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).