Therapy Success – Checking the Facts

Well, I brought a written copy of an emotion regulation skill that I had used in a situation to therapy. My therapist was very impressed and we ended up teasing through the issues that were outlined including talking about things that perhaps weren’t issues, but more worded awkwardly.

This was the check the facts skill to see if the emotions that I was feeling matched the prompting event. First, I described the emotions as feeling alone and insecure. Then, I went through the event that happened when these feelings came up without emotion or judgment. I went through just the facts stating where I was at the time and the fact that I was speaking to my husband about something and his responses. This wasn’t an argument, but he had simply said that he didn’t know what to say.

Then, I went through my interpretations, thoughts and assumptions while giving other scenarios. I gave my point of view which was that I felt disconnected from my husband because he didn’t say the words that I was hoping to hear. I felt alone and like I wasn’t able to communicate what I needed to him or like we were on different pages. He doesn’t understand how that feels. I know that he doesn’t understand the disconnected feeling that I get when certain topics come up. He says he never feels that way so he just doesn’t understand. Based on this, he wouldn’t necessarily know what to say when I’m feeling that way. He’s also just plain not good about talking about subjects having to do with physical attraction. This went on a little bit going back and forth.

Next, I labeled whatever threats I felt would result from this particular situation if it just hung around. I felt like I could feel rejected and resentful. This is a real threat. It could happen; however, the likelihood is slim as this will be dropped. If it is something that is worth bringing up further, it is something that could be discussed in marriage counseling again preventing or reducing feelings of rejection and resentment.

It goes on to catastrophe and I really had trouble coming up with one. I think that’s a good thing. I suppose the worst possible thing would be ending up alone. There would be nothing worse than losing my family.

The last asks if the emotion and the intensity are warranted and gives examples of when emotions are warranted. Well, for me, this was warranted, but the intensity didn’t match the event. In the end though, the intensity of the emotion was significantly reduced just by writing this stuff out.

This morning, I was ruminating over something that happened in the past while I was in bed. I couldn’t go to sleep so I got up. The change of scenery helped. Then, I did the same exercise. Somehow, I went from bad morning to great day. My therapist wants me to do this all the time and I’m excited because it has been successful for me so far.

***The Check the Facts is a Dialectical Behavioral Therapy (DBT) skill which was developed by Marsha Linehan.

 

Thinking About the Dialectic

DBT, or dialectical behavioral therapy, has been a huge part of my therapy for the past 7 years or so. It has been the main therapeutic module that I have used and it has been the one that has shown the most success for me over the course of my lifetime.

A main idea of DBT is that of the dialectic. That idea is that universe is filled with multiple opposing sides and forces and that also leads to the fact that there’s also more than one to view a situation or solve a problem. It also has this idea that change is the only constant. Those two things, which I believe to be true, may seem a bit too philosophical; however, for me, they have been a big factor in my ability to adapt even when I am symptomatic. It’s something that my therapist and I walk through when things come up.

For example, I have two young sons, which is why this blog is called Being a Bipolar Mom, and there are times where things happen around them where we will test my perception or my problem solving abilities. For example, someone in my family will say something about my son’s speech sound disorder and tell me that he needs to have that fixed by kindergarten. I get angry because they make it sound like my son has something where it has a natural progression and we can say exactly when it will be “fixed”. I saw this as a shot at my son initially and I felt that they were placing way too much pressure on him.

Talking to my therapist, we were able to tease out details of the conversation that I may have misread because I was in mama bear mode protecting my son. I had the feeling of who the hell are they to say what my son should and shouldn’t do by such and such time and how the hell do they know if he is going to be able to do it or not?

The part that was missing was that they were trying to help. They told us they wanted us to send him for private speech therapy, which my husband and I were in the process of doing already, and that they were willing to pay for it. My mother-in-law used doctor google and informed herself of the horrible perils of a speech delay in K and how he won’t be able to learn to read, etc. Of course, she doesn’t know that my son can spell phonetically. He may not be able to say the sounds, but he sure as hell knows what they sound like. He can sound out some words too and he’s 4. Neither myself, my husband, his speech therapy team (2 SLP-Ts and a SLP-TA), nor his teacher think that he’s going to have any trouble reading as a result and think that we’re doing a great job with sound awareness.

Basically, in all of this, I learned that there was a disconnect. She was seeing his speech disorder as this horrible thing that was going to cripple him and that we should get him all the help that he needs. I heard it as you need to do more or he’s going to be illiterate. Part of that was that I let my mommy bear get out in front of me. I didn’t want him to hear any of what she said. The other part was that our communication was not clear. Instead of asking us about our son’s progress, she assumed that it was holding him back in ways it wasn’t. Instead of me asking her what she meant by paying for whatever it takes to get it fixed, I shouldn’t have bottled it all in getting more frustrated. We both wanted the same thing though.

