Introduction

Sometimes the coping strategies and techniques (aka tools) that work the best are also the most harmful to ourselves.  By harmful, I mean that the way they are used now is disruptive to everyday life and dangerous to self and others.  In a different situation or used with a different set of feelings, these harmful tools could be useful.  That’s happened to us often in the last few years.

But until we figured out how to change the tools from harmful to helpful, using them only caused more distress and backlash.  Still, none of us wanted to “get rid of” or “remove” them from our skill set.  They worked when nothing else did with a range of consequences.

This is how the In Case of Emergency or First Aid tool box came about.  It’s where medicine like Tylenol and other OTC meds go because meds make our body sick.  It’s where self harm and coloring, exercise, sketching, etc. go because those tools trigger anxiety and flashbacks.

Finally, the Last Resort tool box came in to play during times when I or one of the alters felt/feel compelled to self harm or not sleep because of unidentifiable, overwhelming sensations causing overload.  These tools are: psychiatric medications, various forms of self harm, relapse into anorexia, and reckless behaviors that cause emotional harm.

Four of the most useful strategies that defined my life pre-recovery and continue to assist all of us now are: Denial, Dissociation, Distractions, and Education.

• Denial allowed me to graduate high school and college while still living with my family.  It allowed me to maintain pseudo-friendships and relationships with people until I was able to find real friends.  It helped me block out nasty, scary stuff as I navigated my way through graduate school and a job I learned to love.
• Dissociation aka daydreaming, deja vu, an altered state of mind, or a meditative state.  Dissociation allowed the one in control to separate the abuse from everyday life in order to go to function like a “normal” child in public most of the time.  Dissociation facilitated switching alternate personalities during times of trauma and abuse.  Dissociation allowed all of us to retreat to safe places in our mind when bad stuff happened or feelings got overwhelming.
• Distractions kept me from thinking and feeling what happened inside me before I was ready to handle it.  Reading allowed me to escape anywhere and everywhere while still being in the same physical space as the abusers.  Now distraction helps all of us pause when any of us get triggered by something.  That pause and step back allows us to find and use/utilize the appropriate tools in our tool box for the situation.
• Education taught me skills that no one wanted me to learn.  Under the guise of learning, I had more freedom to experience positive influences that helped me survive the tough times.  No one can take away what we learn.  Even in times of traumatic amnesia, the information is somewhere inside waiting to be let out and used again.

Definitions

• Denial/Avoidance: not thinking about, putting aside, refusing to acknowledge events and experiences that have taken place or are happening in the present
• Distraction: an activity or behavior that allows the user to think about and work on something other than what is currently causing anxiety and stress
• Dissociation: mental separation of mind and body; like daydreaming and deja vu and meditative states.
• Education: any opportunity to learn, explore, and expand one’s horizons through reading, listening, observing, and hands-on experience
• In Case of Emergency box:  a group of coping strategies and techniques that work and are useful but have serious negative or questionable side effects
• Last Resort box: a group of coping strategies and techniques that work in the short-term; that have not been successfully replaced with more positive or healthy tools; and have harmful, dangerous side effects and consequences

The skills and personality characteristics we practice

Problem Solving: Here is the tool box.  Here is a pile of tools all jumbled together.  Now what?

Self Reflection: This is what happened.  This is what I remember.  This is how I felt.  This is where I was.  This is when I reacted.  What is the trigger?  How did I cope?  Which tools did I use?  How do I feel about my reactions and actions?  How do I feel about myself now?  Would I use the tools again?  How effective were the tools?  What would I do differently if it happened again?  Where would I go?

Distress Tolerance: I feel this way.  It’s overwhelming.  I can’t think.  I am going acknowledge my feelings.  Then stop and do something different to give myself a break (distraction).  Or answer a question that’s been bothering me by reading a book, asking people I know, browsing a website or blog, listening to a TED talk, or participating in a related activity (education).  Finally, I will cope with the overwhelming feelings.

