Coping Skills, Life, Uncategorized

What to do when things aren’t working

I’ve heard other people on blogs and in person express the sentiment that they’re trying everything they know how to do, and it’s not working. What do you do when nothing seems to work?

I’ve been struggling with feeling like nothing’s working recently and then feeling even more hopeless as a result. I’ve been having a tough time since my uncle and and grandmother passed away. I’m grieving and being reminded of past trauma and the recent trauma of their deaths in intrusive and unpleasant ways, all the while being apart from my family (away at college) and trying to literally survive and not fail my classes.

So what do you do??? I wish I had more answers than what I have, but I’ll share what’s getting me through so far, and if anyone has any other ideas, please let me know.

Validate yourself. If you’re trying everything you know and using all the skills you have, you’re probably trying really hard and dealing with some pretty hard stuff! Give yourself some credit and acknowledge that you are struggling.

Think about what you mean when you say “things aren’t working.” Sometimes the skills I use do work; they just don’t solve all my problems. For example, the goal of distress tolerance skills in DBT is to get you through the moment without worsening the situation. They’re not supposed to make you feel happy or to get rid of whatever was causing the strong emotion. If I hold ice up to my face (the TIPP skill) in place of acting on crisis urges, then the skill worked. Even if I am still really upset and the crisis urges come back soon, the skill got me through that moment. I expect that skills will help more than they are able to. Having more realistic expectations here would help, I think.

Make sure you’re doing the things that have helped in the past. Personally, I know that I have to eat enough and sleep enough and get exercise and see my friends and have time to myself regularly in order to maximize my okay-ness. Sometimes I get frustrated thinking, “But I slept so much! I ate three meals! I did so much good work and tried so hard! Whyyy am I not feeling better?” and maybe it’s because I’m avoiding my friends and haven’t had a real conversation with anyone in a week. Not doing one essential thing, even when you’re doing all the others, could be the missing piece.

Ask for and accept help from other people. You don’t have to do everything alone! Friends, family, strangers, online friends, old friends, therapists, doctors, etc. can all help! For example, my mom visited me at college this past weekend. She has offered to do this in the past, but this was the first time that I accepted her offer. She was willing to help, and I knew it probably would make me feel better and was desperate. Her visit ended up going great, and I felt much better afterwards deep down.

Still on the topic of asking for help, I sometimes know that I need help but don’t know what I need. When people ask, “What can I do?” or “How can I help?” I don’t know how to answer. I’m still working on learning what I need, but here are some things that I have asked for: a hug (many times), for my friend to let me vent, for my therapist to reply to my email, for an extension on an assignment, for someone to eat a meal with me, for a friend to send me something in the mail, to schedule an appointment with a doctor, to set up a time to facetime a friend. These are things I can ask for! People can always choose to say no, but asking doesn’t hurt and often helps a lot!

Maybe consider bigger changes in your life. I know that if I keep on feeling this badly, taking a semester or a year off of school is an option. Dropping some classes is an option. Going to an inpatient, residential, or day treatment center is an option. Changing my therapist is an option. Transferring schools or switching my major are options. There are lots of options!

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Radically accepting that 1) you are having a tough time right now, and that 2) there are things you can’t change and have no control over, can allow you to see a situation more realistically and therefore make better decisions about the things you can control. I can’t change the fact that my uncle and grandmother died, but I can celebrate their lives, think of fond memories, and strive to embody the qualities I admired in them.

Have patience. I know that this can be really hard to do. But giving things time and just pushing forward can work. Hold on. Time may not heal everything, but it can help with a lot. I have a saying that I like: “There are good days and bad days. Keep going, and you’ll find both.”

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Life, Therapy, Uncategorized

Self harm or self care?

(Please note: This is about self harm and suicidal urges, self-destructive thoughts, and specific ways I try to harm myself (including with food).)

I’ve been struggling recently with basic self care. Anything that I know is good for me or that will help me is hard for me to do.

I used to self harm myself in one specific way. I told my DBT therapist over the summer about it, and I’ve been tracking it on my diary card and using skills like distraction, “riding the wave,” etc. to not engage in the behavior. And, I’ve been successful! I haven’t done that behavior in over three months. Yay!

