I've talked about a lot of stuff on the different pages of this site but the one thing I didn't get into is learning how to establish new, healthy ways of dealing with life. Chances are really good that the things you are doing now or have done in the past to manage your life were brought to you by necessity. Circumstance likely provided you with your tools and while those may have served the purpose at the time, they are probably not doing you any good now. In fact, at this point they may even be hurting you more than helping.
Think of it this way (work with me here)... Five years ago you had the flu and your doctor wrote you a prescription for some medication that worked very well. Over the next few years you had repeat occurrences and were given the same medication in increasing doses, until you reached the maximum recommended dosage. Your body simply built up a tolerance to it. Today you started to feel those familiar symptoms and went searching in your cabinet for something that might help. You came across the original prescription. Taking those pills will hopefully not make you any worse since they are expired. But, you probably won't get any better either. Chances are very good that nothing at all will happen. That type of medication has not stopped working. You have out grown it. Even with a brand new prescription of the same pills, your body would not respond to it the way it did the first time you used it, when you first needed it.
So my point is that in order to achieve health, whether it be physically or psychologically, sometimes the tactics need to be changed. I'm not going to pretend it's easy. People tend to get really comfortable with their methods. It may have served you well for a very long time and you can be grateful for that. However, if it's now at a point where it doesn't help at all or worse, actually adds to the destruction of your life, it's time to let it go. It's a scary thought, I know, but you won't be at a total loss because below I've provided some suggestions for healthier ways to manage those tough times.
Simple Distractions
Some things that pretty much anyone can use as a short term solution for dealing with
urges or uncomfortable memories.
*may not be good for people who self injure
*may not be good for people with eating disorders
Grounding Techniques
The main idea in grounding is to reconnect with the here and now. It's
often hard to stay in the moment when memories or urges are overwhelming you. The suggestions
below are most commonly associated with dealing with flashbacks and the intense feelings
connected with them. But, they can pretty much be used for any situation where you are feeling
extremely distressed.
Attempt to identify the trigger. If you can, get rid of it. If it's a movie, turn it off or leave the theater. If it's a smell, replace it with another. If it's a person, excuse yourself (if necessary) and walk away.
Make a list of your current feelings. These can be emotional or physical sensations. Try to focus on them and be honest with yourself.
Identify distorted thoughts and turn them into positive ones. Usually during these times there are a lot of negative ideas about yourself running through your head. They're just old messages that you were conditioned to believe. Remind yourself of that and turn each one into something positive. If you're thinking, "I'm a bad person.", you could tell yourself, "I'm a good person and I deserve to be happy and loved". You get the idea.
Repeat positive thoughts to yourself while looking at your reflection in a mirror. The theory behind this is that looking in your own eyes helps to aid in conveying the message to your brain. It is not a quick transformation. It takes time to reverse the years and years of negativity you've likely experienced but with practice and consistency it can change a lot.
Visualize a bright red "stop" sign. Symbolically disallow those thoughts to continue.
Choose a color that makes you feel safe or calm (preferably not black). Repeat the name of the color again and again either out loud or silently. Imagine the uncomfortable scene is being washed away and replaced with that color.
Concentrate on your breathing, taking deep breaths from your diaphragm. It's amazing how much control you can feel when you connect with your breathing. It also helps to keep you from holding your breath, which people tend to do when they're anxious or scared.
Plant both feet firmly on the ground. Stomp them if you need to. Take off your shoes if it helps. This may sound silly but actually physically grounding yourself will help the rest of you get there.
Play a modified quick game of I-Spy with yourself. Look around you and say out loud the things that you see.
Try to find the pulse on your wrist and count the beats.
Clap your hands. Listen to the noise and be conscious of the feeling. If loud noises startle you, you can just rub your hands together and concentrate on the texture of your skin.
Use a grounding object like a stress ball, koosh ball, stuffed animal, favorite blanket. Comfort items are great. Children use them all the time. Just because you're a few years older that doesn't mean you've lost that privilege.
Repeat a grounding phrase: "I am here now". "I may feel afraid but I'm not in danger". "These things happened to me, but they are not happening now". This may sound strange but sometimes when you get caught up in a memory it's easy to lose perspective.
Connect with your current reality by asking yourself questions like: "Where am I now?", "What's today's date?", "How old am I?" Again, this helps to bring you back to the time and space your body exists in.
