Trick and Treat

Today I am taking a slightly different twist on Halloween.  Instead of “Trick or Treat”, I am saying “Trick and Treat” because, with the dialectical, I can have two opposite emotions at the same time (Dialectical).  One does not negate or preclude the other.  Please feel free to borrow the saying for next year.

Today has been both.  I am going to be brutally honest.  The tricky part of the day involved the tricks that I allow anorexia to play on my mind.  My body image has been skewed for about 8 months now.  I am not allowing myself guilty pleasures including potato chips, candy, massages and daydreams.  I know that in moderation, any of these are fine and I do believe it sometimes (Wise Mind). 

The other trick is self-doubt.  I was certain about my decision not to get back together with my ex-fiance and I am uncertain that I can stick with my original decision.  I am gullible (Non-Judgmental Stance)am vulnerable when my defenses are down such as when I am tired, when I don’t give my body nourishment, and when I am faced with strong emotions including laughter and anger.

I was really tired, twice today, and I refused to take a nap (PLEASE-Sleep).  In other words, I did not allow myself a treat.  Actually, for me, the narcolepsy makes napping a requirement instead of a treat.  I had a hard time using skills today and I can have a better day beginning now (Turning the Mind).

The treat was that my relationship with my Dad seems to be improving.  We hugged.  I scratched his back.  And he has mine (Relationship Effectiveness).  I also treated myself last night with Belleruth Naparstek’s Guided Imagery for Fibromyalgia (IMPROVE- Imagery). 

I remembered to pray and express my thanks that the pain in my neck and head eventually abated.  I am grateful it was not worse, like last year.  I also asked for help from Mom & God to decrease my anxiety (IMPROVE- Prayer).  They reminded me to use Describe.  I’ve been spending too much time in my own head, so when I realized I was doing this, I stopped.  Instead I focused on one thing at a time (One Mindfully) and described the objects in my room out loud (Describe).  This really works for me and is a wonderful thought stopper. I also focused on the physical sensations of my body, where it was and how I felt (Awareness).

I was cognizant of my language.  I don’t usually curse, but this is not what I mean.  Instead I was conscious of avoiding terms like “Always”, “Never”, “All”, or “None” (Relationship Thinking).  I think I succeeded.

With that, I will proceed to wind down for the night. And once again, “Happy Halloween – Trick and Treat”.

Skills Testing: High Difficulty Level

It was difficult using skills today.  I started off with a high degree of pain from both the fibromyalgia and the stress.  I had a moderately bad headache from the many knots in my neck and upper back.  I did manage to remember to breathe (Breathe) in 2 out 6.  It immediately helped calm my adult version of a temper tantrum.  Dad helped too.  His encouragement and listening made a big difference.  Coffee helped my headache as well.

I am proud to say that I recognized that today would be draining so I made sure to provide fuel to my body and mind in terms of food (PLEASE – Eat). 

Today, I went to visit my maternal grandmother.  I love her very much and she reminds me of how much I miss my mother, her daughter.  Halloween is especially difficult as Grandma, Pop-Pop, Mom, my twin sister and I always went trick-or-treating together.  It’s one of the memories that I’ll most likely have for a lifetime.  Pop-Pop’s gone too.  He passed away six months after my mother.

Luckily, my therapist was able to return my call and help me cope with my latest challenge (IMPROVE-Encouragement). Thanks so much, Dr. H.   I repeated three things that she told me as best as I remember.

1.                Today is a different day

read: the past doesn’t have to be repeated and be totally in the present moment (One-in-the-Moment)

2.                I don’t have to go down that path

read: I don’t have to make decisions before I even face them, and I can prevent a self-fulfilling prophecy

3.                Stay out of my own head

read: I can get lost in my own thoughts and stay fully focused of what I am doing exactly that minute (Awareness) and do something that distracts me (Distraction)

4.                I don’t have to stay if I don’t want to

read:  I can leave at anytime and go for a walk

             

By doing all the above, I was able to fully focus on Grandma while taking care of myself (Effectiveness & Participate). I was able to pray and ask my Mom and God for help (IMPROVE – Prayer). 

