Cultivating Skills

| By Paul | | Comments (16)

In my last post, Healing from a Place of Strength, I talked about many of the positive strengths I have available to me now, much of them attributed to a new sense of awareness.

Not to belittle that positive approach, but there is the reality that healing is not a positive linear progression. I failed to mention what is perhaps obvious to most, that there are many times when a positive outlook is simply not possible. There are many times when awareness falls by the wayside. There are many times when my mind is seriously fragmented and I am completely dysfunctional. Perhaps the most harmful outcome of this "other side" is when we resort to self-harm.

I still think, though, that awareness is the antidote. It is also a skill that we can cultivate over time. In much the same way that dissociation has been an automatic response for many of us for so long, we can learn to use practical skills regularly to help keep us safe. Having and using a safety plan, imagining safe internal places, relaxation, grounding, journaling, listening to music, taking a PRN, and more, are all things we can do to push the odds in our favor. It does not assure that we will stay safe. It does not assure that we will not "break down." It just increases our chances of getting through safely.

Like all skills, we must practice them if we want to get better at them and increase their chances of working when we need them. Unfortunately, when we are feeling "well" or "together", those are the times when we usually do not practice. I have often thought that because so much of our life is consumed with difficulty, when we are in a good spell we want nothing more than to enjoy that time. There is nothing wrong with that.

This is why I have tried, and I know I am not always super good at it, to incorporate skills into my daily routine no matter how well or un-well I am. One of my greatest skills since I started working with my "Healing Guide" has been to keep a drawing journal. For the first year or more, I went through a Canson 120 page Field Drawing Book almost every month. I filled it with drawings, but also hand writing. The attention to feelings that I talked about in the last post could not have been done just in therapy. The drawing book turned out to be absolutely essential.

Another skill I have cultivated over time, was to build up my electronic journal. At first, it was just a single file that I edited when I was on a specific computer, and eventually I programmed a rather elaborate system—thank you programming skills—whereby I can write to the journal securely through a Web interface from anywhere or even from my iPhone-formatted page. This journal tends to be much more focused on words, but I also use it to attach art or photography I make.

I use the journal mainly to make sense of what is going on in almost real time. That is the key. If I find myself in a tough situation, I can immediately take out the iPhone (if only that is available) and make an entry about what is going on. Often, I can make an entry before I dissociate or fragment. In the past, there was no systematic way to keep track of things. Back then, this is just a couple years ago, if a trigger would generate a dissociative response, it would often just sit until I went to therapy. If that was several days later, my access to the experience was probably gone. That meant that my ability to learn from what happened was also gone.

One does not need a complicated system like I have to do what I do. You can easily keep a computer file on your home computer. If you want, you can even take it to and from work via a thumb drive. For the times when you are away from your computer, I used to keep what my therapist called a "feelings journal" in my pocket. These were pocket sized journals where you can jot down thoughts and feelings or pictures that you can come back to later.

I think the nitty gritty of cultivating awareness (and indeed healing from dissociation) is actually pretty straight forward. There is nothing complicated about journaling. It may take some time to stick and become standard practice. I know for me, I struggled for many years before I was able to keep a journal. I had notebooks all over the place, and I never was able to make it a regular healthy habit. I just did not want to spend the time. I did not really think I needed to. I was wrong.

For me, I see daily journaling for someone who is dissociative as absolutely critical. You are shortchanging yourself if you do not journal regularly. I once had a doctor tell me that my journaling was akin to how a cystic fibrosis patient has to hook themselves up to a machine to clean their lungs twice a day. She maybe went a bit too far in making her point, but looking at it objectively, she really did have a valid point.

One area I am really not that reliable in doing is DBT-like diary card check-ins. I have set up an iPhone App called LifeLog to do the recording for me. I have two cards, one is basically an acknowledgement of parts, listed by name. I go down the list in a mindful manner and acknowledge each. I do not do it to necessarily engage in discussion with each part; it is more like that I am taking a breath and saying "Yes, this is who I am and how I am made up."

The other card, is a more standard mood monitoring. I have adapted it for me by highlighting the areas I feel I need to pay attention to. On a 1-10 scale I rate the following: Acceptance, Happiness, Anger, Fear/Anxiety, Fatigue, Physical Pain, Dissociation Level, and Overall Safety.

Of course, like I said, doing these things does not guarantee anything. It does, however, give us a better chance. And even though many of these are "in the moment" techniques, it is important to appreciate that if done over time, the scale at which they work becomes greater and greater.

It is not a magical "awareness" that helps make us better. It is awareness generated from very specific skills, applied regularly like medicine, over time.

I know this is not the first time I have talked about these skills. I discussed the iPhone Apps I use in Survivor's iPhone Essentials, Part I (July 2010). I have discussed journaling in many posts, but specifically focused on it in Journaling (May 2010).


castorgirl said:

Hi Paul,

What I've found interesting over the last couple of months, is that there has been a real drive to journal. I've never had that before. I've never understood why people journal, and possibly been a bit scornful of the whole thing. But now, there's a sense of impatience when I can't write a thought or draw something. I don't know whether it's because there are different parts of the system trying to communicate, or just an increased awareness that this is one way to heal. But, it's an interesting change.

Take care,

Paul Author Profile Page replied to castorgirl:

Hi CG. If there is a real drive to do something (healthy), then I think you have to make every effort to make it happen. As I said, there is so much to learn from journaling. But people need to be ready to do it. My bet is that you are!