Hold an ice cube in your hand. In my opinion, this one is the easiest and usually the most convenient. If you're out in public and get overwhelmed, there is almost always a place where you can get some ice and the best part is that they'll usually give it to you for free. You can also try splashing cold water on your face.
Do a body scan. Take inventory of your body, concentrating on the way each area feels. Once you have an idea of that, tense up all of your muscles. Then, starting with your forehead, gradually move down your body, relaxing each part in sequence. Notice the release you feel as you go from muscle to muscle, concentrating specifically on those problem areas. The places that were tense or rigid at first will hopefully begin to feel less stiff.
Things That Take Practice or Planning
Even when you're not in an urgent situation there are things to be done.
It takes practice and planning to learn how to handle these reactions. You may not feel like dealing
with it when everything seems ok but the more you do these things, the easier they become. Logically,
that makes the management of these episodes more easily accomplished.
Make a list of the things you can and can't control. If this is difficult for you, start small. You can control when you brush your hair. You can't control the rain that messes up your freshly brushed hair. See how many things you come up with that you can do.
Practice mindfulness. In the grounding section you'll notice that many of the techniques require getting in touch with your senses and/or surroundings. Mindfulness is similar in that it is all about observation. The key is to observe without making any judgments. If you were to walk into your kitchen and notice that there were a bunch of dishes in the sink you may think that they've been sitting there all day, you may think that you should wash them, you may get annoyed that nobody else in the house washed them, etc. During a mindfulness exercise you would notice the dishes, simply accept they are there and not allow those other thoughts to intrude. It's a lot harder than you may think.
Map your transition. If you have been making changes in your life recently or are wanting to make them, sit down and draw yourself a map. Mark the places you have come from and the destinations you still want to go to. If you really want to get into it you can add symbols like mountains for the things you've overcome, rivers for the tears you cry during tough times or deserts for times you've felt isolated or numb.
Do some relaxation exercises. What "works" is always different for everyone but much like grounding, it requires connecting with your body, especially your breathing. Things like meditation and guided imagery can help you to learn to compartmentalize the intrusive thoughts we all have when we try to clear our heads. Sometimes just listening to soothing music can do it. If you don't know where to start, there are a bunch of websites with ideas and also many tapes and CDs available. Seems everyone has a hard time relaxing these days.
Create an emergency box to help you through the tough times. Include index cards with info like your name, address, doctors' phone numbers, names of supportive people you can call to help you through a tough time, and at least 10 positive statements about yourself. Also, add a small personal object that will help you ground, a scent that soothes you, a current picture of yourself. You can add any items that you feel you might need like band-aids, Tylenol, a few quarters for the phone (maybe a calling card) or an emergency cigarette if you smoke. The idea is to make yourself a compact kit that you can take with you anywhere, just in case. This is especially good if you have D.I.D.
Identify risky situations that may prove problematic for you. This is good for people dealing with compulsive behaviors as well as distressing memories. You may think you know the situations that could cause trouble for you but chances are, you don't. Of course, there's absolutely no way of knowing ALL of them, but if you take the time to write down as many as you can think of, it will greatly reduce your chances of being caught in something you weren't prepared for. Of course, the key is to actually avoid those things as much as possible.
Keep lists of things you need to do to help eliminate anxiety or confusion. For some people organization is second nature. Others have to work at it. You'd be amazed at how much easier days can be when you know exactly what needs to be done. If long lists overwhelm you, split things up into daily goals, weekly goals, and long term goals. Be reasonable with what you expect from yourself and remember to add in some quiet time for you.
Pace yourself. This one is extremely hard for a lot of people. If you tend to get depressed, when you get a moment of relief you may push yourself to get an unreasonable amount of things done. Same goes for those who have jobs or families to take care of. The thing is, it does nobody (least of all you) ANY good to exert yourself to the point of exhaustion. It may be hard to remember at times, but taking care of yourself is your first priority.
Do your best to stay away from "should" and "have to" statements and thoughts. This is especially difficult if you are responsible for other people or things. But, when you filter those ideas out, you will realize that they really only make you resist and resent the things you do. In life there is almost always something you'd rather be doing. You may not have always had those options but now you have control over which way you choose to go. We are all constantly making choices and focusing our priorities in different ways. If you are resenting everything you do, it's really like you're blaming others for your choices. And that would be like turning your power over to them.
