Dead Panic, Ice Cubes, and Walkabouts

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This morning I was supposed to start my intensive outpatient program, the one I’ve been putting off since October.

Note the use of the words “supposed to.”

I woke up in a dead panic about my day. I think it started when I realized that I would be out and about and away from my checklists, which have become my life manager these days, and that I would need to pack certain things to go with me to the hospital. What if I forgot something? What if I didn’t hear an alarm? What would I need to change to make my day a success?

This led quickly to me in a bawling heap on the couch, absolutely terrified of what I was going to do. I was scared to move, scared to think, and especially scared to make any decision whatsoever. Being asked a question – any question – was a fight/flight/freeze trigger, and I was being asked entirely too many of them. I froze every time.

By the time my wife was off to work, I had made the decision that I would spend the day trying to achieve as many levels on one of my DJ game avatars as I could. Then the servers went down around 9:00 local time and didn’t come back up for nearly six hours. Which led to more panic, though of a lower level. I finally decided my solution was to sleep through the waiting, and that seemed to finally reset my panic-o-meter. As I write this, I’m sitting on the couch watching the indoor cat watch the outdoor cat eat, sipping on a cup of decaf. Life is … well, not good, but at least content again.


When I first posted something about this on Facebook this morning, I got a lot of commentary along the lines of “be easy on yourself.” And that’s where I ran into a roadblock.

“The DBT Skills Workbook” talks about distracting behaviors when someone is in a mindset of self-harm. But they almost exclusively refer to situations where “self-harm” includes activities such as “cutting, pulling out hair, or self-mutilation.” I’ve never cut or self-mutilated once, and I don’t have any hair to pull out (maybe in my case self-harm means growing it out?) so I’m at a loss as to what I can do to distract myself from the type of self-harm that I engage in, self-neglect.

Today I recognized that I needed to self-soothe, another technique that’s used in DBT, and so I decided to bury myself into a computer game and distract myself with that. But during those times of self-neglect, I won’t allow myself food, water, bathroom breaks until it’s almost too late to avoid an accident, reading, watching movies or television, computer games, sleep, or anything else that might be a self-soothing mechanism or a distraction. Or I overeat, to the point of pain and nausea, which over time has led me to becoming morbidly obese. So I’m not sure what to do when my mind slides into self-neglect mode, since it’s much more insidious and stealthy than cutting or mutilation. The same activities that would normally be used to distract me from my form of self-harm are the exact things that my self-harm will not allow me to do.

There is one technique that is recommended in the workbook that might work: holding an ice cube in my hand until the urge to self-neglect passes. If I hold it long enough, I’ll have no choice but to practice self-care, as my hand will be too cold for me to do anything else but see to warming back up. I have to hold it over a sink since I’d be dripping melting ice water over everything, and by staying in one place with nothing to trigger me but the dishes, I’m not stimulated by little things stacking on top of one another in my environment. (When in the state called “emotion mind,” which is where I almost always am when I practice self-neglect, it’s easy for one little thing to become huge, and for several little things to become mentally crippling. The goal, I believe, is to pull yourself out of “emotion mind” and into either “reason mind” or “wise mind,” where you can look at triggers more objectively.) There’s little chance of actual injury from holding ice in your hand (unless you do it for hours at a time) and the aftereffects are much less harmful than stuffing my face to the point of agony. Plus I have permission to pee.

Another might be to have something – just one thing – that is permitted no matter what, so that I can allow myself enough of a distraction to reset my “emotion mind.” I don’t think being on the computer should be this thing, since there’s oftentimes so many negative stimuli coming from news and social media that it becomes one of those stacking situations I spoke of earlier. Walking, perhaps, should be that always-allowed distraction. It gets me out of the house without making me face the public except in passing; it gives me the distraction of my walking playlist to listen to and silently sing along with (I’m in too bad a shape to walk 3 miles an hour and sing; just … no); it releases endorphins that naturally serve to chemically soothe me.

In a short time, physical exercise has gone from something I avoid at all costs to something that I’m using as a soothing technique. If there’s no other indicator that I’m getting healthier, this is it.

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Radical Acceptance

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Photo: The Holy Grail prop used in “Indiana Jones and the Last Crusade.” Image taken from indianajones.wikia.com; the prop itself is the intellectual property of Lucasfilm Ltd.

As promised in last night’s Three Good Things post, I wanted to talk more about the concept of radical acceptance and my rudimentary understanding of it. This is based off a revelation I had while reading “The Dialectical Behavior Therapy Skills Workbook” by Matthew McKay, Ph.D., Jeffrey C. Wood, Psy.D., and Jeffrey Brantley, MD.

The copy I’m reading originally came from my wife’s library. She purchased it for her own use, lost it, bought it again in an e-book format, then we found the original, which she’d barely written in with a pencil. Five minutes with an eraser and I had a virtually new copy all to myself.

It’s important to note that my wife was diagnosed with borderline personality disorder before I was, and in our attempts to understand what she was beginning to go through, I’d picked up a couple of books and did some research online. We knew that the first step was something called “radical acceptance,” where you accept yourself just as you are, warts and all.

