Monthly Archives: June 2009

Quit smoking: Managing the Bloating, the Weight Gain, and the Constipation…

As planned, I quit smoking AGAIN on Tuesday, June 20-some-odd, 2009. I prepared for this by changing my diet and adding exercise to my weekly schedule. Two major life changes! These are things that I did not want to give up or change. I’m no different than the rest of the world…I want my life to change in major ways…but I don’t want to have to change in major ways…and I certainly don’t want to step outside my comfort zone!

About a week before I quit, I began to ride horses with my daughter in the evening…awesome exercise! I also cut WAY down on sodas, diet sodas of course…I cut WAY down on the number of protein bars eaten PER day…and I added a bunch of fruit to my daily diet. I had just recently noticed that I was bloating even though I was still smoking…and I noticed that this occurred after a breakfast of diet soda and a protein bar…and a protein bar for lunch! MAJOR BLOAT! It went away in a few hours and did not cause weight gain though! However, I became mindful of a “while smoking bloating pattern.”

The Tuesday morning that I quit, I purchased a box of generic brand Nicorettes gum. I got the 4 mg strength for folks who smoke more than 25 cigarettes a day rather than the 2 mg strength for folks like me who smoke less than 25 per day. I did the math…it makes the gum half price for me! I would smoke about 15 a day, so I just chew a half piece several times a day. I chew it to keep some nicotine in my system to keep my body revved up so I don’t get so bloated and constipated…and gain 7-10 pounds in 7-10 days!

Everything went well the first couple days…but, everything wasn’t perfect. By Thursday afternoon, I hadn’t pooped for about 4 days…so, I bought a box of Correctol…a laxative that’s SUPPOSED TO BE very mild. The box says to take 1-3 tabs…well, not being a laxative queen, I took just one Thursday evening. Nothing happening by Friday afternoon, so, I took another one. Well…things began to happen Friday evening…and I think everything cleared out including the box of cherry tomatoes I had for lunch that day. Needless to say, my weight was good Saturday AM…and I’m not smoking…and I’m not bloated…nor constipated right now!

Laxatives are a major concern…and something I’ve taken about three times in my life because I absolutely don’t want to become addicted or dependent on laxatives. This will NOT be part of my weekly non-smoking plan! I purchased Activia yogurt yesterday…it’s guaranteed to increase regularity if you have one a day for two weeks. I’m trying that.

Some may think I am entirely crazy to be posting about bowel habits…however, if you go to this link and type in various keywords or keyword strings related to quitting smoking and bloating…or constipation…you will see that MANY people are having this problem. It will tell you how many times in the last month these keywords were entered into google for a search. Also, many people are reading this blog…so, there’s other people who are struggling with this as well. I write this as a help to others…and maybe, folks will benefit from my struggles and come up with a Game Plan to quit smoking that fits their lifestyle and needs.

Another point. I shared my struggles with my sister. She was going with my Dad to his cardiologist that day. She spoke with the heart doc and he was seemingly oblivious to this side effect of quitting smoking. He told her that if I was so constipated, I needed to see a Dr. immediately because I had something major going on! Boy, did she call me back with a great sense of urgency in her voice! FUN-NY! Also, my boy became ill this week and I took him to our family doctor. While there, I asked him what I could do about this problem. Because of what he was advising me, I told him several times that the MENTAL part of quitting was no big deal, it was the physical side-effects that were kicking my butt…and leading me to relapse. You know, I don’t think he ever really heard me because he continued to talk about mood, irritability, bitchiness, etc. Could this bloating–constipation thing be a side-effect that the medical profession isn’t noticing?

In case you’re curious, my Doc recommended Wellbutrin as a medication to help quit smoking. He says he’s had a very high success rate with this, around 85%. He said Chantix isn’t doing so well in his practice. He also recommended the nicotine patch. He didn’t like the idea of the gum because he said you can’t really control how much nicotine you’re getting…like chewing faster, longer, etc. His concern is that I’d end up with a nicotine gum habit to deal with!

I got the script for the Wellbutrin, but I’ll hold off filling it. Will finish the trial of what I am currently doing and I’ll see how it works. Will go to Plan H, I, or J if this current Game Plan doesn’t work!

Well, that’s the update. I hope I have good news at the end of this next week. So… so far so good…for the first 5 days of NO SMOKING attempt number 6 or 7 this year!

