Category Archives: Mindfulness

How Could Someone Try to Kill Themselves: Suicide Attempts and Doing the Unthinkable – from a DBT-CBT Therapy Perspective

When Emotional Mind drives and Rational Mind is left on the side of the road…

When folks are moderately, even severely depressed (say up to an 8 or an 8.5 on a scale of 1-10), they are “Big-Time in Emotional Mind” but they still have some Rational Mind going on (say 85% Emotional Mind and 15% Rational Mind).  Through the small degree of Rational Mind, they maintain some contact with reality and have some mindfulness of the big picture of their life. For instance, they still recognize they have something to live for…they still have some holds on life…and although their grip is loosening and they may be barely holding on…with at least some Rational Mind going on, they recognize the basics…like they have kids to live for…or pets…or their dying parent (examples).  However, as the depression worsens, Emotional Mind intensifies, and Rational Mind further fades…and they lose awareness of these reasons to live.

Patients in various ways have explained how this happens.  They relate that when they made that final decision to kill themselves…to enact that near fatal behavior…they weren’t  thinking…that previously they thought about their kids, their spouse, or other holds on life and they struggled to stay alive…but then, something happened and they no longer thought about these things.

One patient so well described this to me, I haven’t forgotten it.  She said that as her depression deepened, it was like she was going further and further down a well…and the deeper she went, the less she could see out.  She related that she got so far down, she was surrounded by darkness…she could no longer see nor feel…and she lost touch with the love she had for her kids and concern about what would happen to them.  She cried intensely and said that when she did what she did, thoughts of her kids did not cross her mind.  It was utterly heartbreaking, and yes, as a therapist and despite trying to hold my tears back, they rolled out of my eyes.  I stood up and hugged her as she wept and gently rocked her to help soothe her through the pain. It was one of those heart-wrenching therapy moments when I had no words to comfort her and could only pray for her self-forgiveness and healing.  She so loved her babies and could not understand how she could have tried to end her life.  With Rational Mind going on, she realized she did the unthinkable.

I believe that she became 100% (or near 100%) Emotional Mind…and Rational Mind was essentially turned off.   Without Rational Mind, she was not connected or in contact with the reality of her life and what really mattered to her.  It was like a Rational Mind black-out.   She was no longer mindful of the big picture of her life and the reasons to continue the fight.  And we always ask, “God, how could she have done that, she has kids” or “How could he have done that knowing his family would find him.”  They weren’t thinking…that part of their brain was turned off.

Based on the recovery workbook by Melanie Gordon Sheets, Ph.D. -<span
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A Partial Relapse or a Full Relapse – Using Rational Mind and Wise Mind to Tame an Out-of-Control Emotional Mind (A DBT-CBT Workbook Perspective)

The following is “Pete’s Story” – an excerpt from the DBT-CBT Out-of-Control Workbook which highlights a “real life” relapse experience.  This relapse is processed using principles and concepts from the DBT-CBT Recovery Program, especially the three mind states of DBT.  It’s an example of DBT-CBT “In Action.”  The content for this post is the opening for Chapter 7, the “Rational Mind” chapter of the workbook.  As it is from Chapter 7, it refers to things discussed in Chapters 1-6.  So, if you feel a little lost reading it…that’s why!

Chapter 7 – RATIONAL MIND

We’ve been working with Rational Mind (1) throughout this book, so you’re somewhat familiar with this mind state. Rational Mind is the part of us that processes life in a logical, legalistic, fact-driven, reality-oriented, and cut n’ dry manner. In other words, Rational Mind uses reasoning, it respects rules, it’s guided by truth, it deals with how things really are, and it’s the calm, cool, intellectual, and unemotional part of us!

Emotional Mind is driven by how WE SEE AND EXPERIENCE the world while Rational Mind is driven by how THE WORLD REALLY IS!

The Purpose of Rational Mind

A Recovery Goal is PREVENTION of Destructive Emotion-Driven Behavior. We need to STOP OURSELVES before we do what we really feel like doing!
Rational Mind helps us to gain control before things get Out-of-Control.

