DBT#2: I am a zen master

I approached the 2nd DBT sesh with an open mind after being pulled up on my shitty/wilful attitude by therapist Monica. I’m glad I did. I started learning stuff today.

We started as always with mindfulness. I liked this one as it was about sounds and that’s my thing (how I ground myself). Cool. Good start. Not for someone else though, for them it was triggering. I was impressed with the determination of the triggered person though. She was going to overcome it and I could see that she was a strong person. It struck me – everyone around that table had experienced trauma. Essentially every single one of us had been fucked over by someone and then, as a result, by life. Not fair.

Anyway after the mindfulness it was on to homework feedback. As a collective we shrivelled up. The homework feedback was mixed in success. It was certainly intense. Anger, embarrassment, confusion, anxiety, relief, confidence and probably more were all displayed by us. There were tears but they weren’t mine. I can’t say much more because I want to respect confidentiality. It became clear that some people were really committed to the process whereas others were yet to be convinced. Someone stormed out saying it was a waste of time. That was pretty intense too.

Despite the intensity and range of emotions shown all the talk of mindfulness practice was actually quite calming. I felt all zen. All this talk of meditation! In fact the facilitators use these little chimes to signal the start and end of each mindfulness exercise – ding!

We had a break and it was nice to escape the intensity. We sat chatting and started learning about one another. I began to feel a bit of camaraderie for my fellow group members. We are all so varied in age and from different walks of life but we all have this personality disorder and it ties us together. We all know the chronic emptiness, the distrust, the distress and the feeling of just not fitting in the world. Any time someone tells a little anecdote we can all relate – yes, I’ve been there too. It’s comforting. Yes we have something ‘wrong’ with us but we’re not alone. We’re the same (in that respect anyway).

We go back in and Sally leads with a session on the why skills of mindfulness:

  • Non-judgementally
  • One mindedness 
  • Effectiveness

Each point on its own doesn’t make much sense but they are expanded upon. I recognise myself. I know that these are negative behaviours I display. I’d like to be better but, just for a moment, I feel a little bit of doubt; isn’t this who I am? If I change this stuff about me will I still be me? No time to worry about that there’s more mindfulness to be done. This time we’re playing with pipe cleaners and it goes down well – ding! Yeah we’re definitely getting more comfortable doing this.

Then the homework is set – fill in diary card, work on and log examples of using the why skills. Ok. That doesn’t seem too bad. I feel more confident. I know these are things I need to work on and I can see how focusing on these skills will help. I leave feeling much more upbeat. In fact there had been some pretty funny stuff happen in the session and I wish I could share it!

But no, today was ok. Heck it was positively zen – ding! 

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DBT#1: What a crock of shit

Finally the day arrived. Time to start my DBT therapy. I was sick with nerves. Actually it was more than that; I was frightened. I cycled to the place. It’s a big house, Victorian maybe, on a busy road. I’ve been there before for my DBT assessments and now I’ll be there twice a week for the next 14 months.

The receptionist was really friendly. I was nervously saying hello when the nurse therapist appeared. I’d never met her before and she introduced herself with a handshake. Let’s call her Sally. I didn’t take to her. I don’t know why. She was earnest and friendly. Maybe that was it. I didn’t trust her friendliness. Sally ushered me into a room, pointing out tea and coffee as she went. It was unwelcome babble. I was trying to focus on walking, not listening. There were some group members already on the room. I said hello and we all sat in silence staring at anything except each other. More people arrived. Each time the new arrival was greeted with the same babble and then silence. Awkward awkward silence.

Sally then moved us through into Room 1. It was set up meeting room style. A large table filled the room and there was a whiteboard at the front. We all took seats. Sally handed out name cards. I felt really bad. Like I wanted to scream, run escape or break the glass windows behind me. Instead I just tried to disappear inside myself. There were folders and pens and worksheets at each place. We started by filling in questionnaires about ourselves. Sally apologised over and over for this explaining that it was to measure the course effectiveness. I didn’t care. I was glad of something to do. It was all the usual crap about feeling suicidal, feeling like you don’t fit in. Tick this box, rate this feeling. Yada yada yada whatever.

