[yogirl]

why me du it now. me dun had tu go tu hoptal fer one cut dat geted infected an dey had tu lanse it, an wile me layin bed rest so it cud heel me had mor urges an me cutted gen rite bside de uter cut. me cut but it no hurts but dare es sumdin bowt seein bluud. es me stupid or crazy?

[Christina86]

((((((((((yogirl))))))))))))) No, you're not stupid or crazy.

Do you have someone to talk to about this? A T?

[dance59326]

Originally Posted by yogirl

why me du it now. me dun had tu go tu hoptal fer one cut dat geted infected an dey had tu lanse it, an wile me layin bed rest so it cud heel me had mor urges an me cutted gen rite bside de uter cut. me cut but it no hurts but dare es sumdin bowt seein bluud. es me stupid or crazy?

Where's are the cuts located?

[yogirl]

thank u fer witing back, de cuts es on me tummy long ways, an no me no have a T r eni wun tu tawk tu sept heer on forums.

[dance59326]

It's ok, you can always talk with me through PM's.
I'd love to help and get to know you.
Here's some advice sources to look at, don't go crazy while trying to work on them, take it easy and one step at a time
don't let yourself get overwhelmed
try doing one post per day or every other day
I hope that this will help you
Best of hope and wishes
dance59326

[dance59326]

Opposite Action to Emotion Action:

Opposite to Emotion Action the last suggested technique for changing painful emotions. Like all of the techniques we have been learning about, it takes a lot of practice to be able to use it skillfully. The idea behind this technique is that it can help to deal with distressing emotions by setting into motion an action that is helpful, not harmful. Doing this counteracts the suffering you might otherwise feel because of the distressing emotion.

For example, if we are angry, there are many actions that we might take to express our angry feelings. But if the action that we take is one that is opposite to the emotion we feel, like walking away from a situation when we are angry, or distracting ourselves with something nice, then we have put our energy into something that is eventually going to make us feel better. In this way, we not only reversed our action (walked away instead of yelling at someone), but we also began to make a change in our angry feelings. We didn't escalate or heighten our feelings, but did something that made the feelings decrease, by putting something positive in their place.

It's important to know that this skill is not about trying to suppress our emotions. We are using that angry feeling to take a different action. The result of this will be a gradual change in our emotions.

The kinds of situations in which it is appropriate to use this technique are ones in which the emotions might not be realistic to the situation we are in, maybe out of proportion, or escalating, or be emotions that we want to challenge or change.

For example, if we are feeling very depressed and low and like no one wants us around and we might as well just stay in bed, a way to act opposite to the emotions is to get ourselves up and do something (go for a walk, go to the grocery store, visit a friend, go to therapy, etc.). We are not denying our emotion, but we are challenging it by acting opposite to it. Instead of staying at home in bed, we are getting up and going out. We may not see big changes, but little by little we will notice changes in the way we feel.

Several years ago, I needed a major amount of dental work done. I had been a dental phobic all my life. I had major panic if I even smelled a smell like a dentist’s office. But I really wanted this work done - it was mostly cosmetic work, and my brother had agreed to pay the whole amount, enough, as the dentists said, to buy a new car at the time. I was so scared that I could not sleep for days before my first appointment. But I went. And when they called me to come in to the office, I picked myself up and went in. I was screaming no, I can't, inside, but I did anyway. This process lasted five months. I did not lose my fear right away, but I made myself keep going, and as the time went on, I had less and less fear, and now I think nothing of a trip to the dentist. I had to act opposite to my fear in the beginning, to eventually reach a place where that fear had turned into acceptance.

Sometimes this is NOT the best thing to do. If you are afraid because you are in an unsafe situation, pay attention to that fear. Do not go into that unsafe situation.

If you are ashamed about something, and that shame really does not belong to you (i.e. it is from your past or from when someone told you you should be ashamed), you might try to do what you feel ashamed about over and over and over (like buying a new dress, or getting medical treatment, or eating a hearty lunch), do these things over and over, until you are desensitized from the shame.