But… the urges to hurt myself or kill myself haven’t gone away. I have the urges as much as I did when I was still using the behavior. Sometimes I’m successful in using distraction or some sort of positive coping mechanism to manage and resist the urge. However, if the urge is very strong, or I’ve been feeling it constantly for several hours and nothing seems to be helping, or I’m too hopeless to believe skills will work… then I bargain with myself.

I say, “Okay, fine, I won’t kill myself. But, as a compromise, I won’t eat dinner. I know that eating dinner is something that will help me and make me feel better, and that is exactly why I won’t do it.”

I’ll say to my emotion mind, “I know you have the urge to hurt yourself. You can’t do that because it’ll mean you have to stop trauma work. But you still feel intense shame and anger at yourself and want to harm yourself. So, here’s something. I know you feel tired and want to go to sleep. How about you just don’t go to sleep?” And then I stay up until 2 am and don’t get enough sleep and feel more angry and guilty the next day and even more tired.

I’m still harming myself, just in less obvious ways. Not eating enough. Not sleeping enough. Not brushing my teeth. Avoiding friends because I know they’ll make me feel better. Avoiding using skills because I know they’ll make me feel better. Not submitting applications because I’m mad at myself and don’t think I deserve it. Eating chocolate late at night because I know it’ll keep me awake, and I want to prevent myself from taking care of myself and sleeping.

It’s almost easier to self harm in these ways because it’s a smaller decision to make. It often doesn’t require action, just intentional inaction.

Writing this out is helping me realize that self harm is still an issue for me, even if it doesn’t leave visible scars. I’m losing weight, even if it’s not noticeable. I’m hungry all the time. I sometimes have an erratic sleep schedule. My teeth hurt often. My eyesight is getting worse because I refuse to look up from my phone or computer when I start to get a headache. I feel as though I need to feel the pain of the headache because I deserve it.

So, it’s not good. There are negative consequences to doing these things. My “cured” self harm has really just been transformed into different behaviors because I was replacing the behavior, not acting opposite to it.

To be fair to myself, I do sometimes just distract and not do anything harmful. I sometimes reach out to friends or my therapist. I sometimes eat meals because I know it’ll make me feel better. There are just some times that I don’t…

I think the solution is opposite action. Instead of acting on the urge to harm myself, I want to acknowledge that it’s an urge, use the self talk that my therapist and I came up with, and act opposite to the urge.

The self talk is along the lines of,

  • “This is emotion mind talking. It’s strong, but it’s emotion mind.
  • Using skills has helped in the past.
  • Sometimes skills take a while to work.
  • Skills “working” is relative.
  • Distress tolerance is supposed to help get you through the moment, not make you feel better. If you feel better, that’s an added bonus.
  • When you are feeling better, you like feeling better.
  • In the times that you’re not feeling like this, you would want to take care of yourself and help yourself feel better.”

Opposite action to the urge to hurt myself and to the emotions of shame and guilt is to be kind to myself. Some options are: putting lotion on my skin instead of hurting my skin, eating food, hanging out with friends, wearing pretty clothes, watching or reading something funny, etc.

Opposite action to self harm is self care. It’s hard to do because it’s the very thing that the self harm urges are telling me not to do. That’s where the self talk comes in. I have to believe it’ll work and have enough perspective to remember that there’s more than this moment and that self care or skills have helped in the past.

If I’m not thinking clearly enough to do the above, then distraction, calling my therapist, or other skills (if I’m willing to use them) are helpful.

In conclusion… self harm is still a problem for me, and I, Wise Mind Me, want to use the techniques listed above to take care of myself as opposite action to the emotions and urges I sometimes feel. I do deserve to feel better.

Positives

Major accomplishments of 2018

I have actually made a lot of progress in 2018.