There was another facilitator there, a psychologist. We’ll call her Amy. After we’d completed our questionnaires Sally welcomed us again. She told us how lovely it was to see us all. Right. Lovely to have you you bunch of suicidal nutters. Simply charmed I’m sure. She talked a lot about the rules. I was truly bored out of my skull. Frustrated too. Fucking hell! Monica (my DBT therapist) had already thoroughly gone through the rules AND they’d been sent in the post! I was difficult and sullen. I avoided eye contact, even putting my head on the desk. A dickish move I’ll admit but I was feeling so trapped and invisible and was really struggling. The first any of us spoke was to discuss which swear words we wouldn’t allow. I didn’t contribute to the conversation just sat there seething get-the-fuck-on-with-it. Everything was so slow. The swearing conversation drew to a close and I nearly announced THANK FUCK FOR THAT. Sally repeated some of the rules about leaving the room (we can’t be trusted on our own for any length of time?).

Then Sally was showing us our diary sheet that we get to fill in every day. Don’t worry! I know it looks complicated! She reassured. Sally love, I thought, it’s a chuffing table and it’s pretty self-explanatory. You tick the boxes and rate the things like self-harm urges. Anyway the whole thing had to explained and, in fairness, I did have a question. There is a box on the diary sheet where we rate (0-5) how strong our urge to use drugs is each day. My question was what counts as drugs? For example I don’t drink alcohol so say I have a really strong urge (e.g. a 4/5) to get absolutely hammered but I don’t do it, does that get recorded as an urge to use drugs (i.e. is alcohol a drug)? Well, this flummoxed them. Amy piped up that there was a section to record how much alcohol I drank. No, no…the point is that I resist the urge…so there’s nothing to record in the actual number of alcohol box….Frustrating? Only completely. Round and round the conversation went. in the end Sally said yes, record it in the urges box. Right. We moved on. The absolute importance of this diary sheet was hammered into us time and time again and I couldn’t help but ask what is the point of the diary sheet? Sally and Amy exchanged blank looks as if it was a strange question. It wasn’t a strange question! If these sheets are so important  then why? What is the point of them? What will they be used for? They sort of mumbled about monitoring progress. Oh right I said. Strange I thought because all the questionnaires at the start were about monitoring progress but whatever. I’d lost the will to live so I didn’t really care.

Then it was break time. Big collective sighs of relief. Escape. And coffee. Thank fuck for coffee.

In the afternoon we were treated to what is mindfulness? Now I know I’m going to sound an arrogant arse here but I discovered mindfulness back in June 2015 (15 months ago). To have to sit and listen to all of this was so dull. The boredom made me frustrated and I felt so trapped. The only way out of being ill is through this DB-chuffing-T so no matter how bitter the medicine I was going to have to take it. We did a couple of mindfulness exercises and that just ratcheted up my annoyance: they were exactly the same exercises Nora had suggested to me. This was not moving forward. Argh.

Still, I committed to the exercises. When I add up all the hours I will spend doing DBT it will literally be days. If I’m going to spend days of my life doing something then I want it to count so, no matter my frustration or anger, I gave it my all. Homework was set and we all escaped.

When I got home the futility of the last 3 hours got the better of me and I scraped my knuckles along a wall to hurt myself. I instantly felt better. Ha! Screw you DBT facilitators! You can’t control me! I am still bad, still rotten. Ha ha ha. I know that’s a pretty stupid mindset but if I was sensible I wouldn’t be doing DBT would I?

So my overarching feeling about my long awaited, precious, first DBT session was: what-a-crock-of-shit. 

Fuck off wise mind.

 

 

Radical Acceptance

I had my first one-to-one DBT session with Monica yesterday. It was good. It was awkward.

We went over ground rules and we both agreed that honesty, even if difficult, was the best way forward. I like that about Monica. I trust her to speak the truth so I don’t have to agonise second guessing her. It makes things much easier. She is very good at being non-judgemental. 

