Back to Basics: Acknowledgement – yes, I have feelings…now what the #%*?! do I do with them?

Authors’ Note: this post took longer than expected, so we decided to polish this one instead of breaking up the series to post something else over Memorial Day weekend.  Sorry for the lateness.

Introduction

First thing I learned in therapy is that I have feelings.  I may not know what they are and how they relate to my thoughts or behaviors, but they exist and influence my life choices.  The first emotion I got in touch with was anger.  And only because the medication separated me so much from my body and mind that I could “see” volcanoes seething and erupting inside of me during therapy sessions.

Not until 2007 when I started with a different therapist did I start to recognize “fear” and “anxiety” and “sadness” as they overwhelmed my mind and body.  She didn’t tell me at the time, but a lot of what we did together was DBT or Dialectical Behavioral Therapy.  Part 1 of Emotion Regulation is acknowledging and identifying feelings.  Part 2 is using certain strategies to cope with those emotions and not let the emotions influence thoughts and behaviors.

The women only partial program I went to in 2009 focused a lot on DBT.  Depending on how long an individual stayed in the program, she could go through all 4 parts before leaving.  DBT group sessions were daily and mandatory.  I loved them; did not always say a lot, but I listened and learned.

My second time in the same voluntary partial program did not go so well.  The people running it in 2012 were different from the ones in 2009, and groups were run differently too.  Not that it was bad, but my needs were different.  And most of what I learned the first time was repeated again; not much new to learn and experience in terms of coping strategies and techniques.

OK, I can feel.  Now what?

The biggest takeaway from both times in partial programs was how others experienced and showed their feelings.  By observing the women in my groups (I went to a female only partial program because I wasn’t ready to deal with men in that kind of setting yet; and I understood males better than females having worked in a male dominated office for many years), I learned about how different women expressed feelings; how the experiences were different and similar from mine; and how important facial expressions and body language are in expressing feelings clearly.

To some people words mean everything.  To others, actions and expressions tell the truth instead of words.  The rest of the people are somewhere in between; words and expressions are used to understand emotions.  Between 2007 and 2009, I couldn’t articulate a feeling if I tried.  I could easily mold my features and body to express whatever feeling I was supposed to show.  But none of my real feelings showed; not in my voice; not in my eyes; not anywhere except inside my mind.

And there, I always saw destruction: witches toiling over a bubbling cauldron; sleeping volcanoes ready to erupt; the eruption; tornadoes and hurricanes blowing everything in their paths.  Rarely, a quiet lake appeared below a mountain ridge.  Or a meadow clearing deep inside a dark, twisted forest.  But getting there was akin to a hero on a quest.  And I wasn’t ready for that.  Neither were my alters.  Each of us had to go on a quest to find our quiet place.  And from there, find each other.

Knowing of each other; having limited interactions once in a while; hearing voices intermingled with the monsters is not the same as finding each other and working together to be whole.

The second time in partial focused on learning techniques, but not so much about trauma or real life application of said techniques.  In essence, I felt like I was teaching instead of learning to the point where some of my group members said in front of the leaders that I “should teach a group”.  My alters did not like being excluded from group interactions and ignored as if they did not exist – something I had to do in order to get through the different sessions with some sanity.

Definitions

Dialectical Behavior Therapy (DBT): Psych Central offers a good description with links: This website offers an introduction to DBT

Emotion Regulation (mine): Strategies to help me (us) not be controlled by our feelings and emotions. The often used phrase “think before you act”.  In my case, “think before you react”.

Partial Inpatient treatment programs: sometimes extra support is needed, but not to the point of being committed to and inpatient program.  Partial programs (voluntary or court-ordered) offer the extra support and group sessions in an outpatient setting.  Different programs specialize in different mental illnesses, treatment strategies, gender, age and so on.

Mimicry or Learning by doing:  By observing how people we liked and respected acted towards themselves and others, we learned how to treat ourselves and others with respect and acceptance.  By watching others who had and expressed feelings, we learned how to do the same.