When we’re in a troubling Emotional Mind state, the first step for gaining control is Mindfulness. We need to be aware of what’s going on in Emotional Mind. We need to be Mindful of our Raw Emotions, Emotion-Driven Thoughts, and our desired Emotion-Driven Behavior. This includes awareness of our feelings, the thoughts racing through our mind, and what we’re thinking about doing! Once we become aware of what’s going on in Emotional Mind, we need to TURN ON RATIONAL MIND to look at our situation logically and realistically.

Rational Mind helps us to know what is true and factual.
It helps us to perceive the reality of our situations and our life.
The reality of Rational Mind is generally quite different from the picture Emotional Mind paints!

Rational Mind helps us to understand THE BIG PICTURE OF THE SITUATION and the TRUTH about what’s going on. This helps us to challenge our Emotion-Driven Thoughts and to get our emotions MORE IN LINE with the REALITY of the situation. This REDUCES our emotional distress because we FOCUS on the HERE-AND-NOW situation RATHER THAN EVERYTHING that has EVER HAPPENED to us.

Rational Mind also considers the Big Picture of Our Life and REMINDS us of the CONSEQUENCES we’ll SUFFER if we ACT ON destructive Emotion-Driven impulses. WHEN we’re USING Rational Mind to deal with what’s going on in Emotional Mind, WISE MIND TURNS ON and BRINGS US to a GAME PLAN for effectively dealing with our situation. Our Recovery Goal is to PARTICIPATE EFFECTIVELY in our life… so we’re MANAGING and DEALING WITH our problems RATHER THAN CAUSING OURSELVES MORE PROBLEMS!

APPLICATION: The Meeting of the Minds

The following story, “Pete’s Story,” is a good example of how the three Mind States work together in real life.

Pete’s Story

Pete has a lot of stress and family conflict caused by his responses to life. His family has allowed him to stay in their garage apartment “for the last time.” His probation requires him to be employed. He doesn’t have a good work history so it took a while to find a job. He just bought a used car and now has visitation with his kids because he’s paying child support. Things are pretty good in his life… though not the greatest. His boss accused him of doing something he didn’t do. He blew up and walked off the job. He went to an old hangout and started drinking again and snorted some coke. Thoughts began churning in his mind. He is very worried and is thinking the worst, “My family is going to kick me out and I’ll be homeless again. I’ll lose my car without income and I’ll lose visits with my kids. If I get called for a UA (2), it’ll be dirty and my probation will get revoked (3)…especially since I’m now unemployed. Then I won’t see my kids for a long time.” He’s very upset with himself and thinks, “I am such a failure. I screw everything up. My family will NEVER let me hear the end of this. I should just kill myself. I can’t handle all this crap again.” Thoughts are racing through his mind. His emotions intensify and he becomes more and more upset. He begins to panic. He is desperate for a way out and considers going back to live with his ex-girlfriend. He’s afraid of doing that because she still uses drugs. He panics even more and all he can think about is killing himself. He ruminates about this stuff for hours and hours. It’s now 3AM and he’s worried about going home…so late…so upset…and so messed up.

Does Pete’s story seem like Real Life or does it seem like an exaggeration to make a good story? _____________________________________________________________________________________
_____________________________________________________________________________________

Have you been in a state like this before about a lost job or some other major problem? If so, describe how your experience is similar to his. ________________________________________________________________ ______________________________________________________________________________________

The quality of our life comes down to two choices.
We can LIVE IN Emotional Mind and ALLOW our life to fall apart
OR we can TURN ON Rational Mind and Wise Mind
to get a Game Plan for dealing with our problems.
The choice is to stay on the life-enhancing Recovery Path
or to go the way of Relapse Route.

SKILL BUILDER: Pete’s State of Mind

Re-read Pete’s story and UNDERLINE the parts that describe what’s going on in his Emotional Mind. Put a BOX around the parts that are driven by Rational Mind.

You probably had no trouble identifying what was going on in Emotional Mind. You may have had some trouble deciding if his statements about getting kicked out of his apartment, being homeless…and losing his car, probation, and visits with his kids were Rational Mind or Emotional Mind.

What did you decide? Explain what you based your decision on? ________________________________________________________________________________________
________________________________________________________________________________________

When he went to the bar, he was upset.
then he began drinking and drugging,
then he became hopeless, desperate, and PANICKED.

