When it comes to BPD there are so many symptoms and issues to work on that it can be hard to know where to start or where to focus your energy. Besides the main areas of DBT (emotion regulation, mindfulness, interpersonal effectiveness, and distress tolerance) there’s my intense self-loathing and self-esteem issues, sleep problems, sensory issues, chronic pain, dealing with the consequences of my symptoms/poor choices, and just life skills/existence. I know that a lot of those things will improve by working on the DBT stuff, but sometimes things need to be addressed separately.
I’ve been so stagnant lately that I decided to go down to the very basics, make some progress there, and work my way forward. It took a long time, a lot of spinning my wheels in the mud, and a lot of failing at my goals for me to realize I need to lower my expectations.
I don’t know if other people are like this, but often things don’t click for me until I come around to them on my own. I can see something in articles or books or have it suggested to me by others and it just doesn’t resonate with me, but after I’ve gone through my own little experiences or thought process it will suddenly make sense. It’s not that things have to be my own idea or only on my own terms; I just have to see them in a light that works for me.
Visual goal trackers are one of those things. They aren’t a new concept by any means, and I’ve definitely seen them before in articles about productivity, getting things done, etc. I’ve halfheartedly scribbled some out in notebooks before but never kept up with one. A few weeks ago at work I was helping one of the kids use her snack board to choose a snack and it occurred to me that a visual aid would probably be helpful for me. I stare at the things on my walls a lot when I am daydreaming and I do find crossing things off a to-do list to be satisfying. So I picked very basic goals to track and made this.
The picture on the left is from Allie Brosh’s blog hyperboleandahalf. I tried to find a source for the unicorn picture and couldn’t find a definitive one.
I laminated this so I can write on it with a dry erase marker and use it repeatedly. The goals are pretty self-explanatory and are centered around building routines. I think that building routines is one of the most important and fundamental things I can do to facilitate my progress. I think my inability to keep a routine and make things like taking meds and exercising a habit is part of why I am not making progress in most areas.
After a few weeks, I still wasn’t making any progress. I would do okay on some of the goals for some days but miss others. My performance was really spotty across the board. I got very discouraged and hopeless about the whole thing. It seemed pointless because it wasn’t working and I was really disgusted with myself. I kept thinking, “There’s no point in trying anymore. I always get excited and say I’m going to do shit, then I fail. It’s the same thing every time. I’m a lazy, stupid loser.” Blah blah.
Then I started thinking about it from a behaviorism perspective. When a person goes to do something, the benefit of the action has to outweigh the cost. Satisfying your hunger is worth the effort of cooking (or buying or otherwise procuring) food. Not being cold is worth the effort of putting on clothes or pulling the blanket over yourself or turning on the heat. Even stuff we really don’t want to do, like going to a social event we are dreading and will get no pleasure from, is somehow worth it (avoiding guilt, preserving a friendship, etc).
At work we are constantly thinking about whether our reinforcement is strong enough for whatever we are asking the kids to do. Is macaroni and cheese worth the effort of trying to use a utensil? Is the Mickey Mouse puzzle fun enough for the kid to be okay with sitting at the table to have it? Are bubbles worth imitating a b sound? If not, it’s our job to ramp up the reward and make it worth it for the kids to try. If we can’t do that, we need to decrease what we are asking for.
So I decided to do that for myself. I decided to decrease demands first. I thought about which goals were most important to me. I picked meds (obviously), exercise, no money at convenience stores, and oral hygiene. I chose oral hygiene because I have gingivitis right now, thanks to not flossing. This is embarrassing for me to admit, but I think it’s important to talk about the embarrassing things, especially because it directly relates to my mental illness. It’s hard to floss when everything seems pointless, when I can’t picture being alive in 5 years. When waking up and getting to work on time is a fight every morning the 3 minutes it takes to floss seems like a lifetime. But it’s affecting my self-esteem and since oral health can affect your heart health, I need to fix it. I set my exercise time for 10 minutes a day; my concern right now is building the habit.
My reinforcement/reward is that when I hit all of the goals for a week straight I will get $5 toward whatever. In addition to using my goal tracker I’m working on a sort of collage of pictures of things I want to save for, mouths with really nice teeth (my teeth will never be perfectly straight and white, but the pictures will remind me of healthy mouths), and people exercising. It feels kind of corny, but I’m trying it anyway.
I’ll see how this goes. I hope I’ve reached the point where I’m tired enough of stagnation that I will be more motivated to try, or that I will do it even if I don’t feel motivated.