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How do I recover from Borderline Personality Disorder: A DBT-CBT perspective

Recovery from Borderline Personality Disorder (BPD) will be one of the hardest things you’ll ever do. It will require a lot of perseverance and focus…and Mindfulness every waking hour. It will require great effort to gain control of out-of-control emotions, behaviors, and thought processes. Then it will require great control to MAINTAIN control over time. You’ll have to want recovery more than anything else in life. Just like the alcoholic…to recover they have to want recovery more than anything else in life. You’re attitude will have to be “Recovery is my #1 priority” and then you’ll have to act in ways to make it so.

The question of how to recover from BPD was posed to me and I wrote a couple paragraphs to give the person an idea of what it would involve. I did not spell out a comprehensive treatment program, just an overview of some things it would involve. BPD is a severe personality disorder that requires a comprehensive treatment plan and years of therapy…and years of practicing new behaviors and skills to undo and change years of dysfunctional responses. So consider the following information to be an overview of the process and know there’s more to it!

Some aspects of recovery include:

    Therapy
    A support system
    Mindfulness
    Practicing life-enhancing coping skills to replace self-destructive ones…and using these in the heat-of-the-moment…and on a day-to-day basis to keep negative emotional levels as low as possible.
    Challenging self-destructive Emotion-Driven Thoughts with Rational Mind thoughts. Rational Mind thoughts relate to the unchanging TRUTH and facts about a situation, our life, other people, etc. Our Emotional Mind thoughts are based on our “in-the-moment perceptions”…or the way we think about things when we’re in an emotional state. For instance, when we’re upset, we may think and say, “Nobody cares about me.” This will be a habit…so we’ll have to catch ourselves (Mindfulness) and turn on Rational Mind and say, “Many people love me and care about me. I’m just thinking that because I’m upset right now. That’s just stinkin’ thinkin’” If we think, “Cutting would help me to feel better.”…we must catch ourselves and say, “Cutting helps in-the-moment, but it ends up causing me more pain and problems. Calling a support person and working through the moment will help me NOW and in the future. Cutting is relapse for me and will only bring me down and land me back into the Cycle of Suffering. I want recovery and I’ve got to use life-enhancing coping skills.” Wise Mind is already kicking in and will be offering some suggestions for getting through the moment.

Borderline Personality Disorder also involves dysfunctional relationship dynamics and patterns. Part of the recovery process is awareness of our sensitivities and our typical responses in relationships. Mindfulness is essential here. When we catch ourselves responding in old dysfunctional ways, we’ll have to use Rational Mind and Wise Mind to alter our responses. Like when someone hurts our feelings, we might think, “She is such a b—-. She was never my friend. I’m never going to talk to her again. I don’t get mad, I get even.” That’s Emotional Mind thinking…it’s Emotion-Driven Thinking…thoughts that are driven by or are caused by whatever emotions we are experiencing. We’re thinking that way just because we’re Big-Time in Emotional Mind. So, we’ll have to catch ourselves and challenge that thought with Rational Mind. For instance, we might remind ourselves of the truth about her and other people, like “She’s usually nice to me. Maybe something’s going on with her and she’s not in such a nice mood right now. She’s been friendly and she’s been my friend. Everyone has their moods…and I guess she’s in one right now.” Wise Mind would kick on and make some problem-solving suggestions, such as, “I’ll pull myself together and go on with my day and TRY not to worry about this. I’ll check back in with her later and see if she’s okay. If something is troubling her, I’ll offer to talk with her about it. If it seems like she’s upset with me, I’ll let her know I appreciate her friendship and I’m sorry if I did something to upset her…and I’ll encourage her to talk with me about it…and I’ll work real hard not to be defensive! I’ll try to smooth things over with her so I can maintain this relationship.”

There’s a lot to working through and changing a lifetime of experiences, habits, thought processes, reactions, etc. Therapy, support groups, a support system, mindfulness, following through with life-enhancing coping behaviors and problem-solving, and an attitude of “Recovery is my #1 priority” are some key elements to recovery. READ self-help books too…and learn as much as you can about recovery. Know that it took a lifetime to get us to this place and time…and it will take a while to recover. It’s step by step, minute-by-minute, hour-by-hour, day-by-day…month after month..and year after year. I think it is reasonable to expect that even though we get to a point of being “pretty well recovered” things will still come up…things that will bring up old feelings, insecurities, and issues…that we’ll have to deal with. But, by then, we’ll be real practiced at it and it won’t take long to set ourselves straight. Honestly, I am “pretty well recovered” but I still have to deal with myself on a daily basis. I consider myself to be “a work in progress.”

Another thing to think about is that it is normal to be “abnormal.” Most people have issues and concerns that bother them. Some struggle to get better n’ better…and others remain in denial and blame others, avoid their issues…and remain in a Cycle of Suffering.

Quit smoking the DBT-CBT therapy way: Attempt #7 – Making my “failures to succeed” successful failures

Here I go again. Another attempt to quit smoking. This constitutes try number 6 or 7 this year. However, I’m stubborn, hard-headed, and persistent…and I’ll keep trying until I make it. This is something that is do-able and something I’m able to do!

My last blog entry was a week or two ago and I had resumed smoking because of major bloating, constipation, and weight gain…like 7-10 pounds in 7-10 days. This has happened each time I have quit smoking this year.

My plan is to quit on Tuesday, my next work day. No smokes on the way to work…and none thereafter! Over the past two weeks, I’ve noticed that I’ve bloated even while smoking; however, I haven’t had the constipation and weight gain. The bloating has come and gone. So, I became mindful of the bloat patterns and noticed it seemed to occur when I drank soda and ate a couple protein bars. So, I gave up soda and protein bars for about 5 days and I had absolutely no bloating. WOW! I began eating some protein bars the last few days because I started feeling VERY tired. However, I did so in moderation and I’ve had a few sodas. Only one bloat session occurred. I’m going to practice moderation with both of these because I like them…and don’t want to have to give them up, TOO!

I am going to start exercising today. I’ll get the junk off the fancy treadmill and do that in front of the TV. I’ll ride horses with my daughter a couple times a week. I need to do something to offset the decrease in metabolism due to not smoking…and to offset a couple hundred extra calories that I might consume daily due to quitting smoking. I’ve lost more weight than I care to admit in the last four years and I have no intention of putting on a lot of weight. I can tolerate a few pounds…but then, it must come off again!

I’ve also added several servings of fruit per day over the last week. I’ll keep that up because it will help offset constipation.

If I start bloating again, I’ll buy some nicorettes and give that a try. If I fail this time again, I have a Dr’s appointment in a few weeks and I’ll try something else. I WILL make this happen.

Here’s an excerpt from the DBT-CBT therapy workbook that I wrote…and it’s something I believe in and I live by. It’s from a section entitled, “Failing to Succeed…or Successful Failures.” It’s in Chapter 7, the Rational Mind chapter…where the Emotional Driven Lies we tell ourselves are challenged through Rational Mind. This excerpt relates to the “I’ll never be able to do it.” and the “Everything I try gets screwed up somehow” type of lies we tell ourselves that sabotage our recovery.

“When we fail, we need to SEEK AN UNDERSTANDING of WHY WE FAILED. We need to LEARN FROM IT and CORRECT WHAT WE’RE DOING. We need to change or adjust our plan to deal with what went wrong. Successful “failures” start with PLAN A and go to PLAN B, C, D, E…and so on until things work out! Despite their failures, THEY KEEP ON KEEPING ON!

It’s also important to be Mindful of our successes and accomplishments and to note WE’VE ALL HAD SOME! We also need to realize that WHEN WE’VE TRIED…when we’ve REALLY STUCK WITH IT, we’ve overcome challenges…and WE HAVE BEEN SUCCESSFUL. Consider the 8-18 attempts at recovery that it takes people ON AVERAGE to become clean n’ sober. Through our recovery attempts, we learn about our triggers and relapse patterns. We learn we REALLY HAVE TO change the things in our life that we DON’T WANT TO CHANGE…things that we’ve refused to change, like friendships, activities, and abusive or conflict-filled relationships. Because of our repeated failures at recovery, we FINALLY SUCCEED! That’s because we’ve revised our Recovery Plan SO MANY TIMES that we FINALLY GET ENOUGH OF THE NECESSARY CHANGES made! We’re hard-headed and we’ve got to learn from OUR experiences…and in the world of recovery…these experiences ARE OFTEN RELAPSES.

Changing our LIFESTYLE and our LIFE IS VERY DIFFICULT. We need to ACCEPT OUR FAILURES and UNDERSTAND they’re a NATURAL part of the LEARNING PROCESS…IF we learn from them.

The truth is, WHEN WE KEEP TRYING, things FINALLY work out. Sometimes, we don’t succeed because we aren’t going about it the right way. Therefore, we need to get a NEW PLAN. Sometimes, we try to do more than is do-able at one time. We plunge head first when we’d be better off wading in and taking smaller steps! There are many reasons why we haven’t reached our goals. Fortunately, most of these problems can be overcome with PERSISTENCE and a REVISED GAME PLAN!”

So I will practice what I preach and I’ll keep trying until I make it. I’ll just DBT-CBT my way through it and rather than failing to succeed, I will make my attempts successful failures.

The following are some quotes off the side margin of the aforementioned section in the DBT-CBT Recovery Workbook:

“The Self-Fulfilling Prophecy of Failure: I expect to fail so I don’t try very hard …so, I fail.”