Mindfulness of the consequences suggests he was in Rational Mind. Some think he was in Emotional Mind because it seemed like he was catastrophizing4 how bad things could get. However, given his life situation, his worries WERE based on truth and reality!

A reason to suspect he was Big-Time in Emotional Mind is…WISE MIND DIDN’T TURN ON and OFFER LIFE-ENHANCING SOLUTIONS. All he did was ruminate for hours about consequences and finding a way out…NOT A WAY THROUGH. He was panicking! All the COCAINE and ALCOHOL did was PUSH HIM DEEPER and DEEPER into Emotional Mind…and farther and farther away from Rational Mind and Wise Mind. He couldn’t think straight. The MORE he ruminated, drank, and snorted, the MORE DEPRESSED, ANXIOUS, WORRIED, and PARANOID he became.

In order to think straight,
we’ve got to be straight!

The Big Picture of Pete’s Story suggests he was Big-Time in Emotional Mind. He had SOME Rational Mind going on…but, not much. He was AWARE of the consequences of losing his job, he KNEW he should not return to his ex, and he KNEW his behavior would cause family problems. He was probably 80%-20% Emotional Mind – Rational Mind. Wise Mind flickered on and encouraged him NOT to call his ex. Not having that option…and having more time to drink and snort, he panicked even more…and came to believe that suicide was his best option.

Isn’t it odd how we can go from bad to worse…
and we begin to think the worst option is the best?

Given Pete’s story IS Real Life, how do you think this part of his story ends? _______________________________________________________________________________________
_______________________________________________________________________________________

He’ll either do something MORE DESTRUCTIVE, like a suicide attempt, driving drunk, or a full-blown relapse OR he’ll do something LIFE-ENHANCING like staying safe and sleeping it off in the car and TURNING ON Rational Mind WHEN HE COMES TO…TO GET HIS LIFE BACK IN ORDER.

Pete’s story tells about the “Something That Happens” on the Recovery Path and the two choices we have. Pete CHOSE the RELAPSE ROUTE in the Heat-of-the-Moment. HOWEVER, he DOESN’T HAVE TO stay on that path. He can call for help at 3AM or crawl into his car and sleep it off.

SKILL BUILDER: How to Get Control Once We’ve Lost Control

Let’s suppose he chose the Recovery Path at 3AM.  When he comes to and is able to shake off the cobwebs later that day, what might Rational Mind say to him? ____________________________________________________________________________
____________________________________________________________________________

Rational Mind might lead him to think,

“I blew up and walked off the job and I drank and used coke last night. I was scared. I freaked out…but this DOESN’T HAVE TO BE the end of the world. It’s time for DAMAGE CONTROL. MY PRIORITY RIGHT NOW is to get a job. Whether it’s my old job back or a new one…I need to act fast! No doubt my folks know Something Happened because I didn’t come home last night and I’m home now when I’m supposed to be at work. I need a plan for dealing with them, too, so I don’t lose housing.”

At this point, Emotional Mind will probably rear up with all kinds of self-defeating thoughts and feelings. Pete MUST TURN ON Rational Mind to Fight for his peace and stability.  He cannot ALLOW Emotional Mind to control the course of his life.   When a destructive thought comes up, Pete needs to remind himself that HIS NUMBER ONE PRIORITY is to STAY ON the RECOVERY PATH and that HE CAN AND WILL HANDLE this situation. He needs to tell himself that he STRUCK OUT last night, but there’s still MORE INNINGS in the game. He’ll have to challenge the destructive Emotion-Driven Thoughts AS THEY COME UP and REMAIN FOCUSED on TRUTH, REALITY, DAMAGE CONTROL, and PROBLEM-SOLVING.

At this point, Wise Mind will kick in to help him with a plan of action. What might Wise Mind suggest? ______________________________________________________________________
______________________________________________________________________

Wise Mind might suggest he visit his boss to apologize for blowing up and to ask for his job back. Wise Mind might suggest he TRY to assure his boss he didn’t do what he was accused of doing. Wise Mind would likely remind him if “Plan A” doesn’t work, he could apply for dozens of other jobs until he gets one…and that IT’S NO TIME TO BE PICKY! Wise Mind might encourage him to explain the situation to his parents…to let them know HE SLIPPED…but was BACK ON the RECOVERY PATH. If needed, he could tell them he’ll have a job quickly, REGARDLESS OF WHAT HE HAD TO DO. Wise Mind would likely inform him that it’s unlikely he’ll get called for a UA over the next few days and to pray on that! If he did get called for one, Wise Mind might suggest telling his probation officer what happened and the POSITIVE WAY HE’S DEALING WITH IT. Wise Mind would have MANY DAMAGE CONTROL and PROBLEM-SOLVING IDEAS for GETTING RECOVERY BACK ON TRACK!

