Category Archives: therapy

Ashamed

This is a personal piece. Please be aware some of the content may be triggering.

Today I had a melt down. Not just a little one but a major, uncontrollable show of emotion. I was in the DBT peer support group that I’ve started attending and I got triggered and that was it. My mind started turning over everything. Memories came back with full force. The voice started. It was overwhelming. I started by sitting quietly with tears going down my face. We were doing an exercise and everyone was focused and I just couldn’t ask for help. Then someone noticed me. They asked if I was OK and I got asked if I wanted to take a moment. That’s when things just nose dived.

I practically ran out the room. I wanted to slam the door behind me but couldn’t do it. This infuriated me and I hit the wall and ran to the stairs. At that point I just sobbed and emotion overtook me. There were so much emotion that I have no idea what it was I was feeling. All I know is it was horrible. In that moment I wanted to die. Everything was so intense. It felt unmanageable. I felt nothing was going to be OK again.

Luckily the peer support facilitator followed me. She was amazing. She got down to my level. I think she grabbed my arms. It’s a little hazy. I can’t remember what she said. All I know is she got someone else to go in with the group and took me somewhere quiet.

When we got in the office I just wanted to curl up small and hurt myself. I hated my reaction as well as still feeling the heightened emotions. Also everything was still going through my head. I couldn’t look at her. I was so ashamed of myself for so many reasons. For my reaction. For my feelings. For the thoughts of what had happened in the past. For what the voice was telling me. I started to hit myself as I was asked to stop. I hadn’t even realised I was. Things were hazy. It was like being in two different places.

The facilitator started talking to me. The conversation is a little bit of a blur. But it started to calm me. She got me to focus on my breathing to bring me back to the moment. She then had to leave me to go back to the group but someone else sat with me. They talked to me about nothing in particular but it helped. I started to be able to respond and the tears seemed to stop. The intensity of the emotions slowly eased.

When the facilitator came back we decided to have another talk. I opened up about a lot of things from my past. It all kind of blurted out. There were things I had never really spoken about. It just felt, well not easy but, OK to talk about. I felt listened to. I felt understood. I felt I mattered. But this was also contradicted by other feelings of shame (of what had happened in the past and of needing to ask for help), of being selfish, of guilt. I hated myself. As much as I was told it was OK I couldn’t believe it. I was (and am) an awful person. I couldn’t stop apologising.

Eventually I left, apologising as I went and promising to email her and contact my care coordinator. I decided to text my friend. She was the only one I wanted. I explained to some extent what had happened and she was concerned about me. Immediately guilt started to escalate again. But I kept talking (still apologising). She kept me calm. She was great. I’m so grateful for her. I’m so grateful for the facilitator too.

When I got home I got into trouble for being home late. It started as soon as I walked in. Immediately all the negative emotions started to rise again. I tried to explain I had a melt down and the questions started. They were things I found difficult to discuss but they wouldn’t leave it alone. Even when out walking with mum she brought it up and told me I just need to get over it. Maybe she is right but it added to how bad I’m feeling. Shame came forward again.

Since then things have been hard. My mind has been going over things. The voice has played its role. I’m trying hard to stay afloat. But its tough. I hate myself.

If you have any suggestions on dealing with shame feel free to share in the comments or on Twitter, Facebook or Instagram.

Picture from Pinterest

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6 Months From The End Of DBT

This is a personal piece. Please be aware some content may be triggering.

It’s been roughly six months since I finished my DBT (dialectical behaviour therapy) skills group, therefore I thought I’d reflect on how things are going.

In all honesty I found the DBT skills group difficult. It revealed a lot more areas that I need to work on than I thought I did. I learnt a lot about myself and how BPD (Borderline Personality Disorder) effects my life. It is a lot more than I thought. I think I thought some of the things I thought were normal, when actually it’s far from normal.

DBT gave me some ideas on how to cope with the self harm urges and things to do instead of self harming, as part of the distress tolerance module. While I’ve tried to practice these, I’ve not found them that effective. The urges don’t go away like I hoped. Instead I’ve found myself fixating on the idea of self harm and how much damage I could do. The only thing that seems to relieve this is to self harm. This isn’t a failure on DBT’s part, it’s mine. Although I do feel I would of benefitted from a revisit to the skills, I also feel I needed some individual help to go through the problems that lead me to self harm and someone who could help me find what’s effective for me.

