Discharged

To prep myself for discharge I set up my journal with check in sheets similar to those we did daily in outpatient but adjusted to best benefit me. It includes a scale of 1-7 rating of my depression, anxiety and suicidal idiation in both the morning and evening at the bottom and top of the page. It additionally has a space for 3 things I’m thankful for that day. Additionally there’s a space for goals for the day, for daily wins and accomplishments, a space that says “I used [skill] today to:” in which I can write things like “I used radical acceptance today to accept that I am anxious about going to the show tonight and seeing my friends I haven’t seen in 2 months since I left for outpatient. I accept that this is where I am right now and that is okay” or “I used opposite action to go to the show even though I was anxious”. Lastly there’s a spot for exercising my self worth that reads, “The thing I love about myself most today is:”. I feel like this will help keep me mentally structured and build upon everything I’ve worked on at outpatient.

I returned to work as well twice this past week and 6 days a week starting next week. I came back feeling excited, overstimulated and confident. I surely did miss my job. I’m scared the most that I’ll not practice my skills as well as I did while I was in outpatient, but there’s no reason for me not to be able to build upon what I’ve started and exercise the new neural pathways I’ve been creating for myself. I need to remember to look at my affirmations, my vision board, journal and track my wins. These are things I have set up in my favor for success. I feel that transitions are usually hard and this one in particular because of the uncertainty is stressful, but I think I’m sitting with the uncertainty and uncomfortable feelings pretty well and stopping my rumination as fast as I can.

Lastly for this post I wanted to share a letter I wrote to a future patient at the hospital outpatient program I just finished. It was my last assignment before I finished and it was optional.

“Dear Future Patient,

You are a wonderful person. Don’t believe me? I mean we don’t know each other, but I say this with confidence because despite the things you feel like you can’t do right now (which is okay by the way, work from where you are toward who you want to become and accept where you are as a first step to moving forward) and despite the things you may have done that you don’t feel so good about, you are worthwhile of a full life and of help.

Outpatient was my second place I went for help. I was leaving outpatient elsewhere a month before and walking in here I felt like an embarrassment to myself and becoming vulnerable was brutal. However, it was a necessary personal choice I made that helped me grow. It’s a safe environment to be challenged in and supported and the discomfort I felt here made changes in myself.

Because of the paradigm shifts I experienced each week I challenged myself to work a little harder. Your treatment team here will give you tools, teach you and be the tools for processing, guidance and growth. May you open your toolbox here and be willing to use what you’ve been given. There are no comparisons as our struggles are each uniquely our own but for me there has been no better place to be while facing the hard bits of life than at outpatient.

May you grow, even just a little, for little wins add up to benefit the future self you want to be, even if just in this moment you’re not 100% sure you know what that looks like. You will.

My very best wishes for you,

Former patient”

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Radical Acceptance

In outpatient I had to pick a DBT skill and present it. I wanted to share what I put together with y’all. I chose this topic because it’s one that I have a hard time with. Unlike mindfulness where you can refer to your breath, this idea is a little more abstract with nothing physical to be able to rely on for grounding acceptance.

  • Marsha Linehan the creator of DBT had some things to say on radical acceptance.
  • Radical acceptance is – Moment by moment letting go of having to have what you wanted and accepting reality how it is.
  • “You need to radically accept that you want something you don’t have and its not a catastrophe” – ML
  • “You only have to radically accept the moment you are in, and the past.” – ML
  • “In order to change things you have to accept them otherwise what you’re trying to change is something else that you think is reality…and if you want to change it you work on changing it which is perfectly legitimate also.” – ML

Clean Pain vs Dirty Pain

-These are types of pains we have when accepting or not accepting.
-Clean pain example: “I’m sad and I’m human and this is a normal response.”
–Dirty pain example: Fighting against something that gives us clean pain to try to find relief and avoidance/nonacceptance is causing suffering.
–Letting go transforms suffering into more ordinary pain which is part of life.
–When you spend time fighting yourself you aren’t learning how to be a friend to yourself.

Letting Go

Another way to think about letting go is to think of your mind as carrying a backpack.  If you need to go from point A to point B and you get tired somewhere in-between you may be carrying too many unnecessary things in your mental backpack. Getting rid of things that no longer serve you or are not useful to carry will lighten the load and you will be able to make it to your destination quicker and easier. What can you let go of to lighten your backpack?

  • Another way to practice Radical Acceptance which I have personally used and has worked for me is to write down “I accept (reality)” (ex. “I accept that Ryan and I are no longer in a relationship together”) several times being mindful and taking breaks if I feel myself zoning out so that I am focusing on the meaning of what I am writing, writing it in different ways, (ex. “I accept Ryan is no longer my boyfriend”) and reading these aloud to myself.
  • This has benefit me in being engaged in the statements of the reality of the situation. Over three days doing this I noticed myself letting go a little more every time and coming to acceptance of reality as how it is (not to say I like it, but that’s where other DBT skills come in).

How Hard is Radical Acceptance?

It’s a process that requires a lot of energy but it CAN be done.
Some things are easier to accept than others.
As Marsha Linehan said, When we accept reality as it is, we can move forward to change things if we want to, but if we don’t accept reality as it is we’re addressing change to something that’s not real and that’s going to prolong suffering and make no changes moving forward.
Radical acceptance is hard and further you can’t measure acceptance like you can mindfulness and your breath. But trust how your body and mind transform pain as you accept and let go. When we accept we can move forward.

Reality Check

I’ve faced reality for too many years now without the luxury of dozing off into fantasy land or regressing to better times. I’ve been sick with something or another for ten years, dealing with more than the average person on a daily basis because of it, and I’m very tired of it all. I think that’s why I’ve been so entranced with Sailor Moon again lately. I have the whole series at my fingertips and it never fails to bring the magic. I treated myself to Luna earrings and a tank that has some of the transformation ribbons and locket on it. It’s geek chic if you ask me. Now I’m losing weight and on a mission to lose a lot of it. I’m trucking through school, making the five minute walk from my parked car to the building and facing all the eyes on me. I haven’t written anything other than blog entries in eons. I used to write story after story and even a few fan fictions that I was proud of. I used to draw, I used to act, I used to do so many things I was so full of confidence about but once the spyroketes attacked with the Lyme Disease 10 years ago I lost all that confidence and my artistic side has suffered. Even the discipline I decided to follow in school is a science, not an art. I think it’s time for me to pick up my old hobbies (maybe not the acting, those were golden years I’ll always cherish though) and even if just for myself and my keepsake boxes for generations to come to enjoy, I think it’ll better my quality of life.