“If we don’t put forth a FULL effort, we’ll never REALLY KNOW if we can succeed.”

“Some of our greatest leaders and wealthiest people failed many times before they achieved great success.”

“We never fail until we quit trying. Success comes to those who are determined to overcome obstacles
in their path.”

“When we understand our failures are a part of the learning process, then we can constructively accept our failures and learn from them.”

This relates to the 8-18 tries at recovery it takes on average to recover from substance abuse: “Some say, ‘Been there, done 14, I’ve got to be real close to making it!’ Folks who are new to recovery are discouraged, ‘I don’t want to do this that many times.’ Be Mindful that 8-18 is an average. Some make it on the 1st try (they need to write the book!), others on the 25th. Some make it in 3 tries, others in 20. Bear in mind though…these numbers don’t mean it’s okay to relapse 17 times ‘just because we can’ and then work real hard on the 18th try!”

Dream Interpretation – What do dreams about losing teeth mean?

I’m a psychologist and interpreting dreams is something I’m very good at…when I know a person well. The images in a dream are symbols (Jungian psychology), they symbolize something. What a dream image means for you may be very different from what it means for someone else. There are some “universal” symbols that mean just about the same thing for just about everyone in a particular culture because we have all learned similar things about it (similar understandings). However, I strongly recommend NOT consulting a dream dictionary because what a symbol or image means to one person may be very different from what it means to another. That’s because our personal experiences with the symbol or our associations to the image may be very different from the experiences or associations others have for the same image, symbol, or concept.

For instance, for most people, the symbol of a witch is associated with an evil or mean female, often a maternal figure. However, for a particular dreamer, the symbol of a witch may be very positive. Maybe they won a costume contest when they were dressed up as a witch and it was a very positive emotional experience, perhaps they felt very special, “on top of the world,” recognized, or very pleased with themselves because they beat out their bully or rival in the contest…(so it reflects success, self-confidence, overcoming something). Maybe it was one of the first times their mother really focused on them and helped them with a project (the costume)…so it was a time of feeling emotionally connected with their mother, loved and cared for by her…etc.

The best way to interpret dreams is to write out your entire dream…absolutely everything you remember about it even if a detail doesn’t seem important. Then, begin to “free associate” and write down everything that comes to mind for each symbol, experience, emotion, person, or image in your dream. Write down everything that the image or experience reminds you of. That way, you are interpreting YOUR dream…based on what your dream symbols mean to you. Most of the time, this will help you to understand your dreams…and usually it will be a WOW experience.

I have had “losing teeth” dreams….one falls out…then before I know it, most of my teeth are coming out…or crumbling, etc. I have had this dream many times, so my mind, body, and soul is trying to get something across to me…it’s pushing me to pay attention to something…to deal with something. It’s trying to help me to heal and recover in that area. The dream keeps coming up because something in that area of my psychological or emotional life NEEDS some work.

It’s a dream image that I have not figured out yet…and it’s odd to me to not be able to figure it out. I guess I’ll be having that dream until I do…or until I heal and recover in that area in other ways.
I have made associations to teeth…and all I can come up with is that they are something that’s supposed to be permanent…we are not supposed to lose these. Maybe it represents the major attachment losses in my life…people who were supposed to be permanent, people I loved and depended on, who left. I have become aware in recent months that I had MANY losses of special people in my age 13-16 time period…and life got real bad for me during those years. I was an utter mess emotionally and behaviorally during those years and for years thereafter. I will certainly pay attention to THAT theme if I have the dream again! Maybe I won’t have the dream again since I am dealing with this on my own!

I don’t fully have this association worked out yet, but I’ve also considered that our teeth are things that are “presented to the world” – people see these as we are relating to them…speaking to them. Losing our teeth may represent some vulnerability in this area…The concept of a defense or protective barrier also comes to mind…and if we lose these, we are somehow vulnerable. Our words are a mirror of our soul and our psyche when we are open and express ourselves to others…and losing them may represent a vulnerability, a weakness, or a concern in this area. Maybe we wish we could keep our teeth and protect ourselves from opening our mouth and bearing our soul. Or maybe if we lose our teeth…we are losing our psychological defenses and we are feeling very vulnerable.

See how this is done. Just free associate and think about what teeth mean to you…and then how those associations relate to your life and your issues. When you start to understand your dream and you begin to grow in that area…your dreams will change as you change. Actually, working with patients, I find that our dreams reflect progress we are getting ready to make…the dream comes first…and then manifestations of that progress or change is noticed as we relate to our world. In other words, changes in dream imagery reflects psychological growth that is going on internally…that we are soon to experience in action! They are a signal of the changes the patient is making…and changes we will soon see!

