Friday, May 25, 2012

Distraction vs Avoidance


Angry Birds, wii party, reading novels and dare I admit it, Blogging!   All of these can be helpful distractions, and yet, there comes a point when distraction slips into avoidance.

I had the first proper DBT sessions this week.  First the Skills Group, then next day the one to one with Joy.  This is how it is now and every week, twice a week for a whole year.  In fact the person leading the group session said 12-14 months!  Even after all the pre-commitment work it is a daunting prospect.

At the moment we are a small group (just 3).  We were all apprehensive.  I was very aware that both the others seemed a lot further on than me in terms of skills (even though two of us were new).  This was most evident when we looked at diary sheets.  They had both used lots of skills compared to my one.  I was quite ashamed of my comparatively blank sheet so when it was my turn I focussed on a question.

“Is what I have been doing distraction or avoidance?”

We concluded there is a fine line between the two.  When the activity is used as an alternative to unhelpful thoughts or behaviours it is distraction.  When the activity is used to numb the brain and feelings so you don’t have to address or acknowledge unhelpful thoughts, emotions or behaviours, then it is avoidance.  At the moment I think I am functioning at 70% / 30% in favour of avoidance.

So, Angry Birds, you might not be so helpful after all!

Wednesday, May 16, 2012

Change like the weather!


One of the most distressing aspects of BPD for me is the way my mood and the way I see myself and the world around me can shift between extreme opposites in a very short space of time.

I got up this morning, showered, got Jenny ready for school, had a proper conversation with Jo before he left for work, walked my dog and hung out the washing.  It was a great start to the day!

Then, with nothing I can pin point to trigger it, everything changed.  A bubble descended and settled around me separating me from the rest of the world making everything seem distant and unreal (derealisation in BPD technical jargon).  A sense of pointlessness overwhelmed me – what is the point of shopping, possessions, rushing around doing jobs, going to work.  Everything that keeps society as we know it running is meaningless.  Full of such thoughts I descended into a low mood and all the energy I had for doing anything drained through my feet into nothingness.  For a while (I don’t know how long), I sat like a zombie deep in my unwelcome thoughts. 

Suddenly I was brought back to the here and now by my dog (Jed) barking at something out the window.  I looked out and saw that just as my mood had changed, so had the weather.  Heavy grey clouds filled the sky which not long before had been blue and full of sunshine.This was like smelling salts as two practical thoughts burst the bubble I was trapped in.  The washing was out and the grass was getting long again, and last time I’d had to strim it because it was too long for the mower.  Full of energy I dashed out, rescued the washing and got out the lawn mower before the clouds emptied their heavy load making the grass too wet to cut again.  

Usually I find cutting the grass quite satisfying.  It isn’t complicated, it’s reasonably quick and you see a very good result for your effort.  Not so on this occasion. 

First, despite the grass being a reasonable length and dry, it kept clogging the blades.  This was frustrating me and I was starting to get angry, having urges to kick the mower and give up.  My self-control held out though, and in the end, on a more thorough search I found a twig trapped near the blades.  After removing that all was well – for a few minutes.

The second glitch was quite painful.  Our garden slopes downhill quite steeply making doing the bottom edge quite hard work.  It is easier to work with the mower pointing uphill than downwards or sideways.  As I walked backwards to get as near to the edge as possible I stepped too far, my foot went off the edge into the flower bed. I lost my balance and fell backwards so I was sitting on a rose bush!  Ouch!  Fortunately not with my whole weight as the fence broke my fall and save me needing embarrassing assistance to remove the thorns.

I recovered from that, swearing at myself for being so stupid – but got on with the job as now I could feel the first spots of rain.  I only had a couple of runs to go when the mower started to dig in the ground and not move across the grass easily.  I couldn’t work out why and was becoming frustrated again.  I turned and started to force my way, with an unwilling lawn mower back for the final run.  I had started and I was going to finish before the rain came in earnest.  I was half way back when I saw it.  There, lying on the grass was one of the wheels.  No wonder I was having trouble pushing the blasted thing.  I picked it up, pushed it back on the axle and hoped it would last till I finished.  It did.   

A few more drops were falling by this time so I rushed it back to the shed, losing the wheel again in the process.  It was a relief to have the job done.  I went back inside to have a well-deserved cup of tea.

As I sat with my tea, enjoying the view across to the mountains over the valley, something dawned on me.  The sky was blue and the sun was shining once more.  The dark clouds had passed by – and so had my mood (for the time being at least).

There’s a well-known phrase “change like the weather.”  Well, that’s me, and a big part of BPD.

Tuesday, May 8, 2012

Angry Birds


Diary sheets! 

Apparently these are an essential part of DBT and I will need to do one every week till the end.  Joy had given me one at the last session saying I may as well get started.  The idea is that as I gain the skills I will learn and apply them more often and the giving in to the self destructive urges will ultimately stop as the urges become less intense and less frequent.

Fair enough!

I’d dutifully recorded my moods and urges to self-harm alongside things I did that helped.  At the next session we looked at what I’d recorded.  I had listed as one of the things that helped when the urge to self-harm was getting intense, 

“playing stupid computer games”

Mistake!  In Joy’s words,
“If it helps it’s not stupid!” 

I can see what she’s saying.  If faffing with a game prevents me from acting on powerful urges to self-harm, the game has a useful purpose.  What was a silly, pointless, frustrating, time-wasting game of “Angry Birds” became a helpful, even therapeutic Angry Birds.   

What a great investment that 69p app for my i-phone was!

Friday, May 4, 2012

S.C.I.D. Danger


Well my DBT pre-commitment sessions are drawing to a close.  One more to go and then I start the programme properly.

In this penultimate session Joy explained that we’d pretty much covered all the pre-commitment work and there was one more baseline assessment to do.  This time not a multi choice questionnaire but a s.c.i.d.  This immediately made me think of dirty pants but Joy went on to explain it was a diagnostic tool for Borderline Personality Disorder.  

S.c.i.d. is an acronym for Structured Clinical Interview  for DSM disorders (DSM being an acronym for a diagnostic manual of some sort).  Confused by acute ‘acronymitus’, I preferred to revert to my own understanding of ‘skid’ – “a dirty stain on clothes or fabric caused by a pooey bottom.”  It turned out this wasn’t such a bad interpretation.

The interview took the form of a series of questions covering a range of the BPD diagnostic criteria.  These were asked by Joy who was able to ask me to explain further or clarify any of my answers.  It also meant when I said, “No, I don’t do or experience that!” she was able to ask about it in a different way to make sure.  

I’m not quite sure why we did it.  I had to have a BPD diagnosis to be referred to do the DBT in the first place – though she did say that if I put the work in I could expect not to meet the criteria anymore at the end, which is a very appealing thought.  The actuality of the interview however was as unpleasant as any huge skid you can imagine.  It forced me to think about all the things about me and that I do that really are horrible smears in my life.  By the end I felt pretty crap (excuse the pun).

Role on the end of DBT!