When we mess up, we don’t give up.
We STAY IN the game even if it’s our toughest inning ever.

If at the end of the next day, he didn’t get his job back and he didn’t get a new one, Emotional Mind could easily start the self-defeating rumination and worry process. What could he do to help himself if this starts up? ________________________________________________________________________________________
________________________________________________________________________________________

Rather than spending days worrying about a catastrophe happening, Wise Mind would inform him that he’d be BETTER OFF PREVENTING ONE by focusing on a Game Plan! Wise Mind would strongly encourage him to chill-out and focus on Damage Control, problem-solving, and the use of Life-Enhancing Coping Behaviors (5) to avoid destructive worry.

Through Rational Mind, he could TAKE NOTE of the PRODUCTIVE things he’s done the last two days INCLUDING his MAJOR SUCCESS with QUICKLY GETTING BACK ON THE RECOVERY PATH and preventing a full-blown relapse. He could LIST HIS GOALS for the next day and a PLAN OF ACTION for the rest of the week. Since money is tight, he could WORK OUT A PLAN for paying what HAS TO BE paid. He could DISTRACT himself with POSITIVE ACTIVITIES (support group meetings like AA, helping his family prepare a meal, visiting with a recovery friend, etc.). He could SEEK TEMPORARY WORK cleaning yards, painting his parents home, and whatever else he can come up with to earn money and to KEEP HIS MIND BUSY. He could even talk with businesses about hiring him for a day or two to do “odd jobs.”

This WORK-UP of Pete’s story shows how RATIONAL MIND helps to CONTROL the INTENSITY and NEGATIVITY of an UPSET EMOTIONAL MIND! Rational Mind DOESN’T BUY INTO a “I’m a total screw-up. This is going to ruin everything. I can’t deal with it. I should kill myself.” mentality. Rational Mind CHALLENGES panic and negativity by looking at the situation in a calm, NON-EMOTIONAL, realistic, logical, and truthful manner. In the upcoming sections, we’ll look at some common Emotional Mind experiences from the viewpoint of Rational Mind. We’ll see how Rational Mind TAKES the POWER and NEGATIVITY OUT OF a destructive emotional experience.

Rational Mind tames what comes out of Emotional Mind.
Rational Mind pulls on the reins and helps to get control
of what is going Out-of-Control.

Footnotes

1- Dr. Linehan calls this mind state “Reasonable Mind.” On page 65 of her Skills Training Manual, she states, “This is your rational, thinking, logical mind. It is the part of you that plans and evaluates things logically. It is your cool part.”
2- UA – urinalysis – a urine test to check for drugs or alcohol.
3- Probation revoked – to lose the privilege of being on probation. Folks have to serve their sentence in jail if their probation is revoked.
4- Catastrophizing – (cuh-tah-stro-fi-zing) –when we’re focusing on the very worst things that could happen. It’s a form of the word, catastrophe – (cuh-tah-stro-fee).
5- Being busy with problem-solving…and working towards the solution is a powerful coping tool. Getting a newspaper and a phone book and making a list of jobs to apply for and businesses to call and visit is solution-focused. Visiting the employment agency and ironing a decent set of clothes for job hunting is very constructive, too!

Why Am I Eating More and Gaining Weight: Using DBT-CBT Principles to Become Mindful of Mindless Eating

I’ve gone through a very hard time in recent months with my “diet”…or better said, “my eating plan.” My positive eating patterns had become a habit and little emotional energy was invested in the process. I had peace and stability in this area of life. People would ask, “Isn’t it hard to stay on a diet?” No, it really wasn’t because I HAD developed good eating habits…and eating in this manner was natural for me. It was more of a lifestyle than a diet.