So, maybe instead of losing all our teeth, one or two or several will come out and we’ll be able to get them back into the socket and keep them in place. Knowing dreams, probably at first, the means for getting our teeth back in place will be crazy and won’t make much sense…but nonetheless, in the dream it worked!

How to Get Control of the Quit Smoking Bloat, Weight Gain, and Constipation! Must DBT my way through it!

I teach DBT (Dialectical Behavior Therapy)…in fact I wrote the DBT-CBT Recovery Workbook, “Out of Control.” I have the skills and understandings for behavioral change…I’ve recovered from many things…and I’ve kicked many habits…but this one is kicking my butt this time. This is a follow-up to two previous “I’M TRYING TO STOP SMOKING” WordPress blogs. It’s been about two weeks since my last blog on trying to quit smoking and the bloating and weight gain that compels me to resume smoking. So, I’ve been smoking again for the last two weeks. It’s really a love-hate relationship with smoking…I love to smoke, I hate to smoke. I hate it more than I love it and I’m determined to quit. My plan continues to be to get a Game Plan for quitting. I am going to a conference tomorrow in California on risk assessment, the Reid Meloy PCL-R one. I didn’t want to suffer the agony of being three sizes bigger and “feeling fat,” so I’ve allowed myself to smoke for this period…two weeks plus the conference.

Folks in my DBT Group would say I am just sabotaging myself and falling into the trap of Emotional Mind by coming up with Emotion-Driven Lies and Excuses to continue smoking…that my excuse to smoke is nothing but an excuse to smoke. Alike many people who sabotage themselves this way, I would say, “I’ve got a plan to quit and this is part of my plan. If you knew me, you’d know I was going to quit…and this is part of my quitting plan.” And everyone else would say…”Bull Sheets…that’s just bull, Sheets!” And I would say…”Just sit back and watch. I’ve quit many things in my life and I will quit this…come hail or high water…I’ll find an umbrella to make it through this storm.” And, I will. I’m determined to quit and I’ll find a way. If I knew that smoking two more weeks and through the conference would cause me lung cancer, I’d put this cigarette out right here, right now, and call it quits. Glad I don’t know that! I do think about it though and I’ve asked God to see me through this…and keep me safe while I get ‘er done.

I sent an email out to the Docs and nurse practitioners at the hospital yesterday and was just about desperate enough to send an email out across campus. I explained this bloating – constipation – weight gain problem and I asked if they knew of a medication or patch that would minimize this. I read a bit about Chantix and stopped at the side effects of constipation and gas! I haven’t studied any more…so, I don’t know if Nicorette gum or other nicotine replacement therapies will help. I’m hoping some readers will share their experiences and we can figure out what to do. Many people are reading this blog, so many are struggling with the same thing. Please leave some comments and let us know what works and what doesn’t. I’d really like a magic pill or patch so I can easily quit smoking. I’ve quit 5-6 times this year and I’m fine mentally, emotionally, and psychologically after the first couple days…until this bloat thing happens and my weight soars…and my pant size increases by 2. So, if I can get this bloat thing figured out, I’d be quit again in no time. I seek the “No pain…big gain” method of recovery!

So, if I don’t know of anything else to do when I return from the conference, I’ll set another quit date, try Nicorette gum or something similar and go at it again. I understand that the gum is expensive…and I did try to sabotage myself with that excuse…but, my Rational Mind isn’t going to put up with that crap and quickly reminded me that smoking is more expensive. Ended that. I do have a doctor appointment set up in early July and I can get some information from my PCP at that time if Nicorettes doesn’t work. I’ve also become Mindful that my current diet is very high in fiber and protein and that may be why I am having this new problem with quitting smoking. I’ve always been able to quit for long periods of time and have never had this problem…until this year. Maybe I have to change my diet and eat more roughage rather than soft protein bars. Maybe I have to exercise more often. Do you know that riding a horse burns about 200 calories an hour? All I have to do is to go outside, sit on a horse for an hour, and let it take me for a walk! That’s sure a lazy woman’s way to exercise. If I can hold on while the horse gallops, I can burn about 500 an hour! I thought about putting a sign on my horse’s butt and trotting past power-walkers on the road or galloping past a jogger that says “I’m burning more calories than you!” FUN-NY! Yes, I know I’m not getting the same cardio benefits…nor pulmonary…but the mental picture is quite amusing!

Long blog short…I’m still smoking and I’m not done quitting! I’ll keep folks posted on this journey and what I learn as I go…and what I have to do to get there! Hope there’s a magic pill!