Tag Archives: coping skills

Quiet

7 Nov

It’s been interesting lately.  And of course by interesting I mean a combination of hard, no one knows what is going on, and yet I keep my head above water.  I’ve given hints, but some family reads this and I worry what they will think- but I started this for me.  About a week ago my nephew was born, about a week and three days ago I started to transition in wearing male clothing and bought boxer briefs and switched my jeans into male ones (though I’m still having trickiness with sizing.)  The voices came back soon, they said the baby was going to die unless I went back and stopped making my changes.  The voices were the back 1s, the voices that used to be the constant companions, not the episodic side voices like usual.  Also the back 1s in the past have been positive, negative, neutral, or narrating so this was interesting that they came back for this to take a stance.  I didn’t listen and added coping skills and increased my anti-psychotic.  Unfortunately it was during midterms, otherwise I may have just went into hospital for respite/relief.  I had actually taken extra Latuda the night before and morning of a Greek midterm and managed to still get a B, with double dose in me and active voices.  My case manager thinks the voices are back because of my sister having the baby and that they want ME to hurt the baby and that’s not the case, that’s probably come from side voices.  All my midterms are done, 2 B’s and an A; I didn’t try hard so I’m happy with my grades.  I’m not very motivated, when not in class, at a club or workshop; I’m usually sleeping.  I’ve been home weekends a lot, I don’t know if that’s better or worse, it prevents me from sleeping the weekend away.  This weekend is my birthday, most my family is gone anyways, so I’m going to visit 20 somethings friend.  Since I told my case manager about the voices I know it’s going to slow down transitioning, medically wise and I really don’t want to tell the therapist because I don’t have as good a relationship with her and it’s harder for me to tell her this is two separate things- even though I’M SURE they are.

Ten times… Day 10

29 Jul

ten-times-to-be-happy

Day ten:  Ten ways to get yourself out of a rut. (To cheer yourself up)

  1. Plan a vacation
  2. Talk with a friend
  3. Have fun with a friend
  4. Smash* book
  5. Blog
  6. Candy Crush
  7. Look through wellness box/journal
  8. Swim/spa
  9. Drink a red bull
  10. Take a nap

DBT: ABC Exercise

19 Jun

Not many people voted in the poll yesterday, of what you would like to see more of on this blog.  Feel free to go and vote here.  More information on Borderline Personality Disorder was the highest with three votes, so here is a resource from my DBT class last week.

Accumulate Positives:  This letter of the skill is about having a bank account of positive experiences that you have been saving up to make a withdrawal from when you need to balance out an upsetting situation.

Build Mastery: This component of the skill is about thinking about or doing something that you are good at.  By thinking about or doing something you are good at.  By thinking or doing something you are good at, you are facilitating healthy self-esteem.  This boosts your confidence to get through times that are difficult.

Cope Ahead:  Develop plans to deal with expected and unexpected difficulties.  Note: Cope Ahead doesn’t always work, so use the accumulate positives.  It is about your willing to try something, but try not to get too attached to the outcome.

Some examples:

Accumulate positives: setting up social events that go well, compliments from friends, going to Disneyland, getting good grades on an assignment.

Build Mastery: creative endeavors, making scrapbooks, working on my smash journal, blogging, school related stuff.

Cope Ahead:  If I have an upcoming counseling session that I think will be tough I can ask a friend to hang out afterword.  Practicing or rehearsing tough conversations.  Scheduling a massage after/during a big/stressful project .
*note some things can overlap in categories

Having a crappy day but using DBT skills

3 Jun

Yesterday was crappy and it rolled over to today.  I woke up not wanting to get out of bed, so I didn’t.  I laid in bed drifting in and out of consciousness till my mom told me to get up at 11 and take my pills.  I did and promptly went and laid back down.  After writing my last blog and laying there for awhile, my thoughts started bothering me again and then my weight.  I vowed not to go out to lunch today and I didn’t.  I’m thinking about talking to my case manager about the issues this morning, but ashamed again.  I was really happy when I got a comment on my blog saying here is a smile for you.  I decided to use opposite action (an emotion regulation skill) and willingness over willfulness (a distress tolerance skill).  I feel proud of myself for getting up and using skills despite the way I was feeling.  I just wish someone else would recognize it, that would make me feel much better and more confident.  I have some plans tonight and that is helping.  I don’t think it’s fair I have to do so much work to try and feel decent.  I was thinking and most the people I admire have had difficulties in their life, I find it really hard to admire someone who has had an easy life, even if they have accomplished great things.

DBT Core Mindfulness: the How skills

6 May

the how skills are: non-judgmentally, one mindfully, and effectively. The how skills are how you do the what skills.
Non-judgmentally is about accepting what is, as it is, because it is. In fact, everything that has gone before has conspired to create this very moment. Not only is this moment like it is, it has to be like it is because of all that’s come before. It can’t be different. Grasping and hanging on too tightly to people or things can cause suffering. So acceptance is actually a more effective first step in the process of change. Instead of saying “hey, they shouldn’t be doing that” we really need to understand and accept that in this moment they are doing that and usually for a reason that makes perfect sense to them. Then it is a matter of what we are willing or able to do about it. Because at the heart of judgment is usually fear. This fear keeps us separate from others and even ourselves. To do that we have to let go of grasping at what we want or pushing away what we don’t want. The result is that we will start connecting to split off parts of ourselves and others and dramatically decreased our suffering.

