Affirmation #12 — I can remember AND stay in the present

I can REMEMBER and stay in the PRESENT.

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As part of the prolonged exposure therapy I’ve been doing, I do imaginal exposures, which involve talking through a traumatic memory. I tend to dissociate when talking or thinking about the trauma, so it’s sometimes hard for me to continue thinking about the memory because my mind goes blank with dissociation. However, I need to engage with the memory in order for the memory to make me less scared in the future, so I can’t just block it out. I have to balance not dissociating (by grounding myself in the present moment) and remembering the memory (which brings me a little to the past).

This affirmation is to remind me that it is possible to do this. It is possible to remember without having a flashback or dissociating. I can remember non-traumatic events and still know where I am in the present. With time and hard work in treatment, I am gradually able to do the same with traumatic memories.

Making therapy sessions better

Sometimes I leave therapy feeling worse than how I felt before it. But sometimes, therapy is really helpful, and I leave feeling heard, validated, hopeful, and knowing what to do when things get bad again.

So, I’ve been trying to think of what makes some therapy sessions better than others.

I think a big part of it is making sure I actually say the things I want to in session. If I don’t, I leave feeling disappointed in myself, frustrated with my therapist, and invalidated. This can spiral and I can start to feel hopeless and think “no one can help me,” “no one likes me,” “I’ll never get better.” Those are all-or-nothing thoughts and aren’t true.

I’m not entirely sure what the solution to this is, because sometimes I don’t know that I really wanted to say something until after I’ve left and realized I haven’t said it. It sometimes just takes me a while to get my thoughts in order.

It also takes me a while to remember stuff. My therapist will ask what was going on on x day before y, and I have no clue. I think this is partially because I dissociate, which interferes with memory somehow (I don’t know the specifics), and partially because I avoid thinking about bad stuff because it upsets me. Dissociation is essentially avoidance, so these are kind of the same thing at their core.

I guess a solution to this could be for both me and my therapist to be patient with myself during session and wait for my thoughts to come and for me to be able to say them.

I could also spend time before session thinking about what I want to talk about. Sometimes I write things I want to talk about on sticky notes and bring them to therapy. That is helpful, but I have to make sure that I do actually say the things I have written down. To do that, I have to overcome any shame or embarrassment and not feel too afraid of saying them (if they’re about upsetting things or trauma reminders).

Sometimes it’s helpful when I say, “I wanted to say something, but now I don’t,” and my therapist helps me through what’s getting in the way of me saying it, whether those emotions are justified or not, whether I need to do some grounding before talking about something hard, etc. So I guess in general it’s good to be open in therapy as much as you can.

It’s also good when I journal before going to therapy because then I know what’s actually going on and have already given it some thought. Writing things down generally helps me. Plus, if I’m avoiding saying something, I could just hand it to my therapist to read instead of trying and failing to say it out loud, or I could email it.

I’m working on it. 🙂

Things I’ve learned about myself

I’ve done three weeks of my treatment program now. I have at least one more week in the program, maybe more, depending on what I decide to do. I have learned a lot of new skills and ways of behaving, but I have also learned a lot about myself!

I have learned:

• Dissociation: I dissociate a lot. I know I am beginning to dissociate when I lose track of what is going on, ask “what?”, feel like my legs are disappearing, feel confused, have trouble moving, and have trouble focusing my eyes on things.
• Minimizing: I minimize my problems a lot. I say, “Eh, I’m just having a bad day, but it’s okay,” when really I am experiencing intense fear, shame, sadness, and anger and have very strong urges to engage in my target behaviors (self harm, suicidal ideation, etc.). This interferes with asking for help because I think my problems are “not bad enough” to deserve help. But they are.
• Self-validation: It is hard for me to validate myself. I tell myself that I “shouldn’t” be feeling emotions, and I try to block them out. It is hard to be understanding and kind to myself and to acknowledge that there are very valid reasons I feel the way I do. I may be overreacting to a situation, but I am overreacting for reasons that make sense, given my life.
  • Before my therapist left for her vacation, I told her to be safe on her trip and that I was scared that she was going to die. It was hard to say that, and especially hard to say it without prefacing it with, “This is weird, but…” After some talking, I was eventually able to validate myself by saying, “It makes sense that I am scared of this because it has happened before.” My family and I nearly died on a trip once. That doesn’t at all mean that my therapist is going to die when she goes on this trip, but it is valid for me to feel that way.
  • All emotions are valid! The specific emotion, intensity, and duration may not fit the situation, but it is still valid to feel that way.
  • Maybe I look to therapists, friends, and the internet for validation so often because it is hard for me to give myself validation, yet I still need it.
  • Purposefully reminding myself of my trauma (looking at my scars, going through old papers, finding triggering things), even though it upsets me, also serves the function of validating that something bad did happen to me and that it was real.
• Judgements: I judge my feelings and thoughts a lot. Now that I think about it, this could be the reason I minimize and invalidate myself. I say out loud or in my head, “This is stupid,” “This is weird,” “I’m so weird,” “Shut up,” “It doesn’t matter,” “It’s nothing,” “It’s weird; don’t say it,” etc. I am working on being more nonjudgemental and only stating the facts, not my judgements of them. For example, “I notice that I am feeling scared. I notice that I am having an urge to run away. I notice that I feel my heart pounding.”
• Abnormal behavior: I am learning what is normal and not normal behavior for a teenager.
  • Making plans to run away from home is not normal.
  • Staying up to 1 am and sleeping in to 9, or 11 or 12, is normal for a teenager.
  • Staying in bed or in my room for five hours after a nightmare is not normal.
  • Being afraid of going to sleep and as a result doing everything I can to put off going to sleep for hours is not normal.
  • Having feelings of wanting to die every day is not normal.
  • Having panic attacks every day is not normal.
• Avoidance: I avoid a lot of reminders of my trauma, and I have many methods of avoiding them. I have a list of triggers with over 50 items. I avoid looking at said list. I refuse to share it with my current therapist. I don’t look at pictures we have in our house that remind me of the trauma. I tune out of conversations that only indirectly remind me of it. I limit the places I go. I barely watch movies or read books because I’ve been upset so many times by them. I limit the classes I take in school to avoid topics where memories might be brought up. I clamp down on thoughts of the trauma, when I have them, and I very, very rarely talk about what actually happened (even just the basics).
  • I also avoid thinking about how I am feeling. In DBT, I have to fill out a “diary card” every day with my symptoms, emotions, target behaviors, etc. When I show it to my therapist, I flip it over, push it to the side, and try not to talk about it. It is hard for me to think back and explain what was happening when x on my diary card occurred because I bury it so deep.
  • This isn’t something I’ve learned about myself but something I’ve learned in general. Avoidance is okay in the short term but a problem in the long term. Avoidance is okay when it prevents me from engaging in target behaviors. In exposure, I will gradually stop avoiding, but it will be done in safe ways. 
• Relationships: I am scared of pushing people away and losing relationships. I genuinely don’t understand why certain people don’t hate me by now.
  • I had several close friendships end abruptly in my childhood. This could be why I feel like this.
• Self-hatred: I have feelings of self-hatred and worthlessness, and think I don’t deserve kindness, compliments, or good friends.
• Wanting to be a therapist: It is common for people who struggle with mental health issues to want to study psychology and become therapists. I am not weird for secretly wanting to be a therapist or to take psychology courses, even though I’m currently studying a totally different field. It’s okay for my interests to change.
• Diagnoses: I don’t actually know what diagnoses I have, and I’m not sure if I want to ask. I know for sure that I have Post-Traumatic Stress Disorder and that I have had (but maybe don’t at the moment? not sure) Major Depressive Disorder. Other illnesses I think I have or have had at some point (but I could very well be wrong because I am definitely not qualified to diagnose myself) are Social Anxiety Disorder, Obsessive Compulsive Disorder, Hypochondria (health anxiety), Generalized Anxiety Disorder, Seasonal Affective Disorder, Pre-Mentrual Dysphoric Disorder, Borderline Personality Disorder, and Panic Disorder.