But, SOMETHING HAPPENED and these past few months became the most trying time during my four year diet. Not sure what happened, but somehow things got Out-of-Control. I struggled through…and regained fairly good control. Naturally, I’ve been reflecting on WHAT HAPPENED…because I don’t want to let this lifestyle slip through my fingers and for things to get out of hand! I don’t want to get fat again…I don’t want to start the weight gain cycle…AGAIN.

Here’s some things I have thought about. I FINALLY quit smoking in June after 6 attempts this year! Quitting smoking leads to increased eating because my hands and mouth aren’t busy…and reduced metabolism because I’m not loaded with nicotine…HELLO WEIGHT GAIN…and increased appetite!

Another thing that has changed in the last couple of months is that I started taking a daily multivitamin. Now, I haven’t studied recently, but from what I remember, vitamins increase appetite. Not sure why that happens…or if that’s really true. Just some tidbit of information I picked up and think is true.

Another thing…I began living on fruit…fruit was my mainstay…the largest source of calories per day. I loved the fruit diet! However, something was going on and I was craving sweets more…like CHOCOLATE! I was eating the Snickers protein bars…Mmmmm good…however, they are 290 calories each. When I seek to keep calories below 1300 or so a day…that adds up F-A-S-T!!!!

So, I’ve stopped eating fruit…and this has led to a major decrease in the sweet munchies. I’m thinking the sugar in the fruit did something to increase my appetite for SUGAR! In my four years of dieting, I would chocolate binge about once every 4-6 weeks…and while on the fruit diet, the craving for CHOCOLATE was STRONG…and something I gave in to. I believe in “have a craving…satiate it and go on with life.” That has worked very well for me…because I’d eat 800 calories of chocolate…eat less dinner or no dinner…and suffer little net gain in calories that day…and little effect on the monthly average…and little effect on my weight…until recent months!

Another thing that happened in July…is that an overwhelming workload greatly increased…and the type of stress changed…from internal pressure to get the job done…to external pressure…like performance counseling…and a 30-day deadline! I expect the extra stress and the type of distress affected me, too.
Anyways, lots of changes…radical physiological and psycho-emotional changes (nicotine withdrawal and loss, diet change with increased fructose and then refined sugar…and EMOTIONAL STRESS from work…and stress from my daily diet spiraling out of control! You know, I’m sure there are other factors too…that I’m not currently aware of…but, those are the biggest ones on my mind right now!!!! You know…I may have gotten cocky too…had my weight down real good…had this diet thing “down to a science”…and then…slacked off a bit!

Anyways, things have gone fairly well the last 3-4 weeks…actually regained some semblance of peace and stability in my eating. Revisited the 124-125 range…the size 7’s fit again…(size 9 slim fits are sized like a 7!). Went out of town a few days…and did alright. Not a major pig out…ate some restaurant food, but did well with that. Got favorite foods and ate about half. Some extra calories…but nothing Out-of-Control! Back to work tomorrow, will tighten up again…and go on with life. Average calories for October was in the normal range for me…similar to the last 4 years…so,, that’s good!

The last couple of posts in October note what I did to try to get control, so I don’t want to restate EVERYTHING here…cuz I can’t remember and I’m too tired to go back and check!!!! I am Mindful right now that I greatly increased Mindfulness of my eating plan…by reminding myself of my goal (stability in eating, weight management, not get fat again!), counting calories all day so I’m not engaging in mindless eating and CALORIE SHOCK at the end of the day when entering data in the Excel file, controlled portions and food selection (toting certain foods to work and not toting others…and choosing how much to bring, deciding what I’d eat when I got home, eating a little something before I leave work so I don’t go home STARVING TO DEATH…and ready to scarf everything in sight), and temptation management (telling family about my struggle and how to help…DON’T BUY FATTENING FOOD AT THE STORE…and certainly don’t bring it in and let me see it…AND me not buying fattening foods at the store…the ones that are MY favorites!) So, I went back to my early days of dieting…what I did then that worked best for me…to attempt to regain control over my eating.

Another thing I considered is that my weight is low…calorie needs are lower than the early days of dieting…I may be reaching my low…and this may be as low as things naturally go…and I may need to revise MY goal to go lower…and just focus on maintaining this weight…that it may be unreasonable to push myself to lose more. So, with all this in mind…I’m TRYING to be Mindful and to approach this diet thing with Rational Mind and Wise Mind…because Emotional Mind is eating me up!

