macular degeneration, macular, diagnosis DBT – My Macular Degeneration Journey/Journal

Cope Ahead Redux

Lin asked me to do an outline on the cope ahead skill from DBT. I am not an outline sort of person. I prefer to free flow, stream of consciousness sort of thing. So, here goes, by request…sort of. [Sue’s written about cope ahead before. I wanted her to review it again and give us an example of its use.]

Dialectic Behavior Therapy (DBT) is a skills-based approach. That means DBT therapists directly teach skills of living. One of these skills is how to cope ahead to effectively get through a situation. [Lin/Linda: to read more about DBT, read Sue’s page Teacher, Teach Thyself.]

Effectiveness is doing what works to get to your goal. It assumes you know what your goal is. Most people have an idea of what their goals might be but they describe them in the negative. “I won’t mess up” for example.

Now those of us who have ever had anything to do with small children can tell us all something about the use of negatives. You tell a kid not to do something and that is the first thing he does. Hate to break it to you, but you do the same thing. Tell yourself not to do something and that is exactly what you do, too.

People don’t end up with an eye on the prize. They end up with an eye on the booby prize and that is exactly what they get!

Ergo, first rule: be positive! Your goal is to succeed. It is not to avoid failure. The scenario you want to construct for cope ahead is positive, positive, positive.

The second rule is include details. You want to make it as true to life as possible. Your imagination can construct very vivid images. Let it go. The more vivid and lifelike you make your cope ahead image, the more real it will seem.

Last but not least is practice. Imagine yourself just breezing through the situation. Look at me! I am doing everything right! Imagine yourself being collected, skillful and brilliant. Imagine doing everything right until it becomes second nature.

Then take it into the real world and try it out.

Ta da! There you have it, ladies and gentlemen, I give you the cope ahead skill.

Lin/Linda here: I also asked Sue to help me come up with an example of a cope ahead visualization. One of the experiences that causes some people anxiety is that of going for an anti-VEGF injection for wet AMD. Try this:

Think of driving to the office on a beautiful day noticing everything around you.

Enjoying the day.

Going in to the waiting room and sitting calmly, distracting yourself with beautiful photos or a funny story in a magazine.

Think about getting up easily and walking into the examination room.

See yourself joking with a technician and then sitting comfortably.

Feel the numbing drops and know that they’re working.

Greet the doctor with a smile and look in the direction that he told you.

Breath calmly.

Feel the pressure of the shot.

Think of having the doctor tell you how well you have done and see him smile.

Sit there calmly while the technician checks you out. Get up, walk out the door . Wave at everyone.


Feel free to embellish this basic outline with as many, very positive details as possible. The idea is to really feel as if you are skillfully practicing it for real. If there is a glitch, don’t be tempted to give up or start imagining horrible things. Calm yourself and start again.

PS Those of you who had Intro to Psych  may  recognize something else in the visualization exercise of cope ahead. Did you see it? It’s desensitization! Three bonus points on your quiz if you got it right!  Desensitization is exposing yourself to the feared stimulus without the feared consequences. The connection between the stimulus and the fear is lessened.  And you thought you would never use any of that stuff in the real world!

Written August 17th, 2019

Next: WHAT IS VISUAL ACUITY?

A Minor Epiphany

Not exactly on assignment right now. I want to run something past you…

Every once in a while, the stars align. The penny drops. Whatever metaphor you wish to use, I have a minor epiphany. OK, wait for it…(sound of penny dropping)!

It is the beginning of a new year. Everyone is making resolutions that will be promptly broken.

Actually, make that nearly everyone. I gave them up years ago. Resolutions are rather superficial phenomena. They generally get us nowhere…except, perhaps, for giving us guilt for not being able to stick to them. [Lin/Linda: I’ve given them up for the same reason!]

Also, since I have been teaching dialectic behavior therapy (DBT), I have come to realize resolutions are very judgmental. They wag their fingers at us and point out – repeatedly – how we need to improve. Is it any wonder most people want to part company with resolutions as soon as possible?

Add to the concept resolutions are judgmental, and ergo ineffective, two other things. One came again from DBT and the other came from yoga class. Yep, two of my favorite sources of things to ponder once again.

DBT has added values clarification to what we are to teach. Many of my clients have a lack of direction in their lives. Being able to define their values can give people direction. I have been pondering how I want to squeeze values clarification into an already crowded agenda. Values have been on my mind.

Add to that the “lesson” we had in yoga this morning. We were taught a little about sankalpa.

According to Catriona Pollard writing for MBG, sankalpa is intention. It can be as simple as one word, the affirmation of a value you want to include in your life. Having this intention and keeping it in your mind every day will help to manifest it into reality. Instead of putting yourself on a path of denial and pain, you are putting yourself on the path to growth.

Sankalpa allows for acceptance of faults. It allows for compassion for the self. It allows for slow progress.

Identify your value. Manifest it in one, simple act a day and you are on your way. Hey, it worked for the Cowardly Lion. What other testimonial do we need?!?

What value/virtue do you want to manifest in 2019? Do you need compassion for yourself when you fumble with something? Practice loving kindness with your mistakes. Do you want to be brave in the face of vision loss or frightening treatments? Tell yourself you are brave and then walk the walk as well as talk the talk. Manifest your values through a simple act everyday and you will find you possess that virtue. Not bad. Not bad at all.

So there is my epiphany for today. What do you think? Hopefully it will be one more way for you to find your way through the travails associated with vision loss. Personally, I like it a lot better than resolutions for giving up chocolate chip cookies and ice cream, but that’s me.

Catch you later!

Written December 31st, 2018

Next: I’M BORED – AGAIN

Lemons and Lemonade

Back as a psychologist this time…

We had a little “incident” Saturday morning. I found my glasses in the middle of the floor. This time the lenses were chewed. Big tooth marks on both lenses.

All I can say is it is a good thing the puppygirls are cute.

Now, I don’t know about you, but having unusable glasses is a minor disaster for me. I got extremely irritated and rather miserable. DBT to the rescue!

DBT teaches there are four responses to any problem. #1 is fix the problem. The on-call doctor at the hospital was zero – as in no, nada, nothing (can you tell she irritated me?) – help. A couple of other places no one was home. The person who did call me back was able to get me in and at least pronounce my current lenses officially “dead”. He was also able to order new lenses…to arrive around Wednesday the following week. Sigh. Not exactly the answer I was hoping for.

I am going to skip to #4 of the DBT possible solutions to a problem. That one is be miserable. Being miserable when problem-solving attempts fail is definitely an option. You are allowed to be miserable. However, when I am frustrated and allow myself to continue in that mode, I am not fit company for man nor beast. If I am going to continue to be effective in life, I need another option or two.

Back to option #2. That one is try to feel better. That is where emotional regulation comes in. I took care of physical needs by taking my medication and eating breakfast even though I wanted to be focused on the glasses crisis. I worked on therapy notes to build mastery and feel in control. When my husband made dinner, I expressed gratitude. All of these things changed my emotional state some for the better.

The #3 response to a problem is to learn to tolerate it. This is where we come to acceptance and distress tolerance skills. It is what it is. I gave it all my best shot and the realities of the situation were against me. Now I get to cope until the end of the week.

How to cope? Keeping busy always helps. What can I do to keep my mind occupied? Then there is comparisons. Could be worse. In the world of disasters, this is a small one. No one died or was maimed. It can be fixed. I can just will myself to put it away and not think about it. I can do for others.

Then there are what we DBT sorts call the IMPROVE skills. I could improve the moment through imagery. If I were in Aruba, what would I be doing right now? That is a nice image. I could do relaxation exercises. I could prayer. “Dear God, keep me from killing these little monsters!”

And the one I am using right now? Meaning. This situation has meaning because it is allowing me to share, both with you and with my student, the DBT, 4 possible reactions to any problem.