Make a list of what is important to you and what is not. In order to keep things simple, it's really important to know where your priorities are. It's helpful in setting goals, but it does so much more than that. If you tend to get angry, frustrated, or generally overwhelmed this list can help you get a more complete overview of the things that you value enough to become emotionally involved with. That way, if an issue comes up and you immediately start to get agitated, you can take a time out and decide if it's worth that kind of emotional energy. It's kind of like that old saying, "pick your battles". You want to be working FOR yourself, not against.
Make an urge card. This is a great idea for anyone who deals with self injury or compulsive behaviors. The idea is to make yourself a small card that you can fit in your wallet and carry with you everywhere. On it you should list at least 10 healthy coping skills you can use when confronted with a difficult situation. These should be simple things that you can do easily and fairly quickly to keep yourself away from harm. Also, list 10 positive statements about yourself (pick a few that refer to your ability to deal with urges - they don't have to be true yet!) Then make a list of 20 negative consequences - 10 long term and 10 short term. Whenever you feel the urge to act out in any way, pull out your card and read it over and over again. It may not work 100% of the time, but it helps a lot.
Something you may have heard about a lot is a "safe place visualization". I'm of the opinion that before you can visualize it, you need to do a little work creating it. The best way to do that is by writing a detailed description. Make it as specific as you possibly can and be sure to include elements that appeal to all five of the senses. It can be a real or imaginary place or a little of both and can include anything you can create to make you feel secure. It is suggested, however, that it not include other people because the goal is really to be able to make yourself safe without having to depend on others. Once you get the written description done, it's a good idea to draw a picture of it. You don't have to be an artist, just do something visual that gives you the feeling you are trying to experience by "visiting" your safe scene. Then the key is to practice going there several times a day until it becomes pretty easy to control. Then when you find yourself dissociating in an uncomfortable way, you can switch yourself over to your safe scene and regain the comfort and control you're needing.
A containment box is something that can be done mentally or physically. What you're doing is creating a place where you can store uncomfortable memories until you are better able to deal with them. Some people like to visualize the box in their mind and see the memory go in there. Other people prefer to make an actual container out of a shoebox or something and write their memories down on a piece of paper and put it away in the box. I don't think one way necessarily works better than the other. All you're really trying to do is set aside what is overwhelming until you are equipped to deal with it.
Build a strong support system. You need to have compassionate, understanding adults in your life that you can depend on. Whether it be family members, co-workers, old friends, a sponsor, or members of a support group, it's really important to build and maintain a network of people you're close to. I understand that it's sometimes very difficult to trust people. Building healthy relationships with healthy boundaries will help you to trust these people more than you thought possible. Besides, you may be strong but you cannot handle everything on your own.
Long Term Planning
It's really, really important to create a life that is balanced.
I actually have a particularly hard time with this myself. But, I do understand the importance.
There are certain components that are really helpful to consider when attempting to balance things
out. You have to take time for basic needs such as eating and sleeping. You have to consider other
people and decide how much time you will spend with them and what your boundaries will be with each
person, as well as finding time to be alone. Most importantly though, you have to learn to balance
your work life with your social/recreational life. That seems to be the most difficult for the
majority of people.
Here I'm concentrating on adding recreational activities to your life. You may think that's weird considering that those other things that I just mentioned are really quite important. Believe it or not, finding pleasurable activities is just as important. Think about this: when you feel depressed you have a hard time doing things, even if you enjoy them. So you don't. In a way you are depriving yourself of possible pleasures. Your thinking will likely become more negative and hopeless, decreasing your desire even more and taking away more of your energy. Having less energy makes it even harder to do anything so you begin to feel even worse and your level of depression increases.
Of course, I can't fix any of that. And your depression may linger no matter what you do to try to change that. But, there are some things that can help and activity is one of them. There needs to be enjoyment in life and whatever healthy way you can find it is ok. So below I'm just going to get you started thinking about it with a list of ideas that may point you in a direction you haven't yet explored.
Obviously not everything on this list appeals to everyone and there are also a lot of things I'm leaving out. Be sure to keep in mind that you don't want to be combating the psychological issues you're working on. You don't want to choose something with too much emphasis on physical activity if you tend to over exercise, just as you wouldn't choose to become a wine connoisseur if you were an alcoholic. Be realistic. Other than that, just find something that appeals to you and try it. If it turns out that it wasn't a good fit, you can always try something else next time.
What makes a good goal?
A goal should be:
