Mouse Does DBT: “How” Skills

Week Two brought Mouse to the “How” mindfulness skills. Though Mouse wasn’t sure why they were called that, or how to do them…

Non-judgementally

To be non-judgemental is to be factual and not emotional. Using the wise mind you can disarm the judgemental thoughts that we all have about ourselves or others. The disarmament comes from simply recognising when a thought is a judgement, not a fact.  For example:

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The first two mice are non-judgemental. They are stating facts about the state of the cake. However the third mouse is in emotion mind and is using emotion based judgements to define the cake. It’s really hard to be non-judgemental, particularly if you are so hating of yourself that you see the judgemental thoughts as fact. “I’m ugly.” “I’m stupid”. “I’m worthless”. We all have those pesky thoughts. But by realising that they are judgements rather than truths they can be less upsetting.

One mindfully

Doing things one-mindfully is about using the whole of your awareness in a task. One thing at a time, even if the thing you are doing feels insignificant. Notice the tiny details like the backgrounds of film scenes or how many buttons are on a shirt. One mindfully can be practiced using the ‘what’ skills from last week.

Effectively

Effectiveness is about practice. A lot of practice. Practicing these skills again and again until you become more mindful, and thus more effective.

Next in Mouse Does DBT, Distress Tolerance!

(Please note that Upside Down Chronicles has no training or therapeutic expertise, only experience. This series ‘Mouse Does DBT’ is to support people going through DBT themselves, or for those interested in the therapy. Please contact your GP if you need further support for mental health problems.)  

DBT: First Fortnight Thoughts 

If you’ve been following the start of my ‘Mouse Does DBT’ series you will know that I have recently started an intensive course of Dialectical Behavioural Therapy. So far I am undeniably sceptical. I’m intrigued how and if this therapy will help me.

DBT is practical- which is a good thing. The practical approach means that the skills are useful for any human being on the planet- regardless of if they have illness. I have noticed that DBT is incredibly hard work. Coming out of my first group session I felt like I had been run over by a bus on the M25. Once I had recovered from it, there was stacks of reading and a piece of daily homework to do. After my first one to one I was terrified. I was told that I (like everyone else) will inevitably get things wrong in DBT. Even though I logically know this, it isn’t a comfortable thought for me. I desperately want to get everything right so that I have the best possible chance of recovery.  The therapist also said that she would tell me if she felt that I was not working hard enough- but what if I truly do work my hardest but DBT just doesn’t work for me? 

To mice sitting around a coffee table with a box of tissues on. One of the mice is wearing a lanyard.

The frustrating thing is that I am already aware of many skills that could help me. I can talk breathing exercises and self soothe boxes until I’m blue in the face. Unfortunately dissociation means I am zoned out, cut off and unaware at the exact moment I should be using any of these techniques. To the outside world it looks like a seizure and I am completely unaware of everything around me. 

Apparently with DBT I will one day be able to break down the chain of events that lead to a dissociative episode and eventually catch it before it strikes. At the moment disociation feels like the plug for my consciousness being pulled out suddenly for reasons I’m not always aware of. I can’t even imagine having the time and prior knowledge to slow -let alone stop- an attack. 

At the moment I have serious doubts over whether DBT is for me. There’s no way of knowing for -realistically- a few months at the least. I find it frustrating that even when I am not depressed and feeling pretty good I still have to go to therapy that stresses me out. I am aware that it would be completely stupid to stop going, because I know in my heart of hearts that depression will inevitably come knocking for me again. When that happens I need all the help I can get. I’ve got to keep going, keep trying to understand the skills and keep talking to all the professionals. I always find my own way in the end and in the long term DBT will do me no harm even if (worst case scenario) it does me no good.  

Mouse Does DBT: ‘What’ Skills

 It was explained to Mouse that mindfulness could be practiced in different ways- some of them are covered here in the ‘What’ skills. 