But if you feel shame because you have done something that is contrary to your sense of right or your own ethics, then do your best to repair the situation and to apologize, and then move on. This is not a situation where you would want to act opposite to your emotion, because your emotion fits the situation.

[dance59326]

Describing Emotions:

Emotions involve what we call action urges. An important function of emotions is to prompt behaviors. For example if we feel angry, we may be prompted to fight. Or if we feel fear, we may be prompted to run or flee.

The action itself, the fighting, or running, or hugging is not part of the emotion, but the urge to do the action, the feeling that prompts you to do the action, is considered part of the feeling.

If we feel angry at someone, we may feel an urge to start yelling at them. That urge is part of the angry feeling. But the fighting is not part of the feeling.



1. Prompting event

• 
  Emotions can be either reactions to events in the environment or to things inside a person. These events and things are called PROMPTING EVENTS. They prompt, or call forth the emotion. A person's thoughts, behaviors and physical reactions prompt emotions. (Recently someone put his hand on the back of my neck, and I felt fear and anger.) You might have an automatic feeling, without thinking about it, like "I feel love when I see my cat."
  
  What triggers it or gets it going? Prompting events can be events happening in the present (an interaction with someone, losing something, physical illness, financial worries). A prompting event might also be a memory, a thought, or even another feeling (we feel ashamed, and then feel angry about feeling ashamed, for example). In managing our emotions, it is important to be able to recognize prompting events.
  
  Think of some examples of your own where there is an inside prompting for a feeling you have

2. Interpretation of an event or experience

• 
  Most events outside ourselves don't prompt emotions. It is the interpretation of the event that prompts the emotion.

Event

Interpretation

Emotion

Seeing my boyfriend with my best friend

They must have been talking about me

Anger

My car has a flat tire

Some neighborhood kid did this

Anger

It starts to thunder and lightning

I have heard of people being killed by lightning

Fear

I see Mary at the concert with Betty after she promised to go with me

Mary doesn't care about me

Sadness

I see Mary at the concert with Betty after she promised to go with me

Mary is trying to get back at me

Anger

• 
  Can you see that the emotion comes after the interpretation is made, after you have the thought about the reason something is happening?

Think of some examples of your own, and list the event, your interpretation of the events (what you think about it) and your emotion.



3. Body Changes

• 
  Emotions involve body changes such as tensing and relaxing muscles, changes in heart rate, breathing rate, skin temperature, rises and falls in blood pressure, etc. The most important of these changes for you to be aware of are the facial changes - clenched jaw, tightened cheek and forehead muscles, tightening the muscles around the eyes so that they open wider or shut more, grinding or clenching teeth, loosening and tightening around the mouth.
  
  Researchers now believe that changes in the face muscles play an important part in causing emotions. I noticed years ago, for example, that stretching out my cheek muscles like in a lion's roar made me cry - still does.

Be aware of the changes in your facial muscles when you are experiencing emotions.



4. Body Response to Emotions

• 
  When we experience emotions, there are changes in our bodies. Sometimes people have trouble sensing their body changes. To regulate our emotions we have to be pretty good at sensing what is going on in our bodies. If we have practiced shutting off our body sensations, this can be difficult. However it is a learned response and we can unlearn it by practicing something else.

5. Action Urges

• 
  An important thing that emotions do is to prompt behaviors. An action urge may be to fight or attack verbally in anger, or to flee or hide in fear, etc.

What are some action urges that you might have for these emotions?
Anger
Fear
Sadness
Shame
Disgust
Surprise

6. Expression and Communication

• 
  One of the most important functions of emotions is to COMMUNICATE. To communicate something, an emotion has to be expressed. Sometimes, if we have not learned to express our emotions, we may think we are communicating but the other person isn't getting it. This can cause misunderstanding.
  
