Noticing

One of the most popular activities in our weekly group is our 'noticing'. We spend up to 30 minutes outside (particularly positive when Spring is in the air) and focus on each of our senses in turn as follows:

1. Notice 5 things you can see.
2. Notice 4 things you can hear.
3. Notice 3 things you can smell.
4. Notice 2 things you can touch.
5. Notice 1 thing you can taste.

It's a simple exercise and it builds on our regular practise of mindfulness. So the aim is not to focus on the number of the things we notice but on the experience of focusing on the world around us, rather than being stuck inside our own heads. Above all we are not judgemental of ourselves and we try hard not to be competitive. Some days it is easier than others to be mindful of what's around us. What is most important is that we try so that we learn to 'give our heads peace' - if only for a moment.

The Feeling is on the tip of my Tongue

I've been revisiting the DBT Skills in a more structured way recently. It has brought unexpected challenges to my day to day practice. It has been some time since I have found myself noticing and, therefore recognising the distinction between primary and secondary emotions. Coming back to DBT skills after a time when I had become accustomed to a narrow range of skills which suited me and with which I had become comfortable, has reminded me that continuing to manage my emotions effectively starts with being able to notice and name the feelings I may be grappling with.

One day I found myself feeling unutterably irritable, angry even at the world in general, other people, but (an echo from the past) most of all at myself. It was an uncomfortable feeling as I have managed to achieve a reasonable level of equilibrium. However, I am embarking on a number of new projects which I find challenging.

In the past I would have been tempted to wallow in the discomfort, allowing it to grow into the impulse to self harm. The Poison Tree by William Blake, has always summed up the dangers of nurturing bitterness, anger and hatred, particularly when it is turned inward. 'I was angry with my friend, I told my wrath, my wrath did end, I was angry with my foe, I told it not, my wrath did grow...'

As someone who is emotionally sensitive, I find it easier to forgive others than to forgive myself. Self directed anger needs a range of skills to manage, particularly so it does not become a spur to self harm. Naming it is vital. Spiky was how I would describe my general sense of how I was feeling, but it took me a long time to name 'anger' as the surface emotion. The problem then became, angry at what?

Rather than sit and ruminate, nurturing and feeding the destructive emotion, I decided to 'stomp' it out. So, along with my dog, I embarked on a two hour brisk walk. One hour in, the feeling of anger moved and changed into another feeling. I realised then that I was feeling sad, I was missing some key relationships from my time in Mental Health Services. I have moved forward to a point where I can use my skills, I have learned to self reflect. However, there will be times when I need coaching and encouragement. I am moving into a phase where that needs to be something I do for myself, having previously relied on my Care Co-ordinator and DBT Therapist to guide my reflections.

It is good to reflect that the storm of irritability lasted around three hours from when I first felt angry to resolving the feeling into sadness and allowing myself to feel sad about good relationships that have past. It is ok, it is understandable. In the past most of my emotional life was dominated either by a feeling of numbness when I was engulfed in an amorphous cloud of numerous emotions, or outright irritability and anger at myself which periodically exploded against those closest to me, but primarily at myself.

'Telling' my feelings allows me to look the challenger in the face. I was able to move forward when I acknowledged that I was angry, used opposite action to deal with that feeling until the main emotion, sadness was ready to be named.

I am learning that when I can't immediately tell you what I am really feeling, I know it is just on the tip of my tongue... I am learning to make space and give myself time until I am ready to tell my feelings and stop them from becoming an all devouring monster.

Making Use of All the Senses in Mindfulness

The longer I go on with mindfulness practice the more I recognise that I can become stuck in ruts. We like habits and sometimes it's a relief to have stability in something in contrast to the turbulent emotional and internal lives many of us battle against. There is a need though, to 'mix it up' and rediscover the fresh in our experience of the everyday. I find that I focus a lot of my mindfulness practise on hearing and sight, I tend to ignore taste, smell and touch. Yet, I know when I do try something out that focuses on these senses I tend to enjoy the change and what it gives to me in opening up a sense of moving forward and experiencing new things in the every day.

To help structure my ideas around my senses I have put together a worksheet, with a view to including it in a day course I'm running in October. Let me know what you think - any feedback (kindly meant) is gratefully received!

Making Sense of Mindfulness

You have been practising Mindfulness for some time now. These questions are designed to help you decide what works best for you, and to help you try out fresh ideas to use all five senses in your mindfulness practice.

1. When I take time to be mindful I usually use exercises which use my
Hearing /Sight/Taste/Smell/Touch *

2. I have never or rarely tried exercises which use my Hearing/Sight/Taste/Smell/Touch *

*Circle the answer

3. List your top three favourites sounds:
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4. List your top three favourite sights:
________________________________________
________________________________________
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5. List your top three favourite tastes:
________________________________________
________________________________________
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6. List your top three favourite smells:
________________________________________
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7. List your top three favourite sensations (Touch)
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Now from these lists, note the experiences which you find help you to feel:
 Calmer
 Pleasure
 Enjoyable anticipation
 Warmth
 Nurtured
 Relaxed
Exercise:
Sit as you usually do when practising Mindful exercises. Notice your breathing and allow your mind to focus on the rise and fall of your stomach/rib cage. Focus on the sensation of your breath in your nose, then as it travels into your lungs and out again. Allow distractions from thoughts, memories, to pass through.
Now choose one of your senses to focus on. (touch or taste or smell make sure you have any props set up within easy reach). As you use your senses become aware of initial thoughts/judgements? Notice them, then let them go.
Spend some time simply experiencing your activity. Notice feelings about what you are experiencing. If it is pleasurable do not push it away, but allow yourself to sit with it. If it is negative, notice it and let it pass. Change your focus back to your breathing and away from what you are experiencing, then return return to the focus on your sense. Repeat twice more, then when you are ready, return your focus to the room.

Cocoons

I've been thinking a lot about cocoons lately. In the past I believed that wellness for me would mean that I would no longer have need of safe places, bolt holes, places to retreat when the world became too much. Recently, however, I've realised that it is not the need for cocoons which has changed in me, but the type of retreat and how long I need to remain there so that I can rebuild, or rest, or restore myself ready for the day to day battles which make up every day life.

In the past I would cocoon myself away for weeks, months on end. In many ways I was entombed within emotional cocoons for so many years. That's the effect of refuges which are not designed to release me to live a meaningful life, but those which enclosed around my internal pain, so that all my effort and strength was used up trying to live with the prickles on the inside of my 'safe places'. In some ways I was like a porcupine or hedgehog which had curled in on its own prickles, stabbing myself repeatedly as waves of emotional pain assailed me.

In nature, when caterpillars are wrapped up in their cocoons they are enclosed around nourishment, stored up fuel which sustains them until they are ready for release and new life. I have had to learn to experience nurturing refuge, time and space which rebuild positive emotions. At first leaving my pain outside the cocoon felt strange and awkward. I had to fight against the hardened belief that I did not 'deserve' to feel better, that I was not worth protecting from whatever was draining me at any given time. Instead I have had to work hard to focus on ways to be kind to myself. I have written about my 'self soothe' and 'Validation' treasures boxes, here: http://bpdlifeinthemoment.blogspot.co.uk/2013/11/my-self-soothe-kit-whats-in-yours.html and http://bpdlifeinthemoment.blogspot.co.uk/2014/03/my-dbt-validation-treasure-box.html

Some who misunderstand emotional and mental pain assume that there is a laziness, or desire to be miserable, which stops us from 'getting better'. Think about that for a moment. Is it credible to believe that someone who has suffered so much really 'enjoys' feeling that way? That someone who feels so much distress that they believe the only way out is to either cause more physical pain to themselves or to die, actually doesn't want to find another way?

