Archives for the month of: July, 2015

Warning this post may contain more spelling and grammatical errors than usual

I am sleep deprived.  Been a tough week full of unexpected joys and stresses.  Spent one sleepless night and many restless ones this week.  On top of that, nearing the end of an energy cycle, so already feeling sleep deprived.

Sleep Deprived

Recovery work takes a lot of energy whether you are low-functioning, functioning, or high-functioning (like me).  For people who consider themselves normal, any kind of excess stress over a long period of time can feel this way.  For survivors, the “excess stress” and work to manage and cope while living and working is their version of normal.  Not surprising that many feel tired all the time and will sometimes crash into a period of sleep or rest for no apparent (to outsiders) reason.

Live Independently or Dependent on Someone Else

I, we, chose to live independently,  That means:

  • not taking medication
  • not self-medicating with drugs, alcohol, food, cigarettes, (something I missed here)
  • Not letting my family or friends take care of me when I have a panic attack or get so tired I can’t move

No offense intended to those who can and want to let others care for them when this happens.  I learned a long time ago that taking care of myself was much safer and healthier than letting others take care of me.

We don’t have to worry about:

  • shaming and blaming tactics for “getting sick” and being weak
  • punishment for not accomplishing daily tasks
  • guilt for taking up someone else’s valuable time and space; being a burden
  • negative criticism about being weak and stupid and lazy like our mother
  • pity and condescension from outsiders for always being “sick” and “irresponsible”
  • vulnerable and unable to protect ourselves from the monsters

Precautions

  • At times like this, my parts and I have a plan.  It goes something like this:
  • Inform supervisor and relevant co-workers that I am tired and not feeling like myself lately
  • Increase the self-care – eat more, take more breaks, keep multiple coping strategies and techniques on hand, make sure the house is relatively clean and stocked with food, use sleep hygiene routine, call hotline for help
  • Keep items and thoughts that help me feel safe close by
  • Prepare to take a sick day
  • Make sure I remember to email supervisor if I take a sick day
  • Stay close to home; wear comfortable shoes and keep my phone handy if I go out

When I Crash

Usually that means I sleep for 12-20 hours with breaks for food or hygiene.  Or I am awake, but unable to leave the house because of muscle cramps, stiffness, and pain.  So I move slowly and rest a lot at home.  I rest when I can, sleep when I can, and move when I have to.  I keep busy with books and movies, knitting, cooking, or sometimes doing nothing at all.  Eventually, my body feels better, the tension leaves, my muscles relax.  I am not so tired anymore.  And I go back to my “normal” life.

So here you have it – my plans for the weekend.  Hope yours is much more interesting.

Necessary But Not Sufficient

All of us:

Coping strategies and techniques are resources.  The more you learn, the more help you can access.  Therapy, programs, medicine, etc. are resources. Asking for help widens your support system; another way to find potential resources.

Angora:

Meeting basic needs is a resource.  Taking care of physical, emotional, and spiritual health is a resource.  Practicing basic hygiene is a resource.  Discovering and implementing ways to feel safe are resources.

Sunni:

Human characteristics like resilience, courage, intelligence, creativity, persistence, flexibility, acceptance, tolerance, and respect are resources.

All of us:

One is not enough.  How many is enough?  Is there such a thing as too much?

Dawn-to-Dusk & Breezy:

My therapist says that one resource is not a cure-all.  It takes practice and use of many resources to create a solution.  Many times when we reach a wall in therapy, it is because a new aspect of my trauma history has been revealed.  We brainstorm together and separately.  She asks her resources, and I research information.

Sienna:

And when I get frustrated, she reminds me that one resource or many resources, it does not matter.  The more knowledge you have, the better your chances of finding a solution.  What I know, everything I have learned so far is necessary but not sufficient.

Blue, Purple, & Silence:

I like to draw and play in the quiet room.  I like to run and help the adults with protection.  I like to use the catapults and the bubbles.

All of us:

No one individual or resource has all of the answers.  Change is inevitable so we have to adapt to them in order to move on.  Sometimes that is easy.  Most of the time, it sucks.  We tried going it alone for a while.  And we tried having a support network and resources to help when we stumble.  Guess which option worked better?

It has taken a long time for all of us to accept this.  Asking for help is scary.  Accepting help is scarier.  Trusting someone else with inner thoughts and safety is probably scariest.  It took me eleven years to get where I am now.  Some of my parts are in the same place.  Others are not.

