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emotional dysregulation and CBT


12 years ago 0 356 logo logo logo logo logo logo logo logo logo logo 0
Davit (and anyone else interested in how this whole befriending ourselves thing works)

I had an aha moment today I want to share. Finally somethign good to report :)

I have been suffering emotional episodes characterized by much rage, anguish, frustration that i sob and "discomfort being in my skin" barely describes it. anyone who has felt that discomfort where you watn to run away from yoruself but can't knows what i am talking about. it is sort of a panic attack but with lots of other things mixed in too. apparenlty my brain thinjks i can handle all negative emotions at once...

 but finally a break through. my emotions spoke and i listened and was able to soothe myself in a real way. it might be the first time ever i have done this. 

Davit, what you describe matches up with what i have read about distress tolerance and how to plan for how to deal with distress, focusing on the moment, using sight, smell, touch to re-ground yourself when feeling anxiety. i have really struggled to do those things. i have been stuck by my desire for someone (someone else, not me) to hear me when i am upset. 

my emotions got steamrolled as a child. surprise surprise i developped anxiety whenever a strong emotion came over me. for a long long time i searched for someone to help me reclaim my emotional self and not be fighting with it, supporessing emotions, and responding to my emotions with frustration and anger.

well, for me that person didn't show up. i have met kind people along the way, but no one who was able to befriend my emotional self. the self i had to abandon so many years ago. i have been really frustrated that no one wanted this 'job'. (the job that is supposed to be the parents job but that is a long story,... they did not tkae the job is the easiest way to summarize that. 

my last "counselor" shamed me when I asked for help with my emotions. SHamed me! a counselor! i am still in shock. i hope this person never does that to another client again but they probably will. 

anyways, the aha moment. i did what i wanted all those other people to do. screw them if they are not going to do it, i got sick of waiting! :) i should not have had to get to mid life before getting my fear soothed but there you have it. better late than never. i believe i can do it for myself. the seed is planted. relief. 

thank you for listening. onward. i hope this post gives someone else hope.

listen to yourself. 
12 years ago 0 6252 logo logo logo logo logo logo logo logo logo logo 0
love trees.

Periodically I take a mood stabilizer. I like it because there is no adjustment period and no taper when I want to quit. It also helps with the anger that comes with a lot of pain. Its only side effects for me are a dry mouth and trouble waking up in the morning. I know it should be taken steady to work better and I have in the past taken it every day long term. I just am not that bad that I want to fight waking up every day.

My way of doing exposure is different than the usual way. My way, I put in place skills to handle the effects of the exposure and then used the exposure to test them rather than the other way round. In other words what I did was set up distractions and relaxation skills and an escape route for each scenario and filed them in my memory for future use. So to go to a restaurant I would have an escape, (bathroom) a distraction, (looking out the window, stirring my coffee) And a relaxation (closing my eyes and breathing slow, saying a mantra to myself)
(saying I had a head ache for an excuse for closed eyes) Then and only then would I go to the restaurant. I found that this way I could stay longer than if I just jumped in with the intention of getting used to the strain. That may work for some but never did for me.  And my mantra. It varied but was usually along the lines of "I'm here because I want to be, not because I have to be. I'm okay, I can do this". (positive memory thoughts building) Other exposures had other skills to use but pretty much were based on the same idea. I have absolutely no trouble going anywhere or doing anything my physical limitations let me. And I have gone from an anxious anti social reclusive type to a social blabbermouth. I still don't like socializing on a large scale but do enjoy people and events. I just tire out at them so easy.
People do have emotional swings and realizing that fits in with the skills needed to do exposure. You can't fix something till you realize it is there. 

Patience and good luck with your search for some one to help.

Davit.
12 years ago 0 356 logo logo logo logo logo logo logo logo logo logo 0
Sunny, thank you for the encouragement to keep seeking out someone to talk to. I am going to push to at least find out who the people are in my town who do DBT.

Ashley, thank you also for the reply and supportive words. I know that i have to eventually trust another new therapist because I know that I need a therapist very badly. Every time I get dysregulated, I am deeply frustrated that I have no one to ask for help from. SO many emotions get jumbled together right now. I feel fear, anger and frustration over and over when I am upset. Meaning I go from angry, to ashamed, to upset, to angry, to frustrated (That i am alone) to hopeless. 

Davit, I have realized exposure work isn't relevant for me right now. It cant be. Triggering an episode before I have the skills during my emotional episodes is a bad plan. especially without a therapist.