She asked me how the first DBT group session had gone. I didn’t lie. I told her it was a crock of shit (in much nicer language!). She wanted to do a chain link analysis on the self-harm I had done after group. Ouch! But in for a penny, in for a pound…

We went through the day noting my thoughts, actions and feelings. At the end Monica said “yeah that’s a really detailed description of your day but nowhere have you said then I decided to hurt myself”. True. So I explained that I hadn’t decided to do it – it just happened. “No, your arm doesn’t move by itself. You need to have a thought.” Hmmm, right again. So we talked a bit more about it and I admitted that actually I was angry. I was angry at being in this situation; that this is my life now; and it’s not fair that I have to come to this stupid place weekly for 14 months. I know it’s the ‘wrong’ thing to feel but I did.

Aha! Now we were getting somewhere!

She said I needed radical acceptance. Apparently this is accepting my situation for what it is. She used an analogy: imagine you’re on a tennis court and one of those machines is firing balls at you. That’s life. Life will always throw balls at you. You can get angry about it, smash your racquet, shout and scream or you can pick up your racquet and hit the balls back. This is your situation. Accept it. 

That made me more angry so I told her I wanted to smash the room up, to scream, to go absolutely mental (fear that ship may have sailed!). It’s not fair not fair not fair. I could see her point. This was a waste of energy. I was still pissed off though as she was explaining about acceptance and I’ve done so much fucking accepting over my lifetime that I have had it. I accepted my shitty childhood situation, I accepted the rape, I accepted my chemist career failing, I accepted losing the pregnancies, I accepted resigning my promotion, I accepted having to go part-time, I accepted having to walk away from work, I accepted not being allowed to drive. I’m done accepting stuff.

Too bad, Monica tells me, you can turn up here every week for 14 months and you won’t get anywhere until you accept it: this is the situation now.

Fuck.

So radical acceptance it is. I’ll work on it. (But damn I still want to smash some stuff up!) 

Splitting With My Psychiatrist 

Saw my psychiatristyesterday for the 2nd time. Was sick with nerves and up at 4am, unable to sleep for worrying. My memory of the psychiatrist was that he was tall and lanky – all angles. I remembered him as dismissive and bored. So yes I was terrified. 
My memory lied.
I walked past him in the corridor and didn’t even recognise him. When he doubled back to collect me from the waiting room I was all curled up in a nervous ball. I peeked out from my makeshift shell. Eh? Who was this guy? He was not tall. He was quite short actually. Weird. 

Then in the consultation he was really friendly. I felt at ease and blabbed away. I found myself…liking him. What?! I really hadn’t liked him at all last time but he was being kind. I admitted something out loud that I’d never admitted before. He said that the thing I said made him sad. That surprised me and touched me because he was so disinterested last time. I’m not sure if it’s a good sign but we kind of had a laugh. Even when I pointed my fingers to my temple mimicking shooting myself in the head. It was a joke and he laughed and I was surprised again. It’s quite normal to be taken to task by hcp when I try and use humour, particularly very dark humour. I left the appointment feeling positive and confident that I really am getting somewhere with this whole mental illness thing.

I had to laugh at myself: how EUPD can a person be?! That was the phenomenon known as splitting good and proper. From devaluing someone to idealising them. Still, it was nice to like him instead of despise him. Now I’ll have to see what his report says.

My Strange Belief: The Universe-Blip

Strange beliefs. The phrase conjures up images of believing that you’re being controlled by aliens, or something.

Do I have strange beliefs? Ummm…

Well, I’ve never really told anyone this but, I believe that I am a mistake. That’s not so bad. Lots of people with mental illness have that don’t they? The specifics of my belief are that I was never meant to be and there was some sort of blip in the universe that meant I came into being when I wasn’t supposed to. I believe that because I exist (when I shouldn’t) that it causes upset in the world; bad things happen because the planet is unbalanced because I exist. 

WHOA!

Yup. Deep down inside me I believe this and I look for evidence to confirm it – particularly bad world events around my birthday.

You want to leave now? That’s ok. I get it. It’s proper bonkers. I know it’s not actually true. D’uh! Let me explain…

You know that feeling when you’re alone at home? It’s dark and you just get the sense that someone is watching you. You know there is no one there. Absolutely factually know it. However you can still feel like there is someone there. No matter how much your rational brain tells you ‘dude, there’s no one there!’, you still can’t shake the the feeling. That what my strange belief feels like. I know it’s not true but I still feel like it is. Anyway, no matter, I’m pretty good at managing my strange beliefs and although the universe-blip belief never goes away it also never bothers me. It’s just there. 

