An Image for Emotion Regulation and Mindful Breathing

Here is another picture that I use when dealing with difficult emotions like anger, or anxiety.

I use the picture to focus while bringing my breathing under control. I imagine myself in a small boat on the river. I allow it to carry me forward carried along on the river, as I lie in the bottom of the boat watching the sky above with its clouds and beautiful sunset. As I am carried forward on the water I change my focus from my breathing in and out to notice negative thoughts and feelings as they arise, I then change my focus to the clouds floating by above, returning to focus on my breath until it has slowed and become regular. As I notice the thoughts and feelings, I notice as they float up from the boat to the clouds above. I give them the form of words, often with characteristic size, shape and colour, so Anger cna be spiky, red, and large when I first notice it. I then watch the negative feelings grow smaller as they drift upwards away from me towards the clouds until they dissolve completely. As each thought or feeling arises and floats away I watch, then return my focus to my breathing, until I feel completely calm.

It works for me because it helps me to balance control of my breaths along with identifying and controlling the emotions as they arise. Managing to identify and manage the emotion until it grows less intense takes time and practice. Concentrating on slowing down your breathing is a good first step.

My DBT 'Let that Emotion Out' Playlist

Sometimes I don't want my self soothe to be an opposite emotion - sometimes I'm right to feel angry or frustrated - it is after all only a human response to some things in life. Not all these songs are obvious choices, but for me, sometimes the real power is in the lyrics and the expression of thoughts, particularly about injustices in life. Some you will naturally already guess at, just cos they let you bounce around the room and shout your feelings out - safely!

1. It's my Life - Talk Talk (beautiful expression of becoming an individual - No Doubt also did a brilliant cover).
2. Caught out There - Kelis (!)
3. My Life - Billy Joel
4. The Frog Princess - The Divine Comedy (best ever break up revenge song so clever and funny! - don't miss the guillotine)
5. I know where I've been - Hairspray soundtrack (This is righteous anger well articulated - great build up to crescendo)
6. Just a Girl - No Doubt
7. Not Ready to Make Nice - Dixie Chicks (for when you encounter assumptions and prejudices!)
8. Gives you Hell - All American Rejects (Just angry)
9. He had it coming - Chicago soundtrack
10.Road Rage - Catatonia

I guess this falls into Emotion Regulation rather than Distress Tolerance as it is a way of accepting emotions such as anger, but equally being able to express it safely is part of managing distress. Listen and move to the music until the crest of the wave of emotion has died down - it should be easier to manage and 'sit with' afterwards. HINT: Don't focus on the cause of your anger as you listen, try to focus on letting the song express your anger or frustration and let it go at the end.

Why do you have to be so mean?

This week I have come across what can only described as 'hatred' for people with Borderline Personality Disorder. It shocked me. Don't get me wrong, years ago, before I was diagnosed with BPD, I used to work in the Criminal Justice System, and my specialism was Mentally Disordered Offenders, the majority of whom were diagnosed with some form of Personality Disorder.So, I was aware of negative attitudes to people with Mental Illnesses, and in particular, those with diagnoses of PD.

My colleagues used to groan if case notes included the dreaded BPD diagnosis. 1) because people with BPD are 'difficult' 2) because at the time, BPD was considered 'untreatable' by local NHS Trusts and refused to admit even suicidal cases 3) because there was a high likelihood of suicide/self harm from this 'group'. In short I believe BPD sufferers as a group have received and continue to receive a bad press from a number of sources.

I found that being consistent and listening closely to what was being said to me, often helped me to manage my cases, in other words: compassionately treating people, regardless of labels, as if they were human beings seemed to work. (not rocket science is it?)

Anyway, back to the guy who has obviously had a bad relationship with someone with BPD. His take was that BPD doesn't deserve to be treated as a mental illness, but is just down us being some kind of 'crazy ass' (his words). He even managed to intimate that the abusive backgrounds of a large number of people with BPD was actually the fault of the victims. Initially I felt defensive of myself and others who have suffered from what some describe as 'emotional sensitivity' rather than BPD. Then I considered that perhaps, following a messy break up (I've been involved in my fair share of those!) his anger was robbing him of his humanity. Which is understandable.

How do I respond to his point that I'm just an emotional mess? That I do not deserve treatment? Well, I think that I would point him to Marsha Linehan's (the creator of Dialectical Behaviour Therapy for BPD) explanation of BPD as equivalent to suffering 3rd degree burns.

Imagine suffering emotional and psychological pain that is so deep and so painful that the only solution you can think of is either to inflict physical pain to distract from it, or to believe that dying is the only way to stop it? Does that sound like something that you could sustain while maintaining a functional life? Yet many sufferers of BPD do manage to do just that, while holding down very respectable jobs and being creative and dynamic in certain spheres. This 'apparent competence' in certain spheres, my BPD-hating 'friend' points out as proof that BPD is made up by selfish women seeking to justify messy love lives and as an excuse to be nasty to men.

I think at this point we can recognise the ignorance and stigma evidenced here towards Mental illness in general. I mean you can't possibly run a country with a severely debilitating clinical depression, can you? Winston Churchill, anyone? Just because my professionalism and training allow me to carry out a job from 9-5 does not mean that the emotional distress I am experiencing is not real and does not have an impact on my mental and physical health.

If I may, I need to return to the burns analogy, even when time allows a skin to grow over the burned area, there remains a sensitivity that often never leaves. The levels of abuse I suffered as a child have left me with emotional and psychological scars. My diagnosis whilst not perfect, has allowed me to access help to develop skills which mean that I no longer consider death to be a solution. My treatment means that I am able to begin to 'function' again, after a complete breakdown two years ago.

I am responsible for the people I may have hurt throughout my life. I would say, though, if you rip the dressing off a burns victim, you can expect a strong reaction! My plea is: try to listen, try to understand, try to give space, and, if you think you are too angry or too hurt to see the human behind the label, make it a clean break.

http://bpdlifeinthemoment.blogspot.co.uk/