Might as well turn those lemons into lemonade, huh? Have a cookie! Staying miserable in lousy situations not required.

Written December 16th, 2018

Next: HAPPY NEW YEAR 2019

Sue on Assignment: It’s Not Your Fault!

Hey! How are ya? Like I said, I got sort of intrigued by the Just World fallacy. I figured I would read a bit more. Knowledge is power.

It turns out, according to Wiki, this fallacy has been around pretty much forever with philosophers in 180 CE arguing against it. In the 1960s Melvin Lerner started to study it in social psychology. He was curious how brutal regimes maintain popular support. The Just World fallacy helps these regimes because people feel when other people suffered they deserve to suffer. After all, in a Just World why would good people be punished? Thus, if you can make a group suffer, others will look down on them because they deserve what they got. Yikes.

Lerner did propose belief in a Just World is important for our well-being. It allows us to have some faith in the future. However, what happens when you are the one who is experiencing the suffering? Not only do other people tend to blame you…a la the Just World fallacy…but you blame yourself, too!!

This is why the Psychology Today author suggested ditching the Just World concept. It is also why DBT teaches two of the lessons it does.

The first one is the nonjudgmental stance. Pointing the finger and blaming is ineffective. It does not get the job done. What it does do is produce shame and guilt.

The second lesson is “everything has a cause but it is not necessarily you!” When I teach that concept I get out the list of risk factors for AMD. Above 55 years of age. Female. White. High blood pressure. Family history of AMD. Sun exposure. A diet lacking in some nutrients. I have the whole lot of those. Yes, I missed blue eyes, smoking lack of activity and obesity, but hey, that is 7 out of 11!

It is not a question of why me, but one of why NOT me?

And did you notice most of the ones I hit are things I could do nothing about? I am a 65-year-old, white female who had a father with AMD. So, shoot me. How is this my fault? It’s not. When all is said and done, life is not fair. There is much that is not contingent upon our behaviors. You did not cause your AMD You are not bad.

So that is the Just World fallacy. Recognizing the world is not fair and just and, indeed, bad things happen to good people may not do much to end your coping fatigue but then again, it could do quite a bit. Are you the type who is afraid you are somehow responsible for your vision loss? Do you spend hours and days trying to decide what you did to deserve this? Knowing the Just World assumption is a fallacy can get you away from beating yourself up. It can remove the burden of guilt. You did not do this. Life is not fair. You are off the hook for this one! Feel better now?

Written November 30th, 2018

Next: Sue on Assignment: Exhausted by Life?

Go back to the list of “On Assignment” pages

Salvation: DBT Revisited – 2018

I preface this page with this statement: there is no greater zealot than a convert. I was “converted” to Dialectic Behavior Therapy (DBT) about five years ago when the counseling center needed another skills trainer/ teacher. Since then it has colored my thinking, my approach to therapy and, yes, my life and my approach to my disability.

DBT has been another thing that has “saved” me in this journey thus far. It has awakened my “inner Buddhist” and reminded me that to desire for what I do not have and perhaps cannot have again is the way to suffering. It has taught me to stick to the middle path and shun absolutes as well as to live in the present. (Of course, closer to my own, cultural roots, Matthew 6:28 indicates living in the future through worry is not necessary. Matthew 6:28? Consider the lilies of the field…)

DBT has reminded me what we pay attention to and how we pay attention are actually crucial to our mental health, and even our physical health for that matter. It teaches being mindful (no more than focused attention) of even the most basic of activities. It also is a proponent of gratitude. I quoted someone somewhere as saying happiness is wanting what you have. I would suspect most of us could make a long list of things we have and do want. We have reasons to be happy as well as sad. Hey, that’s a dialectic!

DBT has strong roots in the major religions and schools of philosophy. After all, dialectics is actually a school of philosophy. (If you really want your eyes to cross, investigate Hegelian Dialectics.) But the really cool thing about DBT is it does not expect you to dig up the roots to figure out what it might have to offer. DBT has grown branches and it produces fruit!

The “fruit” to which I am referring is the collection of skills we teach in class. DBT has skills for staying in the moment and not allowing your mind to ruminate on your situation. It has skills for regulating your emotions when they get out of control. It has skills for navigating social situations successfully and perhaps most importantly, skills for tolerating the distresses that come with life and, in our cases, vision loss.

When I was in need of ways to emotionally navigate my vision loss, I was blessed to have my DBT skills “tool box” to reach into and find something useful. Just like Blindness and Visual Services gave me tools to help with reading and moving about in my physical world, DBT gave me ways to navigate in my emotional and social worlds.

If you have not looked at the DBT pages on this site, I would suggest you look through them [check out how to find them below]. I listed the skills as I was either using them or teaching them, so the order is a bit jumbled. If you would like skills listed and explained in a more coherent fashion, there are a number of DBT sites on the web. DBTselfhelp.com comes to mind as a more straightforward resource.

Good luck on your journey. We hope the experiences of those of us walking along, perhaps a bit farther on the road, have been helpful.

Written September 15th, 2018

Finding the pages about DBT

There are several ways:

  • To read some of them, click here for Sue’s Best Pages – Part 4 where you’ll find some of the ones that she’s written.
  • To find them all, there’s a section on all pages called ‘Categories.’ It will be either in the right-hand column or at the bottom. Choose ‘Cognitive Therapy.’  The pages are backward – newest at the top and oldest at the bottom.   I’d advise you to start at the bottom and work your way up. Wish I could change that, but I can’t.
  • Another way to find them all is to find the ‘Search website’ box that’s on every page.  You can find it in the same way as ‘Categories’ (right-hand column or bottom).  They’re also listed backward.

Next: A Freckle in My Eye

Sue’s Best Pages – Part 4

continued from part 3

Part 4 Using the Tools from DBT (Dialectical Behavioral Therapy)

  • “For the past two years, I have had the opportunity to teach the educational components of Dialectical Behavioral Therapy (DBT). Just by chance, the unit I was teaching was Emotional Regulation. If anyone needed emotional regulation at that time it was me. Teacher, teach thyself.”
  • “DBT has a technique called Opposite to Emotion. It is just what it sounds like. If you have an unhealthy emotion, act in the way you would act if you were having the opposite emotion. Behavior follows emotion but emotion also follows behavior.”
  • “One of the DBT Distress Tolerance Skills is ACCEPTS (another acronym I’ll explain). The A is for activities.  A lot of time to sit around and think about everything that is going wrong is not good for anyone. Getting out and about and – for even just an hour – forgetting that all hell is breaking loose in your life is great therapy.”
  • “Enough said on that. Besides activities and comparisons, there are five more ACCEPTS skills: contribute, (opposite-to) emotion, pushing away, thoughts and sensations (the CEPTS). This website is my idea of contribute. Contribute means doing for others. Get out of yourself and make things better for someone else.”
  • “DBT has some skills for improving the moment. These skills are good for getting through the rough patches when you are down or frustrated and there is not a great deal you can do about fixing things at that time. Conveniently, they are called – acronym alert here – IMPROVE skills.”
  • Dialectic Behavioral Therapy (DBT) has Self-Soothing Skills that are taught as part of the distress tolerance module. You remember self-soothing? When you were one it was the thumb in the mouth and the favorite blankie. Maybe it was sitting in your crib and rocking. Right now those ways of self-soothing might not appear very appealing, but they worked when you were one. What can we old, mature folks do that will work as well without the stigma…or the buck teeth?”
  • “Back on track, DBT concepts here. I think that this situation may highlight the ACCEPTS skills. I see contributing (the first ‘c’ in ACCEPTS). We sometimes have to weather a crisis by getting out of our own problems and helping someone else. It gets the focus off of us. It gets us back into the human race and allows us to flex our compassion muscles instead of our self-pity ones.”

