Distraction Techniques

In my last post I talked about distraction, the first part of distress tolerance skills. I’m sure most of you have no problem coming up with distraction techniques, but just in caaaase I’m going to post a list of ideas.

  • Watch cat videos on youtube. Or dog videos. Any animal videos are great.
  • Color, paint, or draw. I got a pack of decent watercolors for $5 at Walmart. Crayons and colored pencils are even less.
  • Play a video/computer/tablet/phone game. I have a Wii, but even if you don’t have a video game console there are so many free games for devices. My favorite is The Simpsons Tapped Out. It has a story line, but there are plenty of basic games like solitaire and Tetris and Candy Crush.
  • Read a book or magazine or something online.
  • Watch a show or movie that you find comforting, inspiring, or hilarious.
  • Do something that requires a little bit of thought or concentration like a jigsaw or crossword puzzle. Put something together or organize a bookshelf.
  • Exercise. I don’t enjoy  exercising for distress tolerance because I hate exercising, but some people find this very helpful.
  • Replace destructive behaviors with different behaviors. Draw on your body instead of cutting. Punch a pillow instead of taking your anger out on someone else. Tear up paper. Write the name of the person you’re mad at on a balloon then stomp on it.
  • Cuddle your pets/kids/a loved one.
  • Spend time outside, even if it’s just 5-10 minutes.
  • Text or call a friend.
  • Eat one of your favorite foods.
  • Take a shower or nap.

Those are some examples of enjoyable activities to distract yourself with. You can also distract yourself by paying attention to other people. For some people it helps to focus on someone else. Sometimes it helps me to text someone else and ask how they’re doing. Other times I might write people letters or make something for someone I love (like a collage or some other craft).

If you have a good imagination or find it easy to get lost in your thoughts, you can distract yourself by thinking about other things. This one is difficult for me, but some people find it helpful. Here are some examples.

  • Imagine meeting your hero and getting to hang out with them for a day. Imagine that they are totally psyched to spend time with you, and think about what you’d do that day.
  • Pick a room in your living space and imagine navigating it if you were only 3 inches tall.
  • Envision your dream world. Sometimes when I am anxious or can’t sleep, I imagine a place in the woods where fairies live. I think about the creatures that would live there, and all the trees, plants, and dwelling places that would be around.
  • Picture the world being made of food and decide what each item would be made of. I feel like horses’ tails would be spaghetti.
  • Pick the 5 people you’d want with you if you were in a post-apocalyptic situation. It can be people you know in real life, famous people, fictional characters. Then pick 12 items you’d want to have with you.

I mentioned this in the last post, but other ways of distracting yourself are to leave the situation that is upsetting you (if leaving is possible), counting (things around you, like floor tiles or counting by 7’s to yourself or listing prime numbers), and concentrating on your breathing.

I hope this was maybe a tiny bit helpful. In the future when I come across great distraction techniques, I will post them and tag the post “distraction techniques” and “distress tolerance.”

Distress Tolerance Pt 1–Distraction

Yesterday someone with BPD asked me what distress tolerance is, so I decided to write a post about it. I assumed everyone with borderline personality disorder knew what distress tolerance knew what distress tolerance is. That was kind of a ridiculous assumption on my part, since a lot of people don’t have access to therapy and other resources that would provide them with info on distress tolerance.

There is sooo much to say about distress tolerance, so I’m breaking it up a little into multiple posts. This post will be about distraction techniques.

First a little bit about distress tolerance skills. They are basically anything that helps a person get through physical or emotional pain. However, in DBT (dialectical behavior therapy) it gets a little more specific. People with borderline personality disorder often experience overwhelming emotions. A lot of the time when people are dealing with overwhelming emotions they use self-destructive coping skills like self-injury, drugs, alcohol, overeating, taking things out on other people, etc. DBT teaches people to use distress tolerance skills to deal with intense emotions in ways that are not destructive and therefore will not increase suffering.

Distraction is the first part of distress tolerance. Distraction is great because it gets you to think about something besides the pain, and it gives you some time to think of another coping skill.

My favorite form of distraction is to engage in pleasurable activities. That just means doing anything you enjoy. It’s helped me to make a list of things and put it on the wall above my desk so that when I’m extremely upset, I don’t even have to think of something. I can just go to the list.

