Showing posts with label DBT. Show all posts
Showing posts with label DBT. Show all posts

Abandoned

They stand like witnesses to a lost era. Solid brick, lines still nice and square. I wonder if new floors and windows would be all they need, these abandoned houses. Who used to live there? Why did they leave? Why did no one buy a nice 2 story brick home? What led to the boards and the warning placards and the decay?


I suppose I could ask myself these same questions. Long ago, I chose to abandon myself just like an old brick row house that had long since passed it's purpose. I left emotions and being and conviction behind and I followed the paths others had broken ahead of me. I suppose that's how I became a nurse instead of a doctor: a PhD prepared professor instead of a clinical degree; how I became a mother quite by accident but slowly and surely let those responsibilities slide into the abyss of incapacity and unwillingness.


I sit in front of the 16th floor window.  The one that, ironically, still opens out to the street. The pavement glistens with rain many floors below and I am mesmerized. Somehow in this hotel room, accusations and invalidation have taken root once again; somehow, nothing else seems to matter.

But tomorrow WILL contain happy moments, carefree moments, even moments of satisfaction and fulfillment.  I WILL make it. My brain has tried to kill me before, and so far it doesn't fritz out badly enough that I lose myself completely.

So I walk away from the window and decide this is not about my own ugliness or failures at all - it's about those pathways in my brain that were ridden so often the pavement is wearing off. It's those slippery pathways I slide inexorably into, sometimes because of a single thought ("I'm not good enough" or "my place in this person's life is meaningless").

Today I'm paving new pathways. Today I refuse to slip into old patterns. When the ugly thoughts come, yes, I still think them. But somewhere mid-thought I realize I'm headed down that pathway again, and I stop and reassure myself and climb back up the hill to self-compassion. My therapist says eventually it will work. Eventually, if I train my brain to toss those useless, fictional thoughts, slowly I will go free from the prison of my own mind. Maybe someday, my brain won't try to kill me anymore.

Utopian? Yes. Unrealistic? Yes. Worth trying? Yes.

If you hate the play, change the script


If I hadn't been born with a heavy dose of piss and vinegar, I'd have given up long ago. Several people have tried to break me, destroy me, discredit me. The specter of that possibility - someone exploding back into my life and pulling the thin veil off my secrets - tortured me for far too long. The only antidote is to grit your teeth, accept reality, and be honest about who you really are. The only cure for internalized shame is to air out your dirty laundry once and for all so you can get back to life the way it was supposed to be lived. After you've radically accepted your experiences, your strengths, your flaws, then - and only then - you will be free to value the person you have become in spite of all the pain. You will be able to stand tall in your own shoes and devil-may-care if the world values you as much as you do yourself.

When someone hurts you when you're small, tells you to keep it a secret or else...there's no one to blame, there's no validation of your pain, there's no healing. Perhaps the greatest tragedy of child abuse is that the disgust and the shame of it grows into that person inextricably, often saddling them with a heaping pile of steaming guilt that was never theirs to begin with. What happened can't be that bad, because you have to live with it. So you minimize the abuse and instead believe it is you that is bad. I'm bad, I deserve nothing, anything nice that happens to me is a fluke, a gift, or a mistake. My internal monologue had this sentence on constant repeat, a looped excuse for my self-hatred and self-doubt.

For the longest time I thought the only way to fix myself was to see myself "clearly" as the sinner and screw-up I was, and hope that there was forgiveness enough for a 7 year old girl who did nasty things like I did. I took the pain, shame, disgust, betrayal and evil and drew it into myself, held it so close to my heart that it grafted itself in. I thought I could think away the pain. Just will it, do it, one thought at a time. I sang the Pink song loud on karaoke nights, willing myself to change, to change those words and those thoughts that pinned me down and kept the blood running fresh from old, old wounds.

You're so mean when you talk
To yourself - you are wrong
Change the voices in your head
Make them like you instead
So complicated
Look how we all made it
Filled with so much hatred
Such a tired game

So cool in lying and we tried, tried, tried
But we tried too hard, it's a waste of my time
Done looking for the critics, cause they're everywhere
They don't like my jeans, they don't get my hair
Estrange ourselves and we do it all the time

Why do we do that?
Why do I do that?



