What Serves You? Helpful DBT Questions During a Pandemic

There is no room in love for fear.  Well-formed love banishes fear.  Since fear is crippling, a fearful life-fear of death, fear of judgment-is one not yet fully formed in love. (Marcus Borg)

Thank God for DBT!  I was doing so well emotionally that I was able to stop therapy for a while. And then...the global pandemic happened!  I started getting paranoid and lonely and really worried, especially since my job is on hiatus during this time.  After having some old impulses resurface, I decided that it was time to re-enroll in a DBT class. Let me be clear:

 There is no shame in returning to therapy or returning to a skills class-in fact, it is a good sign that you are self aware of what you need to stay well.   

Immediately after the first class, I felt so much better.  It is soothing for me to see my therapist on a regular basis and it feels good to know I am doing something that tends to work for me.

Right now, we are needing to self soothe ourselves even more than usual.

I thought I would share what I am learning in DBT class-even though I've taken it many times before, I always receive fresh insights into myself and into what works.  I am fully aware that I made this promise the last time I took DBT and then didn't follow up with it here, but I was still working then-the gift of this pandemic for me is that I have more time to write.

We started emotional regulation this past Monday.  The theory is that there are things we can do besides taking medication that can help to regulate, or even out, our mood.  It is always so frustrating to me when people only focus on medication, because no matter how well medication may work, it's still only part of the puzzle.

The topic of their homework was three concepts of mindfulness:

1. being "radically open" 
2. being nonjudgmental towards ourselves and our thoughts
3. approaching actions "one mindfully"

I really like the phrase, "radically open."  During times of fear and isolation, we have to be radically open to accept the good that is also going on.  I learned in "The Body Keeps The Score," by Bessel Van Der Kulk, that we tend to remember negative experiences much more so than positive ones and so we have to be radically open to see the good, especially during a global crisis, especially if you are someone who is prone to severe anxiety and depression.  (That's me!)

It can be really easy to go off the deep-end when having severely negative thoughts, especially urges to "act out," self harm, etc.   Even though we did not act out, we beat ourselves up just for having the thoughts.  Our thoughts are not reality - it is the intensity and interpretation that we give them.  For instance, I have an urge to self harm-I could catastrophize and beat myself up for having that thought, OR I can say, "huh," and just dismiss it from my head onto the next thing, letting the thought come and go without any great harm to myself.  I don't have to suffer just because a thought wanders in I don't like.  

"One mindfully," is being totally absorbed in an activity.  Yesterday when I cleaned the kitchen, I did it "one mindfully," and I experienced great delight in getting the job done in the time I allotted for myself.  Since I was focusing solely on the task, I was able to finish it in a fairly short time.

***************

Now onto emotion regulation skills.  These skills are especially helpful right now - if we can catch our pain before it gets too bad, we have the power to change them, instead of letting them get worse.    

We talked about the "scale of distress," with 1 being not that bad and ten being horrible.  When you are somewhere 1-5, then try emotional regulation skills to get to the feeling that you want to be.  However, if your distress is somewhere 6-10, then your feelings are too distressing to try to change at the moment; you need to switch to distress tolerance skills, because it is going to be just too hard to try to change them at that point.  I really like that DBT acknowledges that there are limits to our powers, especially in deep distress-you can always tolerate emotions if you use your skills, but you can't always change them right away.  (I know you're thinking, no you can't always tolerate them, but I promise you, you can if you have enough practice.  Otherwise, it's off to the hospital, and at some point you gotta realize that it's better to sit through the emotion than to go somewhere that is only going to cause more trauma.)

Ask yourself, "What do I need right now?" and "Does this serve me?" to reduce your emotional suffering.  This is especially good to use to check our interpretation of events.  Basically, our emotions come from somewhere.  An event happens and it is our interpretation of the event that determines how we feel about it.  Keep in mind that something is already going on in the background that influences how vulnerable we are to interpreting the event negatively.  Here's an example:

Vulnerability: tired-late at night

Prompting Event: get an email from work

Interpretation of Event: "oh no, not another thing, this is too much!"

Biological Change: stomach tightens up, shallow breathing, beginning to panic

Emotion: Extreme worry/panic/fear

However, if we interpret the event in a different way, then our body and emotion will be different.

Let's try this again:

Vulnerability: tired-late at night

Prompting Event: get an email from work

Interpretation of Event: I know I'm tired, so I will check the email in the morning.  As long as I give myself enough time in the morning, there is nothing to fear.

Biological Change: body loosens up; I relax knowing that I will go to bed soon and that I have a plan of action for the next day.

Emotion: Relaxed, Peaceful

*I have more of these exercises in my book, Hope Is Real: I Have A Purpose.  If you want something to read during this pandemic that might be helpful in combatting worry, consider ordering my book on this website (through PayPal on the upper right hand corner, just under the main picture).  I will be able to personally sign the book before sending it to you.  Of course, you can still buy it on Amazon as a physical book or for kindle.

We talked about how our interpretations can sometimes be overly intense when we are comparing them with events from our past.  Something bad happened then, so surely the same bad thing will happen again!  Hmmm...might need to check the facts on that thinking...

I then asked the facilitator,

 "what if you're worrying about genocide? That's about as intense a worry can get!" 

 I was expecting the therapist to laugh, but thankfully she was very kind.  I explained that I read a lot of articles on facebook that compare our current events with the events right before World War II and that possible genocide and the downfall of our civilization is constantly on my mind, so that there is an underlying sense of fear at all times.  (Fortunately, this is a fairly recent thing-being around people was enough to snap me out of it before, but with the isolation, my brain has too much free time).  