I have learned to use cocoons to heal. It is tiring to carry both internal, historic pain and the day to day weariness of every day life. If I cannot accept and leave the past pain behind, then it will continue to turn up the volume on my current pain. So, I don't just carry the disappointments, sadnesses and pain of today, I also carry every moment someone or something has hurt me all my life. It is the focus of experiencing the present moment as it is, unfettered to the past which has helped me to let go of the store of pain so that I don't feed the present with the past.

Instead of wrapping myself in a cocoon around intense pain, so that I emerge exhausted and unable to function, I build into my cocoons activities and actions which soothe me until the pain has gone and I feel able to tolerate the company of others.

The other most important thing about cocoons which is helpful is that I set time limits, so that I am not tempted to stay there. Whether it is a matter of hours or a day, this means that I focus on making the most of my time, rather than letting hours drift into days, as I have in the past.

Here are some ideas to help you make the most of your cocoons:

1) Plan the time ahead. This is a Bank Holiday, I have made sure I have built in time with some good friends. However, after a week or two with intensive meetings and lots of thinking, I need to be alone. I have planned one whole day.

2) Make sure there are things which can keep my focus - I have stored up whole series on Sky+, am colouring in using 'The Secret Garden', I have enough food to make some delicious recipes.

3) As I move through my activities I do so mindfully, being aware of what unwanted emotions may arise and dealing with them using my DBT skills. I do not want the focus of my emotions to end up draining me - that would defeat the purpose of the cocoon.

4) Allow myself to enjoy it - even if I begin to feel guilty I must use 'non-judgement' skills to let it go. The aim is to rest and relax - that is okay I am practising self care and it will help me to be able to engage with and care for others.

5) Plan how I will re-engage with the world outside my cocoon - I cut myself off from Facebook and other social media. It is also important when I need cocoons that I don't engage with UK and World news - particularly at the moment I can become emotionally sensitive to injustices.

Above all, cocoons are as much a part of my toolkit as other DBT skills, I can emerge from my cocoon either drained or restored. I am learning to do the latter, the more I practice these moments of calm in a turbulent life.

Measuring Progress in Recovery

I'm at a strange stage in my recovery. It's not a 'crossroads', I'm not in 'limbo', I'm not even 'stagnating', but I am living with a sense of tension and unease. My problem is the future - or the fact that I cannot see what's going to happen in the future. Now, in reality I have never been able to see ahead in time, but I have always had plans, ambitions, career paths to follow, so it created the illusion that I had some control over how my life was progressing.

I don't think I'm any different or less able to read the future than anyone else, I have just become more acutely aware of how quickly my plans can go awry, just like Rabbie Burns' 'mice and men'. Having had an unremitting cycle of work and retraining, relocation and travel over the years, it is an alien experience to have lived in one place for more than a decade. Up until the last three years I have also had the stability of a career with a definite career progression. Surely that is what stability is built on? Yet, I don't think I have been as peaceful and untroubled by emotional storms as I have in the past year.

Nonetheless I am troubled by the short term nature of my ability to provide for myself. Going by the patterns of the past I SHOULD be relaunching myself in a new direction, be completely absorbed by a new job and praised for my external progression. My problem at the moment is that any opportunities to help out or volunteer are short term and sporadic. I feel the pressure to go back to work, but the idea of applying for full time work is so troubling that few people venture to ask and I daren't even consider the possibility, even though, on the surface, that would provide the greatest stability - financially.

As I write this, I realise I am in a process of adjusting my life to new priorities. My greatest needs are to manage my emotional life so that I don't regress to the inexorable daily cycles of damaging emotions and behaviours that have marked most of my life. That means that looking ahead is not helpful.

I am only able to plan up to a month in advance. I have a monthly meeting as part of the Experts by Experience group of my local NHS Trust. I am still meeting with people one to one to help them with Mental Health needs as part of my involvement in the church. Over the past three months, having had some disruption to my emotions caused by the pressures of managing the needs of elderly parents who live at a distance, I have learned to set the running of a five week course to one side - and learned that the sky didn't fall in because I put my own health first. Overall, it means that I have managed my mental health well and managed not to slip back into emotional dysfunction.

I need time to be able to reflect on these changes as realities which indicate that my progress in recovery and managing the symptoms of my BPD continues, but is not at an end, or, indeed an end in itself.

One of my biggest challenges is creating my own patterns without the regular hours of paid work. This includes valuing what I am able to do as helpful and contributing to those around me as I am able, without having the external validation of a pay packet at the end of the month. After over 35 years working in various jobs and careers this continues to be a battle. If I am able to turn up to events at church that means I am part of a community and I am valuable simply as myself. When I am asked to help out in developing a website and writing the odd article that means I can enjoy using skills and experience I have developed over the years. I need to change my internal validation compass to accept that I am contributing in a positive way without having a salary point to indicate my 'progress'.

Of course there is a daily reality of bills to pay. I know that it would be good if my progress could result in rejoining the ranks of those who are paid to work. At the moment I am learning to accept that whilst I am capable of working, my emotional resilience casts a question over how far I would be able to sustain a full time role. So, again I come back to looking ahead and seeing only bends in the road. Acceptance means that I settle my ambitious, career driven self to the here and now. Recognising the need some days to give myself a break means that I would not be the ideal employee at the moment, particularly in a nine to five, five days a week environment. Some structure would be nice, though.

Little Things Mean So Much

We all recognise the daily grind. The wear and tear of a million tiny burdens which work together to bring us to our knees. In much the same way as drops of water add together over time against land to wear away our literal foundations, the constant wearisome action of day to day problems tend to grind down our emotional resilience. As someone who is emotionally sensitive the impact of the feelings of weariness may at times seem out of proportion to the triggering event. If only I could give as much weight to the little positive things, as I do to those things which work against me and my emotional resilience.

It is a phenomenon that is not reserved solely for those of us who battle internal as well as external pressures. Large firms are quoted as giving additional weight to positive comments about their service or products as opposed to the more frequent negative comments. We find it easier to notice and dwell on the negative in our lives, than we do the positive.

The fact is that life is light and shade, ups and downs, positive and negative. In our DBT skills group we had a jar which was passed round the group into which we placed different coloured glass beads. We had to tell the group about positive and negative events from the past week and place coloured beads accordingly into the jar, but we had to put two in for every positive event and one for negative. It was a great way to help me to notice how many positives there were in my life over time.

As someone who feels things intensely I find it fascinating that I am comfortable in experiencing the negative in life, that I tend to dismiss the positives that flow my way from positive relationships and events. Noticing and keeping a record of good things has become a necessary discipline in helping me to maintain emotional balance.

Another thing I have noticed is that, at first, I kept waiting for the big events and encouragements, whilst I dismissed the small things that make life bearable at times. If only I would give myself more of a break and let go of the million small disappointments and knocks that are also a part of life.

I have started listing the little things that lift me up.

1) The extra boost that the lengthening days gives to my mood.

2) The joy of how satisfying it is to bake and cook for myself - also helps that the products can be consumed - saving me money and keeping me from junk food!

3) Allowing myself to get soaked through on a rainy day followed by enjoying a hot shower and some pampering before climbing into my onesie.

4) The physical and emotional sigh of getting undressed at the end of the day and curling up in my pjs afterward.

5) Enjoying the freedom of dancing madly to fun music - thankfully I've reached an age where I just don't care and I'm enjoying that!

