We are finding it challenging to use skills to cope with depression and panic. In addition to three times per week therapy sessions, we are in a weekly skills group that focuses on psychoeducation regarding trauma’s effects on the brain and on DBT skills to change behavior. We have a history of unsuccessful DBT applications, but in reality, we think we have a history of sporadic, cyclical engagement/disengagement with skills in general.
DID is a frustrating condition because, for us, a primary challenge in life is lack of continuity of experience. We find it very difficult to change behaviors in lasting ways. Conditioning and habit are so strong for us that our attempts to remake our ways of responding to stress, interacting with people, and viewing ourselves seem to fizzle out over and over and over and over.
About five years ago, when survival became a full-time endeavor, DBT is what was first introduced to us as coping skills. And in the intervening five years it has come up again and again in therapy, hospitals, reading. This time around, in skills group, we are trying to take from DBT that which might serve us; and leave the rest.
We lack hope. A few years ago we were meditating on a somewhat regular basis. Maybe we could achieve 10 minutes of focus on our inner experience (feelings and sensations–after years of trying to learn what feelings and sensations are) or on repeating compassionate phrases or on breathing. The pandemic threw us off course. We did not have the coping skills to be around people 24/7 as occurred with the pandemic. And we ceased being able to use our skills. We reverted to surviving, which probably meant using old skills: dissociation, distraction, delusion, avoidance.
As we gain more space with Spouse occasionally leaving the house to work (a few days per week for an hour or two at a time) and the Children having both moved to college, we find ourselves needing to learn skills again, new ones or relearning ones we used to have.
Progress is challenging to see. And our symptoms are very intense: depression is severe, suicidal ideation is up, our internal people are disordered because one of us whom we have not seen in months or years has returned and is up front, and our lack of continuity of experience is so prominent.
This lack of continuity may be the reason that skills seem to come and go with us. We use them and then they disappear. Either the skills are not right for the challenges that come up, or we are changing too frequently to keep those skills available. We know that we need to practice skills when we are relatively calm, and that may be part of the barrier. In order to get a skill to stick, we think we need to focus on it intensively: every day, multiple times per day. And before pandemic, that is what we were building up to doing. It took a few years to get to that point, and now we have lost ground. We feel like we need space to be able to practice. Space, for us, means being alone in our house. Other people’s energy affects us. And we are rarely alone. It is a lot of pressure and unrealistic to think that every time Spouse leaves the home, we are able and willing to use skills.
So we need to learn how to use skills when others are around us, and that alone is taking so much time and energy–with so little progress to show–that we are not able to access and use coping skills sufficiently. Even the word “practice” is freaking out some of our insiders. Why? It feels like the low end of a binary of proficient/practice, in which proficiency is the privileged polarity.
Trying to find our values every morning is itself an ordeal. We want to be nonviolent and several of us inside enjoy the theory and use of Nonviolent Communication (NVC). But with no one with whom to practice in-person (technology-mediated communications such as video calls are not effective for us and are actually triggering of panic) and an inability to have a consistent experience with reality and the present, we are constantly having to relearn NVC in the same way we have to keep refreshing every other fucking skill. Frustration for us. Despair. Hopelessness.
So we are having to enforce some boundaries with outside people. We find ourself occasionally advocating for self. Our world is contracting. We have had digestion problems for four weeks. It seems our body can suddenly no longer digest meat! We already have a limited diet. We somewhat follow FODMAP because this food scheme is closest to what foods make us sick: many kinds of sugar (natural and refined, including lactose, honey, and sugars in cherries, apples, etc.), gluten, onions, and now meat. We are struggling to get enough calories without meat. We are struggling to enjoy food without meat. We are struggling to handle cramps, gas, frequent bowel movements (toileting was already an ongoing trigger for us). This is contributing to increased depression.
We reached out to our primary physician this week but have not heard back. New T is researching dieticians for us. New T is a very strong support.
Spouse wants to host people at our house for the holiday season. This would be triggering for us without intestinal distress, and with intestinal distress we need access to our bathroom without the specter of guests. So we said no to holiday parties, with regret that it doesn’t meet Spouse’s need to celebrate. Spouse will need a new strategy for celebrating that isn’t at our home.
T2 wanted to us to practice inner-communication this week. We said it’s too hard. We need to do that in session. We said we can focus only on one skill this week, and even then it’s nearly impossible to keep that skill in mind. There are too many voices in our head, too inconsistent an experience of life. Too many rules for coping and healing and interpersonal relations. Overwhelm, confusion.
So we chose this one skill to practice this week: take our time.
Stimuli make us feel panic and fear often. If we take our time, we will have more choices because we will give our brain time to get away from fight, flight, freeze, collapse, etc. We are keeping “take our time” in mind. Still, the words don’t mean a lot. It just means don’t rush. Still, we had strong emotions yesterday. We did not take our time. Even with just one skill in mind, we can’t be perfect with it. That depresses PJ, our resident perfectionist. OCD confounds skill development.
Even if we take our time, everything else that happens after that is unscripted. The unscriptedness of life is really hard right now. Especially with the food challenges. And now that it’s winter holiday, the house is full again (Kids are home). This means even less space for us. More laundry. More dishes. More cooking. Yes, more ways to nurture people, but we feel lacking in nurturing ourselves. We will need to self-advocate (make requests based on our needs) if we want anything to be different.
Take our time.
Change is slow. Only one moment exists and that is right now.