Next: Coming soon – Technology

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I Know Who I Am

Hello, there once again! How y’all doin’. Today was “interesting”. Somewhere in India our server [not for the website] went down. Yes, we send all of our data to India. Anyway, no server meant no place to take notes, no way to schedule clients and no way to know our schedules! I had a “mystery guest” checking in every hour! “Mystery guest, enter and sign in please!” Who remembers What’s My Line?

Of course, since I had only a way to take paper notes, everything will have to be put into the cloud…but not tonight. Tonight I get to talk at you.

Lin told me she posted some questions about “coming out” of the visually impaired “closet”. She put a video by Fern, a motivational speaker, along with them. Some of the questions concerned whom you may have told and why you may not have told. Fern talks about embarrassment and shame and the judgments and misunderstanding that may have engendered those feelings.

I assume Fern was a child with visual impairment. I assume she had some tough, social interactions growing up. Kids can be crazy cruel. Trying to navigate the ups and downs of elementary school – not to mention middle and high school! – can be tough on a kid who is different.

I was researching relationship repair DBT style and found DBT Relationship Recovery 101. The second bullet caught me. It said “Work on your sense of self- worth”. Wow. A strong sense of your own self-worth allows you to let judgments and insults just roll off your back. In other words, “Who are you and what the hell do you know about me? I know who I am.”

A bit ago I had someone get angry with me and tell me she wanted nothing to do with me. Ouch. I fretted about it way longer than I should have. Then I got into wise mind and had an epiphany: for all my (many) faults, I ain’t all that bad! Her loss!…and yes, every once in a while if I do something cool like going to Summer Academy I think “Not worth knowing; huh?”

And a couple of those faults? I am not above being petty and gloating…I might actually have to work on those…later. ?

Remember I mentioned one of my yoga instructors has a visually impaired child? She is 5 now. One of the reasons I would like to still be working in school this year would be to watch this little dolly take kindergarten by storm. According to her mother, our little girl walked up to the special education supervisor and announced herself with “Hi! I’m new here.” I do believe she has enough moxie for three kids and I, for one, am glad she does.

That is a five-year-old. She seems to have been born with tremendous strength of character. (She flushed about three pairs of glasses down the toilet. She was NOT wearing them. At that point I think she was 3). But what about us? I would contend most of us who have come to visual impairment later in life have track records of competence. We have mastered all manner of things.

“Who are you and what the hell do you know about me? I know who I am.”

Remind yourself you have been there, done that and have the T-shirt – with “winner” printed on it – to prove it. No one gets to judge you. You know who you are.

Written August 16th, 2018

Next: Filling the Pumps

HOme

You Don’t Look Blind

The words for the week are validation and invalidating. Either those words or situations exemplifying those words have cropped up all week.

The online dictionary gives the third definition of validation as “the recognition or affirmation that a person or their feelings or opinions are valid or worthwhile”. In DBT an invalidating environment is believed to help to cause borderline personality disorder. An invalidating environment will punish or trivialize the expression of personal experience.

Invalidating environments were a big topic at the training we did as well as being a big topic in our assigned reading. Then, this week, when I was feeling awful about leaving my school job, everyone kept saying how “wonderful!” it was to be retiring. Nobody ‘got’ me. Every remark invalidated my private experience. Some people even told me how “crazy” I was not to be overwhelmed with joy!

Trust me; these are all kind people. They were not trying to give me mental health problems. (They have been doing that for the past 40 years! Oops! I did not say that.) They were just projecting their desires on to me. Either that or they did not know what to say.

All of this got me thinking about the invalidation we experience with vision loss. How many people have told you it is not that bad? Then there is my all-time favorite: “you don’t look blind!” Write in and share your favorite invalidating remark.

Jamie Long wrote The Power of Invalidation: 5 Things Not to Say. I recognize a number of them as things I say or have had said to me. How about “it could be worse.”? Then there are the twins, “ I am sorry that” and “you should not”. They are members of the “Feel-that- way” family. Long also reviews “Don’t think about it. Just move on” as well as “ I am not having this conversation!”

So how to be validating? Long has a short list of suggestions for that. She states that validation does not mean agreement. Emotions are different from behaviors. You can recognize a feeling without agreeing with a behavior.

Long also suggests we not become defensive, or at least try. This is not only if you are the person receiving the invalidation but also the person delivering the invalidation. Like I said, people react from their own feelings and realities. They may not match yours. They might also be at a loss as to what to say.

And if you step in it with what you thought was a supportive remark? Accept at least a part of the blame for things going off the rails. Long also suggests reflecting the feelings or even summarizing the experience. Heavy on the feelings involved, that is.

Last but not least, there are some situations we just can’t fix. Muddling around and making some inane comments in hopes of making things better doesn’t work. Better to just listen. And if the inane, ‘helpful’ comments are aimed at you, cut the other guy a break and actually tell him you don’t expect him to fix it. Ask him just to listen.

So those are our (or at least my) vocabulary words for the week. Quiz next week! Class dismissed!✌?

Written June 8th, 2018

Next: Why Drop Out?

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That Little Summer Dress

I bought a little, summer dress the other week. It has paisleys on it. Paisleys!  Everything old is new again. I don’t believe I have worn paisley since high school. Remember the Beatles Summer of Love (1967)? [Lin/Linda: Long live Beatlemania!]

Anyway, that is just a bit of nostalgia to help us feel more positive.  In truth, I am writing about the dress because it – and what I have on with it – represent a bit of, well, defiance on my part.

Now I have you curious.? I will let you mull a second before I tell you.  Nothing bad. Capri leggings and sneaker ‘slides’, no backs on the shoes. Bright red. Definitely not a little, old lady outfit.

I have been having some problems with the people putting on this week-long seminar. They have been reasonably OK with my being visually impaired. (Like they have a choice? I am not above screaming ADA.) The problem is they arranged for continuing education credit for social workers but not for psychologists! They are now scrambling to try to rectify that little oversight and I am wondering if it is still worth my going!

I got very judgmental about this oversight. Just because psychologists will be in the minority, just because we are different, we should not be ignored!  What rude event managers!

Then I felt bad about being judgmental and thought about conforming as much as I could and keeping my mouth shut.  We different people can be such bothers!

Then I started thinking how I have a right to be different, to be me. Next thing you know I have on my paisley dress, leggings and red shoes and I am off to work! So I am different. Deal.

And the DBT skill that is? Opposite action to urge. I had the urge to just slink away but, since I had done nothing wrong and there was no reason for me to feel I was wrong by being different, I did the opposite to the urge and presented myself as even more different!  My action was opposite to my ‘wrong’ urge.

Thinking about the above situation made me wonder how many of you feel guilty about being ‘different’, about being such ‘bothers’ to the rest of the world. Who just tries to muddle along without any special consideration because you don’t want to put people out?

Goodtherapy.org did a 2013 article on shame and the disabled. Shame is different from guilt. Guilt is feeling bad for what you did. Shame is feeling bad for being who you are. Goodtherapy reported people can limit themselves severely because of the shame they feel about having a disability.

In a 2010 posting on intentblog.com RainMacs the blogger, talked about snarky comments and feeling paranoid about being “found out”. This was  even though she was not faking!

Most of the posting I found were blogs with very few of them being research. Sort of surprising I did not find a lot of research because nearly all of the blogs mentioned guilt and shame as emotions of those with sight loss. No one seemed to pick up on that as a research topic.

So to recap:  I am different. Sometimes I feel guilty about that. Sometimes this square peg would really like to fit into a round hole. Sometimes it would be nice not to have to ‘inconvenience’ people.

Then I stop and ask two questions: did I do anything wrong? Is there something inherently ‘wrong’ about me? If I can answer “no” to both of those questions, I put on a cute, paisley dress with leggings and bright red sneakers.  And that difference about me? I flaunt it.  It is alright to be me, flaws and all.

This little light…let it shine, let it shine, let it shine.