I cannot believe how frustrating this is to find someone to help me. It is awful. I am trying to do as much as I can by myself right now. Due to circumstances i have not asked for, things other people have chosen to do or say to me, i've been thrown off my path, rough as it was to begin with, each and every week lately. I am exhausted. 

Once I start feeling angry, I do not feel in control of the anger at all. It literally hurts to be angry. I sob and yell and shake with discomfort. I will go through and re read the CBT stuff again to see if I can see myself applying it during an episode. The verdict is out on whether I can change this without mood stabalizing medications which I have never tried and am seeing as a last resort . 
12 years ago 0 6252 logo logo logo logo logo logo logo logo logo logo 0
I've been going back over my last five years with this condition. Basically they were my therapy years. The last two were not really therapy but more information so I could understand what I had gone through and related information that explained what my friends with real mental diseases were going through. It has helped me a lot. Some times when they hurt me bad I wanted to tell them to get out of my life and never come back. I learned that it is the disease they have talking not them just like right now as the morphine leaves my body it is doing it kicking and screaming telling me I can't live without it. Not true of course but it is very strong.
I learned two important things. If medication is causing a disorder as a side effect then it takes medication to counter it for the period a person is on it. This she (my therapist) said is a given and I have a choice, I can use the meds or I can tough it out.
Second, almost all mental diseases have anxiety as a side effect even if it doesn't show.
I have a bipolar friend who does well on the medication for it. She is like a changed person. But still she has anxiety even though she is happy and the depression side of the disease is in check. She lived with me for eight days and it was an interesting experience to see some one go from appearing happy and normal to manic and violent with no control over herself. And she had no control over this. The same with my other two bipolar friends. All of these people have had to tweak their medications to get a balance and it is on going, but they have a life now. A better one than mine because they don't have to fight the tendency toward negativity that comes with anxiety disorders. And since my triggers are not constant I get days that are very good and ones that sneak in and blind side me. The thing is though that this happens to normal people too. Difference is they don't know why so they get sad or lash out and with that release it is gone. At first I tried to fight this but now let it happen. Difference is that I might be sad around people but I don't lash out at them.

Loves trees, I don't know how you can find a therapist like mine. In Canada if they are attached to the medical system they have to have credentials. If not then they don't have to be anything and some of these people know way less than I do. Mine is very good as was the person before the person she replaced. The one in between was qualified but not capable if you know what I mean. 

One thing about BPD that makes it difficult is the fact that a person with it does not trust so it is very hard to accept. It takes a special therapist to instil that trust. Much like I would do anything I can to help you with information but the parameters of the site do not allow that.
Instant messenger does not work so I can't even help in private and this makes me sad.

I will say though that I do not think that the "off the deep end" way of doing exposure will work for you, but that is just my opinion based on the fact it did not work for me. It kept coming back. 

Davit
12 years ago 0 11214 logo logo logo logo logo logo logo logo logo logo 0
Hi Loves trees,
 
Interesting thread; thank you for your honesty. CBT is a proven affective tool for addressing anxiety however, if other issues are involved then these other issues need to be addressed appropriately. One point you made stuck out with me and that is your thoughts on emotional  dysregulation.  To my understanding emotional dysregulation is often associated with other disorders or illnesses like Bipolar Disorder, PTSD and Borderline Personality Disorder amongst others. In order to get proper treatment for the emotional dysregulation and anxiety which could be symptoms of another disorder or illness you would need a proper diagnoses. Treatment would depend on the diagnoses. To my understanding the main diagnoses would be treated and if the anxiety remained then the anxiety would be treated.  Keep in mind I am not a doctor and you would need to speak with a psychiatrist or psychologist. 
 
I am sorry you did not have positive experiences with Health Care Professionals up to this point. Do not let this discourage you. This is your health so don't let bad experiences hold you back. With perseverance and a lot of research you will find the answers you are looking for.
 
We will be here to support you until and when you find treatment that works for you.
 
Members, can you share your experiences on how you found treatment that works for you.
 


Ashley, Health Educator
12 years ago 0 1665 logo logo logo logo logo logo logo logo logo logo 0
Hi Lovestrees:  Sorry to hear how hard it has been lately.  Glad you have come back to the site and found some way to vent and release some stress.  Is it possible to call your local hospital for a list of therapists in this area? and get an appt. with them.  Usually the therapists affiliated with hospital and mental health clinics are good.  Might have a better chance at finding a good one there rather than a stab in the yellow pages where there are no references.
Just an idea.
Sunny
12 years ago 0 4027 logo logo logo logo logo logo logo logo logo logo 0
Loves trees,
No relationship is perfect, let alone the therapeutic one.   It's worth it though in the end to continue your search.  Personal advice is helpful since it is tailored to your needs.  An example is that of helping with "exposure" as its called here, so it can be tweaked to your needs.
 