You can't will those thoughts away any more than you can will the abuse away. If you keep all that despair and blame inside, afraid to expose your naked flesh to the world, no one will ever be able to tell you it was wrong and that it wasn't your fault. The first step to changing your thoughts is to invite someone into them. Then, armed with their more objective interpretation of the twisted jumble of events, you can begin to forgive yourself. Even without forgiveness, though, change is possible. You can choose to act as if you deserve love and respect long before you truly believe it.
If you are extremely miserable and you would like to feel better you may have to change your behavior despite whatever argument is going on in your head. If you could treat yourself with kindness and compassion, be understanding, and acknowledge your deepest fears and hurts- at least to yourself- why wouldn’t you? If this made your life easier, more livable, and more hopeful- why wouldn’t you do it? Arguing about deserve-ability certainly isn’t doing anything for you. In order to feel differently you have to act and behave as if self-compassion and kindness matters. You may have to tolerate some guilt, set some limits on your time, or even say no to the demands of others. The point is that you should get started on acting and behaving in ways that are worthy or deserving of you. Over time, your attitudes may change right along with your behavior. And in addition to feeling better because you are behaving as if you have more self-respect, you will have more resources for coping when other people put you in demeaning situations, take advantage or you, or assume that you are willing to be treated poorly. (Renee Hoekstra, Dialectical Behavioral Therapy counselor)
It's a magical thing, being compassionate to yourself. You can go back and love yourself when you were least lovable, when you were covered with tears and filth and confusion. Every one of those childhood moments when you felt unimportant, unnoticed or unloved? You can look back on that now, close your eyes and feel what it felt like to be that child. And you can notice. You can validate that experience, acknowledge that it hurt you. You can tell that little one the significance of that moment, how it bent you and strengthened you all at once. You can tell her that because of her - not in spite of her - your life has been amazing.

Do you believe you are worthy of your own compassion and love?

Mermaids


She is older than I was when the darkness dragged me down. She is so much wiser. Sweeter, more adventurous. Were those things stolen from me, too?


The questions I would ask are drowned in the twilight ringing with laughter from the pool. I feel it - 7 years old - and I act it, splashing, diving, doing headstands underwater. Showing Amy how to breaststroke and kick turn.


If you are one, like me, with the hyperactive thoughts, if your thoughts cascade over your head as full and powerful and rushing as a waterfall...drown them. Find something that shuts them out. Find something that makes you SO happy, you are literally soaking up every moment of it.


When you are sad, won't you remember that you were happy and you will be happy again? I dunk down until only my nose and eyes are above water. I look and I breathe and I save these images and the sensation of the water on my skin and the muffled sounds of tinny laughter. I save them for later. I save them for now.


The camaraderie of sisters. That's what I was promised that fateful year of seven. And still that wish hasn't come true. I hold my sisters-in-law as close as I can, trying to be a sister, feel like a sister.


The laughter winds down as the crickets drone louder and the frogs belch their love songs in a chirpy chorus from the wetland. The long grass is alive with the crickets hopping, the air filled with bats dipping and drifting, trolling for their mosquito meal. And we are midnight silhouettes against the pink of the sun's goodbye sky. A moment cherished and savored is a moment I couldn't feel pain or torment or torture.


When you can't stop thinking, what's your "hard stop"? Do you have an activity you can do to take a break from thinking?





How I learned to surf


I surfed once, in California in my early 20s. I only managed to get on top of 4 waves, but I will never forget the incredible feeling of falling and flying simultaneously. Since then, I've only been on a bodyboard. A doctor, John Kabat-Zinn, uses surfing as an analogy for emotions: "You can't stop the waves, but you can learn to surf them." A surfer named "Buzzy" characterized surfing in a way that relates to all of life: "Waves are not measured in feet and inches, they are measured in increments of fear."

I am intimately acquainted with fear. It is the monster inside that roars at the slightest provocation, sometimes even convincing my terrorized brain that old threats long gone are nipping at my heels. Life feels not only radical as I step into a new reality, a new person, a new way of seeing - it is terrifying. Change of any kind is not a welcome guest in my life, and to change the very structure of my self is breathtakingly scary and uncertain.