Therapy and DEAR MAN

Last night, I had therapy and I spoke of some communication breakdown issues that I have been having. Of course, I didn’t actually KNOW that was the issue until we sort of teased it out. We did some role playing using the DEAR MAN skill primarily. So, this is how it went:

D – Describe the situation using a non-judgmental stance. (We through a little GIVE in here with gentle manner.) It’s important to us that we get to see you and we appreciate that we have the opportunity to stay with you when we are there. The house is 2 bedrooms though and there are four of us. It can get crowded and we are also on our family vacation making memories.

E – Express. We appreciate your hospitality, but feel like we are putting you out. It gets crowded after some time and this really is our only trip so we really want to make some family memories. Plus, the boys don’t really have playgrounds or any areas to play because you live in a 55 plus community.

A – Assert. Ask for what you want. We really would like it if we could spend half of the time in your home and the other half of our trip in a hotel. It is rare for us to get the opportunity to stay in a hotel and the boys enjoy it.

R – Reinforce. Tell them what’s in it for them. It must be difficult for you to have 4 additional people in your home. This will give everyone some space while we get to spend time together. Plus, if we stay at a hotel we are more likely to spend more time in town.

M – Stay Mindful. Be a broken record and stay on track if the subject is changed. We really appreciate the opportunity to stay with you and we really love spending time with you and we really would like some space for some of the trip.

A – Appear Confident. Maintain eye contact. Use a strong voice. Go in believing that this is going to be a success.

N – Negotiate. We are flexible as to how we split the time between the hotel and your home. Lets figure out what works best for everyone. (If they don’t agree to splitting the trip 50/50.)

So, now I have roleplayed a scenario with DEAR MAN that can be useful. My above example isn’t really perfect because I’m not going off our exact words unfortunately. It’s close enough though.

The stigma won’t silence me

I haven’t blogged in years until yesterday and there is a huge reason for that – stigma. I had been told that based on my publicly blogging about my mental illness that I was not employable. She found out that I had bipolar disorder around the same time and told me it didn’t change anything, but suddenly I was unemployable because I had an illness. She compared it to people sharing images of themselves partying Girls Gone Wild style and it has hurt me since. My life is NOT a party. It’s not a choice. I have to cope with the challenges placed before me due to my illnesses and I am continuing to learn and implement skills to do so.

I have mentioned that I have bipolar disorder. I received a bipolar disorder type 2 diagnosis in 2002 which was later changed to bipolar 1 with mixed features. I have also been diagnosed with various forms of anxiety with the latest being anxiety NOS or anxiety not otherwise specified. My anxiety typically revolves around people and social situations though which is why my main anxiety diagnosis has consistently been social anxiety disorder or agoraphobia with panic. The anxiety stuff for me is confusing.

In 2010, I was also diagnosed with Borderline Personality Disorder. At first, when they were doing the screening I was confused. I thought of course I have these symptoms. I have bipolar disorder. Then, I learned that they are not one and the same and the stigma facing BPD is even more extreme than that of those with bipolar disorder. Insurance isn’t even required to cover it to the same degree. People with this disorder are seen as needy manipulators, even in some psychiatric literature.

Over the course of several years, I have developed DBT, Dialectical Behavioral Therapy, skills to help me handle the emotional extremes, the abandonment fears, the outbursts, the self harm urges, and all of the other qualities that I scored high in during my screening. Now, I only have traits. I don’t have enough of the symptoms to classify as having BPD. I still have the attempts to thwart real or imagined abandonment and emotion regulation is an ongoing learning experience.

So, now that you know about my issues, I want to share an article written by NFL wide receiver Brandon Marshall about the stigma around mental illness. I found it well written and it inspired my post.

Brandon Marshall on the Stigma around Mental Illness

This said, I’m no longer going to give into the stigma. I am going to tell my story, still anonymously, but I’m going to tell it. Once I know I can handle the negative reactions of the ones that I love, I will share with my name and shout it from the rooftops. I have nothing to be ashamed of and no one else with a mental illness should be ashamed either. I wouldn’t be ashamed to say that I had cancer, heart disease, fibromyalgia, or a host of other illnesses. I’m not going to be ashamed of this any longer. My kids are going to know that their mama is a strong woman with an illness who isn’t afraid to admit it.