I knew I always had problems identifying emotions. The most I could do was say whether it was a good or bad emotion. I used to use cues from others to put a name to the emotion. It was something I started working on in art therapy as a teenager as before that I could barely express how I was feeling. I think with DBT skills I learnt some more ways to identify my emotions and the 10 page handout on ways to decide which emotion it is you’re feeling was comprehensive. I just wish I had it in the form of an app on my phone as you can’t really carry a thick A4 handout around easily.

I also learnt through the emotional regulation module that emotions aren’t wrong to have. It’s something I’ve always said to others but never applied to myself. Anger has always been a tricky one for me to deal with. But I’m working on accepting it. I punish myself less for feeling angry though I do still struggle to express it outwardly. I think at the moment I’m not in a safe enough space to allow this expression so hopefully with time that will come.

The biggest learning curve for me came with the interpersonal relationships module. I thought this module would be a waste of my time. I thought I was doing OK. How wrong was I? I came to realise that I was allowing people to treat me like dirt and accepting it too easily. I learnt that there were ways to try and change this and that I didn’t have to accept it or just go into a rage over it. I must admit that most of my time doing this unit I was trying to figure out my relationships and which needed working on rather than the skills to tackle this. Over the last six months this has continued but I’ve lost my grasp on what skills to use. I feel I would maybe benefit from repeating this unit at a later date. I’m not ready at the moment still.

In the core mindfulness module of DBT skills I learnt a little about how to make myself be in the present moment. Before DBT skills group I had a tainted view of mindfulness as something I was no good at and would never master due to previous experiences in therapy. What I learnt was that for me I need to approach mindfulness in a different way and that there are many more ways to practice mindfulness than I had been taught before. For me, mindfulness wasn’t about sitting in silence breathing. I needed to do activities mindfully. This was a revelation but it was, and is, useful.

Overall I’m in two minds about whether DBT skills have been useful. I think there is potential for them to be useful in my life but I don’t feel the course was long enough for me personally. I also feel full DBT, which includes individual as well as group therapy, would have been more useful. I feel that one of my psychiatrists agreed with this also (he’s left now but it would of been good to have him on my side). I am also hoping to attend a DBT skills peer support group that is starting as part of my local Mind. Hopefully this may help a little with the gaps in my knowledge.

For more about my therapy you can click here or you can follow me on Twitter, Facebook or Instagram.

Picture is from Pinterest

End Of Therapy Reflection

I know I’m behind on sharing my therapy journey but today I finished the 6 months of DBT skills therapy and I need to reflect on it so why not share on here.

This six months has been hard. It has opened my eyes to issues I wasn’t even aware I had or maybe issues that I was hiding from. It has taken me to new lows. I’ve seen the crisis team once and made two attempts on my life. At one point it was discussed whether I should carry on with the therapy or whether the risk was too high. But I persevered and here we are at the end.

And how do I feel? I really don’t know. I feel kind of numb and a little lost. I know I’m luckier than most of the people I was in the group with. I have a safety net of a care coordinator and access to the crisis team and duty workers. Yet still I feel abandoned. Originally the therapy was meant to be for twelve months but was halved. I feel I could of done with the extra six months to reinforce the skills that we were learning.

I am kind of proud of myself too. This is an alien feeling but it was an achievement to get through the six months even when it took me to my lowest points. Feeling proud though, is that the right thing to be feeling? I really don’t know.

The people on the course with me have been amazing. They have been there for me at the low points and helped me see ways forward. I’m forever grateful to them. The psychologists running the therapy were amazing and we had laughs throughout the six months. There were also tears but we were well supported. I think this is why it feels such a loss. From having weekly support we are left with very little or nothing.

Overall I’m glad I did the course. I’ve learnt a lot of skills and I hope to integrate them into my every day life rather than them be isolated skills I just try to practice for therapy. I would recommend DBT skills to others. It made me see mindfulness in a different way which was an impressive feat as I was very anti mindfulness at the beginning. It may not always be easy but I can see it’s worth.

I will hopefully catch up with sharing the rest of my therapy journey soon. Feel free to use the comments, Twitter, Facebook or Instagram to keep in contact or ask any questions.

Picture from Pinterest

Therapy Journey: Weeks 1 & 2

This is the next blog post in my therapy journey series. For the rest of the posts in this series click here.

Week 1

I actually missed the first week of my DBT skills group as I had a hospital appointment but I got all the handouts from the first session. This means I know roughly what happened.

The session began with getting to know each other. I’m pretty sure this was just going round saying your name. This was followed by going through the rules for the group. These rules are to keep the group safe and ensure confidentiality. This was followed by going through the goals for skills group and the behaviours to be decreased and increased. This was linked into how they relate to each of the modules of the DBT group.