  Example: I am told that for most of my life I did not show any expression on my face, and it still is not the easiest thing for me. I would feel angry, hurt and rejected because people did not respond to my feelings, which I thought were very obvious. Now I understand that people could not tell what I was feeling and so they did not respond. I find that it works best for me to tell people what I am feeling, instead of relying just on
  my facial expression.
  
  Emotions are expressed by facial expressions, words and actions. Expressing emotions through behaviors can also cause problems, because different people interpret behaviors in different ways.
  
  Example: When I am so angry that I am afraid I am going to say something I will regret, I leave the room. People have interpreted this as meaning that I am chickening out or I don't care or I am saying "in your face." I have learned to say that I am leaving to cool down and I will be back, so people will understand what I am doing.

7. After Effects

• 
  Emotions have after effects on our thoughts, our physical function and our behavior. Sometimes these effects can last quite a while. One after effect is that an emotion can keep triggering the same emotion over and over.

[dance59326]

Imagery

Using imagery, you can create a situation or a scene that is different from the one that you are now in. In a way, you can leave the situation. Envision in your mind a place that you would like to be - a safe place, a relaxing place, a beautiful place. Focus on this place. Relax, and let yourself feel that you are in this place. It usually helps to notice details of the place that you are in. See that safe place, maybe a room, that is fixed up just the way you want it. Or imagine that spot along the ocean, or being with a good, safe friend.

Imagine things going well for you. Imagine that you know how to take care of the situation you are in. If you practice doing this, you will find that it begins to work for you. Things DO go better, and you CAN cope better. You can deal better with the crises in your life, if you practice feeling like you can take care of things.

Create a safe, comfortable place for yourself. It will help if you do this in a quiet room or a quiet spot outdoors. Try to relax, and close your eyes if you feel safe. Settle into this comfortable, safe, beautiful place. Let your hurtful feelings drain or wash out of you, relieving you and making you more comfortable. Breathe slowly and gently as you do this.

An image that I use is floating in Cape Cod Bay, with the sun shining and the waves gently bouncing me around. This makes me feel very peaceful and safe. I try to feel the waves and see the sun and the sky as I am doing this.

When I have a conflict with someone, I tell myself that I can handle it, that I can do a good job, keep my cool, and deal with the situation in a good way. I keep telling myself this, and imagining myself doing it. It helps me to handle the situation effectively.

[dance59326]

"ACCEPTS"

There are four groups of crisis survival strategies: Distraction, Self-Soothing, Improving the Moment, Pros and Cons. All of these are strategies that help us to get though difficult feelings and situations, to tolerate (deal with, get through, sit with, accept) the things that we can't immediately change. This is one of the keys to DBT skill usage, to find some of these skills and techniques that work for you, to practice them until they are part of your everyday life and you can call them up whenever you need them.

The first of the four distracting skills is ACCEPTS. This is an acronym to help you remember "Wise Mind A C C E P T S"

Distract with Activities:
Do hobbies, watch a video, go for a walk, play a sport, cook, garden, go fishing, go shopping.

What other activities can you think of that you can get involved in and distract yourself from your distress? Make a list of your activities and put it up on your refrigerator, so you can find it in a hurry.

Distract with Contributing:
Contribute. Do volunteer work. Babysit so a friend can go out. Do something nice or surprising for someone.

What have you done this week to contribute? What can you do next week to contribute? Plan something in advance. This takes you away from your pain and puts your attention on your concern for someone else.

Distract with Comparisons:
Compare yourself to people coping the same as or less well than you. If you are doing better than you were a year or two or five years ago, make that comparison. The manual suggests that you compare yourself to others' suffering, watch weepy soap operas, read about disasters. Some people find this helpful, others don't. Just do what works for you.

What do you think about comparisons?

Distract with opposite Emotions
Read emotional books, go to emotional movies, listen to emotional music. For this to work, you need to read or watch or listen to things that have an emotion opposite to one you are feeling. If you are sad, watch a comedy. Watch a scary movie. Listen to silly music. I think that the reason this works is that it kind of jars your feelings loose. If you are sad or angry, watch a silly or funny movie, and bust up laughing, you have changed your emotion and put yourself in a different place.