This was a concept that I had trouble with even when I first learned about it. How are you supposed to accept who you are when you know all those mistakes that you’ve made and just thinking about them brings those same emotions washing over you just as they first did when the mistake first occurred? How does one even begin to break that cycle? So for a while, the concept of “radical acceptance” was something that was a nebulous thing, a legend, a myth – something that we weren’t sure could or did exist, but would change my life if I could just find it. (Even before I was diagnosed with BPD, I knew that the concept would be a helpful one for me. Did I know in my bones that I really had BPD all this time? Not sure if I’ll ever be able to say.) Radical acceptance became something of a Holy Grail for me to search for, doubting I’d ever find it.

Fast forward to last night, when I was reading in the workbook and discovered that radical acceptance goes beyond just yourself and your self-image. It deals with accepting your present environment, whether it be good or bad, as being the perfect combination of all the events and decisions that have transpired before it. This is a concept that I more or less adhere to. Oftentimes I reminisce about some of the experiences that I have in life, and usually my wife will ask if I wish that I had done things differently, that my life was somehow easier than it is now. Invariably I tell her that I don’t wish anything were different because I don’t know if one tiny change in my past may have resulted in me missing out on meeting her, falling in love, and marrying my best friend and soulmate. When I read those words last night, I was stunned to realize I’d been practicing radical acceptance all this time – I just wasn’t directing it inward toward myself.

The revelation came when I realized that I can’t be a different person than the experiences that brought me to this point have led me to be. The two are interconnected, and that means that I am exactly the person that I mean and want to be, right now, in this moment.

If I can radically accept what events in my life brought me to this point, whether they be good or bad, it’s not that far of a stretch to radically accept the person those events made me into.

Last night, I found my Holy Grail. And unlike whatever Indiana Jones tells you, it resides within me. And my wife’s resides within her. And yours resides within you. All it takes is just accepting this moment as being perfect within all the imperfections that led to it. Accepting yourself as a product of all the moments before this is just a simple leap of faith. And any Indiana Jones fan worth his or her salt will tell you that’s the way to finding the Grail.

Self-Esteem and Cherry Blossoms

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Photo credit: WindyLife@deviantART

I’m currently reading a book entitled “The Buddha and the Borderline” by Kiera Van Gelder. It tells the story of one woman’s struggles with borderline personality disorder (BPD) symptoms for years before having it properly diagnosed, and her use of dialectical behavioral therapy (DBT) and Zen Buddhism to recover. I’m five chapters in, but it’s a fascinating read. Van Gelder is almost bluntly transparent about her struggles, and it’s refreshing to hear someone else go through similar experiences to what I’ve been through in my life.

One of the main tenets of DBT is a concept called radical acceptance. It essentially means that you accept who and what you are, right now, in this very moment, strengths and weaknesses, flaws and all. Mindfulness is a big part of this concept, and the yoga is helping with that. But how do you accept who and what you are when you don’t know what that is?

I thought I’d address the topic of self-esteem today, since that’s one of the parts of the title of this blog. I know I have pretty low self-esteem, but what does high self-esteem look like? So I hit Google to try and find an answer.

The Mayo Clinic was my first hit, in an article called “Self-Esteem Check: Too Low or Just Right?” It talks about healthy self-esteem rather than high self-esteem, and to be honest, that’s more along the lines of what I’m looking for anyway. I came across this passage:

When you have healthy self-esteem it means you have a balanced, accurate view of yourself. For instance, you have a good opinion of your abilities but recognize your flaws.

That sounds so much like what “radical acceptance” starts with. But does self-esteem lead to radical acceptance, or is it really the other way around, with radical acceptance blazing the trail toward healthy self-esteem?

I have so much to learn about this new diagnosis. Looks like I’ll be starting a DBT group therapy of my own on the 10th, so I’ll find out.

In the meantime, I can just acknowledge who and what I am, right now, in this very moment, strengths and weaknesses, flaws and all.

I am a compassionate person.

I am disabled.

I am very talented in the kitchen.

I don’t think I’m worthy of love most of the time.

Sometimes, I believe I’m a pretty awesome guy.

Other times, I don’t think I’m anything.

I am a very good listener.

I get distracted easily if I’m bored.

I’m working hard to improve my physical and mental health.

I’m so tired most of the time, all I want to do is sleep.

I am all these things and more, and I acknowledge them all. Right now, in this moment, it’s okay to be a flawed human being. Technically, we’re all flawed.

One of the minor subplots of the movie “The Last Samurai” is Katsumoto’s (Ken Watanabe) search for an elusive cherry blossom.

The perfect blossom is a rare thing. You could spend your life looking for one, and it would not be a wasted life.

At the end of the movie (I won’t spoil the rest of the plot), he has an epiphany as he gazes on a spectacular tree of the beautiful flowers, some blowing away on a light breeze.

Perfect. They are all perfect.

Perhaps that’s how we should view our humanity. Perfect in all its imperfections.

I am like a cherry blossom.

I am flawed.

And that’s just perfect.