Then they looked at.how different characteristics of Emotionally Unstable Personality Disorder (EUPD) are helped by some of the different modules. In particular impulsiveness which can be helped by the distress tolerance module and confusion about self which can be helped by the core mindfulness module were mentioned. After this there was more information on the format of the sessions, the materials that would be handed out and how to fill in the DBT skills diary card. Then there would of been a short break as each session is two hours long.

After the break the group moved on to the first of the core mindfulness sessions of this module. This is what will be repeated at the start of the three modules of the DBT skills group. This started off by looking at what mindfulness is including the history behind mindfulness, why mindfulness is important and the goals of mindfulness. The goals of mindfulness here are to reduce suffering, increase happiness, increase control of your mind and experience reality as it is. 

They then moved on to look at the different states of mind and what each of them are. There are three states of mind mentioned; reasonable mind, emotional mind and wise mind (see image below). The focus though is on the wise mind state and recognising what it is, and in particular this definition that it is “the ability to make healthy decisions about your life based on both your rational thoughts and emotions.” This was followed by an exercise to practice entering wise mind, using mindful breathing. And that brought this session to an end.

Week 2

This was my first week and I was incredibly nervous, especially as I had missed the first week and because of the group environment. The session started with a recap of the previous week and seeing how people had got on with practicing the skills between sessions. This have me a chance to gain some insight into what happened the week before.

We then moved on to the new skills for this week which were core mindfulness skills again, which will be repeated at the start of each module. We started off by looking at the two different type of mindfulness skills; ‘what’ skills and ‘how’ skills. ‘What’ skills help us to be more mindful of what we are.experiencing, while ‘how’ skills help us to learn how to be both mindful and non-judgemental. 

We then looked at each of the ‘what’ skills in turn. The first one was ‘observe’ where you try and stay present to the moment without labelling or describing it. We did an exercise to practice this skill. I found this tough. We then moved on to ‘describe’ where you use words or labels to represent what you observe. We then practiced this by looking at a leaf and describing it. This felt more natural. The final ‘what’ skill is ‘participate’ where you enter wholly into an activity. We practiced this by playing a game. I found this tough as I was extremely self conscious but I wasn’t the only one. 

After a break we moved on to the ‘how’ skills. We started off with ‘non-judgmentalness’ where you aim to let go of judgements and focus on facts. We then did a couple of activities to practice this skill which is harder than you realise. The second ‘how’ skill is ‘in the moment’ where you aim to be completely in the moment, doing one thing at a time. The final skill is ‘being effective’. This is about focussing on what works and what is needed. We were then given instructions on how to be effective but it is a skill that confuses me. This brought the session to an end.

Overall I felt incredibly overwhelmed at the start of this group therapy. There was a lot of information to take in plus the anxiety of the environment. Hopefully with time it will get easier. If you are starting therapy my advice is to talk when you’re struggling and stick with it if you can. 

For more info feel free to use the comments or TwitterFacebook or Instagram

Therapy Journey: Reaction 1

This is the next post in my therapy journey. It is a reaction that I wrote after hearing I’d been accepted to do the therapy. For other posts in the series look here.

Today I got the call I have been waiting for. I have been accepted to do a DBT skills group. This group will last just over a year (this was later changed to six months). It is the long term therapy that I have been fighting for, for a long time. It’s due to start next Tuesday but I will be missing the first session as I have a hospital appointment and therefore will start a week later. I am sat here with very mixed feelings.

I am pleased that I am finally getting the therapy that has been promised to me for a long time. Well actually I am getting better therapy than I was originally expecting. I know I need this help to make positive changes. I know that this is the way forward. This is what I have been told I need for a long time. So it has to be a good thing, doesn’t it? I really hope it is. I know I am lucky to get this opportunity and I want to make the most of it. 

But… There is always a but. I am terrified now that this is happening. Terrified of all the expectations that have been out on me and therapy. My mind is racing with thoughts and it all feels overwhelming. “What if I’m not good enough?” This thought is the main one Loughborough my head. Accompanied by “you’re going to fail.” This is a real fear. What if I am too broken to be fixed? What if it isn’t the thing that helps me on the way to recovery? What if I can’t manage it or screw it up in some way?

All these thoughts keep going through my head and I start to wonder whether I am doing the right thing. I wonder whether I am ready to make the changes that I know will be asked of me. Am I in the right place mentally to do this? I know I need to make changes to get better but change is scary and makes the future feel uncertain. 