Mental Health

I’ve gotten more serious about making actual progress in therapy instead of using it as more of a temporary fix to my immediate problems and worries. In the winter/spring, I made a bunch of new lists to follow in different situations. Over the summer, I started DBT, which has really helped me. I learned more about emotions. I was a little clueless before. I can now generally identify what I’m feeling — sadness, anger, shame, fear, love, etc. — and understand where that emotion came from and whether or not it fits the facts of the situation. I didn’t really know that shame was an emotion before this year, and I feel shame a lot!

I also learned what dissociation is, what it feels like for me when it’s happening, and what I can do to stop it. Another thing I didn’t know that was happening to me a lot!

I made the decision to start prolonged exposure therapy for PTSD. I’ve been doing behavioral exposures on my own to things I avoid and things that scare me for the past few months, and already I can see a significant improvement in my PTSD symptoms. There are some reminders that I can fully tolerate now, like pictures of brains, and some reminders that don’t give me as bad flashbacks, like car chase or car crash scenes in movies. I am also doing exposure stuff in therapy and plan to do more.

Relationships

I’ve developed some very close friendships. I have one friend in particular that I’m very close with. I think it may be the most intimate (emotionally intimate) relationship I’ve ever had. I tell her so much. She tells me a lot, too. I love her and am so glad we’re friends.

I’m also much closer with my parents, mainly thanks to the DBT program I did this summer and the family therapy that came with it. They now understand the nightmares, flashbacks, dissociation, and suicidal thoughts I struggle with. Although we still don’t always get along, it’s nice to not have to carry around those secrets anymore. I can also get emotional support from them sometimes, especially my mom. She has made an effort to learn how to validate my feelings, and it makes such a difference. Talking to her does actually make me feel better sometimes. It also feels like they’re on my team now. For example, my dad got me “stress relief essential oils” for Christmas, which I probably won’t use because essential oils have upset me before, but it was a sweet gesture that shows he cares and wants to help.

Because I did the program this summer, many more of my friends know that I have mental health issues and am in therapy. Everyone was asking what I was doing over the summer. I could have lied, but I chose to be vulnerable and tell them the truth. I’ve done a lot of vulnerability exposures in the past few months. They are hard but generally bring me closer to people. I recently also told my friends at college that I am in therapy. I kind of let it slip in front of a fairly large group of people at a Secret Snowflake gift exchange. This was a big deal for me because I’m not close with most of those people. But it was fine, and I feel so much better.

Adulting

I can now file an insurance claim! I can call my insurance company, I can set up my own doctor’s appointments, I can choose to take over-the-counter medicines and buy them on my own, I bought my own razor for the first time. A lot of these accomplishments have to do with me being away from home and being able to do things without my mom’s permission.

I set up some certificates of deposit, which mean I’ll be making some money, or at least not losing any to inflation. Planning for the future!

The place where I live at college has a kitchen (unlike last year), and I also had a portion of a CSA (Community Supported Agriculture) vegetable share this fall. As a result, I can now cook or prepare various vegetables for myself. I can make eggs (scrambled or in an omelette) fairly quickly. I can clean a kitchen and feel okay/confident about its cleanliness. I learned to use a gas stove (my family has an electric stove). I plan on doing more cooking next semester.

School

Well, I’m two semesters closer to getting a degree!

I declared my major, but that may change…

I think I’ve gotten better with procrastinating. I haven’t turned anything in past the deadline this semester!! 🙂 One skill that particularly helps me with this is setting a timer for 20 minutes and saying that I’ll only work on it for that amount of time. It helps me to get started on things and not be overwhelmed by all I have to do.

I’ve learned more about engineering and realized how much I like it. 🙂 Although I’m still not entirely sure about what to major in within engineering, and I sometimes think about becoming a psychologist, writer, dancer, or artist instead, I know that I really do like engineering, too. 🙂

General Health

I’ve consistently been getting 8-9 hours of sleep a night. 7 hours is now low for me. There are weeks where I get less, but for the most part, I really have been getting more sleep. This makes me feel so much better emotionally!

I lost some weight unintentionally over the summer and became more underweight than I normally am, but I’ve been seeing a nutritionist at school, and I’ve gained some of it back! More importantly, I am building better habits of eating, like eating 3 meals a day, every day, and snacks in between. I’m keeping more snacks on hand. I’m eating more calorie-dense foods first. If I skip breakfast, I’ll have two dinners instead of simply having only 2 meals that day. I think these strategies will continue to serve me well.