Using DBT CBT Workbook Recovery Skills To Get Control Of My Out-Of-Control Eating! Losing Weight Again!

I made it through the diet crisis. What a horrible time that was…to feel so out-of-control of my eating and knowing I was very close to relapse back into an EATING DISORDER! It’s kind of sad to think back to that…I was so desperate and struggling. Writing one of the blogs in that period, it occurred to me how much drama and chaos I was experiencing and allowing myself to go through. Because the theme of my life is “Peace and Stability,” I became sick n’ tired of the chaos and drama…and I took control of my out-of-control self! It was like “Ah, hell no” and I got very serious about getting my life under control.

So, I resolved to take advantage of my Wise Mind thinking and I got a Game Plan. I Followed Through with it and packed my food for my work day (planning, decided what to eat), stopped buying fruit (managed temptation), counted the calories throughout the day (Mindfulness), kept reminding myself of my goal to get control (All Day Daily Devotional), was Mindful of the two choices I had – to eat what I wanted and gain all my weight back or to control my eating and keep my weight down (Two Choices), put up tempting food that the family left out (more temptation management), and I Talked Myself Through impulses to eat something that would increase calories too much (Self-Talk, Talking Myself Through the Moment). I practiced what I preach. I wasn’t perfect though…but kept with it (Perseverance).

Just looked and the last entry was 10 days ago. In that time, I had 3 “bad days” in a row (1380 calories or more)– I pigged out on my husband’s home cooked beans and cornbread one day, another was a bunch of M&M’s, and another was chips. However, had many good days, too. Total calories this month is 1255, so, things have averaged out pretty good. Weight went up to 131 one day…and is now back to 124. 122 is my lowest during the last 4 years of dieting. Was often in the 124-125 range before things got out of control recently.

Other dynamics that have helped me over the past week have included…being overbusy and working long hours at work and having less time for food at home (I have been packing an insulated bag with food for work) , my husband hasn’t cooked since the beans and cornbread episode, I have been playing Zuma a lot when I’m home (pleasure and de-stressing time from overworking at work), and the kids have been VERY busy with school stuff in the evening and they haven’t been cooking much either!! So, the planets have lined up well…and all is well. Praise God. How can I forget…I also prayed and asked God to help me Get Control…because I was doing a horrible job of it on my own.

For some reason, I forgot that it was the 10 days after my period that my weight went up (like to 131 recently). Falling to 124 so fast caught my attention and I looked over my Excel spreadsheet and remembered that. So, I’m at a good time now when my weight should stay lower…for a few weeks. Would be fun to lose a new pound and get to 121.

It’s really unbelievable. I once thought that it would be impossible to hit 135…and that if I ever got to 165 it would be an amazing thing. I started out at 260 on my scale…(did I just put that in print) so, it is pretty unbelievable to be in the 120’s…or even under 200!

My goal is 112. I spent many years of my life in the teens…usually 115-118. If it’s do-able, I would like to hit 112 so I have a little room to move up and down and still stay below 118.

My kid was just reading this and asked why I wrote that I’ve lost 145 pounds if it’s only 136. I reminded her that I got pregnant during the last 4 years…gained weight during the pregnancy and when all was said and done after I lost the baby, I was 13 pounds higher. So, when I went back to my diet, I had to lose those 13 pounds again. So, in reality, I’ve lost 136 pounds + 13…so, I’m really at 149. I count those 13 because I had to lose them again…and regaining them wasn’t my fault…like going back up to 131!

Anyways, all’s well…for now. I guess that’s “for now in the diet world” because my life is entirely Out-of-Control at work…and I can’t stand the feeling. It’s not a wonder why I entitled the DBT-CBT Workbook, “Out-of-Control”!!! The way I’m dealing with that is by busting my butt to get caught up…or at least to get things well enough in control that I don’t feel so overwhelmed and desperately Out-of-Control! I’ll focus on that…work hard now…play later!

Balance is a big thing in the DBT-CBT recovery program and I noticed that I was achieving some semblance of balance by allowing myself to play Zuma for hours instead of working at home and making myself do things I didn’t feel like doing at home. I had to notice that because I felt guilty about playing so much Zuma!

