I finally got my DBT homework finished. If you’ll recall from my post about week 5 of DBT, this homework was a bit harder than prior assignments. Luckily we had two weeks to do it, as a session was cancelled for Memorial Day.
This assignment was about crisis survival skills. It required coming up with a crisis, destructive behavior, and the pros and cons for both doing and not doing the destructive behavior. I had a hard time getting started because I didn’t know what to use as a “crisis” and destructive behavior. It also took awhile to finish up because I was having a hard time thinking about pros for tolerating distress. So here’s a summary of what I put together for my assignment.
Crisis I was faced with: starting new job
Destructive behavior I did/wanted to do: smoke pot
Pros of destructive behavior:
- relaxing, reduces anxiety
- easier to get into tasks
- more creative
- better mood
- feel good
Cons of destructive behavior:
- self-medicating (which I don’t want to do)
- lower overall motivation
- mindless eating
- illegal
- makes me sleepy, fuzzy-headed
Pros of tolerating distress:
- legal
- less mindless eating
- not self-medicating
- no medication interactions
- easier to get up in the morning
Cons of tolerating distress:
- still anxious
- panic attacks
- paralysis
- irritability
- frustration
- less productive
The instructions say to weigh out which side is heavier and act accordingly. Honestly, it’s the cons of tolerating distress and the counterbalancing pros of smoking pot that are winning this battle. The cons of smoking pot that bother me most are the mindless eating and the pot hangover that makes me fuzzy-headed and slow in the morning. But it doesn’t come anywhere near the cons of tolerating distress and pros of smoking pot.
Trying to keep Pandora’s box of freak-out tightly closed.
Neither approach solves the real problem. It doesn’t matter what the crisis actually is, nor the destructive behavior. Anxiety is the persistent issue, but my docs haven’t considered it much of a concern.
As far as I can tell, my anxiety issues are not diagnosable as separate from bipolar because there are relatively few/infrequent autonomic responses, although I have some of the other symptoms and it interferes with normal functioning at times. More often than I’d like to admit, quite frankly. Mood stabilizers have made it better (overall) but anxiety is nearly always riding shotgun. So I’m trying to manage as well as possible with the means at hand. Marijuana has always been an effective anxiolytic with relatively mild side effects. But the whole point of doing DBT is to get better at handling this stuff without resorting to self-medication.
Using the DBT skills for distress tolerance isn’t really helping much right now. I can’t afford to spend all my time self-soothing and distracting myself when the distress is pervasive and ongoing. Most of the skills are designed for managing difficult situations, cases where something nasty is happening for the moment, not something that spreads throughout the whole day, day in and day out. I can try to use the DBT skills for this kind of thing, but the second I stop distracting or self-soothing or whatever, I’m right back where I started. And then I just feel worse for not having accomplished whatever it was I ought to have been doing. Maybe when we get to emotion regulation I’ll find something more helpful.
I really admire you for taking this upon yourself. You’re grappling with tough issues. Even if you don’t come up with fixes, it seems like exercises like this at least provide some degree of clarity about what does or does not work for you, and more importantly, what the issues really are.
Yeah, the group leader said that’s what they had found was part of the value for people. Other group members who have been through this exercise before also suggested that sometimes you get more clarity about it over time.
Seems like this week’s exercises will be more useful, though.
I’m sorry to hear that you are struggling with anxiety issues. I know what that feels like. I hope you are able to come to grips with your anxiety. Just keep in mind that you are a wonderful success. Maybe keeping that thought in mind will help quell your anxiety.
I love the analysis – maybe I will try that myself!
Thanks, Monday! The anxiety is frustrating because I don’t feel like it’s bad enough that I need to really emphasize it to the docs, but at the same time, it does get really disruptive at some points.
I agree with what you say in your last paragraph. I have tried some of the soothing activities I read about in a DBT workbook, but when I’m done, I still have the problem. I feel like it’s more distraction than anything else.
Well, funny enough, distraction is the point of the self-soothing skills. The idea is to distract yourself from the distress long enough to get through the situation. But I find most of the distressing situations I face aren’t that temporary, so like you said, when I’m done distracting myself, the problem is still there.
Distress Tolerance and Interpersonal Effectiveness were the hardest for me. I’m still waiting on my DBT group. Actually, I heard back on Friday but it turns out there are only three weeks left so I think I’ll just wait for the new one to start up.
I feel ya on the last paragraph too. If there’s anything I’ve learned is that it has to be a continuous thing, which sucks. My Ex-Young Therapist used to say, “your distress is like a bottle that keeps getting filled up, so you have to open the lever at the bottom continually. I liked the metaphor but hate the thought of it because it’s true, especially right now.
I expect Emotion Regulation to be a tough one for me, but Interpersonal Effectiveness not so much. I hope the new group works out well for you!
The continuousness of the distress is distressing in itself! The distress is never really gone, which (when even mildly depressed) usually leads me down the mental path of, “it’s never going to get better, so why keep trying?” One of the group members also echoed the sentiment – “When am I not in distress?” Hear, hear.
Hope they get better!