The skills and personality characteristics we practice

Persistence: Ignoring feelings makes them stronger and more powerful.  Fighting them does that too.  We can’t make the feelings go away.  We can acknowledge and identify the feelings that come and go.  Odd thing is that acknowledging the feeling takes some of the feeling’s power away.  Identifying the feeling and welcoming it also takes power away.  The feeling is not so overwhelming; it’s not in control anymore.  But doing this is scary because it means that we have to experience all of the physical and mental sensations (thoughts, behaviors, etc.) that come with it too.  Eventually, though we can say to ourselves, “I feel ___.  ___ is expressed as _____ in my body and ____ in my mind.  If I welcome all of it, the feeling will go away faster and on its own.”  And the feeling does go away eventually.

Active Listening: I learned that feelings expressed in sounds are easier for me to understand, yet also very triggering.  Noise tends to disrupt me far more than anything else.  Specifically voices and movement are triggering.  Growing up, listening to voices and body movement kept me out of danger more often than any other sense.  So I stopped hearing actual words for a long time.  My focus was on listening to tone, pitch, and volume.  Those three pieces would let me know how much danger I was in and what kind in each environment.  Not until I started college did I realize that I had stopped hearing actual words, sentences, conversations, etc.  Most of the time I lived inside my head with ears tuned for danger or potential danger.  Then I realized that if I wanted to participate and socialize I had to listen to what people actually said and respond with my own words.  Later, when we all started communicating with each other, every alter had to re-learn how to listen actively, interpret the verbal and non-verbal cues, and respond using positive interpersonal communication skills.  By using active listening, we can identify how other people feel and react to our words so that there are less problems with communication.

Solitude: looking inside and working with feelings requires time with safe people, time with instructors, and time alone to practice and learn.  Solitude is not loneliness.  It is a way of making friends with oneself and enjoying one’s own company.  It’s a time to explore different ideas and skills without fear.  It’s personal “me” time in which the individual can do anything or nothing or something in between as long as the task is done with purpose.

Analytical or Critical Thinking:  a pause is an opportunity to use the logical side of the brain and ask “why am I feeling this way?  How will I react?  Do I want to react like that?  Or do I want to react differently?  How do my thoughts influence my feelings?  Am I feeling something else under this feeling that is pushing me to react?”  And by answering one or some of these questions, I/we have a chance to change our thoughts and reactions from negative to neutral or positive instead.  This gives us control over ourselves instead of letting the feelings control our reactions.

Empathy: empathy is difficult to understand, respect, and accept because many people equate it with weakness.  And others will be cruel by telling them that no one can feel what others feel because they didn’t “experience” it exactly the same.  But empathy is not about “knowing what others feel” so much as “being able to relate to others’ feelings and situations through shared or similar experiences.”

Observation: Please refer to any of the characteristic explanations above.  Each one provides many examples of observation.

Final Thoughts

I’d rather have feelings than live in a numb, colorless world.  My alters agree and disagree. Understanding feelings and how to express them is one step closer to being able to understand ourselves.  From there, we can understand others and use empathy to inform our choices and decisions.

No one gets hurt on purpose.  Learning from mistakes is not so costly.  And every success is a reminder to be grateful for the gifts we have and use to survive in a hostile world.

We all prefer to try any possible technique and strategy at least once.  That’s why we tried the partial program again.

Thanks for reading.

Back to Basics: Denial Works, Dissociation & Distractions help, but education matters too

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

Back to Basics: A Tool Box, a Magic Bag, and a Safe Place to Practice

Introduction

Like everything else, learning a coping strategy and remembering it takes practice and some kind of organization.  We in the AlterXpressions system use a tool box (or many tool boxes), a magic bag (or many magic bags), and at least one safe place to practice our coping strategies and techniques.  The terms can be changed to suit individual needs (pick something that reminds you of safety, happiness, or something positive); whatever helps the individual or system remember where the coping strategies (tools) are stored and how to access them.

Definitions

Tool Box – internal storage space/container for coping strategies and techniques (like a memory box maybe?)  We use a vault inside the library as our main tool book.  Some of us hide our tools in candy boxes or recycled food tins. Mine looks like a prism.

Magic Bag or Grounding Bag – physical container to carry when out and about; I use the phrase magic bag because everyone in the systems believes in magic and coping strategies are like magic for us.  My therapist uses grounding bag; she learned it from a training workshop run by an EMDR specialist and trauma therapist

Safe Places to Practice – internal and external places with some quiet and privacy to learn and use coping strategies; we little kids love practicing on the jungle gym and obstacle courses.  The trees like practicing in meadows or looking over the bluffs to see water below.  Some of the boys work best in a sound proof radio station.