Jill said:

Maybe this is a stupid question, but could you perhaps give an example of how to start journaling? I have never journaled before, and have no clue how to start. Is it ok to write down thoughts and feelings, or is it better to stick to events and happenings and leave my thoughts and feelings out of it? Or is it better to go about it in some sort of other way?

Paul Author Profile Page replied to Jill:

Hi Jill. Good question. There is no "training manual" for journaling. I'll make an attempt at discussing this soon. The short answer is that there is no right answer. Whatever you are able to do it right. And that will change over time. Most people find that sticking to events and happenings makes it easier to get started and is less emotionally charged.

Nansie said:

Hey Paul... you really got this stuff down. I was never able to journal... hand writing is very threatening to me for some reason. But since I have started my blog I am able to think about stuff and write it there. When I close the blog it disappears from me so I do not see anything unless I want to go back to it. I have found myself blogging and writing more lately... I seem to be getting more self aware. You are right about writing though... it is a very necessary piece to this puzzle and it offers lots of insights in. Can you explain more about what DBT is? Why do you do cards? How does this help you and what is the goal with it? Thanks and keep up the good work!

Paul Author Profile Page replied to Nansie:

Thanks Nansie. I'm glad blogging has helped you. I'll write more about the questions you brought up as well as Jill's. I want to talk more about skills because they are so important. So, stay tuned.

Nansie replied to Paul:

Will do Paul! :)

Holly said:

Hi Paul,

I think awareness is the antidote to just about all things related to Dissociative Identity Disorder. I find Subjective Units of Distress Scales really helpful in cultivating greater awareness. I don't keep track of nearly as much as you do, though! I just rate my anxiety level every hour and name how I'm feeling physically and emotionally. I find that just doing this one little thing has, over the past several months, increased my awareness of my system and helped with communication as well. I think the reason is simply that taking my anxiety temperature brings me more into the present moment, even if it's just for a moment. In other words, increasing awareness in one area is increasing awareness in others.

Have you ever read any of Anthony DeMello's work?

Paul Author Profile Page replied to Holly:

Holly, Thanks for taking the time to opine on this! I had not known there was a name for the 1-10 rating. I like it. I learned a little bit about DBT inpatient over the years. At the time, several years ago, I did resort to a lot of really basic monitoring. But I am now past that and the skills seem to have fallen into place some. What I did not like about the whole Marsha Linehan DBT training (and the accompanying book) is that it's too complicated. As you say, you really don't need to do much to increase the awareness inside. This is a whole area that I am aware that I've made so much progress in, so it's an area I'll probably focus my writing on in the coming weeks. No, I've not heard of DeMello, but did a quick search. I'm taken by the whole mindfulness movement and rather like Jon Kabat-Zinn and even Eckhart Tolle. But admit to really not getting too involved with what they all say. I seem to be comfortable with finding my own path and not needing much "direction". Thanks again for stopping by. Love your sites!

Holly replied to Paul:

Hi Paul,

"But I am now past that and the skills seem to have fallen into place some."

I'm really glad to hear that. I only started the Subjective Units of Distress about 7 months ago after an inpatient stint and I'm definitely still in the having-to-think about it phase. I'm hopeful that if I stick with it, it will eventually become second nature, or something close.

I agree with you about DBT over-complicating things. I assumed it was my dissociation problems but I took one look at DBT and knew it was too much. I can take one piece, like the SUDs, and use that but any more and I'm creating anxiety rather than quelling it.

As for DeMello, I'm heavily resistant to anything that smacks of guru-ness or "rightness." So I wouldn't say I'm really into DeMello - he doesn't turn me off though, like Tolle and some others do. But I mentioned him to you for one reason: he wrote a book called Awareness. Actually it's a collection of transcripts of short talks he's given. Anyway, the point is I found some of his points about awareness incredibly compelling as someone with DID. A lot of it was too look-at-my-enlightenment for me. But the pearls were worth it.

I'm looking forward to reading more from you, Paul. And thanks for the compliment! I appreciate that.

Paul Author Profile Page replied to Holly:

Holly, My comment that "I am now past that" is a bit misleading. I do struggle with all of this. Just that it's easier. I will check out DeMello. Maybe I'll add his book to the huge stack of books I mean to read sitting beside my bed!

Nansie said:

Hi Paul and Holly! I found this post interesting so I went and researched DBT. I can see where it would help but they do focus alot on applying it to bipolar folks. I know some of our parts could be bipolar but if we treat them are we treating the parts instead of the person as a whole? The more I read the more confusing it became to me. It's very interesting stuff though!

Paul Author Profile Page replied to Nansie:

Nansie, DBT is sort of "skills training" to help with distress (and also in a "mindfulness" context). I'm no expert, but that's my take. As such, it's not at all just helpful with bipolar. DBT was originally aimed at borderline personality people because of the problem with distress tolerance. But it applies to anyone whose mental health is in a state of flux or crisis.

Nansie said:

Yea... I just skimmed the surface with the info and it looked really complicated? :(

Paul, thanks for sharing this post with Carnival Against Child Abuse. Journaling has played a really important part in my journey of healing as well. I do the same with my blog. Writing has brought me so many awarenesses. Awareness is the beginning of change.

Patricia. Thanks for coming over from the Carnival. I'm so glad you find journaling to be helpful. So many want to journal but never do it and then never see the benefit. Hope you are doing well on your healing journey.

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This page contains a single entry published on October 21, 2010 9:30 AM.

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