Some other ways of distracting yourself are to exercise, do housework or chores, pay attention to someone else, thinking about happier things, or focusing on your breathing. Sometimes when I feel bad it really does make me feel better to listen to someone else talk. Other times it makes me feel worse. Some people can distract themselves by focusing on breathing evenly and counting their breaths.

You might immediately know what is going to work for you or it might take some trial and error to figure out what will be helpful to you. I will post a list of suggestions in the very near future.

Shame

I’ve been in a partial hospitalization program during the day for the past 2 weeks. Most of the day is spent in group therapy. Today is one of the groups we talked about shame. The therapist said that research suggests that shame makes things like depression, alcoholism, addiction, eating disorders, etc. worse.

Then we were instructed to pick something that is a source of shame for us and write a little bit about it in our notebooks–how it makes us feel, where we think the shame comes from, behaviors related to the issue that causes us shame, etc.

After that we picked a compassionate figure (a person in our life, a famous person, an imaginary entity, a ball of light, whatever) and write a letter from them to us. The letter was supposed to offer encouragement, love, acceptance, and compassion in regards to the source of shame we’d picked.

I chose my shame around being fat and hating my body. I didn’t think it would be difficult since I spend a huge percentage of my waking hours thinking about how fat and ugly I am. However, I got extremely agitated by the first part of the exercise. Just writing about my shame around being overweight and ugly made me angry, sad, humiliated, and ashamed, of course. I had to leave the room and pace in the hallway for a little bit.

When it was time to write the letter, I couldn’t imagine a human being saying compassionate words to me on this topic. People are so weird and uncomfortable with fat. They either tell me I’m not (when I know I am) or act like it’s a horrible thing about me that I can change and that they are willing to look past because they are so amazing and kind. So I just thought about one of my cats and how he loves me no matter what. What I look like is of no consequence to him. I imagined him lying snuggled up to me and radiating love. That calmed me down a little.

Next the therapist asked people to share. I was already kind of irritated because there are two people in the group who derail the discussion in every single group. And they were doing it again this time. Also, since I’ve been tapering the lexapro all my emotions seem a lot closer to the surface and I’ve been getting pissed about things I normally don’t.

When the therapist asked me to share it caught me off guard because it didn’t seem to follow the flow of the discussion. When I said that I’d been unable to imagine a person saying compassionate words to me on the subject, she asked me what I would say to someone I love if they were in my position. I might share my response in another post. Next she asked what emotions I was feeling and I said, “Embarrassed and mad.” She asked what was there if I tried to peel back the anger. I realized that I was sad and hurt because there was no one in my life who would say those compassionate words to me. I was also irritated because I wanted to cut myself and couldn’t. I was getting teary and choked up at this point. She asked what I could do instead of cutting and where I could find my strength. I started crying harder and said I didn’t know and didn’t want to talk about cutting. She said I didn’t have to. I covered my face and was curled up in the chair and had my hands squeezed into fists. She asked what the emotion was then and pointed out that I was making myself very small. I said that I was mad that people were in the room and that I didn’t want anyone to look at me. She asked how old I felt right then. I thought about it and pretty quickly realized I felt 7. I told her that and she asked what I wanted to hide from when I was seven. I said, “I don’t know and I don’t want to talk anymore.” Then she said I didn’t have to but that I might want to explore that with my individual therapist.

I cried for the rest of group. I used my hair as a curtain around my face and wrapped my arms around my head. I wanted to leave the room so badly but I didn’t want anyone to look at me. It was so painful–the whole thing.

When the group was over and people left the room to take a break I went to the bathroom and cut my arm. That kind of helped.

So I feel like I realized/figured out some stuff during the group and maybe let out some pain. But I don’t know what I am supposed to do with that information. It doesn’t fix my body image issues or my shame. It doesn’t provide me with compassion from others. It just brought all this hurt to the surface. Now what?

Whatever It Takes

I’m starting a partial hospitalization program tomorrow. I was in the same program a little over 6 months ago. It was helpful then and I’m sure it will be helpful again.