I haven’t had too many headaches! 🙂

Other

I started this blog!!! 🙂 Having a blog is something I’ve dreamed of doing for years. I’m so glad I finally did it and that I am still at it several months after starting. It feels like it gives me more purpose. What I didn’t expect from blogging was getting to read so many other people’s blogs, which has been really nice.

In the spring, I was baptized into a church, and I later left it. It was a very stressful, confusing experience at the time, but I think it has helped me understand what I actually believe, which makes me more confident and causes me to have fewer existential crises. People in this church group also gave me a lot of hugs. I generally avoided physical touch before then, but now I willingly accept hugs, enjoy hugs, give good hugs back, and am comfortable asking friends for a hug when I feel like I need one.

It’s hard to believe that my first time in group therapy was just last year. I’ve made some good friends through group and learned just how not-alone I am. It’s also been eye-opening to be able to talk with people about mental illnesses and similar struggles. I feel like I understand people better.

Lastly, I’ve been dancing for years, and last spring, I finally learned how to do a pirouette! 🙂 One of my goals over winter break is to be able to spin around twice in a pirouette instead of once.

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Yay! This was uplifting to write. 🙂 I’ve liked reading people’s reflections on the year. Do you have an accomplishment you’re particularly proud of?

Coping Skills, Uncategorized

Alternatives to “Everyone hates me!”

Instead of jumping to the conclusion that everyone hates me, here are some more realistic and positive explanations.

When someone hasn’t texted me back:

  • They saw it when they were in the middle of something and forgot to respond.
  • They saw it when they were busy and want to take the time to write a thoughtful response.
  • The message didn’t deliver because either I or they lost cell service or wifi.
  • They forgot about it.
  • They are waiting to confirm something else first before replying.
  • They forgot about it, remembered, and now feel so guilty for not replying sooner that they’re anxious about the whole thing and aren’t replying at all.
  • They’re going through a really busy time and have a lot on their plate.
  • They’re going through a really stressful time and have a lot on their mind.
  • They’re not checking their phone.
  • They’re on a camping trip in a place without cell service.
  • They got a new phone.
  • They’re out of the country and not receiving texts.

When someone didn’t smile back at me:

  • They’re caught up in their own thoughts.
  • They’re worried about what they’re going to say next.
  • They didn’t see me.
  • They thought I was looking at someone else.
  • They’re tired.

The vast majority of the time, people don’t hate me. There are many good reasons why someone would not reply to a text or smile back at me that have nothing to do with what they think of me.

Do you have any to add? Or any other situations where you might jump to a conclusion and there’s a more reasonable explanation?

Therapy, Uncategorized

Packing for trips

I made a joke in a group chat with my friends recently…

Me when I’m packing: I should bring at least three books in case I’m not in the mood to read the other two, might as well bring this flashlight, nail polish is always good to have

Me when I arrive: looks like I forgot underwear, socks, pajamas, and my toothbrush

😂 this is literally what happened ughhh

It’s funny, and I was laughing, but it also annoys me how I’m like this. I have such a strong urge to bring everything I could possibly need with me. I think it’s part of my PTSD/OCD.

PTSD because it’s part of the trauma belief that traveling is dangerous, and I could get into a serious accident, and you never know what will happen so you have to be as prepared as possible at all times because who knows when you’re going to need everything you could possibly need.

OCD because I have the obsession (intrusive thought, worry, fear) that I will be in danger on this trip and maybe not come back home, and I appease that obsession with the compulsion of bringing lots and lots of stuff with me. At least, this is OCD as I understand it. I haven’t been “officially” diagnosed with OCD, but a therapist once implied that I probably had it but that she didn’t want to bother to separate out what is PTSD and what is OCD because the treatment for both is the same: exposure.