6) I can choose to make myself sick on all my favourite childhood sweets - if I want to.

7) When I am happy I can indulge it as much as I used to indulge my negative feelings - without feeling guilty.

8) I love enjoying cotton sheets and clothes - cool

9) Coffee - just excellent, freshly brewed coffee, the smell, the taste, the sight.

10) (I'm wary of advertising, but here goes anyway...) Lindt chocolate - eating a Lindor - slowly...

At first I need to be deliberate about noticing and keeping a record of these little things, but, as with most things in life, as I keep going it will become as much a part of my world view as my tendency to think negatively about myself and my experience of the world used to be.

A WHOLE New Year?

I have spent the last few New Year's Eves huddled inside my little cocoon with my dog, avoiding the forced socialising and build up towards midnight. This year I wanted to be with others, so spent a really fun evening with friends. The countdown to midnight comprised the final ten minutes of our night together. It was good to see the New Year in with friends and be able to reflect on how different things are from the same time last year.

A conversation on the way home about how we didn't welcome the WHOLE of 2015 in at midnight, simply the second after midnight on the 1st of January started me thinking and has led to this blog post. It's made me think again about how much pressure we put on ourselves to find a 'magic bullet' or 'magical season' or 'magic moment' that will end our misery or bring us final fulfilment. The problem with putting all of our desire to change and improve into what turns out to be one week of determined effort, or if we are really focused, perhaps a whole month of living up to our 'resolutions' is, that our NEW YEAR quickly disappoints us and we often end up feeling failures and give up on our resolutions and, often, ourselves.

Midnight on the 31st December 2014 has not suddenly meant that I have woken up with the job I so desperately need/want. My chimney and roof remain in desperate need of repair. I still have to walk my dog so that she is happy and doesn't chew or destroy my furniture. Nor was there a handsome (or any other kind of) Prince standing at my door awaiting my response so that he could whisk me away from my drudgery to contentment and bliss. Even in the original fairy tales (often really gruesome) there was no Happy EVER After. We've managed to 'Disney' out the reality that for most people who have an awareness of the world around them and their place in it, life is often painful. There are very few of the friends of my generation who do not struggle financially. People become ill, both physically and mentally. However hard I try, I cannot foresee any of these events simply because I have stayed up until midnight on a designated night of the year. I cannot prevent them from happening, nor should I be surprised if they do. Happy New Year is a blessing, a desire that 2015 will be good. It is not a statement of policy or intention.

All that happened last night at midnight, was that one moment of my life moved into another. Through the practice of mindfulness this is how I have learned to manage life. It has been important that I have learned to ACCEPT those things that are beyond my power to change. I am better able to watch the Daily Politics, as a result. I don't get overly emotionally involved anymore, because apart from using my vote and expressing my opinion, there is little else I, on my own, can do. I know, I would love to think that the universe revolved around me more than that, but difficult as it has been, I have learned I am not the solution to the world's problems!

Last year, I finally decided to stop setting myself unmanageable dieting goals. It was only in March, after I had achieved some level of progress in managing my BPD, that I felt ready to work on feeling better physically. For the first time I stopped looking ahead to an arbitrary target weight and decided to focus on my love of fruit, vegetables and home cooking. The changes I made had to be in the moment. Any progress I made was not reliant on my feelings - a lapse was not a relapse (something repeated as a mantra to drug users in recovery). I don't know when it happened, but as the weight came off pound by pound I made my way through the year shedding over three and a half stone.

Change is possible, but I can't decide how a whole day is going to go, let alone the whole of a year. So, any decision to change how I do things must be on a moment by moment basis. What matters is the ability not to judge myself for the times I miss my targets. I have had to learn to readjust my aims. To look at the target and decide if it is the right one for me, then reset my sights and try again. It is easy to become discouraged if I think I have to determine the progress of a year in advance. Or even if I actually believe that by any effort on my behalf I can influence the progress of the year, I will condemn myself to constant battles with myself about how powerless I am. Better for me if I learn to accept my life as it is right now, then choose areas that I want to change, before I set myself achievable goals. Above all, I do not have the capacity to live life in wormholes or time and space vortices, which means I can only live my life along a line of time which progresses, moment by moment. You know what? I think that's more than enough for me to handle!

Unlike Burping, Thinking is NOT always 'better out than in'!

You know the moment, that one when the belcher states with satisfaction to the belchee 'oooh, that was better out than in!' Etiquette aside, I think we can all agree there are few things that are more irksome than trapped wind. Enough said. What about 'trapped thinking'? Impulse control has always been an issue for me, particularly when I have been emotionally overwhelmed.

In the past I had a reputation for lobbing conversational 'grenades' into social gatherings. It has been damaging to me and damaging to those on the receiving end. Much of this has centred on two things that I have always struggled with. 1) My inability to read social situations appropriately and 2) My need to find a way of managing the crescendos of difficult emotions. I've come to think of these moments as my BPD having a verbal 'burp'. As with other impulsive behaviour associated with BPD such behaviour was ultimately self defeating and actively prevented me from building sustainable relationships. I mean if your opening gambit is 'Hi my name's Alma, I was abused as a child, how are you?' it's hardly surprising that most friendships ended before they began, with potential good friends stuttering away from me as they headed to the hills.

Such impulses I see as the 'burps' that have arisen from my emotional turmoil inside. Along with my expectation that others should be able to read my mind and that I, in turn, could tell what other people were thinking about me, such outbursts were a way of de-cluttering the mess of thoughts that were running around in my head. I have had to learn to filter myself a lot more, I'm still tactless at times and often say what everyone else is thinking, because I don't always follow the rules of social restrictions, which is not necessarily a bad thing.

The skills that have helped me to do this start with mindfulness. If I take a moment to breathe before I speak, especially when meeting new people, then that allows me time to notice what I am thinking, before I 'burp' it to the outside world, unfiltered.

Other methods I use, especially when I notice difficult memories and thoughts is to use thought diffusion exercises - such as turning the thoughts into leaves or clouds and watching them pass me by without having to articulate or cling onto them. In times when I have needed clear space to do this, I have made my excuses and retreated, literally from the room. Ultimately, if I can remember to ask myself, 'would this thought help me or the others around me if it was on my lips instead of in my mind?' this can act as a useful net to catch any damaging thoughts before they cause any harm. In Northern Ireland there is a saying 'catch yerself on' which basically means, 'would you have some sense, please?' This needs to be a reminder to myself to keep thoughts that are best kept in - in, until I can deal with them appropriately.

A helpful way of bringing this process out of my mind is to draw or create a head with a large circle for the mind and a large mouth. If I can write down examples of thoughts on pieces of paper and place them in either the mind or the mouth, as appropriate, I can teach myself to recognise which thoughts are 'better in than out'. This picture is one example of how someone has used this method to practice filtering their thoughts.

How does Your Mindfulness Smell?

Smells - I'm sensitive to them. I used to be plagued by regular severe migraines and strong smells, either pleasant or not, could trigger them for me. Since I've been practising mindfulness and managing my life stresses more effectively through DBT skills, I have found that I am only suffering migraines about two or three times a year. As a result I am re-acquainting myself with the power of smell. I am learning not to fear this neglected sense.

