Saturday, 20 September 2014

Recovery is not a Straight Line

I've had an interesting couple of weeks. I am facing a lot of change in my life, positive change. The problem is that, in the past, I have struggled with new situations and people simply because my trust in the relationships around me were shaky. It is now nearly six months since I completed the DBT programme and nearly three months since I was fully discharged from mental health services entirely. As with any routines and structures, the skills which have replaced my previous coping mechanisms have bedded in and become habit.

The problem for me comes when I find myself lapsing into old familiar patterns of coping and thinking, and allow myself to go back to the familiar rather than the helpful. After all, I am in the process of replacing over 30 years of self destructive behaviour with skills I have only been practicing for just a couple of years.

As ever, the problems for me have lain not in practical problems. I am currently organising and running a public event, I am more than capable of doing so. However, relationships and my emotional response to them remain a major challenge to me.

One working relationship has been particularly problematic to me. I am used to dealing with difficult people. I guess some would say I am a bit of a challenge myself! I have found myself shocked at how destabilising I have found this working relationship. My concerns grew when I found myself becoming disruptive in a training session. The result was that I have decided not to attend that particular group and to withdraw from that team for the time being. Initially I felt this as a failure - it has been a default response to many situations for me for so long. However, after a couple of days beating myself up about letting the world down, I actually took a step back and was able to reflect on positive steps forward.

1) I recognised that my response to the training was not helpful to my recovery.
2) I took action to look after myself in the situation.
3) I recognised my emotional limits had been reached before I exploded in frustration.
4) I managed to withdraw from the team by using the DBT FAST (be Fair, don't Apologise for being alive, Stick to your values, and stick to the Truth) interpersonal effectiveness skills.
5) I have found a way to continue with my work without putting myself under this emotional stress
6) I have managed not to damage any of the working relationships involved

(This sheet from DBT Self Help website explains in detail:

In the past such interpersonal issues have resulted in me 'behaving badly', often making myself feel really bad about behaving like a stroppy teenager. In the past my self respect has taken a battering as a result of my out of control responses to professional situations.

For a number of days I grappled with conflicting emotions, I forgot to use my mindfulness skills to enable myself to be able to identify and manage the problem emotions in the situation. I was in danger of spiralling downwards. At certain points, I even found myself trying to resist self harming urges. The good news is, with some effort, I was able to use my DBT skills to avoid relapse. More than that, I have been able to manage both myself and a difficult situation. Most of all, I have not been left feeling that I have destroyed working relationships and I am able to reflect on where the difficulties have arisen within that particular relationship.

Incidents like this would have caused crises for me in the past and would have had a detrimental impact on my ability to even be in the same room as people involved. Not good for team cohesion! Although I was tempted to despair of my progress on recovery, I am pleased that this situation has been manageable for me. This is vital, because I am currently in the middle of applying for jobs after more than two years of redundancy. If I am to successfully move back into working life, I need to be able to build up my confidence in using the skills which have been helping me in my personal life.

Life is not a drift through a glassy calm mill pond. At least, my life hasn't been. Having learned skills to manage distress, emotions and relationships, it follows that there will inevitably be situations where I will need to use those skills. I think one of my mistakes which led to me feeling shock at how quickly I felt destabilised was that I had deluded myself into thinking that acquiring the skills in itself would protect me from life's problems. D'oh - I'm with Homer Simpson - when I see it in black and white, of course that is daft. Any skill takes practice - when I was a competitive swimmer there were times when I was training for six days a week. Perfecting the stroke technique, building up my physical fitness, practicing starts, turns, finishes. I didn't really make use of those skills and that fitness until I raced. So it is with managing my condition. There are routine practises which are designed to keep my stability: I need to keep taking my medication, I need to maintain my physical health, my sleep patterns, my eating, mindfulness should be part of my day to day emotional life. However, I will not really know how effective my DBT skills are until I use them in situations which in the past I would have avoided or I would have responded badly to.

Recovery is not a procession, it is part of my life journey. There will be ups, downs, twists and turns along the way. My challenge is not to put my energy into looking back at the things I fear creeping up on me, but to keep my focus and energy facing forward.

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