First, my therapist spoke up and said,

"Catastrophizing, Corey.  You know you have a tendency towards this..." 

"oh yeah," lol 

 Even just saying that was enough to bring down my panic.  

The other therapist then said, 

"you know, there are some similarities to past world events and it's good to be aware of that, but does it serve you to think that times are exactly the same?  You can look at the worst possible outcomes or you can look for the positives and try to be a part of that. Be aware of similarities but also be aware of the differences." 

I found that really helpful.  Since the majority of the depressing articles are found on facebook, and because I just spend too much time on Facebook and Instagram in general, we decided to set some boundaries around my social media.  I've decided that I will spend some time right after breakfast and then again, right after dinner where I will allow myself to be on Facebook and Instagram, only for an hour at a time.  (I do like to post positive mental health memes and continuing to promote this blog and art I think is important.)  I am hopeful that charting my progress and talking about it in the DBT group will help me stay on track and even make a social media lifestyle change.  Think of all the extra energy I will have to be fully present in my life when I am not mindlessly scrolling through depressing article to depressing article!

Being reminded of my tendency towards catastrophes and having a social media action plan has already helped to clear my mind and calm me down.  I will leave you with the questions I am asking myself - let me know if you find them helpful too." 

"What serves you and your mental health? Are you being radically open to the goodness in the world? What do you need right now to reduce your emotional suffering?"

Link Love: 

A Free Guide: DBT Skills for a Pandemic  

Review of Unbusy by Andy Dragt

Workouts in the gymnasium are useful, but a disciplined life in God is far more so, making you fit both today and forever.  (The Message Bible)

Unbusy: How to leverage the physics of flow to accomplish more of what truly matters and feel less busy at the same time by Andy Dragt

This is a Speakeasy book, so I got this book for free because I promised to write a book review.  You can do this too!

In this short book, Andy Dragt explains how if we structure our lives based on the laws of physics then we will get more accomplished but feel less. busy.  I was very interested in this book, as I am trying to structure my life and it is so hard for me!  Fortunately, Dragt understands how hard this is, as he is also a person who does not naturally come to structure but he has found it very useful in his life.  It certainly is true-I definitely get more accomplished when I structure my time.  I like that he has you build in time that is for being spontaneous.  That may seem like an oxymoron, but it's not-it's merely saying that in this time frame, I will do what I want and not worry about it fitting in somewhere else time-wise.  Dragt explains that freedom is not the opposite of structure, but chaos "and a chaotic life is not freedom."

This book was also good for me because it talks about developing your why, your purpose, and your values, and I had just attended a workshop that touched on these topics.  Sometimes it seems like everyone talks about needing a why, but it is nice to have something that actually leads you to it through helpful thinking exercises.  The book had me write down my memories of times when I felt really fulfilled and out of those memories, I could start to see what I value and what my purpose is.  Now, with my "hope is real" brand, I already had a good idea of what my values and purpose are, but it was a good exercise to do anyway.  Our ideas can always benefit from a more thorough fleshing out.

This is what I eventually came up with:

 
(I value this/my how)               (my why)        (so this is a priority/ my what)
Follow my call.                   -> big purpose -> to stay singleminded
Create joy.                           -> big purpose -> to change the system from one of fear
Immerse myself in Spirit.    -> big purpose -> to be able to hear my call
Challenge myself                 -> big purpose -> to inspire hope (which changes the system)
Receive genuine validation -> big purpose -> to enable people to see the benefit of community

Big Purpose: To change the mental health system of isolation and fear into a community system of joy and hope.

As a friend then said to me: What does community look like to you?

I think community looks like relying more on people than just clinicians.  Clinicians can be wonderful-my therapist really did change my life for the better-but still having them on an equal plane as other supporters is a more balanced view.  I think it's important not to set clinicians as the ultimate authority because in the end, no one knows ourselves better than ourselves.  I am my own true expert, although I may need the expertise of others to see that at times.  The more people that we have as supporters in our lives, the more balanced and enriched our lives will be.  We will learn how to sift through everyone's many viewpoints and come up with our own truth.  Having a wide community safeguards our supporters from burnout and it makes it more likely to get our needs met in a compassionate way.  In our capitalist society, the system is ultimately about money-we need people and places who's ulterior is not getting paid in order to truly care for our soul.  If I look to a hospital for a solution, my pockets will always be empty and I will probably feel pretty empty too.  I believe a community of compassionate people fills us up regardless of whether we have insurance or not.  Communities also tend to have more creative solutions to problems rather than a bureaucratic system. When I create a wellness plan for my recovery, I look towards all of my possible resources, not just the ones that fit the medical model.  Relying on a wider community also makes us more independent from structures we may not want to always depend on-knowing that I have supporters to back me up inspires me to take more chances.

After figuring out your values, purpose, and priorities comes the task of structuring your time so that you use it well.  I have found that knowing these things motivates me to want to follow them more wisely.  My days are lot more structured than they used to be, but I will certainly admit that becoming more structured can be a hard and frustrating process.  And yet, I guarantee you it is true-when your life contains more structure, you really do get more done and feel less busy and tired overall.

I promise.

What I have found the most useful is using Instacart as needed (lol), grouping my days as themes, using Monday to plan for the week and Friday to plan for the weekend, starting the day by reading helps my mind calm down and then writing out what I need to accomplish that day is super, super helpful.  Also, two cups of coffee every morning.  (lol)

Different strategies will work for different people.

What works for you?  I hope this book review was thought provoking.  I'm interested in hearing people's thoughts on exploring their values, purpose, and priorities and about adding in more structure.  Do those things seem intimidating and overwhelming, or exciting and interesting? Let me know!