I tell my Group folks that “normal” life isn’t a cakewalk…and “normal” folks aren’t so normal (ain’t I a good example! ) I tell them that “normal” life is stressful and it’s not easy…that “normal” people have many things to struggle with, too….and that’s it’s always something. Things are always “Coming At Us” that we have to struggle through and deal with…that the skills taught in the workbook not only apply to recovery from drugs and alcohol, or cutting and suicide attempts, or depression or Bipolar Disorder…that they are about how to deal with life in general.

I share with them glimpses of my struggles as examples now and then…and I let them know that even though I am years into recovery from my history of seriously self-destructive coping behaviors…I still have to deal with myself on a daily basis…and that I live, eat, and breathe the recovery principles in the workbook…and that I, too, get tired of having to deal with stuff ALL THE TIME!

On Losing 145 Pounds and Using Dialectical Behavior Therapy (DBT) and Cognitive-Behavioral Therapy (CBT) to Regain Control Over My Over-Eating Eating Disorder!

Well, here’s another day of my recent fight to regain control of my eating and to continue to lose weight…and to prevent a full relapse into my over-eating Eating Disorder!

Felt great to weigh in at 127. One less than yesterday and a common weight for me over the past few months…and going in the right direction!

Started my day with Mindfulness of recovery being my #1 priority today. I thought about how I wanted to eat this day and I took note of what was coming at me today that could challenge my recovery. I thought about the Service Awards Celebration that would be held today at work. They’d serve cake, cookies, and other goodies. I wasn’t sure I wouldn’t eat anything there, so I was aware I needed to plan my food day to allow for that!

Started my work day by buying some time and drinking coffee first thing rather than settling into my 1-1/2 sandwiches of fat-free turkey and double fiber bread (230 cals!). Had that at about 11:30. That held me just fine until the Awards Celebration…I got a 20-year with the state of Texas award. Cool. I did good until the end when folks were chatting by the food tables…and I did it! I had a small piece of cake and would have had a chocolate chip cookie, but no chocolate cookies left of any sort and I wouldn’t waste calories on non-chocolate! Got out of there with only about 50 cals worth of cake! Oh yea! Awesome!

Well, just like I am…I get back to my work area…and there’s candy bars on the counter for sale for Relay For Life…and seeing them brings on the sweet munchies that were brought on by not getting the chocolate chip cookie! Mentioned to my friend that I had the sweet munchies now and she told me about all the treats she had stored in her desk! Oh boy! So had a Reese’s candy bar (270 cals), about a dozen M&M’s….and a good handful of cashews. Can’t imagine that to be more than about 130 calories. Delighted because 400 more calories satiated my sweet craving. Did so well that I skipped my afternoon black bean soup.

Worked late, came home at about 7 and enjoyed three yogurts (240 cals) and started on sunflower seeds. Betcha I won’t need to have the Snicker’s chocolate protein bar tonight after sweets earlier today. Really not craving anything except I’m enjoying the seeds! Think I’ll play Zuma for a while and then package up the books which have sold today. I feel so much better that my eating is better under control. Just need to continue what I’m doing and work through this “near disaster” in my recovery!

I kept track of calories all day…grand total of 1030. That’s a bit low (Rational Mind)…though I really like the number! (Emotional Mind) However, I want to re-experience peace and stability in my eating…and not the roller coaster of late. (Rational Mind) Too few calories for one to two days leads me into out-of-control eating while my body tries to replenish itself! (Rational Mind) I’m just not in the mood for more diet drama. Had my fill of that! (Rational Mind) May snack on something to bring it closer to about 1250 (Wise Mind)…but I really like the 1030 number! (Emotional Mind)

Oh boy, hubby just got home bearing Walmart grocery bags…and I get to put them up! My recovery supportive husband brought home three bags of chips…one of which I happen to really like…but, also a bag of apples. So, I was mindful of my recovery and my recovery goals and realized that if I cracked the bag of chips it would be 200 calories in seconds flat! (Rational Mind) Made a decision to put them up and out of my sight. (Wise Mind) Then, I found the bag of apples…ahhhhhh…had two. So, total calories now about 1160…and now he’s grilling hamburgers outside. Hopefully, I’ll just tear one in half and have that! (Wise Mind) That puts me right at that 1250 number! Boy, sure I love the food he cooks out there on the propane grill. Oh…man!