Long ago, as a child, I built four sturdy walls in my soul and put a lid on top. It was my Pandora's box, my underground bunker where I could stuff all the bad things in life, all the tears, all the emotions I was too terrified to feel. I remember going into my room once at 10, clenching every muscle in my body and screaming silently. I was afraid that if I let my emotions out, they would destroy everything. As it turns out, avoiding them has nearly done just that.

Every Monday, in land-locked Wisconsin, I have a surfing lesson for one hour. It takes place in an office, not a beach, and the waves I'm surfing are the huge Mavericks - the biggest waves of all time - that come flooding out of that bunker when I take off the lid. Large waves can literally throw a surfer to the bottom of the ocean, turn him in so many somersaults that he can't tell which way is up, scrape his flesh on the coral, and either send him to Davy Jones' locker or toss him up like a fish gasping on the beach. How do you surf those emotions? The biggest ones of your life?

This is how I learned to surf the big ones:
  1. Don't go it alone. You need a spotter when you're letting a tsunami out of your soul.
  2. Don't rein it in. Realize it's just an emotion, and it will soon be over. Submit to the fact that you can't change the past and you can't change this giant wave of emotion. You can only ride out to safety.
  3. Do be well prepared. If you're letting emotions out, sorting through old memories, often it's intentional. It's our human way of processing the good and the bad that happens to us. Make sure you've had good rest, good food, and a good mood most of the day before you purposefully open your Pandora's box.
  4. Do let yourself be free to express the emotion. You may need to cry, scream, rant, rave, or curl up in a ball. Be somewhere safe for this.
  5. Do rate your emotional pain. Before you start a session of internal or conversational processing of trauma in your life, rate how painful the memory is at the beginning, on a scale of 1-10 with 1 being low intensity and 10 being high intensity. After you've allowed yourself to surf the wave of emotion that comes with the memory, rate it again. You may find the memory is much less intense once you've allowed yourself to experience the emotions that went with it.
  6. Do nothing but surf. A real surfer isn't dropping in on a wave thinking about his grocery list. In fact, surfers report that riding a wave is a blissful, meditative experience that fully captures their mind, body and soul. When you're surfing emotional waves, do so at a time you can concentrate fully on the sensations and feelings. Don't do it at work, or on your drive home, or when you have to do something later in the day. Do it when you have plenty of time and brainspace.
  7. Do remember that emotions never last forever and they generally don't kill you. Emotional waves are always temporary. And they have little power over you once you accept them and let them flow. 
One last thought: when you're new to something, it's always good to have a few lessons. Especially when the stakes are as high as they are out on the ocean of emotion. Surfing isn't learned in a day, and there are many, many wipeouts along the way. A therapist, friend, or lay counselor you can trust may give you some tips on surfing that I cannot. I hope you find that, once you're out there among the waves, it is actually an good experience. And once you've ridden the biggest wave of your life, every other wave will seem tiny and totally rideable.

Surf's up - who's with me?


Progressing to exposure


I watch a ladybug lazily climbing towards the flowers. I don't know if this is her top pace or if the sun has made her drowsy. She inches along, bit by bit. This is me, I think. Inching along. Barely making progress. Feeling the "two steps forward, one step back" process is going too slowly.

Reprocessing is the next step in my therapy journey. This technique holds onto the hope that, if you talk about it enough, a memory loses it's power over your present and future. Before I began this part of therapy, I was very nervous about it. I held it at arms length, even thinking about refusing to participate at all. I also noted that I was self-sabotaging the very process that offered me the best chance at recovery.


Now it's started, and the debate is over. Two weeks of it brings a reduction in flashbacks and a return to somewhat normalcy. I wake up today, knowing it is therapy day, and there's that nervous excitement brewing in my belly. My heart speeds up in anticipation. My palms are cool and clammy. There is something about knowing a little surge of relief is coming. It cracks open the outer shell and tentatively tilts the tender to the sun. 

Bouncing back


In the darkness of the soul, only the shadows of shame, grief, hopelessness are visible. Profiles of black against an unattainable light. The future appears as shrouded as the moment you are in now.


Time and again, I've sighed, resigned myself, and stepped back into the light. The living light. Grace is holding me by the hand, and mercy the tug of life's current around my ankles. You are never alone, He whispers. Each day is sprinkled more and more heavily with happiness. Laughter with my therapist. Sharing a joke with my kids. Yelling and screaming at my daughter's softball game, totally abandoned to the moment. A card full of encouragement from a friend of few words.