I also gave myself permission to leave when I wanted without guilt.  This was a first.  And Grandma does always try to lay guilt on, not to hurt me but to protect herself. 

I also incorporated a little self-soothe (Self Soothe the Five Senses) by using white tea therapy body lotion on Grandma’s hands while doing her nails (Build positive experiences).

I usually experience narcoleptic symptoms after visiting Grandma because narcolepsy is triggered by strong emotions and I love and worry about Grandma very, very much.  So, I am writing now (Describe) and promise that I will listen to Belleruth Naparstek’s Guided Imagery for Fibromyalgia (IMPROVE – Imagery) as I fall to sleep.

Intrapersonal Effectiveness

After reading the title, one might think that I made a ‘typo’ or misspelling.  I did not.  I am aware that the typical Dialectical Behavior Therapy (DBT) module is called “Inter”personal Effectiveness vs. my version of “Intra”personal Effectiveness.  Today, I spent the day listening to my inner power of positive self talk.  I decided to follow my own advice.  I am integrating body, mind, and spirit by heeding my body’s dialogue and not so subtle suggestions.

I did reach out for help today (Interpersonal Effectiveness) and when three of my most important supportive people were out of town, out of the country, or out of the office, I worked with what I had, myself (Intrapersonal Effectiveness).  I also believe that God won’t give me any more than I can handle (and yes, it’s just now that I thought to ask for His help, although this was one of my therapy homework assignments since Tuesday and I’m just practicing it now). 

Now, for the proverbial nuts and bolts:  I have been hearing voices in my head that were not my own.  And while, yes, I have also had auditory hallucinations today including hearing cats meowing, emergency sirens blaring, car alarms activating, and harmonic music playing all when there were none, the voices that I am referring to really belonged to someone else.  Actually, two people, both of my neurologists. 

The details are a little fuzzy now, but back in May and end of June, my sleep disorder specialist and my neurologist for my memory both told me that I should lose weight.  Hello!!!  I was formerly anorexic and when they said this I was at an ideal weight.  My long-time dietitian confirmed this fact.  And I was in shape. 

They both knew my history, they both knew how active I am and how stringently I follow my exercise routines, they both should have known that this advice was not good to give to anyone at an optimal weight nonetheless to someone who, though mostly recovered, suffers from anorexia’s rules of restricting and over-exercising.  This just plain was poor advice.  And I wasn’t going to stand for it.  I stopped each of them in his tracks and told them all of the above.  It silenced one without his mentioning it again.  He was the head of the department but that didn’t intimidate me.  The other one heard me and my rebuttal but just repeated the same thing back ten minutes later.

Aaahh!

In hindsight, the sleep medicine doctor probably has the advice as his standard protocol for people with sleep apnea though I was there for narcolepsy and not all people with sleep apnea are overweight.  Get a grip. [So much for non-judgmental stance (Non-judgmental stance) up until I just wrote this so I’ll start that skill for the remainder of the post]  My other neurologist was going by an older, now more obsolete, method of a standardized height and weight chart.  Today, waist circumference, body mass index, age, level of activity are all used in consideration of determining if someone is overweight.

Well, enough of that. 

Point being, it was their voices I was hearing today telling me that I had to lose weight. And I’ve actually been listening to them for some time.  I take full accountability for giving their words more power than my own. And I’m stopping listening to them right now, this moment (One-in-the-Moment).  I have lost more weight than what they even recommended though I did not need to lose any.  I am the one who chose to go down this path, not them.  I am the one that can choose to recover.  I choose the latter (Turning the Mind).  I give my life meaning, they don't. (IMPROVE - Meaning).

I am employing the power of positive self talk.  Despite the voices, I am listening to my feet tell me that I have been exercising too vigorously.  I am hearing my back complain about degeneration.  I am using my Wise Mind (Wise Mind) to balances out my emotional mind’s desire to keep losing and my intellectual mind's tendency to continue rationalizing. 

Then it came to me.  “I am seeing in color again” is a Six-Word TWLOHA [I’ll explain in another post] that originated when I stopped being judgmental, when I stopped listening to my neurologist’s poor advice, and turned to Radical Acceptance (Radical Acceptance).  “It is what it is”.  I don’t have to agree with the doctors’ advice and I can accept that it doesn’t have to affect my healthy decisions. 