I am learning so much! It makes me sad to realize how badly I’m actually doing, but I think that that’s necessary in order to actually address my problems and recover.

What is something you know about yourself?

(here is Things I’ve learned about myself, part 2)

Using Coordinated Movement for Dissociation

This week I learned a new technique to use when I’m dissociating.

I started an intensive outpatient treatment program in DBT last Monday. I think DBT is awesome. 10/10 would recommend. I am learning a ton of new skills and getting answers to every question I ever had. I feel very lucky to be able to participate in this incredible program.

I have learned many new skills, but this is one that I had no idea existed beforehand and that has been really helping me. I’m not sure if this is a DBT skill or just a grounding skill, but it was my DBT therapist that explained it to me and helped me to practice it, so I am crediting the program with this.

Basically the thing is this: Our brains can’t dissociate and coordinate our movements properly at the same time. So, if someone is dissociating, or beginning to dissociate, doing some sort of coordinated movement can help to stop the dissociation and bring their mind back to the present and their surroundings.

What is a “coordinated movement“? It’s something you do that requires you to focus your body on moving. My DBT therapist suggested standing on a balance board, playing catch, and dancing.

I have learned on my own over the past year that dancing can bring me out of a flashback surprisingly quickly. I have a playlist of specific songs that I dance to in order to ground myself. So, it was validating to hear that dancing requires coordination and that that’s probably why it was helping.

If I don’t have a balance board readily available (I can use one while I’m at the program, but not at home), or if it would be too hard to get access to one in the moment, I can just try to balance while standing on one leg for as long as I can. If that’s too easy, I can stand on my tippy toes, too.

Throwing something around is also great. If there’s someone else around, and they’re willing to do this with me, we can play catch. If I’m on my own, I can throw a ball against the wall or bounce it on the floor. If I’m in a group of people, I can simply toss anything from hand to hand without feeling like I’m being weird.

I am going to start carrying around a bouncy ball!

I am also learning that I dissociate a lot. I’ve known for a long time that dissociation is a symptom of PTSD, but I’ve always thought of it as “that one symptom I don’t have.” I don’t think I really understood what the word was describing.

Now I am beginning to pick up on the clues that I am starting to dissociate. I feel dizzy, all thoughts flee my mind, I zone out, I’m not really looking at anything in particular, it’s hard to remember what I was just saying, I ask “whaaat?” in my head or out loud, my muscles feel weak, my legs feel like they’re dropping out from under me and disappearing, I feel like I’m not here, I feel like things aren’t real, I have an urge to run away and hide.

Grabbing something and throwing it up and down or from one hand to the other is hard in the moment. It is hard to remember to do it, it is hard to be willing to do it and trust that it could probably help, and it is physically hard to do it because I am attempting to override the dissociation.

Standing up when I want to freeze and stay still forever because I think that if I don’t, something bad will happen, is hard. Moving any part of me, even just readjusting the position I’m sitting in, is hard because that is not what my body is wired to do.

But I am safe now. In this moment, I am safe. It is okay to move. It is okay to stay present and to experience this moment. I am having a reaction, that is all. I have gotten through this before, and I will get through it again. It’ll be okay.

Had you heard of this skill before? Have you tried it? If you dissociate, what helps you bring yourself out of that?