Each dark time is shorter. It's a massive amount of work, moving the mountain of those inhibited and unhealthy ways of coping and building a new mountain worthy of the foundation of Jesus' sacrifice. The old mountain spews it's shame and lies across the landscape of my life as the dynamite of hope blasts holes in it's edifice. It's as if she's saying, I won't go down without a fight. And who is it that speaks from that dark mountain of self-neglect, self-loathing, stubborness and sin? Evil is what speaks from there. The explosion of the dynamite of hope is God's thunderous answer to my own self-doubt. SHE IS MINE, He screams at the stubborn rocks. 

I am a woman of words. I carry my books in a bag that says, "I am God's idea. Please be nice." A talismen against those who would cruelly crush me again. Even the new letters etched on my shoulder are a forever tribute to this time of ultimate trust and testing: "Fear not. Only believe, and she shall be safe." (Luke 8:50) I finger the Latin - noli timere crede tantum et salva erit - remembrance of the pain of the tattoo gun piercing flesh a good analogy of the pain of the past 3 years.


Each time the sky grows black, I see the light at the end of the tunnel quicker - as the night grows deeper, the light grows, too. A light that is faint in full sun is brightest in the darkest hours of the night. He leans down and tilts my chin upward, reminding me that I am His daughter and protected and beloved even when it doesn't feel so. The light is blinding. Beautiful. Bewitching.


What am I building this new mountain of hope out of? I have a list of all the skills I've been taught using dialectical behavioral therapy (DBT). Skills like these:
  • Turn your mind (repentance)
  • Teflon mind (refusing to listen to evil)
  • Half-smile (a cheerful heart doeth good like a medicine)
  • Accumulating positives (count your blessings)
  • Coping ahead (stewardship)
  • Mindfulness (do not worry about tomorrow)
  • Wise mind (seek wisdom)
  • Accepting reality (trusting an all-knowing God)
DBT has quite literally been used by God to save my life. If you are struggling with relentless self-doubt, depression, PTSD, or other mental health issues, you can find a trained counselor here. DBT was developed by a psychologist who spent most of her teens and 20s in mental institutions without any relief. She developed the skills herself and then began sharing them with the world. You can read Marsha Linehan's story here. DBT is one of the most proven therapy techniques available today, rigorously tested for multiple conditions using randomized controlled studies. For an introduction to what DBT is, read here. If you are interested in DBT, but wonder whether the skills taught are Biblical, please contact me and I will send you a list of Bible references demonstrating the Christian foundation for these skills.

Holding embers

She says that people like me are living in hell on earth. The searing pain of our situation has us grasping at any means possible to escape the torment. Including deciding to climb up the hot aluminum ladder leading up, even though that is sure to cause more pain with each step. Problem is, she says, I've climbed the ladder before, seemingly "out" of my personal hell, but I've done it on willpower alone. I slog through my disappointment and discontent; I pull up and up into happy and unhappy cohabiting. Beyond that, I keep looking, straining upward, so sure there is something more. Most people are happy just to live in the quiet of this space, and they never glance upward. But I do, and I see a light that leads to another level - joy and despair. To hold on to the emotion and solution at once is like a hot coal in each hand. 

Up here, on my way to radical acceptance of both joy and despair, is where I either fall off the ladder or the level, if I make it that far. Just like that, back in hell.

To be inflated is as certain as to be crushed...extremely good and extremely bad dancing in the neverlands. To be here is to be vulnerable, to risk everything every time. No wonder I fall back in.
How will this next climb ever be different? Have I any say in recovery at all? The hopelessness of it all weighs me down when I would take flight to escape the burn inside.