So, I am just going to write (Describe) and enjoy my night and also pray (IMPROVE – Pray & Relax).  I am not going to exercise (PLEASE - Exercise) instead I chose to celebrate my friend’s 41^st birthday (Build positive experiences) and because I am choosing to get some sleep (PLEASE - Sleep), especially since the lack of it triggers hypnagogic hallucinations.

Please have pleasant dreams filled with positive self talk.

Leaving No Skill Unused

Today I contributed a blog entitled “Leaving No Stone Unturned: My Journey from Total Denial to Radical Acceptance” (Participate).  I also contributed to SMITH Magazine’s Six Word Memoirs and went outside my comfort zone with my writing.  I allowed myself to go inside a little deeper than I’ve ever gone before to let out my buried feelings.  I had much success.  I was sad and happy at the same time (Relationship Thinking/Dialectical). 

I also got the most sleep that I’ve had in three or four weeks (PLEA”S”E).  I needed it and perhaps this helped me have the willpower to dig a little deeper.  It amazes me how crucial sleep is.  I was disappointed that I kept entering REM sleep immediately after returning to bed this morning because that is typical of narcolepsy and I was grateful that the short acting medicine at least worked for most of the night (Relationship Thinking/Dialectical).

Dad and I also had very candid and caring conversations about his health, my memory, our fears, and our fond times (Build positive experiences).  Today, I would say was all about a balancing act.  I feel integrated, and grateful.  I actually was able to give myself a compliment without feeling I was bragging. (Non-Judgmental Stance). 

I also read a lot of other blogs and though not present with the individual, I was glad that we shared common bonds.  Feedback is so important to me in both my professional and personal lives.  I made sure to leave comments on other’s writings in a focused fashion with meaning (One Mindfully & Participate & IMPROVE).

I also built a shelving unit by myself and felt proud (Build Mastery). The directions said you needed two people (yes, I actually read the directions, they helped) and being the independent person I sometimes am (Willingness vs. Willfulness) I decided to attempt it alone and call in reinforcements (Dad) if I needed them.  I didn’t. 

Just minutes ago, I did not think that I used that many skills; however, looking back…it happened again.

Thanks to all who give my life meaning!

p.s.  I also colored a mandala as a way to relax (IMPROVE)!

It Was Like Pulling Teeth

Reaching my goals was like pulling teeth

Today, I had to go to the dentist, again.  While they used the drill, I used skill(s).  Thankfully, I focused on doing one thing at a time (One Mindfully) which helps me since I have truly have serious memory problems.  I’m focusing on what works for me (Effectiveness).  I recalled reading my Covered Benefits statement and remembered that composite (white/bonded) fillings are a covered service.  However, my new dentist, after my other new dentist committed a variety of criminal infractions (yes, really), actually outright lied to me to increase her own income.  This is the story and how I used my skills.

I am very depressed about needing 15 fillings and 1 crown because I brush my teeth twice a day, floss, use Prevident, and Act Total Care both with fluoride and visit the dentist every 6 months.  I just had a checkup two months ago, yet none of this was detected…hence the criminal infractions…charging for services that weren’t performed, falsifying records (after all dental records are used to identify bodies, OMG), and refusing to give me my dental records which is required by law.

Most people are scared of the dentist anyhow.  This certainly scared me.  My newest dentist told me that Medicaid only pays for composite fillings on the four front teeth.  I asked her twice.  Her staff and billing department told me the same thing and recommended that I pay out of pocket and were practically writing up the bill when I resigned myself to the fact that I was going to have silver over most, not all, (relationship thinking) of my teeth.  These are the teeth that I care for every day.  I told the dentist and her staff that I thought Medicaid covered all composites and that I even had composites done on my other teeth.  Of course these fell out and my new dentist told me “You get what you pay for”.

I was scheduled for these fillings at 11am today.  I called the Medicaid State Dental Unit and wanted to know what services were covered.  I explained (Describe) the situation and provided background, I thanked the representative for their past help (Encouragement).  Then I asked (Ask) specifically if composite fillings were a covered service.  She said she didn’t know.  What!  This is the highest level (comparable to the Supreme Court) and the representative was telling me she didn’t know and to just ask my dentist, they would know.