Written May 4th, 2018

Next: I Need a Sherpa

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All You Have to Lose

Morning. Do you ever think that if it were not for feeling stressed you would feel nothing at all? Yep. Insanity still reigns. Just when I got things going the right directions with retirement and the webinar we need to listen to – not to mention other work for the psych office – the accountant sends the tax forms back. What I thought was going to be a credit is a debit. Somebody made a blunder. One hint: not me.

So, you may be hearing from me requesting bail money, but in the meantime I am going to use some skills on myself.

They have made some additions to the DBT skill set since I was trained. We are finding them in this webinar. One thing they are stressing is the brain-body connection. They are talking sympathetic and parasympathetic nervous systems, Vagus nerve and all that good stuff.

I know I hit on this a bit before. Bear with me. There is some neat stuff here and if you get very, very stressed out by life, the state of the world and/or the state of your vision, these things might help.

First of all, ever hear of the mammalian diving reflex? That is what happens when the toddler falls in the frozen river, is fished out from under the ice half an hour later and lives, no worse for wear.

Bending over, putting cold water on your face and holding your breath (15 seconds or so at a time for our purposes) will trigger this response. The reason we want to trigger it is it is fantastic for reducing stress reactions. Flipping out? Ice on your face, bend at the waist and hold your breath. It is sort of a quick, temporary fix but sometimes that is all we need.

There are other ways to stimulate the parasympathetic nervous system. That is the system that brings us down after the sympathetic system revs us up. For one thing you could eat a sour candy. Getting the saliva flowing is one way to reduce stress. Then there is always a good yawn or three or four. Yawning kick-starts the parasympathetic nervous system as well.

One of the distress tolerance skills we teach in DBT is distracting with thoughts. For a long time I thought it was distracting with complicated thoughts like doing calculus in your head. It potential could be, but it can also be simple, repetitive thought. In fact, simple repetitive thought function to disrupt the action of the default mode network of the brain.

According to Wikipedia the default mode of the brain activates when we are thinking about others, ourselves, past and future. Hmm….sounds like brooding and worrying to me.

A great way to block the action of the default mode and reduce worry is to do something verbal that is repetitive or tedious. You can mentally count or say the alphabet. Name the 50 states. Think of a name that starts with each letter.

Or you can go old school. How about the Lord’s prayer or om Shanti, Shanti, om? There are hundreds of mantras, religious and secular. Find one you like and repeat it over and over. All you have to lose is your worry.

Next: Different Paths

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Just the Facts

It is still Friday evening, January 26th, and I would like to do another DBT page about what I taught this week. If you are not up for any more DBT you can stop here and I will not be offended. [Lin/Linda: For those who are just joining us, DBT is a cognitive behavioral treatment used by psychologists like Sue.  To read more about it in Sue’s pages, choose the Category ‘Cognitive Therapy’ that you’ll find either on the side of this page or at the bottom. The pages will come up in reverse chronological order so start at the bottom and work your way up! Wish I could change that but so far, no luck.]

This week I taught justified and unjustified emotions. An emotion is justified if it fits the facts of the situation. Could someone else, as in not you, understand your reaction based on what happened?

If your emotion matches what is happening, it is probably justified. If it does match what has happened, it may be unjustified.

Now, some of our students this week did not like that idea at all! We got all sorts of comments about how someone who would say there are unjustified emotions would be so invalidating and who gets to tell me my emotions are unjustified, anyway?

The person who gets to say if your emotions are justified or unjustified is you. You do that by looking at the facts of the situation and asking yourself if your reaction could have been predicted from those facts. Notice I used the word ‘facts’ twice. We are harnessing our reasonable/rational mind here.

If, being in your rational mind, you decide maybe, just maybe, reality and your reaction are not matching up, the reaction could be unjustified. Then you need to check your ‘programming’. What beliefs do you carry that would have caused you to possibly misinterpret the situation? What is there in your belief system that would have interpreted it that way?

Suppose a neighbor tells you her daughter is paying for her own wedding and will have a very limited guest list. “Sorry, you are not invited.” You are furious and raging because it is obvious -obvious !!! – they do not want you there because of your vision loss.

Where did that come from? Perhaps you feel as if you are a burden to people or that you are less valuable than the people she invited. After all, they can see! Your reaction is fury because you are explaining her action with your own assumptions, not the facts at all. What might be a justified reaction? Disappointment. Maybe sadness. Fury does not match the facts.

Some people justify their reaction based on the intensity of the emotions they feel. If you are the angriest you can ever remember being, there is a reason for being angry; right? Not necessarily. The intensity of the emotion does not make the emotion justified. Would you be so angry if someone else had acted that way towards you? Was it how you feel about that person or really the situation?

In fact, it has been my experience that the most intense emotions are the ones you need the most to investigate. Unless you are dealing with an extreme situation, extreme reactions are generally not called for. Step back and ask yourself what is happening. Why this reaction?

With vision loss, especially recent loss, we are going to be more vulnerable. With our insecurities and preconceptions about people with vision loss, we may have some pretty intense reactions to some of the strangest things. Step back. Would someone else think this reaction fits? Which of my assumptions is fueling my emotions? Am I justified in feeling this way? Adding a little observation and reasonable/rational mind can help us navigate our situations.

Written January 26th, 2018 Continue reading “Just the Facts”

Sight Loss as a Challenge

Greetings. I have a dozen things to do and very little done. Maybe writing a page will help to get me motivated.

I read the pages from our two, most recent guest authors. Great pages from what sounds like two, good people. They both sound like people who took their vision loss as a challenge rather than a death sentence.

People who may have had to let their disability slow them down but never let it stop them.

Right now i’m pretty sure there are some of you who are bristling about that last paragraph. How can sight loss be a challenge? Challenges have a chance of being overcome. How am I going to overcome THIS ? I cannot accept this. I can never resign myself to going blind!

I touched on this a little before but I want to go into this concern in a bit more depth. Acceptance is not resignation and resignation is not acceptance. Acceptance is acknowledging a set of less than ideal conditions exist. For example: I am losing my sight. Acceptance also means acknowledging there are some things you have to give up or some new strategies you have to adopt in order to get by. Acceptance allows you to test the environment and make the allowances needed to move forward.

Resignation is not acceptance at all. Resignation means giving up. It is ripping your clothes and throwing yourself on your proverbial sword. Done. Over. Finis.

I know people who have given up. After all, “I is a psychologist; I is.” They moan. They complain. They lament the truly raw deal they have gotten from life.

What is left for these people? Not much. Not if they don’t learn to accept their situation. Resignation is a dark pit with no ways out. Acceptance allows you to see the branching tunnels with the glimmers of light at their ends. Acceptance makes room for hope.

There is a saying, “happiness is wanting what you have”. It is sort of a pop culture rendition of the Second Noble Truth. Yeah, Buddha again, and I’m a non-practicing Methodist, for crying out loud. What can I say? Siddhartha was one enlightened guy. I like him!

To refresh your memory, the Second Noble Truth says that desire, craving, wanting is the root of all suffering. In other words, pining after what you don’t have and you cannot get makes you miserable. Accepting the situation and being grateful for what you have left lightens the load.

This is not exactly easy. Looking on the dark side has survival value. Therefore we are pretty much pre-programmed to keying into and lock-on to the negatives in life. After all, your ancestors needed to see the wolves in the bushes, not the pretty flowers that were on those same bushes! Seeing the positive takes constant effort and a whole lot of – another DBT alert – turning the mind towards what you need to do to accept and feel better.

So kudos to Vickie and Bob. They seem to be actively working to accept, make the best of bad situations, and move forward. And encouragement to the rest of you. Accepting you are losing your sight will free you from hopelessness. It will free the energy you are using on worrying and fretting and allow you to use that energy to find ways to enrich your lives.

