Carmen tells us how a combination of mindfulness, dialectical behaviour therapy (DBT) and pet therapy help her cope with borderline personality disorder.
When I get cross or anxious I don’t experience it in the same way as most others. It can come on very suddenly, like a tornado or a thunderclap in my brain: rage, terror, anguish, feelings of being let down or abandoned (however irrational), paranoid thoughts, impulsive urges to harm myself in some way or start screaming out loud. The feelings can linger for hours or even days afterwards.
"Someone can say something to me that makes me feel like I’m being invalidated or rejected and it’s like flicking a nasty switch."
So many things can trigger an episode for me. Feeling invalidated, abandoned, rejected or misunderstood are particularly big triggers. Someone can say something to me that makes me feel like I’m being invalidated or rejected and it’s like flicking a nasty switch.
Another significant trigger is when things happen that remind me of traumatic experiences. Or when I feel out of control generally. I worry a lot about money. Something like a missed benefit payment or a bill I can’t pay can send me into a spiral of anxiety, rage, and even a desire to hurt myself or others (even though in my right mind I’m not someone who wishes to harm others, in fact I hate the thought of offending someone and often hold myself back in relationships for fear of hurting their feelings).
If I’m not careful to stay mindful during these episodes I can end up seriously hurting myself, going on a spending spree I can’t afford or impulsively lashing out at someone I care about.
I first learned about mindfulness when I started a course of dialectical behaviour therapy, or DBT, as an outpatient at my local psychiatric hospital. It comprised of two weekly sessions: a one-to-one session with a therapist, and a group session led by two therapists and attended by others with borderline personality (also known as emotionally unstable personality disorder). We learned to be “mindful” of what we were feeling, without judging ourselves for it and just observing our feelings. Once we’d learned to identify our feelings, we went on to learn distress tolerance and self-soothing. This involved using the skills we’d learned in mindfulness to sit with our painful emotions of sadness, anger, self-hate, anxiety, fear, emptiness and worry.
"If I had a meltdown or crisis, she’d help me understand what may have contributed to my feelings and thoughts leading up to it."
We learned how to self-soothe using “grounding” exercises. One I found helpful was to observe five things I could see in the room, then five things I could hear, five things I could touch and so on. I found this particular exercise very helpful during a recent crisis. We also discussed alternative activities to self-harm and other self-destructive behaviours like overeating, overspending, violent outbursts, alcohol or drug abuse.
My one-to-one therapist helped me use the DBT skills I was learning in the group session to face any negative thoughts or feelings. If I had a meltdown or crisis, she’d help me understand what may have contributed to my feelings and thoughts leading up to it.
I’ll admit that at first I thought of mindfulness as being a bit hippy dippy for me. I come from a solid Evangelical Church background, very suspicious of anything the slightest new age-y sounding. And I admit that I did struggle with some of the meditations I was taught at first. But I was also taught other ways of mindfulness. For me, I learned that mindfulness as a way of soothing emotions could be art, colouring books or even stroking guinea pigs.
"When I hold the guinea pigs and stroke their fur gently and rhythmically, I can feel my breathing slowing. When I feel them lick my cheek or chin and purr and chirp in my arms I feel real again."
I grew up with guinea pigs - I have always loved them and found stroking them could be soothing at times. At first I felt I couldn’t go near my piggies when I was having a meltdown. I was worried that in my anger I might not be safe for them. Guinea pigs are timid, prey animals by nature and I feared scaring them. But something I’ve had to learn about mindfulness is that I have to bite the bullet and just do it.
When I hold the guinea pigs and stroke their fur gently and rhythmically, I can feel my breathing slowing. When I feel them lick my cheek or chin and purr and chirp in my arms I feel real again. Like I’m not drifting out of my body. Each morning, my guinea pigs give me something to wake up for. When I feel suicidal, a main reason for sticking around is them. They make me feel connected to this earth somehow. They need me. Some days I don’t see the point in getting up, but if I’m lying there in a heap of pointless pain, wishing I could disappear, I hear them squeak and know they need me.
I’d be lying if I told you that some days even guinea pigs and colouring don’t work. Some days I have to call a mental health helpline line or crisis team (when I’m using services - with this illness, my engagement with services is on and off). Sometimes I need someone to reassure me or do mindfulness with me. Sometimes I need to be “talked down.” But on a day to day basis, the guinea pigs and the DBT skills are there for me. And the more I use these skills, even when I’m well or low level distressed, the better I get at them.
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