Anyway. I do feel like I have OCD, and I feel like I have all these rules I have to follow, just in case. It’s less scary and more frustrating at this point because I have to put up with myself. I have to appease my emotion mind within, or else I won’t feel safe. This happens with germs, too. I’m not particularly afraid of getting sick, but I just have rules, like anything that falls on the ground is dirty and must be sanitized or washed with soap and water before I touch it, and anything that touches anything dirty is now dirty.

I think I’ve gotten better at not always following these rules though, through, you guessed it, more exposures. The rules aren’t as strict anymore. But it’s just annoying. It’s like something extra I’m carrying around and paying attention to, an extra monster inside of me I have to care for and appease. I should maybe bring this up in therapy, but I feel like we’re addressing the more important issues (suicidal and self harm urges, trauma) now, and this is a lower priority. Plus, my old therapist was right: if I do the trauma work, these OCD-like thoughts and behaviors will probably diminish.

For now, I suppose I can radically accept (DBT skill) that this is the way I am now. I bring lots of stuff with me on trips. That is the way it is at this time. AND (there’s that DBT dialectic), it doesn’t mean it can’t change in the future. I can do more exposures. I can take small steps. I can be patient and slowly make progress.

Anyone else have issues like this?

(This was an interesting article about the link between PTSD and OCD.)

Coping Skills, Uncategorized

The Emotions and Opposite Action

These are the ten primary emotions as I learned them in my DBT treatment program this summer.

Knowing more information about them helps me understand what’s going on inside me and what I need to do to resolve the situation, if anything (see the flowchart under Emotion Regulation in the DBT Skills Summary).

Emotions are important!!

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What’s this opposite action thing?

Opposite action is a DBT skill I really like and have been using a lot.

Once I’ve identified what emotion I’m feeling and validated myself, I determine whether it’s justified or unjustified and if the emotion is helping me to be effective in this moment.

All emotions are valid. It is what you are feeling, and that’s the way it is. There’s probably a good reason you’re feeling that way, even if the reason no longer applies to this current situation. But an emotion is only justified if the presence, intensity, and duration of the emotion fit the facts. For example, fear is justified when a threat is present. My fear is often caused by reminders of trauma and is often unjustified. Shame is justified when I’ve broken a group’s value. Guilt is justified when I’ve broken a personal value. Sadness is justified when I’ve lost something. Et cetera.

If the emotion is unjustified, then it’s time to use opposite action! Opposite action is doing the opposite of the urge an unjustified emotion is giving me. I’ve been using opposite action a lot for shame. When I feel shame, my urge is to hide. But, if I 1) identify that I am feeling shame and 2) find that it’s unjustified, then I know I need to use opposite action. Instead of hiding my face, getting squirmy, curling up, running away, talking quietly, and not speaking, I do the opposite. I stay where I am. I sit on my hands so that I can’t cover myself up with them. I keep talking about whatever thing I think is “weird” but which really isn’t. I put myself out there. It is very uncomfortable, but it helps the shame go away.

Instead of wallowing in my (unjustified) feelings, I react in a more effective way. Yay opposite action!

Understanding emotions has been really helpful to me.

Therapy, Uncategorized

Things I’ve learned about myself, part 2

  • I am capable of controlling my emotions.
  • I am a good listener and a good friend.
  • I spend a lot of time thinking.
  • I over-apologize, and it is very hard for me to resist the urge to apologize. Apologizing reinforces my guilt and the feeling that I have done something wrong. If I haven’t done something wrong, I don’t need to apologize!
  • I am very uncomfortable with most physical contact.
  • I like to be prepared for anything at all times.
  • Being sick is triggering for me.
  • My self harm serves multiple functions in different situations. It grounds me when I’m dissociating, it satisfies my anger at myself and guilt and shame, and it sometimes helps me dissociate.
  • Everyone doesn’t hate me.
  • Learning new skills and healing both take lots of time, and I need to radically accept that I won’t be better in an instant, or by the end of the summer.
  • My body posture is often closed off and protective. I am working on being more aware of my posture and lowering my shoulders, uncrossing my arms, and opening my hands up when there is no threat. This teaches my body that I am safe.
  • Sometimes my emotions are justified, and I need to deal with them and not push them away.
  • There might be a part 3 at some point. 🙂 (here is part 1)