Remember accepting is not resignation and we who accept are NOT giving up. There will be an answer. We will find it.

January 13th, 2018


Next: Underwhelmed

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Suck It Up, Buttercup

I try not to throw pity parties for myself. I really do. Some of the time things might not be great but I get by without a lot of feeling sorry for myself.

However, sometimes other people send out the pity party invitations and I am very tempted to attend.

What am I talking about? I was finished with exercise class and waiting for transportation. Again. A friend asked if I needed a ride. “No. I’m good.” And I waited…and waited…and waited. The instructor finished whatever instructors do after class and started for her car. Why was I still there? Was I sure I had a ride? She looked at me with such concern I wanted to cry.

I finally got home – five miles – an hour after class had ended. I got to eat at 8:30. God, this is a pain!!!!!!!!!

Since it is generally good to work through these things before they grow legs and run away with you, I decided to write a page. Self help, ya know?

I know none of you fine people ever feel sorry for yourselves, but bear with me while I work through this; OK??

I found a Psychology Today article from 2013. Russell Grieger, the author, seems to blend a bit of DBT (alright, so I see DBT in just about everything) with a bit of “suck it up, Buttercup!”   Grieger quotes George Bernard Shaw as saying “People always blame their circumstances for what they are. I don’t believe in circumstances. The people who get on in the world are the people who get up and look for the circumstances they want and if they can’t find them, they make them”.  Grieger divide people into two groups. To shorten what he said, these groups are the whiners and the responsible ones.

I don’t believe there are two groups. I feel there are two approaches and most people flip back and forth. Sometimes you have to utter a few “Really!?!? Are you KIDDING me?!?!”s before you can get back in the game.

Geiger does make some suggestions for not getting stuck in the whiners’ camp. Some of them are rather familiar. Pain is the human condition. What makes you think you are so special?  No, life is not fair. Shit happens and it happens to the nicest people. The corollary to that is “the bad guy does not always die at the end of the movie. Sometimes he gets the girl and rides off into the sunset.”

Then the much nicer ones. You are stronger than you think. You can chose not to let this dictate your life.

Geiger did not add these but I am going to. The reason I ride the #¢≠π~£! van is it is a means to a positive end for me. Without it I could not be out in the community doing my thing. I can suffer a bit if it gets me what I want. The second thought I had was “no mud, no lotus”. I like to think the adversity will make the a better person. Good things can come from adversity if it is faced with the proper attitude.

So there that is. Pep talk done. I guess I can “suck it up, Buttercup!” one more time. Shaw would be pleased.

written December 21, 2017 Continue reading “Suck It Up, Buttercup”

This Journey Together

I have had a few days of frustrating myself. I have not been ‘all there’ in Zumba or yoga. Not sure if it is the stress of puppy parenthood, the change of seasons, my bum arm, or the fact that I am 64. Probably a combination. Whatever the cause, I have not been up to par.

Then, I have noticed lapses in visual attention. Details are getting by me. Of course, we all know what that is. Whether I know the reason or not, it is irritating. I am frustrated with myself. I should know better. I should do better. I should do more.

Since I am back to teaching emotional regulation in DBT, I have been back to doing a little research. (I don’t like to do the same presentation every time since several of our students are ‘repeat customers’.) It appears DBT and a little thing called self-compassion therapy have some overlaps.

Self-compassion, or lack thereof, has to do with how people respond to themselves during a struggle or challenging time. According to Wikipedia, my ever reliable (I hope) source, self-compassion is positively correlated with life satisfaction, wisdom and emotional resilience among other things. Self-compassion has been found to be negatively correlated with rumination while rumination has been found to be positively correlated with anxiety, depression and eating disorders. (Aldao et al, 2010). In other words, cutting yourself a break means you won’t be as depressed, anxious or have as many really maladaptive eating habits.

Neff, a big name in self-compassion, postulated there are three parts to be considered. These are as follows: self-kindness, common humanity and mindfulness (of course!). Looking at the explanations in Wikipedia, I discovered self-compassion involves observing the situation in a non-judgmental way and accepting it is what it is. Observe, accept, non-judgmentally. Hmmmm….where have I heard that before? ?

It appears rather than be frustrated and criticize myself, I might accept as my body and eyesight deteriorate I am not going to be able to do what I once could. Rather than berate myself I might commiserate, encourage and be a friend to myself. If you had a friend who gets on your case as much as you get on your own case, would you keep her around? Doubt it.

Common humanity goes back to a guy name Siddhartha Gautama. Also known as the Buddha, the enlightened one. The Buddha declared that life is pain. This is the common condition of man. In other words, you are not alone. If misery loves company, you have a lot of it!

Of course, the Buddha also said pain becomes suffering only when we wish to escape it (very loose interpretation there). That takes us back to observe and accept. (See the Four Noble Truths if you want to understand it more thoroughly.)

Mindfulness! I get a little crazy with all the hype and would get crazier if it did not work so well. Mindfulness is derived from Vipassana, which means to see things as they truly are. It is a nonjudgmental observation of what is. Seeing what is truly there, suggests acceptance, warts and all.

So we have come full circle again. Self compassion: slightly different packaging of some wonderful, tried and true ideas. What it boils down to is this: see yourself for what you are, accept yourself, be your own best friend and remember, we are on this journey together.

Namaste (just felt the need to add that!)

written December 10th, 2017 Continue reading “This Journey Together”

Testing…1…2…3

Back again after vacuuming the living room and filling both the washer and the dishwasher. Starting to wonder which is worse. I have always been a little crazy but tackling some of this research stuff is, well, nuts!

“How do you know I’m mad?” said Alice.

“You must be” said the Cat “ or you wouldn’t have come here.”

Now that THAT is settled….the article, Clinical Endpoints, etc. talks about how using spectral domain OCT can even predict where GA will spread in your macula. With no way to stop it, I might want to be ignorant of where the condition will hit next, but the authors opine being able to discover new biomarkers may indicate new directions for therapies, something we want to hear.

The article then moved over to the wet side of the street. I only had testing for wet AMD one time. They shot me up with ‘carrot juice’ aka beta carotene, and then used what was probably either fluorescein angiography or indocyanine green angiography to look for leaks.

Back to a more general discussion, did anyone ever put electrodes on your corneas and shine a light in your eyes? Multifocal electroretinography measures the strength of the signal coming off your photoreceptors when exposed to light. And I am just full of bad news today, but there appears to be a diminution of the signal strength even in early AMD.

We have talked at some length about dark adaptation and contrast sensitivity. We even mentioned the contrast test they talk about, Pelli-Robson. Allow me a moment of satisfaction for that one?.

On to one I never heard of: microperimetry. This test put stimuli on very specific parts of your macula and you hit the old button if your see them. Your fixation point is monitored so if you “cheat your sweet patootie off” like I do – in other words use eccentric viewing instead of putting my poor, ravished fovea on the target – they will know.

Other than suggesting where on your retina you can actually put your eccentric viewing, the ‘maps’ from microperimetry also give an idea of where the atrophy is going to spread. Not that I want to know perhaps. And even more bad news is the study quoted found even functional macular tissue was compromised.

I think I need to stop reading this cursed study. It is depressing!

Okay, the last section of the article talked about quality of life. Finally, back to my neck of the woods. Remember: social scientist here.

And some last thoughts:

It is just fine to put problems you cannot solve away until you actually have the resources to deal with them. In DBT (and no, I have not forgotten about that) it is called pushing away. I share good news and bad. It is up to you to pick out the things that are helpful and put away the information that is not helpful or depressing. Even the depressing findings add to our knowledge base and lead us towards treatments and maybe even a cure. Let the researchers deal with the depressing stuff.

“I don’t focus on what I’m up against. I focus on my goals and ignore the rest.” – Venus Williams

October 8th, 2017 Continue reading “Testing…1…2…3”

Practice What I Preach

At present I am waiting for the van….again. These pages seem to turn into one big tirade about the truly crap public transportation we have in this rural region.