When I started practising mindfulness I would focus on sound, sight, touch and taste. It's easy to focus on really enjoying the touch, sight and taste of chocolate, for example. I can really savour the moment, taking my time to taste and enjoy the melting, soothing flavours. But how often do I stop once I have unwrapped it to really absorb its smell? I've been slower to first notice and then learn to practice smell as a mindful practise. Yet, along with listening to music, this is probably the most evocative and vivid of my senses. Who can resist the smell of cooking bacon? There is a reason why supermarkets pipe the smell of freshly baked breads. Even more unpleasant smells can bring us quickly into the present. The 'country' smell of manure definitely grounds me in terms of where I am, geographically.

As I have developed my awareness of the world around me and my own experience of the present moment, I have found myself building up a bank of smells which have different emotional impacts for me:

1. The smell of freshly ground coffee beans. This smell has become part of my daily morning rituals. I find I am beginning to be

able to detect different 'nuances' in different blends and roasts of coffee beans. I am drinking less alcohol than I used to, so freshly brewed coffee from freshly ground beans has become one of my regular luxuries. It is an important part of my self soothe routines. It also helps when I am finding myself facing overwhelming feelings of grief. I get a bag of fresh coffee beans from the freezer (best for keeping that freshness) and I stand and inhale the gorgeous aroma. This also benefits me because it is another way for me to practise mindful breathing whilst combining it with self soothe skills. I also love the smell of the fresh brew when I return to my house - it is definitely better than some of the rancid smells that used to greet me when I was too overwhelmed to care about myself or my environment. As I have recovered smells in the house are an important indicator of how much I am caring for myself and my home.

2. The smell of grass in the summer. For a long time this was a problematic smell for me as my Dad was a landscaper and the smell of freshly cut grass mixed with oil, became an ambiguous scent for me, evoking some unpleasant feelings. Now, though, it is part of the freshness of spring and summer. As I am learning to leave my fear of these seasons behind (I think these times of year seemed to be times when I was more vulnerable for reasons I have never explored) I am learning to really savour the smells of summer plants and water, like rivers through woods etc.

3. Citrus smells. There is nothing better for making me feel fresh and clean, than the smell of lemons, oranges and limes - preferably fresh ones. I can just cut a lemon in half and stick my nose right in and really inhale - way to go in getting me awake!

4. The smell of my dog and cat when I snuggle my face into their (dry) coats - it is safe physical affection and the warmth of the touch along with the smell just reeks of comfort. My dog is just the right size for me to lie beside and envelope her in my arms, whilst burying my face in her wonderful furry coat. I need to feel safe with touch and my pets are helping me to enjoy the safe touch and smell of another creature.

5. The smell of my favourite 'smellies'. I love perfumes, soaps and bubble baths. My favourite shower creams and gels are usually from aromatherapy ranges and I love standing in the shower enjoying the smells of my soaps and shower gels. I have always worn perfumes and love that blast of aroma through the day as I move about. It is a pleasant reminder of self soothing baths and showers, again a good way to practice self care.

Other smells I love: fresh cotton sheets, shirts; fish and chips; curries; any Mediterranean cooking smells; nutmeg; all spice; Vimto; melons; fresh paint (yes, paint); the sea;

Of course the sense of smell is most powerful when it is combined with the other senses. Touch and taste in particular enhance my experience of smells and help me to be mindful in my experience of smell.

So go on, get your olfactory juices flowing and really stick your nose into some things that are just passing you by at the moment. You might find yourself rediscovering some old 'friends' along the way.

The Pain of the Unfrozen Heart

TRIGGER WARNING: IN THIS BLOG I DISCUSS VERY PERSONALLY THE IMPACT OF DISSOCIATION AND OTHER WAYS OF MANAGING SEXUAL ASSAULT - MAY TRIGGER SOME, BE CAREFUL WITH YOUR OWN HEARTS.

Franz Kafka once said 'Literature is the axe which shatters the ice around the heart.' Colourful, but I'm not sure he got it right. I think it would be more accurate to say 'Time and therapy are the axes that shatter the ice around the frozen heart.' This has become painfully clear to me as I make progress through the recovery process.

I can tell you almost to the moment, when my heart finally was broken, nearly fifteen years ago now. I was exhausted from all the pain and distress, from the constant battling of emotions I had no control over, from the pain of broken relationships, feared and realised rejection after rejection and the constant internal commentary which was boosted by those experiences and feelings, confirming to me that I was worthless and unloved and unlovable. I didn't think of myself as resilient up to that point, but looking back I realise that I had crashed and burned so many times, that it was almost an automatic response for me to move to a new area, and begin again - new home, new job and, most drainingly, new relationships and friendships. In the moment my heart froze I suddenly felt all the accumulated effort and pain as a burden I could no longer sustain. In that moment, my mind decided that I needed to stop feeling, rather than constantly keep feeling the pain of my life so keenly.

It has been easier in some ways. I was, once again, the victim of sexual assault, but instead of being capable of reacting in any way that any onlookers would deem 'appropriate', I walked out of the situation and continued as if nothing had happened. Why not? It was just another example of how worthless I was, a confirmation, from a stranger this time, that the abuse I had suffered at the hands of those close to me, was indeed down to me - after all I was the common factor in it all.

There are those, particularly in the media, who tell us how victims SHOULD behave. How would they know? If you have never had your spirit broken, been convinced that there is no one out there to hear your screams or cries for help, how could you know what it is like? Being a victim of sexual assault once, makes you more vulnerable to such abuse in the future, (although it is not always inevitable). That seems to be so hard for many people to understand, I mean isn't it a case of once bitten? Let me ask you, if you have constantly been told that what is happening to you is as a result of you and your behaviour. If you are told that something about you meant you 'deserved' it. If one of the voices telling you these things is your own thoughts. If you have become accustomed to abuse as an expression of 'love' and been told that you are 'special' because of it. Is it any wonder that as an adult when you encounter the same behaviour towards you, you don't fight back, you don't 'just walk away'. Survival means that often survivors divorce what is happening to them from their conscious experience. I was passive - a victim - because this was the way I had managed to survive numerous abuses from my childhood onwards.

Having, stopped, short, never to feel again, my heart was incapable of feeling anything, either good or bad. Now, having begun the process of healing I am learning to recognise the tingles and pangs of the ice cracking. Sometimes, it's ok, I realise I can survive feeling again, but at other times even the good feelings are problematic. The other day I mentioned that I was worried I was being 'hyper' to a friend who is familiar with my cycles of mood - 'No,' she said, 'That's happiness'. My immediate impulse was to panic, in case I couldn't handle it, but I sat with it for a moment and realised it didn't have to spiral till my behaviour was out of control, prior to the inevitable crash to the emotional floor. Instead, I allowed the feeling of contentment and enjoyment of the afternoon to run its course and it was ok, in the end I enjoyed the whole day.

I'm off on a break for a week soon. As I contemplate dropping my dog off at the kennels I have encountered a pain from separation anxiety of sorts. Last night, I shed tears. Initially, again my immediate response was panic, what if this is the start of a depressive episode? Then, I allowed myself to sit with the feeling. I tried to use wise mind. After all, we spend every day with one another and she is good company. It's ok to miss her.

The fact this relationship with my dog is having such an impact on me emtionally worries me. I realise that this is part of my natural fear of fondness or love. My dog has been a big part of helping me to heal. I can tell her 'I love you' and I feel that is natural. It is a huge step for me to transfer that ability to humans. As a survivor of abuse the emotion that I am most confused about is 'love'. It is a huge task to separate the sexual from this emotion and to be able to recognise the different nuances of love that are part of the full range of human relationships. For me there is a yearning just to be held, by someone safe, without it leading anywhere. So many times, people touched in ways that were damaging without asking permission, or without a bond of trust to enable me to feel that I had any say over what would happen next. It scares me that my unfrozen heart could respond to another human being and it not lead to an abusive relationship. I wouldn't know how to handle it.

