Becoming an Emotional Grown-Up

Emotions are a hard subject when you have spent your life learning to suppress them.  Then comes the big SMACK in the face when you learn that this is counter intuitive.  You can suppress emotions all you like, but they will find other ways to come out.  For years I turned my emotions into self harming actions because as a child  I learned that showing my emotions only brings hurt and pain.

Now I am slowly learning to let those emotions out.  Naming, feeling, showing... all parts of emotion education that I missed.  I find myself wanting to go back to my maladaptive ways.  I have even gone so far as to find NEW maladaptive ways to handle the on pouring of feelings that comes with opening yourself up to a significant other.  My wife has been very supportive in my recovery process.  So much so that it's become a problem.  So part one of taking responsibility for my own emotions was asking her to NOT support me if I engage in a self harming behavior.  I even outlined what that was, what to look out for, and how to not support me.  I asked her to not comfort me, bandage me, or help me recover after an episode of self harm (SH).  Also, I asked that she tell me when she's upset, disappointed, disgusted, etc with my SH.

This started during my outpatient program.  Having a program therapist who understood my need to extinguish, not just lessen, my SH behaviors helped.  I soon learned how to do a behavior chain and then found myself doing many- one for every time I engaged in any form of SH (including self injury, disordered eating, and therapy interfering behaviors).  This helped to stop the latent SH behaviors and to help me start learning to see the patterns building up to urges and behaviors.

A couple of weeks ago I started part two of claiming responsibility for my emotions: making a safety contract. In the fourteen years that I have done therapy I have only ONCE signed a safety contract and that was because that therapist gave me no option.  It was a cover-her-ass move.  It basically said that I had to try to contact her or any help line I could (not that she ever gave me the number) and that I would do everything in my power to not harm myself.  I did everything in my power to never mention self harm to her again.

This time I made my own safety contract.  I held myself to the fact that I would not engage in self harm, disordered eating, and therapy interfering behaviors.  If I unintentionally do engage I have to fill out a behavior chain.  If I intentionally engage in my target behaviors it is at the discretion of my therapist whether or not I continue in therapy with her.  She added some bit about making an appropriate reference, but that's not the point.  The point is when I do these behaviors I now have actual consequences.  No more "are you okay?" and late night post-harming phone sessions.  Now if I engage in behaviors I just have to do a behavior chain and bring it in the next session.

Another thing I have done is changed the format for therapy phone calls.  Instead of being able to call and discuss crisis with my therapist she is now acting as a phone coach.  I have to use at least three skills before I can call, I have to tell her what skills I've used, and I have to be open to any suggestions given.  Five to ten minutes tops.  It's a more effective way of handling crisis and it makes me have to use my skills.

I am finally become an emotional adult.  No longer will I hide behind excuses.  There may be external causes to my behaviors, but ultimately it is my choice to give in or to use the skills I have worked so hard to learn.

Anyone interested in what skill sets I'm talking about, you can find more information here:
An Overview of DBT
Basic DBT Skills Outline
How Therapists Integrate DBT Skills

Name, Date of Birth, Diagnosis...

I recently had to go the ER for back spasms.  It's not a fun thing to experience and even less fun when the focus lands on all my other "problems" instead of the pain I am currently in.  I was experiencing what is known as breakthrough pain.  Though I have had several courses of epidurals for my back problems, sometimes the pain breaks through and is worse than you can imagine.  Sometimes it can be managed by prescriptions at home and sometimes it's so vast that an ER trip is needed.

As a plethora of people attempt to sign me in, take an EKG, and ask way too many questions for me to handle at once, I hear the most dread question of all, "what medications are you currently taking?"  Although I know this is needed to consider medication interaction and to see if my pain could be cause by any other ailment I have, I loathe this question.  Instead of asking "what are you on XYZ for?" doctors and nurses like to pretend they know everything and insist on guess.  "Oh, so you have heart problems and are bipolar?"  Nothing makes me angrier.  As a client I should have the right to not be judged by every professional who thinks they know what every medication is for.  My only victory is when I get to tell them that, no, I have no heart problems, I have Sphincter of Oddi  Dysfunction and I get blank stares because it's not a very common ailment.

I am not saying that every doctor or nurse I have ever had does this; I am just pointing out  how irritating it is when they do do it.  Assumptions and judgments based on medical history have the power to make a patient feel defeated.  They then become afraid to disclose anything else.  For example: I know that morphine does not work for me (nor for my sister or mother; it's called "morphine tolerance"), but I fear telling doctors this because they often assume I am drug seeking.  My pain management doctor has me on percocets as needed (I take less than one a month) for bad back pain, extra strength tylenol for mild or every-day pain, and dilaudid for breakthrough pain.  However, dilaudid, being more potent than morphine, sends red flags to doctors and nurses alike who assume a young woman in her late twenties should not be on such a potent drug.  Immediately I am flagged as a drug addict, often because they have already decided my every-day medications are for a disorder often associated with drug use.