Willfulness and Willingness…Fighting for Recovery…From My Overeating Disorder!

“You get skinnier every time I see you.” That’s what my friend said to me today…and I thought, “Fat chance of that!”

Weighed this morning – 128. Not horrible, better than 129 the other day…but lots worse than my monthly average the last few months (125 range) with lows at 122-123.

Getting dressed, I put on my size 10’s…my larger pants since I’m not in the 125 range. Oh my God, they were tight. I am not doing tight first thing in the morning, else by mid-afternoon seams will be a-bursting! Went up a half size bigger…ahhhhhh…and to think I was going to put those in storage just in case I started to get fat again. I shouldn’t need to wear those. I wore those at 135. But…if the pants fit, wear them!

I was feeling despondent, helpless, out-of-control…desperate…hopeless. Then, anxiety hit. I realized this could easily be a relapse point. Eating out-of-control…felt discouraged…was bloated…and having to wear “fat pants”…everything was just right for an Emotional Mind recovery sabotage.

My first panic thought was to strictly reduce my calories to 1100…to punish myself. (Emotional Mind thinking).

Rational Mind said, “That’s too low…and punishing yourself will backfire..it’s not a good thing for you.”

Wise Mind said, “Chill out Mel…work to maintain calories in the 1200 range…that’s very do-able for you…you can tighten up a bit.”

Thank God I’m into this DBT-CBT thing…and I live, eat, and breathe it. And thank God I caught myself in the middle of this serious Emotional Mind game. I thought, “You know, I’m not going there.” Then I thought, “I think I’ve just entered a fight for my recovery. It’s at that point now.”

I then recognized I felt a bit angry about this eating thing…frustrated, just tired of it. Then another thought flew through my mind, “I don’t get mad, I get even.” This is usually a negative, revenge type of Emotion-Driven thought, a self-destructive thought. However, for me…today…it was more like, “It’s time to kick this in the ass…I’m tired of it.” “It” being…”I’m tired of my crap”…it’s like “Shit or get off the pot”…or…”If you’re serious about this diet thing, then make it happen already…Get control or lose control. Game’s over. It’s time to get serious.”

I thought about DBT and “Willfulness vs. Willingness.” Well, one is usually bad – the stubborn, willfulness one…and willingness is usually good – the “I’ll do whatever I need to do to be okay”…it’s the “I surrender,” “I accept,”…the, ”I’m ready and willing” one.

Well, for me today, Willfulness was a positive thing. It was the stubborn and determined part of me…that fight from deep inside…being willful in a survivalist type of way…the, “I’ll be damned if this kicks my ass” type of fire from within!

Willingness was there, too. They stood side by side. I was willing to do what I needed to do to get this eating thing going on. I surrender my will to eat whatever I want to eat. I surrender to setting limits for my eating.

Well, I’ve done very well today with just a minimum of distress. Ended the food day at 6:30pm with 1185 cals. For breakfast I had 1-1/2 fat free turkey sandwiches (double fiber whole wheat bread) and drank coffee with about 25 calories of flavored coffee creamer. I had a can of green beans for lunch. That held me over until my mid-afternoon can of black bean soup which kept me from leaving work starving to death and ready to eat everything in sight when I got home from work. Upon arriving home, I had 3 black cherry yogurts (80 cals each and quite a treat) and a Snickers 290 calorie chocolate protein bar (quite a treat…like a candy bar!) I picked at leftovers and had a couple bites of chicken with green peppers. SUCCESS. Had to forego fruit and sunflower seeds today, but I’m fine. Started the sunflower seeds in the evening when I quit cigarettes a few months ago…and also added a lot of fruit then to deal with the nicotine withdrawal CONSTIPATION! Did just fine though without them tonight.

Now…today I went back to some of the dieting basics like I resolved to do a few days ago…yesterday…whenever it was. I kept a running tally of my calories through the day…and emailed them to my home! I was mindful of what I would eat (for the most part), planned my food day (for the most part) and I did the “think through before you do” thing. Now, tomorrow is a new day and I sure hope I experience that fire from within…and fight for my recovery all over again! I hope my battles help you in your fight.

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.