The other reason I fear my love for my dog is that, along with the love emotion, I have always, before my heart froze, feared the ending of any relationship. I have always anticipated the loss long before it arrived. When I realised how fond I was becoming of my dog, I started to fear how I would cope when she dies. This is the benefit of not connecting with any other creature, death doesn't have to hurt so much. Except that's so not the way it works, is it? Even if I don't acknowledge it, I am connected to others around me and losing them even temporarily will be FELT by me, that's part of being human.

In the past, often, rather than wait and see, or trust the relationship I would behave in a way which would hasten the ending I feared so much. That way I believed the pain was somewhat controlled by me. I believed that it was just me fulfilling what I always 'knew' would happen.

In the here and now I am learning new ways to be in relationships. Rather than impulsively rushing in where angels fear to tread, I am learning to be 'careful' with my heart - it is after all heavily scarred and rather fragile. I have managed to focus on friendship at the moment - anything more intimate is beyond me right now. I noticed the other day that there is a lot of change in a number of friendships. This has meant changes in routines - a friend who may have been available to go for lunch is no longer available. Forgetting this the other day, I phoned her at work. We had a quick conversation and I put the phone down. My old familiar panic feelings, followed by shame and then embarrassment flooded over me. In the past that would have meant me backlashing by cutting myself off from her and self harming for being so stupid. Instead, I spoke to myself (out loud) and used wise mind to query if the interaction really meant an end to the friendship. I also used a mindfulness breathing exercise to calm myself and focus on the positives of the friendship, which include a face value honesty that I have always appreciated. When she phoned later in the day, I picked up the phone and we agreed to meet as normal later in the week. For those not familiar with BPD this may seem something very small, but not making this exchange an all or nothing matter, and thereby saving the friendship is a massive step forward for me.

I guess that the pain I am feeling now is not unlike when you are in the process of trying to warm your hands after a good game of snowballing. You know you need the blood to flow again for your hands to function, but you also know that as the blood does so you will feel a world of pain - for a time. As the emotional blood flows back into my heart - I know that it is painful at the moment and will continue to be so, as I risk my heart with others. That pain will remain for a time, but one day my heart will be able to function as it was designed to, maybe with one or two little twinges from the scars it bears, but it will be fully, finally, unfrozen.

What on Earth is DBT?

I have found myself being asked this question a few times by people who follow my twitter feed or this blog. It's funny how easy it is to obscure your message by the use of jargon. I actually enjoy explaining what DBT is and what I have got out of it as a treatment - it has been a massive positive in my life. Unlike the question 'what does the borderline in BPD mean?' Not easily answered as frankly most people now don't actually agree with it as a descriptor of this condition - anyway that's another topic altogether and if my DBT has taught me anything it is not to be distracted by thoughts that are not relevant to the here and now.

Dialectical Behaviour Therapy (DBT) was developed by a clinical psychologist in America called Marsha Linehan (do google the name she has produced numerous videos and articles about her therapy) in the 1990s. It is a combination of mindfulness techniques and Cognitive Behavioural approaches to help those diagnosed with Borderline Personality Disorder learn to understand and control the extreme fluctuations in their emotions.

As a replacement for BPD as a label some have taken to referring to the condition as either Emotional Sensitivity Personality Disorder or Emotional Dysregulation. As a descriptor I find the latter preferable. Whatever term you choose to describe it, what it meant for me was a see sawing of moods which could cycle from being 'hyper', excitable, voluble and energetic to extreme feelings of depression with a high degree of suicidal feelings within the space of a few hours, several times a day.

As you can imagine such constant cycling of emotions can be extremely draining and distressing. A key hallmark of the condition is poor impulse control accompanied by strong urges towards self harm (or self destructive behaviours) and suicide. Throughout my life, until I really started to practice my DBT skills, the idea of killing myself or harming myself was an almost constant presence in my consciousness.

DBT is not offered as a cure for these issues, but seeks to offer the sufferer the means to interrupt and then control the emotional storms which are the moment by moment experience of BPD. One important point to make is that no treatment in Mental Health should be considered as one size fits all. This is why the individual sessions of DBT are so crucial for each person. I can only decide what skills I need to master in order to manage my emotional life. Because it is a skills based treatment it requires a major commitment, not only during the time in group and with your one to one therapist, but, more importantly, after discharge the treatment will only work long term if I commit myself on a regular basis to remind myself of the skills and to practice them.

I remember my GP expressing her frustration with patients who had been referred to the Physiotherapist to deal with one condition or another. She would make follow up appointments to see them after six weeks or so. 'How's it going?' She would ask on their return. 'No use whatsoever'. She would persevere 'Really?'. 'Oh yes, I went twice and to be honest the exercises were alright when I was there, but then the complaint returned in between visits.' Now, it seems to me that the GP shouldn't then have to explain that these exercises should be repeated daily in between 'visits'. If I think after discharge 'well that's that then' not practice or take seriously the skills I have worked so hard to develop, during my time in therapy, then I don't think I should be surprised if I start to lose control and become a prisoner of my emotions once more. I need to keep going with it.

So what are these skills?

The core 'treatment' is a weekly skills group along with a weekly one to one session. In the group we are introduced to the skills and encouraged to start to use them to manage day to day issues as they arise. In the individual sessions there is an opportunity to discuss in more detail the skills that are most useful to me as an individual and the key parts of my emotion dysregulation I should be working on.

There are four main modules:

1. The Core Skill of Mindfulness runs throughout the length of both the group and individual sessions. (typically one year, although some centres are trying to offer 6 months which only allows one cycle of the skills modules).
2. Distress Tolerance - skills to help me manage when I am in distress without reverting to self destructive and self harming strategies that I may have used all my life. (here the importance of developing familiarity over a longer period of time becomes clear).
3. Emotion Regulation - longer term skills to enable me to recognise what feelings I am dealing with and to develop strategies to maintain a stability in those emotions. (these have become more regularly used by me since my discharge in seeking to maintain my progress with managing my emotions)
4. Interpersonal Effectiveness - anyone who has BPD or has lived with someone with BPD will tell you that the emotional maelstroms inherent in the condition wreak havoc in all sorts of important relationships. Reading other people is not a natural skill that I possess because of my invalidating upbringing. This is an area I need to consciously be aware of and that I need to practice constantly in order to counteract the natural urge to respond to my instinctive (often mistaken) feelings about the relationships around me.

I completed a one year programme, during this time, each module is introduced and after six months, and a review of progress, they are repeated and reinforced both in the skills group and in the one to one sessions.

This is a very sketchy outline of DBT, there will no doubt be many other questions.

Such as, what do I mean by Dialectics? Essentially, my understanding (which will be limited to my own experience) is that it seeks to bring stability and balance to my emotional life so that I can enjoy the parts of my life that are to be enjoyed, without expecting everything to be 'sorted' or 'perfect' (I've covered this in my blog on recovery and what it now means to me here: http://bpdlifeinthemoment.blogspot.co.uk/2014/06/putting-jigsaw-together-learning-to-fit.html

The following are links to helpful websites about BPD and DBT: http://www.dbtselfhelp.com/ has really useful exercises and videos for the practice of DBT skills and Mindfulness, www.my-borderline-personality-disorder.com (Healing for BPD) is an online version of DBT but there are also really helpful articles and examples of using DBT skills in recovery. There are many other websites that offer useful mindfulness videos or self soothe ideas etc. Just be selective and be aware nothing will bring about any miracle cure and any skill needs a lot of time and hard work to develop.