I got up to get a 6:54 am van to work (having told them I need to be there at 8:30) and I just got the call it would be another 45 minutes until they arrive. Really?!?!? This is on top of being told they could not bring me home Saturday because my seminar is in another zip code, 5 miles away.

I am angry. I am frustrated and I am resentful. Resentment is defined as bitter indignation. It implies unfair treatment.

From the complaints I have heard from the other people who ride the vans, I suspect I am not being discriminated against. Everyone is getting the same lousy treatment. Just the same, it is not fair!!!!!

Yes, I know fairness is an illusion. I know resentment is, as published in Psychology Today way back in 1995, futile and destructive. I am aware my resentment is most likely disproportionate to the damage that has been done.  I am still pissed!

Psychology Today goes on to talk about how resentment is based on internal need rather than external circumstances. If I did not believe I DESERVED better treatment, would I be as resentful? I would say not. I am arrogant enough to believe good things should come to me almost all of the time. Having those ‘shoulds’ in my head sets me up to see things as unfair.

Resentment gives us a target for our frustrations. “This damn transportation company is to blame for my life not being easy! I could do so much more if I only had decent support!” Resentment allows us to forget that while things are caused, sometimes we are not staring at the cause face to face. Things could have been set in motion a long time ago. Your ‘injustice’ may be just another domino ,’victim’ not the agent that set things in motion. Easier to assign blame to what you can see.

So, recognizing that venting my spleen (who said THAT, anyway? Shakespeare?) at the van people may not be productive, I went online and found a couple of articles. PsychCentral.com pushed the empathy angle. Remember “walk a mile in his shoes”? It helps to look at the other party’s viewpoint, their situation. Are they doing the best they can under the circumstances? Psychology Today suggested something’s that sound, well, rather DBT-ish. They suggest you observe your resentment and sit with it for a while. They also suggest relaxation and self-care.

DBT as one-step shopping?

If I actually try to practice what I teach, I would have to admit rehashing all of the nonsense with my transportation situation is not being mindful in the present. The only thing I can deal with is the now. I should also practice some gratitude. Do I have a lot of freedom because the system exists? Yep. May not be exactly the way I want it to work, but it works…sort of.

So, in consideration, perhaps I should be a bit more tolerant. Deep breath…I feel better now. Thanks for listening!

written 9/22/2017

Continue reading “Practice What I Preach”

Overcoming Uncertainty

Medical treatment is a very uncertain proposition. Writing for the Journal of Graduate Medical Education Wray and Loo quoted Sir William Osler as saying “Medicine is a science of uncertainty and an art of probabilities”. The authors report that rarely is evidence of benefit totally clear-cut when a treatment has been administered. Also, it is rare for practitioners to agree totally on a treatment.

Sometimes opinions are expressed in such a robust manner by both that the patient is left in a quandary. How are we supposed to know who is correct? What are we supposed to do now?!?!

Wray and Loo suggest doctors (and others) look at the evidence. Is there evidence suggesting one treatment is superior to another? What does the research say?

Lin and I are big on research. The truth will be seen in the research. Notice I used the word will, future tense.

Work being done on AMD causes, treatments and maybe even cures is in its infancy. Like all infants, things are subject to change. The infant with blonde hair and a little button nose who you think looks just like your father may grow up to have brown hair and a ‘beak’ just like his uncle on the other side of the family! Final results subject to change without notice. Wait and see.

So many doctors don’t like to say they don’t know. Wray and Loo say it is a mark of professionalism to be able to discuss the pros and cons AND the uncertainties of a treatment, but how often does that happen? Maybe there is not enough time. Maybe they are uncomfortable being fallible. Maybe they think we can’t take it.

Wray and Loo talk about the emotional burden of uncertainty. Uncertainty is nerve-wracking. Many of us feel better believing any plausible nonsense than being told there is, as of yet, no answer.

The problem with believing strongly in something uncertain just so we HAVE an answer? When you find out your life-preserver is actually a cement block, you are too invested in it to let go!

How to handle uncertainty. I actually had to smile because when I went online what I found was totally in line with DBT. If you want to go back to the DBT pages, have at it.

Travis Bradberry, a positive psychology proponent, shares 11 Ways Emotionally Intelligent People Overcome Uncertainty. Bradberry tells us our brains are hardwired to react to uncertainty with fear. He quotes a study in which people without information made increasingly erratic and irrational decisions.The diagram Bradberry showed was a brain and his caption said “uncertainty makes your brain yield control to the limbic system. You must engage your rational brain to stay on track”. Sounds three states of mind-ish to me.

Beyond that, Bradberry suggests calming your limbic system by focusing on the rational and real, being mindful of positives, taking stock of what you really know and don’t know, embracing what you cannot control (also known as accepting reality), focusing on reality, not trying to be perfect, not dwelling on problems, knowing when to listen to your gut, having a contingency plan (what I have always called plan B), not asking what if questions and – guess what! – breathing and being in the moment.

Hope this helped some. Remember this journey is not a sprint, it is a marathon. In fact it is a marathon that we don’t even know the course. Keep an open mind and don’t latch onto anything out of fear. Eventually we will find the way.
Continue reading “Overcoming Uncertainty”

Some Learning to Do

Good morning. Mildly frustrated….again. Suspecting this is the usual state for people with vision loss in the ‘mature’ years (and whom, exactly do we think we are kidding with that ‘mature’ business??)

The online dictionary gives the definition of frustration as “the state of being upset or annoyed especially because of the inability to change or achievement something”. Yep, that’s me. Upset and annoyed.

I miss my freedom and flexibility of movement. I want to be able to go where I want to go and do what I want to do when I want to do it. And I don’t want everything I do to be such a damn project!

I got back to hip hop this week after three weeks of missed classes. Variety of reasons. But then Tuesday I ended up staying home because I had gotten the feeling I had overstayed my welcome with that ride. (Take the hint, girl!) Wednesday I was going to ride my bike to yoga in the park but I got out of work too late. Tonight I tried a different class, one the Y is offering in place of yoga, and really did not like it. Honestly! Niggling little frustration after niggling little frustration!

Then, of course, I feel guilty. I had arranged for transportation, but two people inquired how I was getting home. Either of them would have volunteered to bring me home. That is not a requirement. They are kind. How can I be so frustrated when I am surrounded by kind people? What is wrong that I cannot appreciate what I have?

Summer plans are starting to formulate. I am one of the most fortunate people I know because I have people willing to take me to yoga events, blues festivals and even into ‘The City’. [New York City, that is.] Am I thinking of that? Of course not! I am thinking about how I am going to finagle transportation! How can I get to the kind souls so they are not driving so much? How can I be less of a burden?

When I start thinking this way I start to get very willful. I dig my heels in and say things to my husband like “Fine! I don’t care! I will walk!” Yeah. 20 miles in the snow uphill…both ways. Problem is: I would actually try!

In DBT the question to ask someone who is being willful is “What is the threat?” What is it you are defending against when you dig your heels in and insist things be your way? Pretty good question because dollars to donuts I am defending against something!

In my case, I think I am defending against the loss of my lifestyle. The loss of my identity. Realistic fear? Certainly not for a couple of confused weeks. Best to let the dust settle. See how things shake out to use one more of my colloquialisms.

Of course, my style tends more towards blunt force than patience. I don’t totally embrace everything I teach. Apparently I also have some learning to do.

Written June 10th, 2017

Continue reading “Some Learning to Do”

The Art of Asking

Today was a sad day at school. The teacher who had been battling cancer for the last two plus years passed away.

I have been teaching DBT long enough now, the DBT-ish thoughts come unbidden. First though is about meaning in pain. Some people wonder how you can have meaning in a life full of pain.