Another weird one I have is that my whole life is an experiment. I have a chip in my head and some people in my life can hear my thoughts. Not everyone is in on it though so I don’t believe my husband can hear my thoughts. That one only pops up if I’m kind of stressed. Again, I know this isn’t true! 

Lately I’ve noticed other weird thoughts creep in. I was riding my bike and – pop! –hey my bike can fly!  Err no. It can’t. But what if it can? But it can’t. Ok then. And just like that it was gone. The thought my bike could fly was serious enough to disconcert me. Then, that same night I was in bed trying to sleep. I felt calm. No fears that any visions were about to happen so all good. Ahhhh! We have a TV and a Virgin TV box in our room. Occasionally the box clicks into some mode (I dunno what it’s doing) and it whirrs away for a bit. Nothing new there. So I was lying there trying to do the sleep thing, box starts whirring and I automatically think ‘oh, the box is trying to talk to me’. Ummmm no. Yes but listen to how it whirrs – it could be like a code? No Trudy. It is an inanimate object. It is not trying to speak to you. Are you ok? Yeah I suppose you’re right. TV boxes don’t talk. Flippin’ eck! And I settled down to sleep frowning at thinking such a bizarre thing, even in passing. 

Those two bizarre thoughts both occurred on Venlafaxine day one so maybe that’s the source. Maybe everyone has these thoughts? They were just passing thoughts though not beliefs like the universe-blip so not a problem.

Thing is, although I manage the universe-blip belief pretty well it is the thing, I think, that makes me do dangerous stuff. When I took my overdose I knew that I could be saved. However I honestly hand-on-heart believed that the universe may take the opportunity to correct the blip. It didn’t. Then my fascination with jumping off a local bridge. Again there’s a good chance I could survive it  – if I’m meant to. Same with the train tracks thing. And I find this too hard to explain to anyone really because I know how mad it sounds. I think if I tell the psychiatrist when I see him next week that he’ll think I’m making it up, y’know cos of the BPD? Sigh!

So that’s why I wrote this. Getting it out of my head helps. I can’t believe I won’t ever feel like this. I have always felt like this but I can’t tell anyone (shhhh!). I don’t think they’ll believe my belief. So I’ll just keep it to myself. 

That’s my stigma

I’ve noticed something about the stigma surrounding mental illness. It grows with time. It mutates. At first it’s just a buzzword “stigma“, then it’s an occasional sensation and eventually it feels as real as a brick wall. 

When this episode first began back in December 2015 I was still functioning pretty well. I was working and parenting. So when it turned out my mental health was in a bad way I didn’t feel the stigma because I still saw myself as normal and as contributing. I wasn’t going to shout from the rooftops about the antidepressants I had started but equally I was happy to chat casually about them and the process of waiting for counselling. I didn’t feel judged. Lots of people had similar experiences and had been on antidepressants. At this level the stigma was, in my experience, non-existent. Well, OK, internally I felt a great sense of shame but that’s par for the course no?

Time moved on. I worsened. Days off work sick happened. That internal sense of shame burned more fiercely. The embarrassment of making work commitments and then breaking them. Over and over and over again. Unreliable. No one ever pulled me up on any of this. To my face they were very understanding but I began to feel different. Not quite part of the team and I had no recourse because any work I didn’t do had to be picked up by someone else. I felt awful. Everyone knew or suspected that I was having mental health troubles again for this was not the first time. 

Then I tried to kill myself. More time off work. Having to discuss it with HR and occupational health and knowing it would leak out to certain people. Safety plans put in place. Work were actually really supportive. It’s hard to see what more they could have done and that’s excellent. Stigma isn’t just about that though, it’s about feelings too. I was no longer just a teacher. I was a crazy teacher with a safety plan. I now felt very separate to my colleagues. If anyone made jokes about mental health eg trigger warnings or safe places then it’d cut me deep. These were things others laughed about but not me. I was scared of their opinions of me but no one said anything. 