I think the best way to find out about Marsha Linehan who has an amazing story about coping with BPD herself, is to just google her name.

Access to DBT groups in the NHS seems to be very limited. I have been so lucky to live in Lancashire and to be able to access the Central Lancashire DBT Team for nearly 18 months. I am so grateful for a local NHS Trust (Lancashire Care Foundation Trust) which has seen fit to offer not only this, but also other therapies for BPD. Having not meshed with one previous therapy, I only had a waiting time of one year to access DBT. I am aware that not every area has so much to offer to what is a cinderella condition, but hopefully, if I can encourage others to ask about it and whether it is available in their area then, maybe, some 'up high' might begin to see the light.

For me, having my discharge report set down in black in white that I have not self harmed for over 18 months has helped me to see just how far I have come. My time in the group was an important part of my journey but I haven't arrived, I'm just moving on. I continue to work on my Emotion Regulation skills, occasionally I use my Distress Tolerance skills when an echo of my past takes me by surprise. Rather than creating dependence one of the best things DBT has given me is a developing confidence that I am ready for life without Mental Health Services, that I am capable of maintaining and building on the progress I have made so far and that even, if I may never have a life without my turbulent emotions, they will never have to overwhelm in the same way again.

I will be forever grateful for the visionaries behind this great innovation for BPD sufferers.

Saving the Starfish

There was once a little boy who loved splashing about and foraging in rock pools. For hours on end he would carefully lift rocks and stones to reveal the miracles of nature beneath. Each little pool was a mini world and he saw himself as some sort of benevolent super being 'freeing' each creature from their 'prisons' under the rocks and boulders along the shoreline. He didn't stop to think about the worlds and lives he was upending. Yet, somewhere at the back of his mind was the knowledge that the destiny of the crabs, shrimp, cockles, mussels and other creatures were entirely in his hands. Slowly he began to become more select in the creatures he chose to help. He realised that not every crab under a rock needed to be freed from their hiding place. He began to recognise the 'safe places' for them and changed his focus from changing each creature's lot in life, to making sure there were plenty of safe places in 'his' rock pools for those he wanted to protect.

One night there was an almighty storm tossing angry waves around the familiar bays of his holiday home. With great excitement and anticipation he ran down to his favourite rock pools. A scene of devastation met his eyes. Snotgreen party streamers of seaweed, with assorted pieces of human detritus, plastic bottles, flip flops, string and tins, were intertwined with clusters of discarded fish egg sacks, jellyfish and, seemingly strewn across the whole shoreline, were hundreds, upon hundreds of starfish. The boy sank to his knees and began to sob. He had no way of saving all of the starfish. He didn't even have the ability to save any of the creatures in one of his little rock pools. The raging of the storm had cleaned most of them out, stripped of all hiding places. The storm had proved to him how useless his efforts were.

As his tears flowed he started to look around him. He began to count. Slowly an idea formed. He could reach about 10 starfish immediately next to him as he kneeled in the sand. He picked one up and threw it back into the ocean. 'Saved you.' He said as he threw it. He picked another one up, 'Saved another one.' As he walked along picking up starfish one by one, he stopped looking at the hundreds he couldn't reach, or who were beyond any help, and started focusing on each one as it lay in his hand, before he returned it to the sea. He learned a good lesson. 'I may not be able to save all the starfish, but I can save as many as I am able, one at a time.'

Sometimes we have huge mountains to climb, trying to bring justice where there is none, trying to fight against governments who seem impervious to pain, compassion, or even reasoned debates. Sometimes, we battle our own demons. We have lifetimes of trauma and pain to overcome. If we focus on the whole of the mountain, we will feel very small and very helpless.

I remember taking some 13 year olds to the Lake District to learn about climbing and abseiling. Standing at the bottom of the cliff face looking up I was so overwhelmed by the task ahead, that I chickened out. I learned something as I watched the kids make their way up where I didn't dare to go. They didn't look up or down, when encouraged by the instructor they looked at their feet planted on the cliff wall and they made progress as they moved each step upwards. Even the most frightened child managed to make it to the top and back down again. Because I let my fears overwhelm me by focusing on the whole of the task ahead of me, I was beaten by the cliff face.

There are times when it is tempting to give up trying to right wrongs and seek justice in this world. I am learning that even though I can't change the world, I can try and change the world for one person. I come across needs around me every day. I cannot meet them all on my own, but I am learning to help those immediately within my reach. I love the concept of 'pay it forward'.

As the boy walked through the carpet of dead and dying starfish he was making a pathway of hope across the shoreline. Perhaps, if more of us tried to make a difference to just one person in a small way: speaking up, educating the ignorant, supporting others who share our values and beliefs, then we will be making a start on changing the world. Don't be overcome by the mountain ahead of you, just focus on the one next step you need to take to move forward. Focus on what you can do immediately around you and you can save the starfish, one at a time.

(Credit to my friend Rachel, who keeps reminding me I don't need to take over the world, just save one starfish!)

Meet George - My Shaggy DBT Coach

During the past week I met some animals who helped me remember how to use 'opposite emotion', 'Distraction' and 'self soothe' skills. They also reminded me of the key principles of mindfulness: notice, describe, participate, non-judgemental, one mindful, in the present moment.

George, is the runt of his litter of ten pups, he is a true 'shaggy dog', but when I met him during a difficult week at home with the family he greeted me with unadulterated delight and affection. Somehow, he managed to help me feel accepted and validated. And yet he's considered to be a not very bright dog.

George doesn't care what anyone thinks of him. He launches himself with enthusiasm and overwhelming fondness, at all visitors to my uncle's farm and most people consider him a nuisance. I loved him at first sight. He was a bundle of unconditional acceptance and affection, just when I needed it most.

We became immediate friends and he followed me all over the farm yard, even pressing himself between me and the miniature horses as I petted them behind their gate. He helped me manage my emotions and reminded me of the importance of not missing out on the simple joys in the present moment, which I often miss when flooded by pain from the past or anxiety about the future. If I could have managed it, I would have smuggled him back home with me, so that he could join my own shaggy mindfulness coach, Smilla. I will remember the lessons he taught me and I will remember him with affection.






And his friends the miniature horses:

Return to the Forbidding Planet: Going back to the Invalidating Home

TRIGGER WARNING: Some discussion of childhood sexual, emotional and physical abuse

I am an adult child - my parents are elderly and infirm. As a family we face the same issues as all adult children with elderly parents, but for me I also face battles with caring for the people who created the environment which conspired with my biological disposition to create the Borderline Personality Disorder (BPD) I have struggled with all my life. To all intents and purposes I am a fully fledged adult with my own home and responsibilities. I no longer have to maintain relationships which damage me emotionally,

I am now in a position where I can choose where to invest my resources, both physical and emotional. Which begs the question, why go on holiday with the people who continue to invalidate my value as a human being? And in the response to that question lies the paradox at the heart of the relationship between the adult child and invalidating parents.

I have survived a week with my family. Before I started the week, I felt safe doing so, after all I had more than survived my childhood. I have learned to accept that the approval I have always sought from my parents will never be forthcoming. There is no point in me waiting for some miraculous change or realisation in them. After all, no amount of success or achievement in my life ever evoked any level of validation, or at least none that I could assimilate. Instead, the medals I won in my swimming competitions were dumped by me in one of my drawers at home. Even my winning the Ulster Championships and appearing on the back page of the newspaper failed to evoke any level of praise or approval that I could detect as a child. There was no showing them with pride to friends and family, no display cases full of our achievements as children. To all intents and purposes myself and my siblings were a separate entity from my parents, little people who lived under their roof, and who required 'firm discipline'.