Is counting joys safe? I guess not. I keep counting for today - my gesture of radical acceptance of all of this to the universe.
#2052 Bits of joy ARE beginning to creep back in for the cracks
#2057 ice cream on the weekend!
#2061 phone call from a friend at a crucial moment
#2063 husband's cooking
#2068 little hands reaching in the night









Choices in the dark

I strap on the yellow snowshoes given me by my love early in our marriage, because yellow always makes me smile. But today, my face is stuck in fear, grief, despair.
Night is falling, and I trek down the woods path through 4 foot drifts, floating atop, falling occasionally. I'm on a quest to find the big cottonwood, the one it would take 4 grown men to wrap their arms around. Trees like this don't just happen in Wisconsin. This tree is sacred.
I have the vague idea that if I could just sit there a while, my back against the solidness of that trunk, there would be peace for a few moments. I think, too, about staying there in the dark. Wonder if it would be easy to just go to sleep in the cold. My brain catches the thoughts in it's sieve and I turn them over in my mind and reject them. No precious stones there. I thank God for the cottonwood tree, pray that He will help me stand up and walk home. Choose life once more.
Darkness falls quickly in the woods. But I am smiling now. My breath comes hard and fast, I take off my mittens because the work has warmed all the places I felt dead inside. I pace my breathing. I take a chunk of snow in my bare hand and push it against forehead, the cold bringing my soul rushing back inside, ready for the walk home.
And as the sun sets, and the woods turn entirely to shadow, the snow gray instead of white, I emerge from the woods onto the road and home. I have survived, walked through this temptation. I whisper words from the one Psalm that jumps like Living Water from the pages of an otherwise lifeless Bible:
Restore to me the joy of your salvation and grant me a willing spirit, to sustain me. Then I will teach transgressors your ways, and sinners will turn back to you. Save me from bloodguilt, O God, the God who saves me, and my tongue will sing of your righteousness. The sacrifice of God is a broken spirit; a broken and contrite heart. O God, YOU will not despise. (Psalm 51:12-17 exc.)

Happiness and Joy are Different

I don't want to be here again. But life doesn't usually go the way you want it to. One of the main difficulties I have with depression is that I can't figure out if it's the Potter's chosen way of shaping me right now, or if it is because of my inability to stay focused on Him.

But here we are. There's no denying that. Slowly, old coping skills are coming back, and for the majority of the day, I can ignore the rain cloud hovering over my head. One of the most successful ways for me to dig out of depression, get up out of my bed, and live normally in these seasons is something called Opposite Action. All you have to do is figure out something to throw yourself into 100% that will provide positive reinforcement rather than negative. I'm a mother first, and I carry a huge load of mother guilt, so Opposite Action for me often entails doing something crazy with my kids.



I grabbed a pack of suncatchers and paint at Walmart on the way home from work. Just after breakfast yesterday, I stayed out of bed, and we opened paint pots and set to work. The table was a mess. The children were in heaven. And for an hour, I forgot to be depressed.






After we finished, we packed up, got lunch in town, and went to the Y. We spent four hours, swimming, rock climbing, zip lining, playing basketball, running on the track. Once again, depression and it's invasive thoughts had no room to take foothold as we ran around the Y. We emerged, hair steaming in the sub-zero gray day.

My day wasn't gray at all. I believe this is the difference between happiness and joy. Happiness is a passing emotion dependent on all kinds of external factors. But joy is stored within, and for those of us who have placed our faith in Christ, there is a constant wellspring of joy despite external factors. Ever since Amelia's illness in 2009, I Peter 1 has been the passage that has helped me hang on to joy even when happiness is entirely absent.

Blessed be the God and Father of our Lord Jesus Christ! According to his great mercy, he has caused us to be born again to a living hope through the resurrection of Jesus Christ from the dead, to an inheritance that is imperishable, undefiled, and unfading, kept in heaven for you, who by God's power are being guarded through faith for a salvation ready to be revealed in the last time. In this you rejoice, though now for a little while, if necessary, you have been grieved by various trials, so that the tested genuineness of your faith—more precious than gold that perishes though it is tested by fire—may be found to result in praise and glory and honor at the revelation of Jesus Christ. (1 Peter 1:3-7 ESV)
Opposite Action is, in essence, what Christians have been practicing since the beginning of time. Moses was a man with a temper problem, a murderer, and someone who took flight at the first sign of danger, but he stood up to Pharoah through all the plagues and led the Israelites toward Canaan although he often felt like giving up and told God so on the mountaintops. Noah had never seen rain, but he built an ark out of obedience. Sarah had no hope left of bearing a child and her sadness over this fact is evident in her response to God's promise when she is an old woman, yet she continued to be with her husband, and a child was born from whose genetic line Jesus would eventually be born. Even Jesus, who begged His father for mercy in Gethsemane, walked out into the garden to meet the soldiers when they came to arrest Him, and endured the cross even though He could have easily saved Himself.