Keep looking.
12 years ago 0 356 logo logo logo logo logo logo logo logo logo logo 0
Hi Davit,

Well I've had what we call "set backs" that have thrown me for a loop. I barely recognize them as such since Setback could be the title of my lifes story. 

i had a "therapist" who was not licenced and there was no recourse when they ended up treating me very poorly, blamed me for crossing the boundaries they had been murky on, and then accused me of being a bad person and dissapeared out of my life. very victimizing, lots of shame, anger, still not able to get passed it right now. 

i feel like i want to just rest for a while and not have any more setbacks. I am furious actually that my first year of attempts to reach out for help has left me alone, scared, paranoid about being hurt or taken advantage of and misunderstood by a system that is only here to control people and make money. 

clearly i am not in a very trusting space. I would give my eyeteeth for a counselor like you say you have. where do i find such a person? right now i don't know if i can even try. i am scared that i lose more than i gain when i try to get help. so far that has been the case. 

once my emotions are triggered, the emotional reaction i suffer through is awful. cbt in the moment doesn't do anything. i need coaching and help to get through each episode. sadly i have none right now so i suffer them alone and in anger. there is panic, pain and a desire to find a way to stop the pain. i do not drink or smoke anymore so the things i used to use to calm my "nerves" are not around. i am jsut raw now when i am dysregulated. it is in those moments that CBT doesn't work. all i can think of is needing someone with me to help me. and how to find that person? ugh, after the last experience i had when the person said "call me" and then was very mean to me when I took them up on it, i am spent. 

i think that was a vent. i'll write mroe later when i can go beyond just venting. :) 

I am so glad you are here. i KNOW i am not the only one suffering with this problem. ultimately, when i find answers, i want to help someone else not suffer what i have been going through. 
12 years ago 0 356 logo logo logo logo logo logo logo logo logo logo 0
Hi Samantha,
I appreciate your response. I am going to be direct in my post here but please understand, I am not always good at expressing myself well so please do not take this as aggressive, i am just trying to assert (possibly poorly at times) my frustrations and questions about where to go next. I really do want to get better and want to re-connect with my true self who can balance emotion, thought and wise mind.

Here goes. 
Someone with emotional regulation problems in my experience has a hard time completing the CBT the way others on the boards here seem to. I spent some weeks beating myself up that the exposure work wasnt making sense and wasn't working for me. I now know this is because i suffer from emotional dysregulation. Meaning that exposure is not something I can do without lots of other things set up first and other stages to tolerate distress. This information was missing from the site or at least I missed reading it. :)

I am SO grateful this panic centre site exists. However, and since emotional dysregulation is poised to be more in the public forum in the near future because of pressure to get rid of some of the stigma about it, the people who run this center will be tasked, in my opinion, with outlining how and when CBT works for someone with emotional dysregulation problems. 

Mental health is delicate and one of natures' true complex beauties in that it is not easily understood, analyzed, taken apart or compartmentalized. A lot of what is offered here on this site and with CBT has helped me a lot. But where do I go next? Is there research on how to use CBT when dysregulation happens so easily. when exposure becomes triggering? I hope someone can help. 

Thank you for the space for us to engage in this dialogue. Again I apologize if i come off abrasive. I am tring to find a better way to express myself. 
12 years ago 0 2606 logo logo logo logo logo logo logo logo logo logo 0
Hi loves trees, 

Thank you for reaching out and sharing what you are going through with us. We are definitely here to support you in this. You mention the CBT is not the right thing for you, but as you know of course the panic program here utilizes CBT techniques.
 
CBT is a very effective treatment method for panic disorder and agoraphobia. However, what you get out of CBT depends on what you put in. While some types of therapy involve a lot of talking about the past and attempting to understand the problem, CBT involves actively challenging your avoidance and negative thinking by doing homework. Most often your homework will be to gradually expose yourself to the situations that make you anxious. Also, doing exposure work takes a lot of time. We know that the people who benefit the most from CBT are people who do at least 3 hours of exposure homework each week.
 
You have also received some great advice and words from your fellow members. Know that whatever path you choose we will support you!

Members, how do you deal with being unable to find a good match with a counsellor/doctor etc? 

 
 
Samantha, Health Educator

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