Then I made some Facebook posts. Many people offered supportive messages which I appreciated. Others though, well, they faded away. I remember emailing one person about a work related matter and they replied that they were leaving me be as they guessed that I had other things to contend with at the moment after reading some of my Facebook posts. They were actively doing nothing. I was really embarrassed. I’d embarrassed myself discussing my personal mental health on such a public forum. One of my brothers sent a message that was essentially verbal abuse – because I was talking about my mental health and he was keen to point out that he and my other brothers were normal. I deactivated Facebook. I knew I couldn’t be trusted to only post ‘normal’ stuff (whatever that means). My mental health struggles fill all of my days at the moment; to feel that I couldn’t talk about the main thing that filled my day seemed absurd so best to leave Facebook altogether. No one really noticed. I just faded away and no one came looking. I mean, they knew I was ill but enquires wondering how I’m getting on are few and far between. I do understand: it’s awkward and people are busy. What do they say? What do I say? Hey how are you? Not great, I’m lying in bed trying not to hurt myself. Right, errrrr…… The stigma of self-harming and feeling suicidal is so huge. It’s like people entirely miss the point – what’s wrong with her that she’s want to do that?!?? See, you’re missing the point. It’s because there’s something wrong with me that I want to do that and it’s actually an illness. I’m not just bad and selfish. 

So time moves on. I don’t work anymore. When I left there was no card. No goodbye drinks. I wasn’t mentioned on any of the staff leaving emails (as I would have been had I been taking maternity leave). I disappeared out of the door one day and that was that. The plan is that I’m on a sabbatical year and return to my job in September 2017 but the way I left…felt so…shameful. No one knows what to say so no one says anything.

Today I walked to the supermarket and I realised how far into stigma I have fallen in 9 months. 9 months ago I’d finish work drive to the supermarket (not allowed to drive anymore), swan in swinging my lanyard, pick up my antidepressant prescription and maybe some wine (I don’t drink anymore) and drive home. Now? Well the thought of the supermarket can invoke a panic attack. I often see pupils who know me and it feels awful. Like being stood there in a swimming costume or something. Look at me. Or don’t. Actually please don’t look at me. Today I was in joggy bottoms, trainers, a jumper, and a bright pink waterproof jacket. Basically I looked an absolute sight and, to be fair, today was a good day. I’ve gone looking much worse. I worry about people realising what is wrong with me. How will I command the respect of teenagers if they know I’m mental? What will their parents think? Will they empathise or will they find fault in my work? What if people from my son’s school see me? Will they know? The Facebook posts and being off work and looking like this? People must know I’m mental. 

It worries me and I noticed that because back in December I didn’t worry about stigma. As time has passed, people have faded from my life, the illness has grown and so, too, has the stigma. It’s not that I get abuse for having a mental health condition, abuse is extremely rare for me. No, it’s more that people say nothing. Nothing. Like it’s not there. Like a whole big massive thing in my life doesn’t exist and, it seems, as if by association I stop existing too. That’s my stigma. The invisible brick wall around me that feels impenetrable. The silence. My illness is already invisible, trying to fight it against a background of silence, trapped by an invisible wall, well, it’s hard. And I’d tell you if you ever asked…

That’s my stigma.

Serendipity 

Being a science teacher includes teaching the scientific method. You know the whole hypothesis-plan-experiment-data-conclusion-evaluation thing? And sure, the scientific method has its place but there is another method which yields discovery. We call that method serendipity. It is basically good luck coupled with sound observation and an ability to connect the dots. This is how Fleming discovered penicillin. It was not the scientific method. No sir! His lab was a mess. His bacterial specimens were overgrown and then he noticed that bacterial growth was inhibited in a sample. He connected the dots et Voila! Penicillin! 

I like serendipity. The word sounds good and there’s something quite marvellous about being able to discover. Us humans love to discover.  I’m a scientist and have had my own bit of serendipity recently regarding my medication.

Things were at crisis point again. The crisis team could do nothing, again. I was left to my own devices and needed to do something that wasn’t going to be life threatening so I took 50mg of tramadol that I had leftover from an operation. It worked. My mood lifted and I slept in the kind of peace that I can’t even remember the last time I felt. 