Our emotional needs didn't enter into their reckoning of the parental 'contract', after all, we were fed, we were clothed and we had a roof over our heads. The only emotional contact I had with my Dad growing up was when he was angry. And when he was angry he was out of control. The level of physical abuse we suffered would result in our being subject to 'safeguarding procedures' today. However, my parents were good at sidestepping any outside scrutiny of our treatment - for me, it was all I knew. On one occasion, aged 6, I walked to school with a huge red hand mark visible on my bare leg. I thought I had done wrong when the teacher asked me to wait in the cloakroom. I waited until I was taken to the Headmaster's office to find my Mum waiting for me with a face like thunder. I don't remember the conversation with the Head, but I do know I was 'walked' home where I was beaten with the wooden spoon. I had no idea what I had done wrong, I hadn't said a word to my teacher, I didn't know that anything was amiss. As a family we have laughed since about the fact that Mum beat me so hard one time that she broke the wooden spoon on my legs. Then, she replaced it with a Tupperware spoon, which I attested was stronger - oh how we laughed about that one! No wonder that my BPD means that I am confused about appropriate emotional responses in numerous situations.

The conundrum for me as an adult is how I have managed to understand the complexities and deficits in my upbringing, but still I crave the approval of my parents. At times in the past week, my brother and I reverted to competing for our parents' attention. It hurt that no one asked about my recent health issues, or about the exciting opportunities offered to me in church to help use my experiences to help others. I was once again relegated to my familiar role of observer and silent child in the family.

In my first two years at school I was already so traumatised by my home life, that I was effectively mute around all adults including my parents. My friend spoke for me for the first year at school, until they removed me from the same class as him. I was traumatised and ended up lashing out at the teacher - I was the five year who kicked the teacher - hard, in the shins.... no Daily Mail shock headlines in those days, though, just ongoing punishment for the reported infringement at home.

When I finished my DBT therapy, my Therapist reminded me that I had begun the process of healing from the 3rd degree emotional burns, which are at the heart of the BPD experience of life. I have probably managed to develop a thin layer of emotional skin over deep, deep wounds. If I needed a reminder of that truth, then time back in the invalidating environment soon reminded me as my thin protective layer was ripped through once again. Little things, like talking over me, ignoring what I'm saying, ridiculing my weight, reminding me that I am indeed 'a nutter', 'weird', often pre-empted by me in an attempt to take the sting out of the teasing, took me right back to my childhood.

I was always the 'highly strung' one, the one who cried at the pain or suffering of small animals, who cried at the Little House on the Prairie. My family enjoyed laughing at me for my 'softness', but the truth was those occasions were the safe places to release my sorrow over the emotional pain I was struggling with at the time. All my life I've been told that I'm making mountains out of molehills, that I'm overreacting, that my emotional responses don't bear any relation to reality. Is it any wonder that, as an adult I have struggled to recognise what I'm feeling in any given situation, or that my reactions are out of proportion to the triggers, especially to the onlooker.

One of the biggest legacies of the invalidating environment is a lack of confidence in my own reading of situations. Aged 10 I told my Mum that my music teacher had been touching me in places on my body which made me feel uncomfortable. Her response was to tell me that this was a 'sign' that I was growing up and that I should expect men to be interested in me in this way as I 'developed'. My problem was I was an 'early starter' I had my first bra and period by the age of 11 (before I left Primary School). My Mum's response to my first attempt to speak up about something that felt so wrong (it wasn't my first experience of sexual abuse) convinced me that my feelings about what he was doing were mistaken. She told me that I was 'growing up' and that I should expect men to become interested in me in that way. She hinted that it was flattering. This caused me to doubt my own misgivings and feelings of discomfort about sexually abusive behaviour.

My Mum's response laid the foundations for me to ignore my misgivings and led to me suffering more serious sexual assaults and violations from that age, right into my adulthood. After all, I had told an adult about something that felt really wrong only to be told that, I needed to 'grow up' and accept it as something that just happens and is some kind of rite of passage. Why would I, as an adult, trust my own feelings of distress and pain when I had been so wrong in the past? Such is the ongoing conflict for me between what I know as an adult and survivor and what I 'feel' I deserve in terms of justice. I have moved on, I have learned to begin to protect myself and to fight back.

May I make a plea on behalf of any of your friends or family who suffer from the effects of BPD? Please never tell them that they are 'overreacting', or that they need to 'just let the past go'. If it was that easy for me to manage the overwhelming emotional responses I am swamped with at times, then I wouldn't have needed 18 months of intensive therapy. I wouldn't have had to learn to manage them and to learn to live in the present moment, without letting the pain of the past or the anxiety about the future drown me in waves of distress. Imagine if you will that you have a severe burn. How long before such a wound stops being sensitive? My own experience of minor burns tells me that even when new layers of skin have grown, sensitivity to pain remains a long time. 3rd degree burns, will always remain sensitive. So it is with me. I am learning to allow myself to heal, to let new layers of emotional skin grow. My new life is one which is helping me to heal. However, the reality is that a return to the invalidating environments and their complex relationships, rips through new growth and healing.

Therapy means that I am equipped to manage my distress better, it does not mean that I stop feeling things deeply. During my time with my family I used a variety of different DBT skills:

- Distraction - my ipod equipped with positive playlists and some Loving Kindness meditations. I played with animals. I kept to my room when I needed to restore my emotional energy.
- I prayed
- Self Validation - I texted supportive friends, I listened to positive Mindfulness exercises
- Opposite Emotion/Opposite Action - Instead of getting embroiled in family rows. I focused on my environment, read an absorbing book, or watched other people in the hotel. I didn't explode, which is easier to do in my family environment than in other settings.
- Mindful Breathing - I constantly refocused on my breathing and posture when starting to feel distressed.

Above all, I returned home to my world, where I am in control of my environment. I am able to manage my time and space. I am able to choose the relationships that are positive and validating for me. The realities of family life, dictate that as I have chosen not to confront my parents with the impact of their behaviour during my childhood, I then have a duty to relate to them as an adult child. I choose to treat them according to my values and beliefs, not according to how they dealt with me. That means I will continue to face times when I need to return to the invalidating planet of home. More and more they are becoming dependent on me and my siblings. My own sense of compassion and humanity tells me that it matters that I care for their needs, as I am able. I have learned in the last week that I can survive that. I have learned that I don't have to remain hurt and locked away because of those experiences. I have learned that I am able to manage my BPD and allow my wounds to heal. One brilliant realisation is that my resilience against my family has developed - I am able to recover from my visits home quicker.

Dealing with Panic and His Friend, Anxiety

Anxiety comes over me like a cloud of indefinable darkness and confusion. My heart starts beating faster, my stomach goes into overdrive (like a washing machine) and my abdominal muscles go into spasm. Two years ago these spasms had gone on for over five days, which resulted in my suffering from vomiting reflex once or twice every hour. Eventually, I was exhausted and in total despair and so was forced to go to A&E. Anyone who has never suffered the effects of truly debilitating panic or depression may wonder at the impact on the body, but do not tell me that there is no link between my physical and mental well being.