Resilience: My idea got shut down again; big mistake.  But I figured out a solution and fixed it.  Now the boss is happy, and I learned something new.  Or, this strategy isn’t working anymore.  What if I tried saying the safety affirmations for morning nightmares next time my body starts sweating and my abdomen cramps up in pain?

Creativity: AlterXpressions as a system is using imagination, education, and experience to our internal world.  Each alter in the system creates individual and community toolboxes too.  And all of this takes place inside our mind – our internal world where everyone in the system is accepted, valued, and supported by self and each other.

Value: in creating these boxes, learning, and finding effective distractions, we learn our value as a whole and as individual parts.  We compromise and work together; and realize that we each bring something important to the process.  Without those bits, our system and tool boxes would not work as well.

Acceptance: In practicing the self-reflection needed to transform our tools from harmful to helpful, we learn to face fears with compassion and accept that trauma is something that happened to us, not something part of who we are.  We learn how to love, respect, value, and feel compassion for ourselves, each other, our body, and people in the outside world.

One workaround = One new tool in the tool box

Back to example 2 in the Skills section.  Certain triggers used to cause physical panic attacks where my body cramped up and started sweating.  I lost control of bodily functions and over a pint of fluid.  Then the cold chills set in, and I passed out from the energy released by my shaking, cramped body.  Nothing helped with the pain or the cramps.  Deep breathing made the cramps worse.  Distractions made the vice like pain around my abdomen intensify.  Denial made everything feel 100x worse.  So I tried an affirmation I made to help me when I started to feel hyper-vigilant and unsafe.  In my mind or quietly under my breath, I repeated a 6 line mantra and combined that with an affirmation about pain lessening to pressure and pressure dissolving into nothingness.

To my surprise, it worked.  Eventually, I was able to decrease the length and severity of the attacks and control the passing out period.  Passing out put me to sleep for 8-20 hours at a time, so not something I wanted to happen during work hours or events.  By doing this, I found another use for two coping strategies in my box and created a new tool.  That success built on itself as my alters and I continued experimenting with the effectiveness of different strategies or adaptations of strategies in other triggering situations.  Each success added another tool to our tool box.  Each failure taught us something about ourselves and what we need to help us cope effectively.

Some days, too many triggers and flashbacks occur and overwhelm my mind.  Distractions don’t help because relaxing allows the feelings and thoughts, etc. to intrude again.

Denial with a time limit does help.
I put the triggers, flashbacks, and associated sensations in a temporary locked container with a timer. That gives everyone involved some breathing space and time to consider how the stuff in the box will be dealt with.  The timer goes off, the stuff comes out.  And we work through the stuff with coping techniques and strategies in our tool box.  Sometimes this works.  Sometimes it doesn’t work.  But it’s better than giving in to the panic or using a more harmful strategy.

My favorite kinds of distractions include research, reading, and working with my hands.  Unfortunately, I don’t get to work with my hands often; that and social kinds of learning are major triggers.  But I do read a lot. And use reading to help me learn.  When the anxiety gets really bad, I start to form mental loops or tape recordings that play over and over again.  Asking a question or setting myself up to learn a new task breaks these loops.

First example: I decided that I didn’t want to be in financial debt anymore after successfully breaking away from my parents and starting fresh.  So I decided to learn everything I could about personal finance, frugal lifestyles, and effective strategies to get out of debt.  That included, reading books, viewing a variety of blogs, and going through a non-profit organization to work with a mentor.  Now, I am debt free; pay off my credit cards on time; and even started a small nest egg with help from a financial advisor.

Last Example: My first mental health counselor diagnosed me with anorexia 12 years ago.  It sparked many questions about food, nutrition, and wellness in my mind.  I discovered chiropractic doctors who taught me about integrative medicine through a graduate school internship.  From there, I read books about food allergies and alternative food lifestyles (vegetarian, vegan, raw food, etc.) and began work with a registered dietitian who supported my questing mind and personal goals of nutrition and wellness through real food.

Final Thoughts

Now, all of us are physically healthy and in remission from anorexia.  Our mental health is improving.  It’s hard work, but every survivor and connection has the internal resources, strength, and power to get here and beyond too.

Thanks for reading