Bearing in mind I have a degree in medicinal chemistry I researched tramadol further. I am always very wary of possible other drug interactions, dosage and addiction. I satisfied myself that I was ok to use this in an emergency and the next time a crisis hit (which wasn’t long after) I used tramadol again to avert me from doing something stupid. I was there, ready to do the stupid thing. I had what I needed and was sat crying trying to think of another way when I remembered the tramadol. It worked again. I slept and when I awoke I got rid of the dangerous things I had. My mood had lifted. I was ok. In total I’ve used the tramadol twice and both times have been a huge success. This made me wonder all kinds of things.

I found out that tramadol could increase serotonin – the very thing that the 3 previous antidepressants I had tried had failed to do. Although it’s more complicated than that I began to wonder: why can’t I just take tramadol? Anyway I could appreciate that it is an opioid and addictive so I spoke to Nora about this. I got nowhere. I continued to google to learn about tramadol and it’s use in depression so that I could have a more informed discussion. D’y know what I found out? Tramadol is chemically related to a very popular antidepressant called Venlafaxine (brand name Effexor). Serendipity.

I love molecule pictures. Look at these beautiful chemicals!


It was pure luck that I had tramadol in the house when that crisis hit (although the ectopic pregnancy that the drug was for was certainly not lucky). It was pure desperation that had driven me to take it. It was a pretty fortunate set of circumstances that I am trained in med. chem. That set of circumstances lead me to requesting to try Venlafaxine. The psychiatrist has no issues with it despite previously halting further trials of antidepressants. (See Let’s Talk About Meds Baby)  Ok let’s go! 

I found something that might help. When in that pit – that endless black tunnel – then any little ray of hope is welcome. 

It does seem a bit…I don’t know the word…weird? Weird that I had to have this strange serendipitous set of circumstances and had to connect the dots myself to access a very commonly prescribed medication. 

I’m on day 2 of my Venlafaxine. It’s 2 X 37.5mg. I’ve noticed some changes but I’m changeable anyway so trying not to over analyse it. (Haha! Believe that and you’ll believe anything!) .

Maybe it’ll work. Maybe it won’t but the scientific method says that I should try. Therefore right now I’m in ‘experiment’ then we’ll look at the ‘data’ and draw some ‘conclusions’ because even serendipitous discoveries benefit from a bit of scientific method.

Bitterness

Is this bitterness I feel part of being ill or is it justified? Sometimes I feel as if I look at things with my eyes narrowed, suspiciously – channeling Gollum.

It’s part of the isolation and withdrawal I think. I retreat into me and my sad little world and everyone else becomes them…they does not understand, they does not care….


I came off social media as the bitterness levels being generated within me were utterly astounding:

  • Look at them all having a lovely time
  • Why have none of them noticed that I’m staying quiet
  • None of them are commenting or like my my stuff
  • I am not like them with their barbecues and family dinners or exercise or afternoon shopping.

I am alone. Not literally but in every way emotionally and mentally I am as much in a cave as Gollum was. Having a cave with windows was too distressing. Watching them all happy, all around me practically within touching distance? Well, it was too much. I shut the windows.

I could have continued the charade. I’ve got super cute kids. I could post their photos but that isn’t the message I want to put out from my cave. The message I want to send is an SOS. That message doesn’t get out though or, if it does, it doesn’t get noticed. Bitter.

I read Shoot The Damn Dog by Sally Brampton. Great book but God did I feel bitter reading it? I was bitter about the fact she only had to say she felt suicidal and she was hospitalised. I was bitter about all the psychiatrists, counsellors and therapy she had. I was bitter that she got 5 days a week to herself and that she could afford private yoga. Bitter bitter bitter. I found out recently that Sally Brampton and I share the same birthday but also, very sadly, that she’s died of suicide. May 10th 2016. The day after I got out of hospital. Anyway, I’m very sad that Sally Brampton died of her illness. Perhaps that makes the bitterness more difficult. I can see how wrong it is.

I’m bitter about my mum’s alcoholism, that dad didn’t protect us, that no one in authority did anything, that some family looked the other way. 