I explained that I read it was covered, that one dentist was telling me the composites were covered, and my current dentist was telling me only four were covered.  I asked (Asked) for clarification on the mixed messages.  She said to take the dentist at their word. 

I was in awe that she was not helpful in the least.  So I tried to practice Non-Judgmental Stance (Non-Judgmental Stance).  It worked.  I thought about other ways to get the needed information and called a local dental clinic and Medicaid customer support who all led me back to the State Medicaid Dental Unit.

So, I called again hoping to get another representative.  No luck there so I continued my Objective Effectiveness skills of DEARMAN:  I repeated our earlier conversation regarding the mixed messages (Reinforced). I was conscious (Mindful) that there are only 6 employees for the entire state.  I emphasized my belief that I was correct that they were covered (Appear Confident) and asked her if she could please check with someone on her staff (Negotiate).  She said they were a covered service.  I asked, “For all my teeth?”  “Yes, and you don’t need pre-authorization for fillings.”

Repeated the skills with my new dentist who, rather reluctantly, told me I was correct, however, it was her practice and she used higher grade materials so she was choosing not to do it herself since Medicaid had not raised their rates in ten years.  She was more than willing to let me have them done by another dentist.  She didn’t have to lie to me in the first place to coax me into paying out of pocket to better her pocket.  And she didn’t have to have her staff cover for her.  I am still deciding what to do about this matter, for a later post.

I felt intimidated especially since she was going to be drilling in my mouth, however, I asserted myself and told her she could have told me this ahead of time.  I usually avoid confrontation but instead I was fair to myself, didn’t apologize, stuck to what I knew was right, and kept my honor (Self-respect effectiveness:  FAST) and (opposite to emotion action).  I gave the dentist a half-smile to show I was calm and aware of her final honesty (Half-smile). And I appreciated that she uses better materials and does not discriminate against those with Medicaid. 

I increased my feelings of self-worth and confidence through creative writing at SMITH and on my blog (Building Mastery).  I exercised in moderation (PLEASE).  I also reread my therapy homework assignment which increased my self-confidence and kept me calm (Build positive experiences).

On that note, I think tonight I will practice guided imagery or just relax (IMPROVE).

Here’s to good dental health.

Efficient at Effectiveness

I started the morning healthfully by engaging in part of self soothe (Self Soothe the Five Senses) by spraying my bedroom with Dragonfruit Febreze.

Those who have known me for a long time, certainly know that I can go absolutely berserk when I lose something.  It doesn’t even have to be important.  It is just the fact that my intellect is telling me that it is an absolute impossibility for anything besides steam to disappear into thin air.  The emotional side of me gets hysterical.  Well, today I did it differently (Wise Mind).  I didn’t freak out about losing something fairly important and critical – my Dental Coverage of Services document that explains my benefits to which I am entitled.  I focused instead on Effectiveness (Effectiveness) – doing what works.  So I looked as thoroughly as neatly possible and then instead decided that I am going to call the State Medicaid Dental Association and use Interpersonal Effectiveness (DEAR WOMAN) skills.  Stay tuned tomorrow to see how well that works.

I also used Effectiveness when speaking to my grandmother.  She has been having a very difficult, and sometimes, impossible, time understanding my speech, especially over the telephone.  Due to my medications and residual Bell’s Palsy, especially when I am tired, my speech has been an issue in the past.  However, since getting off of some of my medications, my speech has improved drastically and Grandma is still having problems understanding me to the point where I have needed a friend or family member to interpret for us.  I focused on Effectiveness by listening to her responses to see if she heard me correctly, talking softer, using different vocabulary, and scheduling an in person visit.

This was also a lesson in Willingness versus Willfulness (Willingness vs. Willfulness).  Willingness – Accepting what is and doing what works versus Willfulness – being stubborn and hurt and not calling Grandma at all.  I will need to Self-Soothe (Self Soothe the Five Senses) after my visit since my extreme love for her triggers my narcolepsy.