Helpful Skills

The skills and personality characteristics we practice in developing our tool box, magic bag, and safe place are:

Imagination/Creativity – our tool box is a library inside a maximum security vault with an intercom system that connects it to all of our internal safe spaces.  Our body tends to wear the “magic bag” in terms of clothes, jewelry, tattoos, and accessories; the rest goes into a backpack or plastic bag.

Visualization – The library is like a bee hive or cave system with sunny places, access to the ocean and forest, cozy fire places, lounge chairs, book shelves, a kitchen, blankets and pillows, stuffed animals, a craft corner, etc.  And everything is movable.

Focus/Concentration – Each alter has his/her/its own tool box.  We also have group tool boxes and community ones.  We create these as our go-to places when someone wants solitude or alone time or small group time.  Or for different age groups because not all tools are appropriate for all ages and genders.  Takes focus and concentration to create, store, and remember them.

Persistence – keep trying to create the ____ until each one feels right; and make changes when something doesn’t feel right anymore

Thinking outside the box – sky is the limit; use a scarf and hat as a magic bag or underneath the bed as a safe place.  One of my favorite safe spaces is a walk-in closet with locked doors

Self-Confidence – success builds on success; every time we accomplish something positive, our confidence goes up

Independence – we can learn how to use the tools and build each piece, but it’s up to us to create and utilize our knowledge to the best of our ability

Accomplishment or Success – finish something = accomplishment or success; success brings positive feelings and builds on itself

Final Thoughts

Basic coping strategies are like automatic defense mechanisms.  They get used without conscious thought.  Taking time to think about behaviors and thoughts that help us cope with every day anxiety and triggers helped us develop the first tool box.  As different alters cycled through periods of remembering and forgetting, it seemed like the best option was to create an accessible internal tool box like a library with security and safe places so that everyone could access all of our tools.

And once we learned about physical grounding and started reading about magic bags of holding (fae and Celtic mythology) from some of our favorites fantasy books, a magic bag that holds our favorite coping tools without being obvious was born.  Our magic bags change in shape, size, and contents all the time.  Depends on who is in charge, who is the most distress, and what tasks have to be accomplished.  Yes we have grounding tools in and around our bedroom.  A magic bag is in the works too.

But most important is having a safe place to practice these tools so they are available no matter what kind of stress, distress, panic, or anxiety hits.  And the best way to practice is when we feel relatively calm and safe.  This way, the tools come out of the tool box, get used for a specific purpose, and get put back in the tool box when we are clearheaded.  Like muscle memory, repetition works.

Repetition, not a routine or a workbook.  We practice when we can, as often as we can.

Thanks for reading.

 

Back to Basics Series: Introduction Post

A couple weeks ago, I wrote a post about going back to basics and provided a list of some basic strategies and techniques that get used the most.  These “back to basics” posts are meant to share experiences about how and why they work so others can understand better and try out something when nothing else seems to work.  I and the rest of the alters will alternate writing and sharing experiences so be prepared for different levels of writing skill in each post.

Some of us are adults and write well.  Others are adults and not so good at writing.  The adolescents and young adults vary too.  And once in a while one of the child alters will chime in and share a story.  We will try very hard to change the font or let our guests know when the author has changed in an obvious way, but it might not always happen.  You have our sincere apologies for this in advance.

Some of what gets discussed here will be triggering.  But since these are meant to be resources, we will try not to get into too much detail about the scary stuff.  Instead, the goal is to share only enough through examples so that our guests can understand how different strategies and technique works.

REMINDER: I am not a therapist or a professional counselor.  What gets written here is based on personal experience and shared stories through therapy and groups.

Some of the topics (might be discussed more than once in different ways) are:

  • Mindfulness (DBT version and others)
  • Distress Tolerance (DBT version)
  • Emotion Regulation (DBT version)
  • Interpersonal Effectiveness (DBT version)
  • Thought awareness and changing negative thoughts (CBT version and others)
  • Obsessions and Compulsions
  • Distractions
  • Grounding
  • Self Soothing
  • Comfort
  • Compassion
  • Meditation
  • Food

Thanks for reading.