I will be there from 830 am to about 4 pm each day. I’ll be assigned to a social worker and see a psychiatrist. Most of the day will be spent in group therapy.

I think it will be great to go back there. But I feel like I don’t have the energy/motivation to drag myself out of bed in the morning and drive there. So weird how my thoughts and feelings don’t match. But that’s like 90% of my problem, right?

Last time I didn’t have a great attitude when I started. I was scared and miserable and my only experience with group therapy had been negative. My boyfriend and closest friend were both out of town so I was kind of without support. But after a few days, I was fully invested. I felt safe with the other people there and was ready to work hard on getting better. I was not ready to be done when I was discharged. It felt like I belonged there, like that was where I needed to be–in a place where the only focus was getting better for 7 straight hours.

I hope that this time will be even more effective since I will be going in with a more receptive attitude. I also have a therapist already so I’ll have follow-up appointments. Plus I think I definitely need a med change and I really liked the psychiatrist on staff last time I was there.

I know that my life over the past year, especially the past 6 months, has shown me that I have to make my mental health my top priority. That might mean scaling down to part-time at work after that partial hospitalization program. It might mean putting off applying to grad school. But I can’t keep going the way I have been lately. I can’t put a band-aid on my illness until I’m okay enough to go back to work only to fall apart again in a month or two.

I want to get better so badly. I’ll do whatever I have to.

Horrible Week

I’ve been having a really awful time lately. The past 6 months in general have been very hard, but I’ve declined rather rapidly over the past four weeks or so. This week I have had a lot of suicidal thoughts and urges. I’ve gotten closer to seriously hurting myself than ever before, I think. I have been cutting myself frequently. I’ve been crying a lot and not eating, which is unusual because usually I’m an emotional eater. I haven’t been able to go to work. That’s a baaaad sign because I love my job and am out of paid time off so I’m not able to miss unless it’s a crisis.

I almost went to the emergency room Tuesday morning. Monday night I’d fallen asleep fighting suicidal urges and dreamed about hurting myself. Tuesday I woke up with my heart pounding, feeling completely out of control. I couldn’t grasp on to the feeling that my suicide would hurt anyone else, that I had reasons to live, that there might be something good in the future. I was terrified. I had a razor blade next to the bed, and I cut my arm and leg several times. That helped ground me a tiny bit and I got up and went to find my boyfriend. I stood in the doorway of his home office, shaking and dripping blood on the tile and said, “I think I need to go to the hospital.”

He cleaned my cuts and told me repeatedly that it would be okay. Then he asked if I would rather go to the hospital or take a xanax and have him stay with me every second. I chose the second option, and he called out of work to take care of me.

He suggested the xanax and staying home thing because of a conversation we’d had the night before. I’d told him that I wanted to avoid the emergency room at all costs. There are several reasons for this.

One, even with insurance the emergency room is quite expensive in the United States. Two, the process of going to the emergency room for suicidal thoughts/urges is a miserable one. I’m not sure if it’s like this everywhere, but at the two hospitals I’ve been to it’s consisted of hours of waiting in a room alone. They take away any possessions you have with you, so you can’t read, use your phone, etc. No one was allowed to accompany me, even the person who brought me, and no one could visit. They asked if I wanted something to help me relax and brought it to me twelve hours later when I was being discharged. It’s not a comforting process. It keeps a person safe if they are absolutely out of control and it’s necessary sometimes. But it’s never made me feel better.

Three, if I am going to receive inpatient or intensive outpatient treatment, I know where I want to go. I’ve been there before and the insurance coverage is excellent. They can do assessments by appointment without a person going through the emergency room. So I knew if I could keep it together a little longer I could avoid the emergency room nonsense.

Also when I’m doing badly I want to be with my cats and my transitional objects and my stuff. I want to avoid inpatient hospitalization as long as possible. I don’t necessarily condone that behavior in other people because hospitalization might be completely called for. But its the choice I made for myself.

Tomorrow I have an assessment at the hospital I’ve been to before. I’d prefer to do the partial hospitalization program again but am preparing myself for the possibility of inpatient. I have been inpatient at a state hospital three times and it was so horrible each time that I’m afraid of ever experiencing inpatient again even though I know this place would be much better.