The answer according to Viktor Frankl and others is this: the meaning in a life full of pain can be in the way you endure. Fortitude? Grace? Style? Call it what you will. This woman did it with class.

The other thing I thought about was the comparison skill. The mother of young children diagnosed with terminal cancer? She could have handled this low vision thing with one hand tied behind her back! What am I complaining about? I’m lucky!

And another reason I am lucky? Back to I have people and my people are great. Since my ride home and this woman were friends, she went home early. Before I even knew I was down one ride home, the secretary had called my backup ride for me and I was back in business. Love you guys!

Taking me to what Lin wants me to address: asking for help. She informs me a lot of you folks are not loud, forward pains like I am. I am supposed to talk about how it is done…and not like a loud, forward pain, either.

Remember do as I say, not as I do? We are going to go over asking nicely.?

Lin sent an article by a woman who asks for things for a living. She collects money for charity. I am going to use her Art of Asking as a loose guide.

Know what you want and why you are asking

The author suggests you know what you want and why you are asking. Essentially it should be important to you and other people should be able to see that. Frivolous doesn’t cut it. If it doesn’t matter to you, why bother people?

Ask for things from people who share your interests

I ask for things from people who share my interests. Not only do they ‘get’ I will go nutz if I don’t get to yoga, they are often “going my way”. (Bing Crosby, 1944, and available for free on YouTube!)

Ask directly for what you want and be specific about the expected cost & effort to the person

The author also suggested asking directly for what you want and being specific about the expected cost and effort to the other person. Don’t drag people out of their way and be understanding and flexible about their needs if they take you out of your way. With my ride home from school I have gone to pick out a train set, to the garage and to the chiropractor. Since she needed to go, I went along. She was doing me a favor, not the other way around.

As I said before, my school ride home lives ¾ of a mile away. My backup ride is about 1-¼ miles away. If I know someone lives on the other side of town, I refrain from asking except in an emergency.

Social media can help by asking a small group of people

I am not on social media, but social media has helped in getting my needs met. It has already happened that a usual ride had to back out but ‘advertised’ successfully for a sub. Asking in a small group can get people talking and generating solutions. Sometimes a total stranger will step in to help (just make sure SOMEBODY can vouch for him or her).

Give alternatives

The author suggests giving alternatives. There is more than one way to solve any problem and personally I have found people are more receptive to helping if they see you making the effort too. When I go to my third job, transportation will take me half way. Rather than run someone all the way to pick me up, I make arrangements to get to the halfway point on my own.

Don’t be afraid to get told no

And the most important thing of all? Don’t be afraid to get told no. The author points out not asking guarantees a no. I want to point out graciously accepting a no does not burn bridges or make people feel uncomfortable about being a ‘bad’ person. Most excuses are not excuses at all; they are reasons. Recognizing other people have obligations and needs can only be a positive in the long term.

End of tutorial.

Continue reading “The Art of Asking”

A Stuffed Black Dog

I am practicing my DBT skills on myself today. Today was the day I was supposed to get a new pool liner. Supposed to being the operative words.

I have spent several years trying to extend the life of the old liner with gorilla tape! That one was always a bit of a debacle. I picked an installer at random – and did not find out he had been driven out of business three times before that until I was having problems. (Note to self: research tradesmen!) When hurricane Ivan came along and pushed up the bottom of my pool, I was not able to get a lick of help from that guy. My pool bottom had lumps with wrinkles radiating in all directions. I was dreaming about GIANT spiders living in the pool!?

But that is not why I am practicing my DBT. Today was supposed to be sunny and 80 °F. It is 56 and raining. My pool is drained and there will be no new liner for a week. Frustrated, but it is what it is. No controlling the weather.

Also, why ruin right now thinking about the swamp smells that might (face it, probably will) be coming off the pool until we get the new liner in? My fussing won’t make it smell like roses!

One of our readers/member of our Facebook group recently sent some comments about her first injection for wet AMD. When I read what she had written, I realized in some ways she had practiced DBT! Other ways she needed a little reminder to do so.

The reminder first: the days before her first injection our reader spent a lot of time worrying and fussing. After she had her shot she was sort of upset with herself because it had not been as bad as she had envisioned. She had wasted a lot of time being in a tizzy about it all!

Yep. My pool may not stink as much as I believe it will. The only way to find out is wait and see…and don’t waste time and energy worrying about it.

Reality dictated our reader had to have her shot. Otherwise there would be bigger problems. Reality says I am going to have a swamp in my backyard. No avoiding it. Might as well accept it will happen.

Both our reader and I know what caused our respective messes. She has ‘bad’ genes and my pool guy got a bum weather report. But even knowing what happened, the causes are not under our control. No sense fussing or saying it should not be happening. Better to practice ACCEPTS and get through it. [Lin/Linda: Click here for one of Sue’s pages on ACCEPTS.]

And you know what I loved? Our reader practiced a self-soothing skill through touch! She took a stuffed animal (a stuffed black dog) with her to help her through.

Another DBT skill she used (whether she knew it or not!) was effectiveness. That stuffed animal may not have been a ‘proper’ thing for a grown woman to have, but who cares? It did its job and helped our reader through. Remember effectiveness is all about doing what the situation calls for even if custom (or snobbery!) says it should not be done that way. [Lin/Linda: Click here for one of Sue’s pages on effectiveness.]

So, thanks to our reader for letting me use her comments in a teachable moment. As for me, no sense sitting around waiting for the pool to stink. I am off to Walmart. Continue reading “A Stuffed Black Dog”

Turn Your Mind

Hello, there! Good day today.

I taught class this morning. What started out as a four man, teaching team – two on for 12 weeks, two off – is now down to two people. Looks like my colleague and I are teaching until further notice. There is a DBT teacher training in the Fall and we are strongly ‘encouraging’ some of the younger folks in the office to take it. Really cannot have no depth in our teacher pool. My colleague has already informed me – should I have a huge drop in vision – she will lead me into our classroom white cane in my hand☺. I would say it is nice to think I would be missed but I believe it has more to do with not wanting to abandon the DBT program?!

Taught radical acceptance today. Made the point it is radical because it involves a huge shift in a lot of core feelings and beliefs.

You don’t accept being someone who is visually impaired over lunch, for example.

That will bring us to radical acceptance being an ongoing process. You remember: “every day in every way we are getting better and better.” Every day we accept a little more of our new identity and the ways we now have to live our lives. It is an incremental thing.

And THAT brings us to turning the mind. [Click here for one of Sue’s past pages about turning the mind.]

I remember graduate school…many, many years ago, but I remember it! There was a diabetic kid living on the ground floor. Every week he would smoke marijuana and get a massive case of the munchies. After eating a couple of bags of snacks, this kid would go into a diabetic crisis and someone would call the ambulance. Rinse. Repeat.

This kid needed a good dose of radical acceptance. (He also probably needed a kick in the ass, but that is another page.) He was not like the other college kids. He could not drink and smoke and eat like them. Not and live to tell the tale, at any rate. That was a fact that was not going to change but he did not want to accept.

Part of the problem was he was in an environment surrounded by other kids all doing what he could not do. He was faced with the choice of going along (and just about dying) or abstaining several times a week.

Turning the mind is deciding to make the appropriate choice….again and again and again ad nauseum. Every time you have a chance to either accept your situation or reject it, you have to force yourself towards acceptance. There is no “just this once” or “I will do it next time”. The situation this kid was in may not have given him a next time.

Life is going to give you lots of opportunities to reject your ‘new reality’ and doing so is very tempting. But in the long run will not accepting reality change it one little bit? I suspect the truth will remain what it is whether people believe it or not. It will still be there to deal with, so you might as well get started. Turn your mind towards acceptance. Continue reading “Turn Your Mind”

Why NOT Me?