And we are nowhere near finished with the recovery journey.

Questions for Readers:

How long will it take you?  Are you willing to persist in spite of the road blocks and relapses?  Will you keep an open mind?  Will you learn to trust yourself one day?

I hope the answers are yes someday, if not now.

When I was a kid I liked watching The Incredible Hulk on TV – not the cartoon, but the sitcom version.  It always amazed me how the mild mannered scientist turned into a monster and a hero when he lost his temper.  And in learning to live with his inner monster, he became a better human.

Fast forward about 20 years, and the Marvel comes out with the first Avengers movie.  In that movie, the scientist explains how he learned to control The Hulk: by always being angry and not shutting out his feelings.

My name is Darkness.  I am one of the few make parts in this system who grew up with the other adults.  Sometimes I forget my age and go back to being a child or teen.  Other times, I feel older than dirt.  And before we started using ISF to communicate, I was like the scientist before he learned the secret to controlling The Hulk.

These days, I am much better about not taking out the anger on innocents.  But sometimes, I forget that I am innocent too.  I turn the anger on myself.  That hurts everyone in the system.  And brings me to my knees with shame.

I used to take over and force us into scary, dangerous situations.  And I used to hurt people, not on purpose, because I did not know my physical strength.  Verbalizing is not something I learned, so I write instead.  Or I share images with the other parts.

It got to the point where the adults who interacted with outsiders avoided contact with everyone because no one knew what would set me off.  And I am extremely protective of my internal family.  But I did not know the difference between “safe” and unsafe” touch or contact then.  So I  attacked everyone on the outside.  Even friends and people who tried to help.

Our female body does not stop me.  The one greatest gift our donors gave us was education in martial arts and self-defense.  I remember every lesson and every technique we learned.  Some memories are fuzzy.  Others are clear.  The other guys and girls who remember workout with me on the inside.  We teach the kids and each other to prepare for attacks.

But we hardly ever use the physical body because that triggers body memories we can’t fight.  Feelings we can’t handle yet.  And anger so intense all I want to do is murder the monsters and blow them up to ash so they can’t regenerate.  As you can imagine, this kind of revenge anger is toxic.  And for a while, the rage took over our life.  It was uncontrollable.

We all thought we were going crazy.  I tried to make it stop by locking myself in a prison.  So did the other parts with uncontrollable rage.  Then I tried to make the memories go away.  It wasn’t until the second therapist and the first program stint that we all learned about anger management and emotion regulation.

That helped with the emotional part, but not the physical part.  The body memories weren’t connected to the cognitive memories then.  And every time a button got pushed, both memories got triggered into flashbacks. And our body instinctively lashed out with physical violence.  Our mouth used verbal and emotional violence.

Our current therapist helped us learn to sit with our feelings and body sensations instead of trying to control them.  The goal is acknowledge, accept, let go, move on.  Like the scientist and The Hulk – stop denying the feelings and learn to live with them.  Most of the time this is true.

But I have trouble controlling my anger when the body memories hit.  I see and hear and feel the others hurting and feel helpless to stop the pain.  My goal now is to figure out how to work with body memories in a safe way.  That means integrating physical activity into our lives.

Because acting like the Hulk after he got his temper and rages under control is a good goal to work on.  Being able to share safe physical contact with friends and connections (maybe a lover for the sexual female alters too) is our ultimate hope.

Coping Techniques Explained

Cognitive Behavioral Therapy (CBT)

The first effective coping technique I learned in therapy was cognitive behavioral therapy (CBT).  The psychologist used this to help with my original diagnosis: clinical depression with anorexia nervosa and generalized anxiety disorder.  Practicing this taught me how to identify emotions and negative thinking patterns so I could change them.  The psychologist also taught me how my emotions and thoughts influenced my behavior.  By changing one, I could change the others.

Self-Help Books, Websites, etc.

The next group of techniques came from a series of books.  Working through lessons in the books taught me how to identify triggers, calm myself down when I felt the anxiety, relax, and refocus on the present.  By using those strategies, I could recognize patterns in my behavior and work to stop self-harm behaviors by using different coping strategies instead.  They helped me find new and creative ways to apply my CBT skills and improve on existing skills like meditation and deep breathing too.  I have a list of my favorite self-help resources here.