Thankfully, this last ER trip turned out well, with the Doctor listening to me and my wife and the nurses becoming very understanding.  The interaction between patient and medical staff is vital to correct diagnosis and treatment.  Unfortunately, a some professionals do not understand this.  They still have a "I'm the Professional" attitude, which leads to mistrust and fear in patients.

As with any profession, the only way for professionals and clients to each get what they want is to work together and listen to each other.  I know that the professionals working with me were great once they realized their mistake in assuming they new what my medications were for.  I hope that all clients learn to use their voices and let professionals know that making assumptions is never okay.  And I hope that all professionals learn to put down their guard a little and listen to what their clients have to say.

Personal Resolutions and Revolutions.

The new year is the perfect time to start thinking about how one's life should change. Lately, I find myself wondering how I can give back. How can I make a difference when I have so much going on that I can't keep track of my own life? I was glad to hear that a friend of mine was having the same struggle. We asked a senior in faith about this and got an answer so stupidly simple it was mind blowing: "Become the kind of person who can give people hope." (Tariq Hasan, SGI Chairman of the Board/Chief Operating Officer).

So how am I supposed to do this? By setting an example. Every day we focus so much on ourselves: what we want, what we need, what we "deserve" that we forget that we are a part of every other being on this planet. Call it what you will, but there is a force that connects us all.

Something that has plagued me throughout the years is the idea of helping. I help in obvious ways, but forget it does not mean killing myself for someone else. Doing dishes, laundry, babysitting, helping paint... yes, these are all great ways to help, but sometimes just the task of listening is enough. Having a friendship and enjoying is more of a help to many than you can ever imagine. In a time when stories of teen and young adult suicide run rampant in the media, we may want to reconsider those we are pushing away.

Don't get me wrong- you should never keep someone in your life who is bad for you. However, maybe the next time you decide to turn down an invite to dinner or coffee due to wanting more "me" time, maybe think twice. The friendship goes both ways: each person listens and shares. You may find this seemingly simple act of being there helps you even more than it has helped the other person.

It certainly seems less daunting to work on personal friendships than to go out and volunteer 20 hours a week. I'm not opposed to volunteering, but I am opposed to stretching myself too thin. So now instead of attempting to save the world through activism, I'm going to work on saving the world through friendship.

If I knew then what I know now, it wouldn't have mattered

Looking back on my ten plus years of therapy, I realize how much time I have wasted bashing myself for not seeing or knowing something sooner. I often hear myself complain to my therapist, "That's so obvious and I knew something was going on. Why did it take me so long to figure this out?" Normally she patiently listens to my self ridicule, waiting for the right time to let me know that everything happens for a reason and we learn when we are ready. Recently, we have begun a much more invasive way of processing, which I had initiated.

After having a near-nuclear meltdown in January, I have become fed-up with pussy-footing around my issues. So after completing an outpatient program I spoke with my therapist about being more direct with each other and calling me out when I was trying to skirt an issue or deflect. I had no idea what I was getting myself into. I find myself being questioned about my outlook and having my thought process challenged. It's wonderful to end a session and feel like some really hard work has been done. And once again the thought of "why didn't I know to do this before" plagues me.

The truth is, if I had done this before it would have been futile. I wouldn't have listened; I would have spent a lot of time resenting my therapist and resenting the whole process. I needed to come to this conclusion for myself and ask for help. It's a hard conclusion to come to, but once it happens a whole world opens up.

The realization that all the crap I have gone through is neither good nor bad is a hard one. It's true. Nothing is really good or bad, per se, it just is. IT IS WHAT IT IS. How I used to cringe when I heard that phrase. Now I take it at face value. And the only reason I can do that sincerely is because I have gone through a lot and have taken the time to get lost in all steps of the process: grieving, anger, despair, denial, blaming myself, blaming the world, and giving up. Truthfully, the process of healing from any traumatic life event (be it "little-t" or "big-T" trauma) is a very selfish one. It is one thing to be selfish, it is another to realize you're being selfish. I think the first step of deciding to heal (and it is a decision-based process) is realizing you are being a selfish bitch. Step two is saying "and that's ok. It is what it is."

What happens from here? I'm not sure, but I'll be sure to keep writing about it.