Why did all these people go forward despite their misgivings, their pain, their fear? Because their joy was not predicated on their circumstances, but on the salvation they knew was coming. I see it too, on the horizon of every season of depression - rescue. Someday He will wipe away every tear. And meanwhile, I can REJOICE because, despite all appearances of this life, there is an inheritance imperishable, undefiled and unfading kept in heaven for me.

Five Minute Friday

Switching strokes

She smiled, but there was sadness in her smile; even now she felt forebodings of the coming pain, the air she breathed was heavy with the storm that was about to burst. (Honoré de Balzac, Le Père Goriot, 1835)

The keys of the piano are heavy, and my heart thrills at the tension between unplayed and played notes and all the richness of resonance and volume and cascade the old brown piano holds hidden inside herself. I run fingers through the chords flowing from my memory, chords to a song of lament. Putting music to the emotion calms me, and there is even a smile hedging it's way into the corners of my mouth.


The front room is dark, the bitter cold grayness of January's sunset casting the children's window decorations in relief. I am the frozen observer, and the only activity about my body is trapped inside the mind.

I had a false hope that the ocean of pain held in my story would eventually soak into the ground, disappear into the bedrock under my feet. As with all false hopes, the destruction of this idea undid me. Six months I've walked on water, with joy insurmountable. Someone suggested I turn my mind from the ocean, forget it's there. For just a second I looked down at the ocean, contemplating. Could I leave this behind? Instead, the hems of my pants were suddenly wet as I felt myself sinking back in. Escape from pain? Possible for some. Impossible for many.

My counselor's voice is a soothing melody over the phone lines. She tells me to swim through it. There's no ignoring the ocean. Now you must swim.

I do, stroke after stroke, those moments coming every now and then when I breathe in a wave of water and panic that I can't make this swim. Oxygen-starved brain cells create a firestorm of anxiety. But instead of trucking on with my poor stroke and my mouth filled with water, I will flip on my back and float for a while. I feel every teardrop that made up this ocean of pain. Still beneath me. But I'm looking up at the sky, and the deeps aren't so terrifying.

Maybe this is how you escape madness: to switch strokes in the middle of the swim, and stare at the clouds moving across the azure. I'm no less sodden, no less in the middle of the ocean. But at least I'm looking up. And up there is the Father of lights, with whom there is no variation nor shadow of turning. (James 1:17)


*Photos from Amelia's play camera


Love > Fear


I sat still, my legs drawn up under me, against the purple wall in my mother's living room. I remember heaviness coiled tense in my chest, up through my neck and aching behind my eyes. In my limbs, a happy buzzy sensation, like I feel when I'm deeply thankful. My niece and son came running over and clambered up, my husband busy taking photos, with the white of the flash bouncing off the glittery ceiling. My lips pulled back tight over my teeth, my eyes slowly trying to take in the chaotic scene of family and gift opening frenzy, a heavy compote of Christmas scents from the buffet filling the air.


Perhaps it is the many years of training and practice that makes me think of emotions as a linear thing. After all, the FACES scale for pain, the one we use in children, runs a spectrum from joy to extreme sadness, as if the two never coexist in our chests, in our hearts, behind our eyes.


What if half of your face can say something, and the other half another? I scan through a list of emotion words, trying to capture those feelings of the cool, coiled snake in my chest and the sweet joy of those children on my lap. Happiness and satisfaction. Words that describe love. Nervousness and apprehension. Words that describe fear.

Does that explain the lineless half smile, pulled tight over my lips, the widened eyes, the stilled forehead?

I have a sticker on my van that says "Love > Fear". The two emotions I felt most intensely throughout the holiday celebrations with family this year. Perhaps what kept me going through the holidays is this very principle, which stands out so clearly from The Message:
God is love. When we take up permanent residence in a life of love, we live in God and God lives in us. This way, love has the run of the house, becomes at home and mature in us, so that we're free of worry on Judgment Day—our standing in the world is identical with Christ's. There is no room in love for fear. Well-formed love banishes fear. Since fear is crippling, a fearful life—fear of death, fear of judgment—is one not yet fully formed in love. (I John 4:17-18 The Message)