short time to complete to decrease the intensity of what you’re feeling until you can face it and deal with it. Choose things that you enjoy; choose things that will help clear your head.

NUMBER THREE

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I’ve mentioned this one before, but I want to expand a little on it here, because it really is a wonderful tool! Whether you’re living with a mental health diagnosis or not, every single one of us gets overwhelmed from time to time. For some of us, it’s completing that big work project or research paper for school; for some of us, it’s getting out of bed or doing the laundry. Whatever the task at hand, if you’re feeling stuck, the 10 minute rule can help. It’s pretty self explanatory – you set a timer for ten minutes and work on whatever it is you need to work on until the timer goes off. If you’re seriously depressed and feel like you can’t get out of bed, set a timer for 10 minutes and walk around your apartment for that time. When the timer goes off, you can go back to bed if you feel so inclined. If you’re writing a paper for school, set the timer for ten minutes and write until it goes off. If you feel the need to, stop once the timer goes off. I say “if you feel the need to” because often times, I’ve found, action precedes motivation. Once you actually start moving around or start writing, you might find that you’ve gained some momentum to keep going. Or, you may be completely exhausted after the ten minutes. But either is fine! You’ve done something. In those ten minutes you are tolerating a task that you thought you absolutely could not do. And you can be proud of that!

NUMBER FOUR

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Mindfulness is invaluable. Truly. I don’t care what your diagnosis is, or if you even have one – in this rushed, consumer driven, plugged in, instant gratification culture of ours, mindfulness can save your life. Mindfulness takes many forms. You can mindfully eat an apple by focusing on the texture of the fruit on your teeth and lips and tongue, the flavor, the juice, the smell, and the crisp snap of each bite. You can mindfully take a walk by considering your feet against the ground, the feel of the air on your face and hands, the sounds of traffic or nature around you, and the way the sunlight reflects off your surroundings. Mindfulness is simply being present. Not considering the future or the past. Traditional mindfulness practice involves things like deep breathing and guided meditations, but practice is definitely not limited to these things. Some people prefer traditional mindfulness practice, and that’s fantastic! If you’re moving through a busy work day and need a few minutes of guided meditation on your lunch break, I’d recommend checking out the Headspace App, if you haven’t already. As a trauma survivor living with PTSD, though, I struggle with traditional mindfulness. Focusing on my body and breath tends to trigger a panic attack, and if I’m doing it with my eyes closed, I’m in for a full-blown flashback. So, I’ve needed to get creative in my mindfulness practice. Doing the 5-5-5 technique mentioned above when I am not triggered is great mindfulness practice, and, it keeps the method fresh in my mind for easy access when I really do need it! Choosing to walk away from my phone to engage with my daughter, focusing solely on whatever game she wants to play, the details, the characters, and the inevitable laughter, is mindfulness practice. Completely devoting my attention to learning to play a new song on my guitar is mindfulness practice. Photography is mindfulness practice, as you need to really take in your surroundings, consider the person or object you’re shooting, evaluate the lighting, and position yourself in relation to that person or object to best capture the message you wish to convey with the photo. Opportunities for moments of mindfulness are everywhere. And practicing mindfulness every day can really help you access those skills when you are feeling distressed.

NUMBER FIVE

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Self soothing is intrinsic in the fabric of our beings. Self soothing skills are some of the very first things we learn as tiny, brand new humans on this planet. When things are really bad, though, we have to remind ourselves to get back to the absolute basics. We need to feel warm, safe, secure, and comforted. My favorite self-soothing techniques are wrapping up in a heavy blanket or wearing a baggy hoodie that I can burrow into and away from whatever it is in my environment that is overwhelming me. I also like to light candles or burn incense with comforting scents. Sometimes, I will put on some music, either calming or songs that bring up good memories of time spent with friends and loved ones (I have a special playlist for these moments). Occasionally, I’ll take a very warm bath. I also like to snuggle my cats. Tactile. Real. Sense-based. Basic. These are the essence of self-soothing. These techniques are for the really bad moments. I use them most when I’ve just had a flashback and I’m grounded and present but need that extra level of feeling secure and comforted. I use them when I’ve just woken up from a terrible nightmare and I’m not ready to even attempt to go back to bed yet. I use them when that gaping hole of depression in my chest feels like it’s going to swallow me up entirely. I use them when anxiety is making the world collapse on me and I feel like I’m being crushed. Self-soothing is very literally about just holding on and riding the wave of intense emotion until it passes. No goal in mind afterward. Just getting through the moment as comfortably as you can.

 

There you have it! My personal Top Five distress tolerance skills. What do you do to get through a bad situation without making it worse? Do you have any favorite grounding techniques, healthy distraction methods, motivational tricks (like the ten minute rule), mindfulness techniques, or self-soothing activities or items you like to use? If so, I’d love to hear your tips and tricks in the comment section below, on Twitter (@paradichotomy), or on Facebook!