It also means I have to think about the future. Or at least my thoughts are making me think about it. I’ve had to think of goals I want to achieve but as someone who has been living day to day most of the time this is huge and scary. I barely know what I want for my next meal let alone what I want for my future. It all feels incredibly overwhelming.

So yes getting accepted for therapy is a good thing, and people are right to be pleased for me. It is however a scary thing and full of uncertainty that in my anxious brain leads to over thinking and worry. It is complicated and I know the weeks ahead are going to come with their own challenges. I just hope I can meet them.

Feel free to comment your experiences in the comments or on Facebook, Twitter or Instagram.

Therapy Journey: DBT Screening 

This post is the next in my series following my therapy journey. For other posts in the series you can go here.

Following on from my assessment for therapy, where it was decided I should attend a distress tolerance group, there was a lot of discussion about when this would start. After about six months of waiting it was decided there would be no distress tolerance group but instead a DBT (dialectical behavioural therapy) skills group. I was told I was being out forward for this and had to wait another four months to be screened to see whether this treatment would be suitable.

The screening was one to one with the same psychologist who had done my assessment for therapy. The session lasted for about forty five minutes. The first thing I was asked was what I thought was the area giving me the most difficulty at the moment. We went into a lot of detail about this area and how it was impacting on my everyday life. We then went through some other areas where I am having difficulty and the impact, again, on everyday life.

After we had covered the areas I felt were the most difficult I was asked a lot of questions about my symptoms and these seemed to relate to the criteria for diagnosing BPD (Borderline Personality Disorder). This did not surprise me as DBT is the recommended treatment for BPD. These questions went into detail about suicidal thoughts, self harm and alcohol and drug misuse. I didn’t need to talk about any other past experiences in detail though. I

Next we discussed goals and what things I want to achieve in the future. This I wasn’t really expecting but looking back it makes sense to discuss this when testing suitability for ttreatment. The goals didn’t have to be very specific.

Following on from this the psychologist discussed with me the structure of the therapy. She went into detail about the commitment required as the DBT skills group is longer term, lasting about six months. She talked about how she would need to discuss my suitability for the group with the other psychologist who would also be running the group. She would then phone me to let me know the outcome.

Before I left I was given a safety plan to fill in at home that would detail ways to stay safe between therapy sessions. This included people I would call if I needed to as well as safe places to go. I was also given the opportunity to ask any questions I wanted to. This brought the session to a close. Following on from the session I received the phone call to say I would be starring the DBT skills group. 

If you have and questions or queries about my therapy journey feel free to comment or ask on FacebookTwitter or Instagram.

Therapy Journey: Assessment

This blog post is the next in my series detailing my experience of therapy. For other posts in the series go here.

Following on from attending the Psychology Awareness Programme, I was offered an assessment with a psychologist. This was a one to one session to assess my suitability for therapy and what might be an appropriate talking therapy.

Before the assessment started I was asked to complete a set of questionnaires. These questionnaires asked about all aspects of my life and how they are effected by my illnesses. It included a questionnaire that looked at the symptoms of anxiety and how much they had effected me in the last two weeks. 

After filling in the questionnaires I was taken into a room with the psychologist. The assessment started with her explaining about confidentiality and what would be done with the information I provided her with. This included that what I said would be confidential within the team but would be discussed by the team as a whole. It also meant if I planned to act on suicidal thoughts she would need to discuss this with my mental health team. 

In the next part of the assessment we discussed whether I was having any suicidal thoughts and whether I was safe. I explained that I was having suicidal thoughts but had no plans to act on them. This led to her reiterating what I needed to do if things changed.

Following on, the next part of the assessment was to go over what I thought my main problems were and what my goals for therapy were. We then moved on to discuss my past. The psychologist asked me lots of questions about my background, including my childhood, schooling and home life. This went into a lot of detail and was difficult at times. 

In all we spent just over an hour discussing my past and issues. As we came to the end of the session, the psychologist checked what I planned to do after the session and thanked me for being so brave. She then told me she would discuss my case with the team but had some thoughts on what group would help me. She told me she would be in touch in a couple of weeks. 

After the assessment I went home and looked after myself by watching a film I like and I also talked to a couple of friends as I was struggling with some of the things that came up in the assessment. 

It took more than a couple of weeks to hear back but I eventually did via my care coordinator and found out I’d been accepted for group therapy. I was told I’d be contacted via letter when the next group began. It led to me feeling apprehensive about starting, especially as it was a group. At the time it was decided I would do a distress tolerance group though this was later changed.