Today, I also used part of IMPROVE (IMPROVE) by “M”eaning in which I wrote six word memoirs as my outlet to a lover’s feud, my feelings and fright over natural disasters, and my attitude of gratitude.

I used the PLEASE (PLEASE) skills of “E”at and “E”xercise by having lunch even though I was not hungry and exercising in moderation not to excess.

What more will tomorrow bring…

In the Heat of the Moment, I was One in the Moment

Last night, I had an opportunity to mindfully practice my skills.  It was almost a full blown crisis and I turned it around.  I am grateful that through my hard work in DBT Skills Group & in Women's Trauma Group, also based on DBT, my skills have become ingrained.  They are second nature especially when I start off using the purposely.  What I mean by that will hopefully be explained.

I was very upset however I did not resort to my old behavior of self-harm or anorexia.  I was even able to keep from dissociating.  This may be a first.  I tried the Interpersonal Effectiveness (Relationship Effectiveness) skills of GIVE.  I was gentle in my approach, I communicated my interest, validated the other person's perceptions in an easy manner.  However, they erupted like a volcano.  I could have retreated like I usually do but I know that I would swallow my hurt and it would somehow take on another form.  So, I used (Self Respect Effectiveness) FAST.  I was firm, I asserted my beliefs, in a calm fashion, and did not apologize for something I didn't do, and I remained true to myself.  I did not succumb to their level and yell and curse.  I did not talk at someone but tried to talk to them.  I also used Participate (Participate) by not avoiding the uncomfortable situation but engaging in the experience so I wouldn't stuff my feelings.

I was very upset but I did my best not to dissociate and it worked.  I was One in the Moment (One-in-the-Moment).  I focused on the objects around me and noticed the colors and details (Awareness &  Observe).  I breathed in 2 and out 6 to calm my racing pulse. (Breathe).  Then it happened...

Because I was mindfully using my skills, the ingrained part of my brain used other skills without me even trying.  I used something that is entirely effective (Effectiveness) in a crisis but I can never remember.  It is part of Distress Tolerance's IMPROVE.  I use imagery a lot but this wasn't it.  It was Prayer (IMPROVE the moment).  I was overcome with peace when I asked for God's help and truly believed that 1.) He wouldn't give me more than I could handle  and 2.) I didn't have to go through this alone.  I then immediately calmed down and fell fast to sleep (PLEASE).

Here's to wishing everyone a successful skill-filled good night.

Looking back on my day - Observing

Today, I practiced Mindfulness.  In particular, the Observe (Observe) skill.  At first, you're probably saying, "Big deal.  So you stopped and took notice of what is around you.  Laa.Dee.Dah".  Actually, it's a huge deal. 

I often spend too much time in my own head, replaying my day and pondering what would have been if I did things differently.  I can get lost in there, it's such a maze.

I practiced without judgment (Non-Judgmental Stance), another mindfulness skill, but I'll save that for a later post.  I was feeling a little tense so I laid on my back with both my knees bent and both feet on the couch.  I set an intention (Turning the Mind) that I would just let the thoughts, whatever they were, to come and go without categorizing them.  I started with counted breath (Breathing), in two counts, out six.  The thoughts came and went like a old movie film on a reel.  They were passing clouds.  I saw amorphous shapes that turned into images.  I just was. I was being. I was genuine. I was me.

The second time that I used Observe today was when I was confronted with severe memory problems.  We're not talking about something that just slipped my mind.  We are talking about a TV show that I supposedly watched several episodes last week with the same leading characters and I truly don't recall any of it --AT ALL.  So, instead of freaking out and making my memory even worse, I said to myself..."It just is". No judgment (Non-Judgmental Stance).  Just Radical Acceptance (Radical Acceptance).  Used Wise Mind (Wise Mind).  The rational or intellect met the emotional or feeling.  They kept each other in check.  In balance.  And, I was OK. 

It is scary and I know it's due to a medical condition.  This is a great example of the Dialectical.  Feeling two opposite things at the same time, neither negating the other.  Notice, and I will honestly admit, that I had to correct myself because my original sentence used "but" as a conjunction when Wise Mind meant and said, "It is scary and I know. . ."    [Thanks DBT Group Facilitators and Members] and thanks to my Wise Mind.