Caveats for self-help resources:

  • These resources are guides, not substitutes for qualified professional assistance
  • They can provide factual information, lessons for learning the basic techniques, and useful suggestions
  • They cannot solve your problems and make the issues go away
  • Not all resources are created equal; be wary of anything you read and/or listen to, especially if the resource claims it can solve your your problem
  • If you get frustrated or don’t understand, it’s not your fault.  This may be a good time to reach out and find other supports to assist you on the recovery path.
  • Finally, read, visit, or listen to multiple information sources on the same topic before deciding which techniques to use

Dialectical Behavioral Therapy (DBT)

The third coping technique I learned was dialectical behavioral therapy (DBT).  The creator of this therapy is a survivor and renowned therapist named Marsha Linehan.  Ms. Linehan has Borderline Personality Disorder and created DBT to help her cope with overwhelming emotions and her reactions to them.  I use DBT for feelings of anger, shame, and guilt.  And to help me cope with body memories.  My parts use DBT to help with distress tolerance and emotion regulation that comes from being triggered into flashbacks and nightmares all the time.

If you haven’t noticed already, my internal and external lives are very different with their own perspectives, priorities, and experiences.  Living on the inside and the outside simultaneously requires cooperation and compromise from everyone involved.  It also requires a lot of trust and the development of a system to keep our internal world functional and running smoothly.  That brings me to the final coping technique addressed in this post: Internal Family Systems.

Internal Family Systems (IFS) Model

We are lucky because we are all aware of each other and want to live a full, enjoyable, healthy life together.  That means we work together and help each other instead of working against each other and hurting each other.  We feel safe enough to ask for help, to set individual and group boundaries, and to use open communication to address problems instead of holding it in or casting blame.  Not everyone with DID is that lucky.

I learned about IFS from my current therapist and started using it actively in 2012.  The main point of IFS is that every part has a voice and gets heard.  On the inside, all important decisions are made by committee using 1) majority vote; or 2) unanimous vote.  We have also created a “family hierarchy” of sorts so that everyone shares essential chores and responsibilities equal to their age, developmental stage, and ability.  For example, adults take on adult responsibilities like work, transportation, finances, etc.  Adolescents have chores, responsibilities, and time to explore.  Children get to be children and have chores to complete every day.

We all work together to establish and maintain communication lines.  We all have to compromise and find solutions that work for the system when flashbacks and other symptoms threatens to overwhelm us.  We are all responsible for making good choices, working together, making our internal and external worlds safe, and learning coping strategies to weather the ups and downs of recovery.  Especially when parts get stuck in the past, trapped by traumatic memories (monsters), or lost and get triggered to the point of using automatic defense mechanisms and self-harm to cope.

Without learning and using IFS, none of us would be in the healthy, safe, happy place that allows us to share this information on the blog and the website.

Other Info

Here is a list of some other useful coping techniques.  I do not mention them above because they require assistance from an experienced mental health provider to be most effective.

  • Hypnotherapy
  • EMDR
  • Sensorimotor Psychotherapy
  • Trauma sensitive yoga and other types of moving meditation

Medication

Medication is not a coping technique or strategy I use except under certain conditions:

  • Not sleeping for 36 or more hours
  • Intense physical pain that keeps me awake and unable to move
  • Real physical illness like a cold or the flu

I choose not to use medication because medication makes me physically ill.  I am extremely chemical sensitive and will get the side effects from even the smallest doses (the 1 in 1,000 or 1 in 100 person described in the small print).

This does not mean I am against using medication.  If medication works, please use it.  But don’t expect to see many posts about the benefits of medication as a healthy coping strategy here.  I cannot speak to that topic and work hard not to pass judgement or bias readers for or against any strategies here.

Challenges in not using self-harm as a coping strategy

There are many challenges to stopping self-harm.  The ones listed below are what I have to deal with most often:

Finding Effective Substitutions

Before I started therapy, anorexia, self-harm, dissociation, and switching were the only effective coping techniques in my tool box.  I used them relentlessly to block out the monsters in my mind.  And when that did not work, I isolated myself and developed OCD type rituals.