Distract by Pushing Away a distressing situation by leaving it mentally for awhile.

Build an imaginary wall between yourself and the situation. Imagine yourself pushing it away with all your strength.

Block the situation in your mind. Each time it comes up, tell it to go away, or put some other thoughts in its place, perhaps some more pleasant thoughts. Refuse to think about it. Try putting the pain on a shelf, or in a box, to contain it and get it out of the way. I use the technique of putting my distress in a locked box on a shelf in a closet. I can get it later, but right now I can let it go.

All of these are techniques to give you a break from dealing with the pain all the time. They haven't resolved the painful situation, but they have put it away for awhile so that you get a break and a chance to live some part of your life without it.

Distract with other Thoughts
Some examples are counting to 10 or counting the tiles in a floor or the panes in a window or the stars in the sky, anything to keep your focus on the counting. This is a good one to use in a sudden emergency, when you need to pull something out of your bag of tricks really quickly. Other ways of distracting with thoughts are reading, watching videos or movies, doing crossword puzzles or jigsaw puzzles, writing poetry, if you can keep your thoughts away from your pain.

Can you think of some other ways of distracting with thoughts?

Distract with other Sensations.

You might hold ice in your hand or apply it to the back of your neck (I used to use a bag of frozen peas against the back of my neck - the sensation was kind of shocking, and it shook me out of my tangled up distressing feelings), put a rubber band on your wrist and snap it, listen to loud music, take a hot, hard shower, a cold, hard shower, or swim in very cold water. Any strong physical stimulus like this can kind of jog loose your connection to your pain and distract you from it. After you try one of these activities, you may want to go on to another distracting activities, such as one of the activities described in the last lesson.

[dance59326]

Here is a page that you can put onto Microsoft and print out to keep in hand when you don't feel safe:


“Just stop, press the pause button like a movie because what has happened doesn’t matter, you’re in the now, change what is happening now and forget about the past”

“Cutting is really doing nothing; it’s a waste of time and is only going to ruin your life”

“Do something instead of cutting to get yourself out of the problem of feeling nothing, take a hot or cold shower, just don’t be in for too long”

[dance59326]

IMPULSE CONTROL LOG

The impulse control log is taken from S.A.F.E and is geared specifically for self-injury but can be used for many types of compulsions.
With the impulse control log it is required that you log down every thought or feeling associated with a particular urge to self injure, whether or not you actually go through with the act or not. In the beginning the goal is that the writing will become a diversion from the act itself. The long-term goal is to understand the connection between your thoughts, feelings, and behaviors.

Self-injury itself is a thought, not a feeling. Once you can fully grasp and understand that internally, you can begin to understand that self-injury is a behavior and behaviors can be changed.

Self-injury keeps us from dealing with uncomfortable feelings. Feelings or thoughts we find unacceptable are disguised through self-harming in some way although only a temporary relief is felt. If you feel the need to self-harm there is a feeling behind that, something you need to express.

Using the impulse control log is a good way to make you slow down, think before you act and remind you that you are in control.

Below is a generic example

IMPULSE CONTROL LOG

1.SELF-INJURY THOUGHTS: Burning, Cutting

2.TIME AND DATE: 3/9/07

3.LOCATION: My Room

4.SITUATION: A Friend and I aren't speaking, my boyfriend and I got into a fight, a relative is sick, and I lost my wallet.

5.FEELING: Angry, Upset, Lonely, Frustrated, Alone, And Disappointed

6.WHAT WOULD BE THE RESULT OF SELF-INJURY? If I cut/burn, Then I don’t have to get angry, then I don’t have to cry, then I don’t have to care,
then it won’t matter what they say or do, I can act and appear like I don't care.