I’m bitter that I’ve been in this mental hell for 9 months now and in that time I’ve received one (one!) card of support. No one has got in a car or on a train and actually come to see me. 9 months of life threatening illness and people haven’t seemed, to me, to make any effort whatsoever. I’m probably being unfair and narcissistic but sometimes, every once in a while, maybe I can apportion some of my negativity on to others rather than absorbing it all myself. 
I’m bitter about the time I’m missing with my children. They will never be this age again and especially my daughter who is in toddlerdom; that time before we become aware of the world and can happily dance with no worry of what others may think. It’s marvellous and I wish I could bottle it for her future. 

I’m bitter about my career that has suffered. I believe I could be good at teaching, really good…but not like this. My career has been sliced and diced and carved up. There is still some left but it’s not the same.

I’m bitter about the lack of treatment options; about NHS waiting times; about the psychiatrist who seems to have zero interest in my illness, in me. I’m bitter that the drugs didn’t work – no fair. 

So, so much to be bitter about it. In fairness I think I do have a case. Things are kind of crap and it’s probably OK to be  a bit bitter. However if I am to move on then I must let this bitterness go. Replace it with betterness. I have to rebuild my life, in time, and bitterness is no solid foundation for doing that. The alternative is that I stay in my Gollum cave, my precious being my sense of being wronged, my illness. Just me and the illness. No, that’s not appealing. I’ve got to get rid of this bitterness.

I don’t know how to do that. 

DBT: Chain Link Analysis

Hi

I haven’t started my DBT (dialectical behaviour therapy) yet but in order to help me control my dangerous impulses I’ve done some of these with Nora. We’re probably not doing it 100% properly but if you find yourself about to do something which you know you shouldn’t then this is surely worth a shot. If anyone has any links to better, easy access resources about chain link analysis then it’d be fab if you’d share them.

So there are a series of questions which you answer. You write your answers. They key to getting this right is answering in excruciating detail. Yes the instructions actually say excruciating and, having done it, it certainly is. I squirm and cry as I answer these questions. When answering the detail should be such that someone else could completely re-enact the event using what you have written. You should think about:

  • How you felt
  • What did you see 
  • What were you doing
  • Any smells
  • What thoughts were you having 
  • What words were you saying
  • What could you hear
  • What physical sensations did you have?

Think about each of these when you answer the following:

  1. Describe the problem behaviour. For example this might be cutting or getting drunk or losing your temper etc. It should be about a specific event so not cutting in general but that you want to do it right now.
  2. What has caused you to want to do this? So what’s been happening in the run up to this. 
  3. What are the things that have made you vulnerable? So it might be things like tiredness, extra stress, a sick child, being alone. 
  4. Write down the chain of events. Personally I find it easier to start where I’m at (eg I’m sat here with a knife) and then work backwards (eg I got the knife from…). I try and add the details from the bullets above eg I felt excited and guilty getting the knife, my hands were shaking.
  5. What are the consequences? What will happen if you do this thing? I find I really have to think hard about this because when I’m in that bad place I think that it doesn’t matter. 
  6. What solutions are there to this problem? I’m not so good at this but do try and think – what else could you try before doing this thing?
  7. How could you prevent being in this situation again? I’ll be honest I’ve never gotten this far. I usually have calmed enough be then and I don’t actually know how to prevent it. As I say I haven’t done the DBT yet!
  8. What do you need to do to repair this situation? Practical steps to fix things. 

Ok so obviously there’s more to it than that. I don’t want to mislead anyone; doing this exercise isn’t the same as having DBT (dialectical behaviour therapy). I’ve put here as advice really to help people when they’re stuck in that awful place, with no one to ask for help and urges that are overpowering. I was in that place this morning. I don’t write this from a sanctimonious place (I hope). I get it. Please don’t use this in place of getting proper therapy or support but do try it before you act on those urges. Sometimes it doesn’t work for me as I’m too petulant and don’t engage with it properly. Other times it works brilliantly. I show Nora my answers as it helps her to understand my state of mind at that time. It is awful when she reads it. It’s so raw and personal but it’s the reality of this illness and I will face it.

For additional support there is also the  National Self Harm Network website. I recommend it.

So I hope you find it useful if you find yourself in that bad place. From the bottom of my heart: stay safe.