Therapy, partial programs, and a lot of personal research with books (and then the Internet) taught me a lot of useful coping techniques to help me understand that I did have feelings and how to safely express them in a healthy way.  The four main techniques I use are:

  • Cognitive Behavioral Therapy (CBT)
  • Self-Help Workbooks like: The Anxiety & Phobia Workbook, The PTSD Handbook, and The Anorexia Workbook
  • Dialectical Behavior Therapy
  • Internal Family Systems Therapy

I use “technique” here because each behavior, or group of behaviors, can be learned and used alone or in combination to create effective coping strategies tailored to individual needs.

Breaking Habits

According to scientific research (multiple sources), habits are easy to create and difficult to stop.  A habit can form after a few repetitions.  Breaking a habit can take a at least a month or longer.  Some habits are easy to break.  Others are not.  An addiction is more difficult to break than a habit.

When does a habit or a routine become an addiction?  I honestly don’t know.  But that is less important than understanding the how and why the habit or addiction was formed.  And what purpose it serves in one’s life.

A habit becomes an addiction when the habit starts to take over my life.  When all I can think about is the next opportunity to hurt myself,  Most of the time I used self-harm to help me feel in control of my environment while also distracting me from overwhelming emotions and extreme pain.  The anorexia nervosa was the worst one.  I started that when I was six years old and didn’t start recovery until I was twenty-one.  Twelve years later, I am officially recovered, or in remission.  Like alcoholism, an eating disorder never really goes away.  Relapse is always possible.

These days, my only self-harm habits are food and skin-related: scratching, clumsiness causing bruises, tearing at my nails, eating food that makes me feel  sick afterwards, etc.  And they only come out during a combination of the following situations:

  • feeling unsafe
  • backlash
  • anniversaries
  • bad triggers
  • body memories
  • emotional overload

Any one of these by themselves might cause me to use or feel the urge to use self-harm, but often do not.

I have a variety of strategies to help me when the urges come now.  Most of the time they work.  And when they don’t, I work hard to minimize the backlash that comes with using self-harm.

Relapse Backlash

These broad categories are based on my experiences and discussions with therapists. Please remember that as you read this section.

Anyone who has ever relapsed or failed at something has experienced the negative emotions and thoughts that come with a setback (aka mistake).  Some people and move past these easily because they learned positive, healthy ways to cope from role models.

Others pretend these feelings don’t exist, put them away someplace and forget (or try) their existence; then these people put on a “brave face” and work harder, obsess over mistakes and solutions, to ensure success the next time.  They acknowledge the failure without blaming their sense of self; might or might not hold grudges; and often will try again or decide the task is not worth the time and effort so move on.

Then their are people like me (and maybe you too), survivors who for some reason or other (and to different degrees) have been taught that they do not have feelings; every setback is a failure because they, the human, is a failure and will never succeed; and success is not real success because their is always something wrong with how the task was accomplished; nothing they do is right or good enough, will ever be right or good enough.  And they always get punished for failure.

Backlash is just that: punishment for failure.  Self-inflicted or other-inflicted, it does not matter.  What matters is that some people are compelled to punish themselves for failure of any kind.  Often that punishment is physical; sometimes it is emotional or spiritual or a combination of these.

But punishing oneself for lapsing or relapsing starts a downward spiral back into addictive self-harm behaviors.  I know because I am struggling not to punish myself for relapsing over the last few weeks.

Alters

Many times, my parts and I are co-conscious.  This means we are all aware of what is happening around us – not a complete switch in personalities.  And different parts can/will take control of our body while someone else is in charge of speaking and interacting with outside people.

Many of my alters do not feel like other coping strategies are as effective of as what they already know and turn to like a blankie.  Or they are very young/old and have difficulty remembering the other strategies and techniques under stress.  If they remember the strategies and techniques, they also have to remember how to use them.

Teaching my child parts, adolescent parts, adult parts, and ageless parts these techniques while also working full time, managing day-to-day life, and writing this blog takes a lot of time, patience, and practice.  We practice when we can; try to treat ourselves gently, with compassion and empathy, when there is a set-back or a mistake.

Because it is never failure.  It is always an opportunity to learn.

Finding effective support with therapy

There are a lot of resources available for learning these techniques.  Therapy is not required.  Neither is participation in a program or a group.  But if you are like I was when I first started, working with a professional can help you learn these techniques while providing a safety net to help cope with the backlash, emotions, or memories that can appear as you move through this process.

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