7. WHAT WOULD I BE TRYING TO COMMUNICATE WITH MY SELF-INJURY?
That I do have feelings, that I think no ones cares, that I think I don't matter, that it hurts less if I cut/burn myself, that I'm scared.

8.ACTION TAKEN: Ended up running, doing some artwork, and writing in my journal.

9.COMMENTS: My desire to cut or act out is still w/me but I’m challenging the thoughts. Tonight I plan on going to the gym and then to a friends house.
__________________

Feel free to print out this ICL to log your own impulses.
Share whatever you feel appropriate with us as you wish..
__________________

IMPULSE CONTROL LOG

1.SELF-INJURY THOUGHTS:

2.TIME AND DATE:

3.LOCATION:

4.SITUATION:

5.FEELING:

6.WHAT WOULD BE THE RESULT OF SELF-INJURY?

7. WHAT WOULD I BE TRYING TO COMMUNICATE WITH MY SELF-INJURY?

8.ACTION TAKEN:

9.COMMENTS:

[dance59326]

Behavior Chain Analysis of Problem Behavior
1. Describe the specific PROBLEM BEHAVIOR


(flashback, cutting, disassociation, hiding, closeting, panic attack, etc.)
A. Be very specific and detailed. No vague terms.


B. Identify exactly what you did, said, thought or felt (if feelings are the targeted problem behavior).


C. Describe the intensity of the behavior and other characteristics of the behavior that are
important.


D. Describe the problem behavior in enough detail that an actor in a play or movie could recreate the behavior exactly.
2. Describe the specific PRECIPITATING EVENT that started the whole chain of behavior.


A. Start with the environmental event that started the chain. Always start with some event in your environment, even if it doesn't seem to you that the environmental event "caused" the problem behavior. Possible questions to get at this are:
·What exact event precipitated the start of the chain reaction?
·When did the sequence of events that led to the problem behavior begin? When did the problem start?
·What was going on the moment the problem started?
·What were you doing, thinking, feeling, imagining at that time?
·Why did the problem behavior happen on that days instead of the day before?
3. Describe in general VULNERABILITY FACTORS happening before the precipitating event.


What factors or events made you more vulnerable to a problematic chain? Areas to examine are:
A. Physical illness; unbalanced eating or sleeping; injury


B. Use of drugs or alcohol; misuse of prescription drugs


C. Stressful events in the environment (either positive or negative)


D. Intense emotions, such as sadness, anger, fear, loneliness


E. Previous behaviors of your own that you found stressful
4. Describe in excruciating detail THE CHAIN OF EVENTS that led up to the problem behavior.


A. What next? Imagine that your problem behavior is chained to the precipitating event in the environment. How long is the chain? Where does it go? What are the links? Write out all links in the chain of events, no matter how small. Be very specific, as if you are writing a script for a play.
·What exact thought (or belief), feeling, or action followed the precipitating event? What thought, feeling, or action followed that? What next?
·Look at each link in the chain after you write it. Was there another thought feeling, or action that could have occurred? Could someone else have thought, felt, or acted differently at that point? If so, explain how that specific thought, feeling, or action came to be.
·For each link in the chain, as if there is a smaller link I could describe.

B. The links can be thoughts, emotions, sensations and behaviors.
5. What are the CONSEQUENCES of this behavior? Be specific.
·How did other people react immediately and later?
·How did you feel immediately following the behavior? Later?
·What effect did the behavior have on you and your environment?
6. Describe in detail different SOLUTIONS to the problem.


A.Go back to the chain of your behaviors following the prompting event. Circle each point or link indicating that if you had done something different, you would have avoided the problem behavior.


B.What could you have done differently at each link in the chain of events to avoid the problem behavior? What coping behaviors or skillful behaviors could you have used?
7. Describe in detail the PREVENTION STRATEGY


A. How could you have kept the chain from starting by reducing your vulnerability to the chain.
8. Describe what you are going to do to REPAIR important or significant consequences of the problem behavior.