Sunday, September 27, 2009

Emergency Coping Plan

Just coming out of some sort of anxiety attack (I don't think it is an anxiety attack in the strict sense of the word, but I know no other term for these intense onsets of anger and sadness that come with BPD so I'll just go with that). Since I just finished writing my emergency coping plans from the Dialectical Behavioral Therapy Skills Workbook, I'll post it here and elaborate a bit:

MY EMERGENCY COPING PLAN FOR DEALING WITH SITUATIONS WHEN I'M UPSET AND ALONE

1. First, I'll distract myself by counting, reading quotes, or using self-injury replacement

2. Next, I'll relax with a bath or comfy clothes, listening to soothing music or a relaxation technique

3. Then, I'll tell myself coping thoughts and/or pray about my feelings/situation

4. Finally, I'll radically accept my situation, write out my feelings it I need to or plan to share them in therapy.

Today was the first day I've had to use the plan, and although I deviated from it a bit I think it is a good thing. Not sure what brought me to this point - yesterday was a good day, a day when .something happened that made me feel validated in how I handed a recent problem in my life. But today, I woke up with a migraine. I had to take two excederin to ward it off, and that coupled with the soda I drank put too much caffeine into my system which in turn made me anxious and jittery. I'm worried about the future and my career path. I'm remembering and angry - very angry - about the situation that I felt validated about yesterday, and tonight I am forcing myself to go out into a social situation I really don't want to do, but feel would be good for my well-being. So it all culminated in a huge rush of anger, irritability, and anxiety just a few moments ago.

So I got out my book and followed the plan:

1. I squeezed an ice cube and snapped a rubber band on my wrist as a replacement for self-injury (my anger and sadness make me immediately crave my personal choice of SI, burning). I walked around the house counting backward from 100 by 7s (I personally think this is very effective as it is not only distracting and time-consuming as I have the numerical form of dyslexia - but I theorize it activates the logical side of your brain, which I don't seem to use enough and goes out the window altogether when I'm upset). By the time I got to into the -30s I was lying on my bed, breathing slowly again and feeling somewhat calmed down.

2. I didn't have time to take a bath as I'm getting ready for my outing, but I did lay there for a bit in my favorite sweatshirt, which is very comforting to me. I did a few deep breathes, and something I didn't add to my plan but read in the book - thought about a person I love (my nephew).

3. I flipped back in the book to my chart on coping thoughts to use in different situations. For getting mad about this particular situation (a betrayal by a friend), I had written down the following:

- I can take all the time I need to let go and relax. I may not be able to control others, but I can control myself.

- It's ok to hurt sometimes, and my hurt will not kill me.

- These are just my feelings and eventually they'll go away.

I kept repeating that last one over and over, just under my breath, since I know the feelings of hurt and betrayal and anger do go away, because I have recently been able to experience days when I have let them go and don't feel the pain (that doesn't happen often enough yet, but I have come a long way from feeling hurt 24/7 like I used to, and I know I'll keep getting better).

4. Finally, I'll radically accept my situation, write out my feelings if I need to or plan to share them in therapy. Radical Acceptance is hard concept for me - I've only just learned it, don't fully understand it and don't know if I can actually manage to do it. But I try. I look at the situation I've been through, when someone I cared for lied, hurt me, and betrayed my trust. I accept the decisions that this other person made were their choices, not mine, and I can't control that fact that they valued me and our friendship so little that they made those choices. I accept my part in the rocky relationship as well, the way I lashed out at this person, fought with them, and let the hurt me further by my not knowing and using coping skills when they hurt me. I'm trying - though it is difficult - to just accept both of our actions without judging them, and reminding myself that I can change how I react to such situations in the future.

So here I am on the final step - writing out my feelings. In a way, too, I am sharing them, though not formally with my therapist or support group. But I'm sending them off into cyberspace this afternoon, and perhaps someone will read them and they'll make an impact.

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