What Serves You? Helpful DBT Questions During a Pandemic

March 31, 2020

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?"

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