Observe

A white mouse holds a magnifier to their face 'observe' is written alongside. Copyright upside down Chronicles. Observing is about just noticing as thoughts and feelings come and go. One way to do this is to imagine that your mind is a conveyer-belt and you are passively watching your thoughts trundle by. You are paying attention to the thought as it goes; acknowledging its existence and letting it pass without judgement. You can also observe by noticing the rate of your breathing or by doing a body scan meditation to recognise any physical sensations you may have. You can also observe things external to yourself, like watching people in a cafe or admiring the tiny details in a beautiful view. It’s noting the facts of what is going on in as much detail as possible.

A cartoon image of a conveyer belt. A brown cardboard box is moving along on it. It is labelled 'mouse's thoughts'. Copyright upside down chronicles
Describe

A mouse holds a magnifying glass to the word describe. A question mark above his head. Copyright upside down Chronicles.Describing is all about focus and understanding. In the group session all the mice were each given a chocolate Minstrel. Using the describe skill they tried to find words for the shape, texture, taste, smell and colour of the chocolate. Doing her homework Mouse found that the easiest way to practice this skill was to describe her beauty regime as if she was filming a YouTube tutorial video. She described the products she used, how they felt on her fur, how she applied them and how they change the way she looks. As well as describing actions and objects you can use the same description exercise for thoughts and feelings. Putting words to something as abstract as feelings makes them seem less scary and more controllable.

Participate

A white cartoon mouse poses with one hand on his hip and one in the air in a Saturday night fever dance pose. Music notes around him and the word 'participate'. Copyright upside down Chronicles. Participating is about actively being in the moment. Focusing on the one task you are doing and then doing it with all your might. This could be: singing to the song you are listening to or not allowing yourself to slip into the background during social situations. By taking part in everything you do fully you can stay in the here and now.

What a lot of people don’t understand is that mindfulness is not about clearing your mind. Clearing your mind is actually not very mindful at all. Mindfulness is about acknowledging the moment you are in and accepting things for how they are. These ‘What’ skills are a way to focus and engage with the now. Practicing these skills is hard as you have to try and let the thoughts that interrupt your mindfulness exercise drift past on your brain conveyer belt without letting them pull you completely off task. Mouse’s conveyer belt seems to be being used to transport tonnes of manure around her mind. What skills will need some work.

(Please note that Upside Down Chronicles has no training or therapeutic expertise, only experience. This series ‘Mouse Does DBT’ is to support people going through DBT themselves, or for those interested in the therapy. Please contact your GP if you need further support for mental health problems.)  

 

 Did Somebody Say DBT?

Recently I’ve been having assessments to see if I’d benefit from a therapy programme that uses DBT and Mindfulness. After many worksheets and conversations I have been put forward for a full programme. This means one skills group and one 1:1 session a week for about a year.

What is DBT?

Dialectical Behaviour Therapy is all about breaking down negative and destructive cycles and creating better ways of coping for yourself. It has foundations in Mindfulness and Cognitive Behavioural Therapy and allows people to develop a more in depth understanding of their negative thought and behaviour cycles. It involves practical skills of how to take action to avoid dangerous behaviour. It is also about helping you to accept your struggles as part of the make up of who you are, but not your whole definition.

The Assessments

What came over very strongly during the assessments was how much hard work DBT involves. It means two sessions, plus my CPN appointment and then homework on top- every week! From what I gather it seems the skills need to be practiced near constantly (even when they aren’t required) in order for them to develop into instinct at times of need. It’s about acknowledging the problems you have, why they may be valid, why they may not, and finding strategies to overcome them.

During the assessments I had to talk about some very difficult things that I find painful. The assessment is important because it ensures that you are suitable and will benefit from the therapy. I think the wonderful Ruby Etc. shows the trouble in seeking help from services perfectly in this diagram. In mental health services you are either ‘too mad’, ‘or not mad enough’. Luckily(?) for me during this assessment it appears I struck the middle ground.

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I’ve wanted for a while to include more help and advice on Upside Down Chronicles. I’d like to be able to share skills and strategies with others and enable people to try techniques for themselves. I know how hard it is to get the help from services, so maybe getting second hand skills from UDC might just help someone. Obviously I’ll be writing as a person experiencing the therapy- not as a therapist or expert myself.  I don’t know when there will be a space for me to start the course, but I am very excited to be finally offered some formal help.

If you want to have a look and a head start, the book the programme uses has been published online for free here.