One mindfully is doing one thing at a time.
Effectively is about focusing on what works. It is about asking in the moment, “hey what is going to work here. What is going to be effective to get my long term goals?”  These are such powerful questions because they shift your focus away from a lot of right/wrongness, in which people can often get stuck.

Resource: Behavioral Chain Analysis of Problem Behavior

22 Apr

My Behavior Chain Analysis of Problem Behavior

What is the major PROBLEM BEHAVIOR that I am analyzing?     Suicidal thoughts and voices.

What prompting event IN THE ENVIRONMENT started me on the chain to my problem behavior?  Start day: Thursday 4/16/15  *  (8am) I woke up in a sad mood with a heavy feeling and dread (feeling) and knew it would be a day I would have to fight through to be successful (thought)  * (8pm) Going to 20 something’s group. Anxious, guilty, and dread (feeling).  I hope tonight’s group goes well.  MV is leading it I don’t really like her.  I wonder if it was a good idea to come. (thoughts)  * (9pm) Going to Chipotle to hang out afterwards.  Anxious, ignored, upset (feelings)  I’m beginning to think this wasn’t a good idea.  I should leave now.  If I leave what will the people think. (thoughts)

What things in myself and my environment made me VULNERABLE?  * Already having stress and problems regarding the 20 something’s group. *Woke up in a bad mood.  * Exhausted from using skills earlier that day * Stressing about impending leaving of 20 something’s friend  *No structure after group in hang out time  *Social anxiety

Chain Analysis.  What were the LINKS IN THE CHAIN (Actions, Body sensations, cognitions, feelings, and events)

  1. Actual- 8 am woke up in a bad mood, wanted to go back to bed, skip school and other responsibilities.  Used DBT Skills to get through the first part of the morning. Distraction with activities worked on Smash book, Distraction with contributions worked on pocket letter swap.   Skillful alternative- I think I used my skills wisely
  2. Actual- 11:30am leave for school.  Opposite action didn’t want to go to school. Skillful alternative- I think I used my skills wisely
  3. Actual- 3pm Still in a bad mood.  Start thinking why me, this isn’t fair, I shouldn’t have to deal with this.  Skillful alternative- Willingness over Willfulness, not be as stubborn
  4. Actual 8pm Go to Group.  Using opposite action.  anxious, annoyed  Skillful alternative: should have skipped group and rested.
  5. Actual 9pm Go to Chipolte after group.  Anxious.  Skillful alternative: could have went home
  6. Actual 9:15 20 something’s friend tells me he won’t be able to study Sunday night and will be studying with a classmate from Physics but we can study Saturday night.  Immediately feelings hurt, rejected, angry and like he should have known better (I had texted/facebooked earlier it was a rough day) Thoughts: Not a good time to bring this up.  Try to act normal.   This shouldn’t be such a big deal.  Skillful Alternative:  Tell him that my feelings were hurt even though it was kinda irrational and immature, better communication.
  7. Actual 9:20 Get to Chipotle and there is no seating inside.  I am one of the first ones there and the first facilitator there.  Feelings annoyed, anxious Thoughts: Are we going to have to go somewhere else.  I don’t want to make the decision.  I’m not assertive I’ll wait for another facilitator to solve the problem.  Skillful alternative: Let it go until the other facilitators get there.  Don’t personalize, it’s not my responsibility.
  8. Actual 9:30 Ask 20 something’s friend about what group project he is working on with Physics classmate.  He responds it’s not a project and they are just doing exercises together.  Feeling: more hurt, more angry, unimportant, rejected.  Thoughts: I guess I’m not important and it doesn’t matter if I’m around in fact I don’t matter.  I should not study Saturday out of Spite.  He should know better.  Skillful Alternative: communicate better don’t personalize
  9. Actual 9:35 I begin to shut down, looking at my phone.  Anxiety is building.  Voices begin whispering.  Feelings: scared, angry, hurt, unimportant Thoughts: I’m just not going to say anything.  Don’t bother no one likes you here anyways.  Why are the voices whispering.  Skillful Alternative:  Go home, temporarily push away. Distress tolerance skills
  10. Actual 9:40 A person who was at group who I don’t know asks me if I’m ok. Voices get louder  Feelings: Freak out, anxious,  Thoughts: They know somethings going on.  Is it that obvious.  I can’t tolerate these voices.  They’re right no one likes me. Skillful Alternative:  Go home, push away temporarily.  Mindfulness Skills
  11. Actual 9:45 Start obsessing over how I’m going to leave.  Voices are now loud and repetitive I can’t concentrate.  Feel on the verge of tears.  Test my sister what should I do.  Skillful Alternative: Go home, push away temporarily
  12. Actual 9:50 Leave awkwardly.  Begin crying MD chases after me my voice is cracking as I’m trying to lie and say I’m okay. Feeling: sad, embarrassed, annoyed.  Thought: Now she’s going to tell everyone I was crying and upset.  She/They will think less of me.  Skillful Alternative: Made a more natural exit hugging and leaving like usual.  Wait to fall apart till I got to the car. Briefly tell MD something’s wrong but I’ll be okay. 
  13. Actual 10:00-10:30 Drive home crying.  My sister calls I say I don’t want to talk.  Get home take to Valium.  Feeling: Desperate, angry, hurt, embarrassed, guilty.  Thoughts. I can’t handle this.  Skillful alternative: ?