Since beginning Dialectical Behaviour Therapy I have learned to focus on the signs from my body, including my breathing patterns, so that I recognise anxiety before it can develop into full blown panic attacks. Essentially, when under stress, I actually stop breathing for short periods of time. It doesn't take a genius to work out that if you stop breathing your body will get the signal that something is very wrong and that it is time to ignite the 'fight or flight' response. In other words, I was signalling my body to release as much adrenaline as possible - guess what? Heart rate rises and blood rushes away from where it's needed to where the body 'thinks' it's needed. The same goes for shallow, rapid breathing. Does that make sense? It did to me when my therapist pointed it out to me. So, the very first thing I do is acknowledge that my body is in panic mode which indicates that I am anxious about something.

Mindful Breathing

1. Notice your breathing, what it is doing and focus on returning it to a more measured level.
2. Just focus on the in...and...out, no need for deep breathing, just breathe normally and naturally.
3. Observe, the effect on your nose, in your lungs.
4. Watch the rise and fall of your ribcage and stomach.
5. Don't let worry thoughts distract you from this task.
6. Just focus.

But what about the trigger to the panic? First of all it helps to be able to name the emotion. Sometimes anxiety causes our thinking to become muddled as the reality is that the things we worry about don't come in one by one so we can manage them easily. Instead, they gang up on us and crowd in, bullying and badgering us for not finding immediate solutions. Having acknowledged that I am anxious, I focus on my breathing to relax my body, so I am not entering an inexorable physical and emotional spiral as I did previously. There are a number of mindful exercises that I have learned.

Thought Diffusion

The first and easiest one for me to manage is to attach my worries in my mind to the leaves of a tree and allow the leaves to drop gently towards a flowing river, which carries them away one by one. This exercise takes practice and a basic knowledge of mindful breathing, but is effective in everyday situations.

Guided Imagery (The White House)

Another one I use is called 'The White House'. (Here is the link: http://www.themindfulword.org/2012/guided-imagery-scripts-children-anxiety-stress/) This is a guided imagery exercise for children, but is so effective for anyone. I have found it very useful when I am overwhelmed by the size or number of my problems and worries. The most important thing about this exercise is that you cannot move into the part where you can relax until you have set down the large 'rucksack' of worries at the bottom of the stairs to the big White House. (obviously if you haven't read the instructions yet this won't make much sense, so please take a moment to have a look).

Problem Solving Questionnaire

I have recently found myself working through the 'Yes', 'No' questions of problem solving:

1. Are you worried about a specific Problem? If No, then don't worry. (Accept)

2. If Yes, is it a problem that can be solved? If No, then don't worry. (Accept)

3. If Yes, do you know the solution? If Yes, then don't worry. (Change)

4. If No, then don't worry because there is nothing you can do by worrying. (Accept)

Acceptance and Change
This process reveals two of the principle skills of DBT, in fact they are foundational: Acceptance and Change. The serenity prayer is so called because it holds these two truths in balance and releases us from wasting our energy on those things that are outside our control. My Anxiety can be controlled by using these skills, and by realising that if I can change the circumstances of my problems, then I don't need to worry. Also if I cannot change them but can learn to accept them as beyond my control, then there is no point in my worrying and I am losing out on the here and now.

Not one of these ways of managing my anxiety is either natural to me, or easy. As long as I have had panic attacks and suffered from anxiety I have defaulted to spirals which mean that the anxiety has controlled me. I therefore need to put in as much effort and time to developing the habit of preventing anxiety from (literally) taking me over and making it impossible for me to function to any effective degree.

Maybe you've tried some ideas like these and they've not worked immediately - stick with it. I know there are times when I still slip back, but never again has my whole body gone into spasm from an emotional response.

Again, I would say the key to me making use of these skills is, practise, practise, practise. I cannot change as and when the panic will rise, but I can change my responses to it and its little friend, anxiety.

Learning to Manage the Calm

I have found myself in a strange place recently. More often than not, my life has taken on the tone of routine, almost humdrum and certainly lacking in anything approaching crisis mode. Suddenly the corkscrew roller-coaster that has been my emotional life since childhood has untwisted. I no longer start my day with a spasm of gagging and/or vomiting due to overwhelming feelings of panic and anxiety. The dramatic swing of moods from one hour to the next has slowed down and I find myself better able to recognise and manage both the up and the downswing of moods to which I was once a martyr.

So far, so good. Over two years of DBT skill building and therapy have brought me to a point where I am no longer confused by the overwhelming clouds of emotion that used to swamp and overwhelm me. I find myself better able to reflect on difficult emotions, I no longer run from them, but accept them as evidence of my humanity in the face of significant trauma throughout my life. I still have moments, usually when I have tired of my new structured life. I have caught myself being tempted to familiar path of self destruction, perhaps in a different way than in the past, but nonetheless, I have found myself short circuiting good things in my life.

I know that now, rather than being plagued by capricious emotional storms completely outside of my control, I can learn to recognise the signs earlier. The storms still come, but I am better equipped to survive them.

Except, that I sometimes petulantly, deliberately choose to ignore my emotion regulation skills. In my last 1:1 DBT therapy session the admission that I am regularly staying up through the night, brought an almost exasperated response from my therapist - I mean she's right, just 'what am I playing at?' It's bothered me as I reaped the whirlwind this week and found myself tossed about on the kind of emotional storm I haven't really experienced for at least a good few months. I've realised I haven't been practising my skills when things are good, so that they are second nature when I really need them. I didn't need to go through the exhausting emotional maelstrom and the exhausted aftermath, (still feeling it three days later). Or at any rate, I could have used my new skills to limit the damage from my negative emotions quicker.

Instead, I revisited some familiar old feelings and reassured myself that I could indeed consider myself a total failure, as my internal monologue has convinced me of since my childhood. So, what does this tell me? It tells me that we are indeed products of our past. It tells me that when we have had the mirror of our minds distorted by our childhoods of invalidation then it is all but impossible to recognise a fair reflection of ourselves in it. It tells me that I am not finished healing and recovering from my BPD symptoms. Just because the untwisted mirror image of my 'good life' seems shocking to my invalidated mind, does not mean that I cannot become accustomed to it.


There is something else that this has taught me about certain emotions. Having spent so long learning to manage and 'sit with' negative emotions, I am having to learn to use the same skills to manage positive emotions. One of the reasons for my disturbed sleep has been a propensity to allow the lightness of emotion lead to 'hyper' behaviour, the energetic surges from feeling 'happy' have resulted in really productive moments, but I have not controlled these moments and channelled them, but allowed myself to be carried away into the wee small hours of the morning.

As a result it's back to the basics of distress tolerance and emotion regulation for me. Looking after myself and my lifestyle in order to provide a stable foundation to keep going on a day to day basis. In a sense I am fighting the same enemy, but at a different end of the spectrum. Positive emotions are equally difficult for me to manage, mainly because I find them uncomfortable as they are a dissonant voice challenging my self critical inner monologues. As much as I need to use my Mindfulness skills to 'sit with' my grief and sadness, I need them to 'sit with' and become comfortable with feeling good about myself and what I can achieve in life.

In a sense I am fighting a battle that is familiar to me. I am using my skills to keep me and my emotions in the here and now. Where my negative emotions tethered me to the past, my positive emotions risk catapulting me into anxiety and the future. So, when I started to feel nauseous and was throwing up at the end of last week, I maybe could have been more aware that all was not well.

What is most encouraging for me is that I am no longer unable to articulate an amorphous emotional cloud, but I am naming the emotions and how they are affecting me at the moment. I know what I have to do to regain my equilibrium, it will take more time and effort on my part. I have the skills I need I just need to use them. I don't need to beat myself up for this latest storm. As Scarlett O'Hara memorably said 'After all, tomorrow is another day.'