 What exactly were the CONSEQUENCES in the environment?

  1. Short term-  people wondering “is she ok?” Concern
  2. Long term-  people show a desire to connect and help and if I shut them out, they’re less likely to help in the future and maybe creates distance.  Showed some feeling but better if I talked it through. People may start walking on egg shells not sure how I’ll react. Ignore me because I don’t respond. Positive MD reached out, saw distress, wanted to help.

And in myself?

  1. Short term- Feelings escalated. Tunnel vision.
  2. Long term- I know how to avoid. Internal distress doesn’t go away. Miss the opportunity to see people expressing that they care but your too focused on avoiding.

Ways to reduce my VULNERABILITY in the future?  Trying to find distress tolerance skills that don’t just work at home. Leave earlier don’t let feelings escalate.

Ways to prevent the PRECIPITATING EVENT from happening again. More distress tolerance skills, besides ones I can just use at home.  Recognizing my sensitivity,and  maybe stopping when your ahead.

What HARM did my problem behavior cause? Other people worrying about me. Avoiding never gets the problems solved.

Plans to REPAIR, CORRECT, and OVER-CORRECT the harm? Text MD that I appreciated her coming after me but I wasn’t ready to talk about it. Conversation with 20 somethings friend to practice communication.

My deepest thoughts and feelings about this that I want to share.

The voices are back, scaring me. Knowing what triggered me, but not much about how to prevent it. I need to learn some distress tolerance for on the go.    Learning that it’s somewhat normal to react immaturely and irrationally sometimes.  I don’t want to have such a severe reaction again.

How to do a problem behavior chain analysis:

Continue reading

“Cut”

12 Apr

Wednesday I saw my case manager and was talking about the urges to cut people out of my life. I probably mentioned cutting class a few times too. She said to me, you know if it has the word “cut” in it its not good for you. I also call cutting people out of my life “shutting down” and I do it to various degrees when stressed.

I use to identify as a “cutter” and would use the word cut. I now on my blog try to refer to it as self harm because it sounds less triggering. Most of my cutting I actually did with scissors too, and in some weird way I thought that was funny. I was never proud of my cuts and always hid them but I knew it was a part of me. I never thought I’d be able to give that up.

Part of me gets scared. Self harm was always the middle step between suicide and I felt safer when it was an option. But I’m better now. I have better coping skills. I’m not as suicidal as I use to be, though I’m sure I still think of it way more than the average person.

I’m rambling. Good night!

Resource: DBT Crisis Survival Strategies Worksheet

25 Feb

distress tolerance blank

This is a blank copy as a resource if anyone wan’t to print it out.  Coming soon will be a filled out one.

Coping that works for me: Taking a bath

31 Dec

When you learn DBT, some of the main things are about mindfulness and pleasurable activities.  Taking a bath is self-soothing, a component of emotional regulation as well as a pleasurable activity for me.  I can also add bubble bath or scents to bring me a little more mindful and into the moment.  I use to self harm in the bath tub so that is a trigger for me, if I feel like self harming I know not to use this coping skill.

Lately

6 Dec

Lately things have been good, real good, almost too good to be true good.  I’ve felt better than I have in a year and the only downside seems to be I’m gaining weight and always hungry.  I sort of don’t know what to think of this shift in how I am doing, I was real hesitant at first because I usually do good for a period after being released from the hospital.  I’d like to attribute it to the meds, but I know it’s not just that.  I don’t wake up anymore with that feeling in the pit of my stomach and thinking how am I going to face another day.  This morning I did, but I think that’s because I accidentally forgot a set of my night meds last night.  Things still bother me but they don’t cause me to sink down so fast or even stay there for very long.  I know I have tons of coping skills and when depressed they don’t help or I don’t care enough to try.  I’m also trying to do things that are usually difficult for me or that I don’t do.  Last week I went out to eat twice by myself, this is big because when I move out I won’t have my dad to go out to dinner with me every night.  I’ve also been making myself food, granted it’s food that was pre-made but normally I even have someone else do it for me.  I’m still sleepy a lot.  Yesterday I took a 4 hour nap and didn’t even realize it had been that long.  So things are good and I’m just trying to enjoy the goodness without too much dwelling on what happened and when is it going to end.