I am working on my lesson plan on radical acceptance for DBT. In order to truly be able to tolerate distress and build a life worth living – all in DBT parlance, of course – we sometimes have to radically accept a situation we do not approve of and that causes us pain. [Lin/Linda: Click here for another of Sue’s pages about radical acceptance.]

Why radical acceptance? Things termed ‘radical’ effect fundamental nature and have far-reaching effects. Some changes and distressing occurrences threaten us at the core. In order to deal with them we need to accept them at the deepest levels as well. Thus, radical acceptance.

Think integrating a new identity as someone with low vision into your sense of self. Now THAT is pretty radical.

Radical acceptance not only teaches “it is what it is”, no changing reality. It also teaches “everything has a cause”. When I first read that, I bristled a bit. I do NOT feel I did anything to deserve having this eyesight. Not my fault. Then I decided I would need to research it a bit more (after all, I am supposed to teach this stuff!)

Turns out the idea behind everything has a cause is not about assigning blame. It is, instead, to quiet that chorus of voices saying how things should be and how life is not fair.

Only when we get over feeling the Universe is out to get us can we eliminate some of our distress.

The plain and simple fact of the matter is I was a pretty logical candidate for developing AMD. I am female, white and of a certain age. My father had AMD. My diet runs toward fatty foods and I have high blood pressure. After I took another look at the risk factors I have I had to admit “why me?” was not the proper question. The more appropriate question would be “why not me?” What would make me so special I could have all those risk factors and not develop the condition?

The third tenet in radical acceptance says life is worth living in spite of the pain. (I try to live a full life in spite of my ‘blurries’. I also end up with muscle aches to prove it. Somebody remind me to act my age….later.)

In fact, DBT says pain has some very positive purposes. (Now let’s not get too crazy here.)

Nietzsche really did say “that which does not kill us makes us stronger”. I wasn’t there but I take it on good faith. Jane Juza said in The Positive of Experiencing Pain that pain tends to make us appreciate the good in our lives and to seek out meaning and purpose. Frankl said the meaning and purpose in your life may be in how you endure with grace.

So, there you have it, a preview of my lesson on radical acceptance. Hope it made sense. Going to bed a little early now. I think my pain is telling me I played too hard. Information, another benefit of pain. Night!

written April 30, 2017

Continue reading “Why NOT Me?”

Meaning and Purpose

We are about half way through the distress tolerance module for DBT group. We are working on the IMPROVE skills, the second of which is meaning.

Viktor Frankl said (actually quoting Nietzsche I recently discovered. Learn something new every day!) – to paraphrase – if you have a why to live you can pretty much survive any how. Much of life is in meaning and purpose.

We put up with all sorts of nonsense when we know why, have a personal reason, we are doing it.

When something happens that rocks us at our very foundations – let’s say sight loss, just for devilment? – we can really start to wonder about our purpose in the world and the meaning in our lives. Some people find the problem takes up so much of their time and energy they cannot break free to do anything else. They have thought they have no meaning for their existence.

Frankl came up with an answer to that question. To quote (exactly this time!): “The way in which a man accepts his fate and all the suffering it entails, the way in which he takes up his cross, gives him ample opportunity – under even the most difficult circumstances to add a deeper meaning to his life.”

In other words, sometimes the meaning that is in your life and that will allow you to endure is the grace in which you accept and deal with your fate. You don’t have to be finding the cure for cancer or saving orphans from raging flood waters, all you have to do is be an example of acceptance and endurance.

Acceptance and grace in the face of some truly crappy circumstances is the basis of several world religions. Frankl did not use the imagery of taking up your cross by accident. Some of the allure of the Easter story is Jesus’ example of acceptance and grace in a nasty situation. Being able to say “Thy will be done” is actually pretty impressive when you think about it.

So one of the things that any distress – including vision loss – can do for us is to give us the opportunity to develop grace, to transcend through acceptance (not approval or resignation). The meaning in your life becomes your quest to transcend.

Another thing distress can do is build mental and emotional “muscles”. I have one client who has endured heavy-duty mental illness. He amazed himself with how tough he could be. The meaning he gained through his trials was “I learned how tough I truly am”.

To quote Nietzsche once again, “that which does not kill us makes us stronger”. Or at least it makes us aware of the strength that was there all along. Perhaps the meaning in your pain is “I’m tough, I’m bad. Even this nonsense cannot defeat me.”

So, meaning and purpose can both be helpful in allowing you to accept and endure distress. Maybe your meaning is nothing more than showing yourself and the world you can weather the storm with grace and strength. That’s okay. “The way a man accepts his fate and all the suffering it entails…gives him ample opportunity…To add a deeper meaning to his life”.  Continue reading “Meaning and Purpose”

C for Contribute

Today was not the best of days. I did entirely too much housework and there was a little difference of opinion here on the home front. Of course, you know I was right!?

Since I am now teaching distress tolerance, I tolerated my distress by doing some activities, such as preparing my lesson plan. If you have been following along on this journey you know activities are the A in ACCEPTS in Dialectic Behavior Therapy.

I then looked at my notes for the first C, contribute. The list of stuff we have on the PowerPoint all sounds like a lot of work to me. Do volunteer work? Make something? What, for heaven’s sake? I gave up being crafty in high school. Lots of invested time for needle-crafts that went in a drawer. Maybe that is why they suggested you give the stuff away!

My answer to the too much effort, too much time and need to do something because I am distressed NOW bit was random acts of kindness. Random acts of kindness have become very trendy. [Lin/Linda: there’s even a website and foundation with that name.]  They are so “now trending” that we have a random acts of kindness wall at school and someone has started a line of random acts of kindness gifts. While I tend to think that all this play is making this random acts of kindness stuff a bit schlocky (love Yiddish. It is so expressive!), there is something to be said for the original concept.

The National Civility Foundation has a civility toolkit in which they encourage 24 acts of kindness in 24 hours. They obviously believe it does something positive.

I found several lists of 100+ random acts of kindness. I took the one with 102 things because it was a regular list and would print out on three pieces of paper. Random act of kindness for the environment and my pocketbook. Ink is expensive.

One of the things suggested on the list was donating old clothing. That was one thing I actually did today. Strolled over to the church and put things in the Red Cross bin.

Which brings me to a cautionary tale. I know this went viral on the news networks so you probably saw it in the States, maybe other places, too. Anyway, a woman in the region died after she got her arm stuck in a Salvation Army donation bin. She was, shall we say, doing a ‘reverse donation’ from the bin at 2 a.m. in February. Her stool went out from under her, her arm got trapped, and she froze to death. I teeter between saying it was all very sad and saying it was poetic justice. Not that any of you people would do such a thing. I just found it amazing. The fact she was stealing from a charity while driving a Hummer makes it even more amazing.

And that, my dears, is the second C, comparison. We are all allowed to feel a little superior that we have not done anything like that. At least I hope we haven’t.

So go on out there and hold open a door. Put a coin in someone else’s parking meter. Smile at a stranger. And if you go to the clothing donation bin? The stuff goes IN the bin.

written April 1, 2017

Continue reading “C for Contribute”

Keep On Keeping On

I gave a client “there is nothing else you can do” speech today. I told him if his relative is not a danger to himself or others, he could not force him into treatment. Doesn’t matter if he is in communication with the fairy people or if he sees the devil in the fireplace, there is nothing my client can do to force him into treatment.

People hate that speech. My client told me he hated when people said that to him. We like to believe in our efficacy, our power. “There has to be a way! Maybe I can try harder, find a better argument, something.”

Accepting there are some things you are not able to influence is a bitter pill.

In at least that way, you folks who have wet AMD are ‘better off’ than those of us who have dry. At least you folks get to actively participate in your own treatment. Granted, getting a shot in the eye is not my idea of a good time, but it is something. We folks with dry AMD get to do…..nothing.

How do you sit there and do nothing when everything is falling apart around you? The thought that you may have to endure for years and years and have no recourse is terrifying for people.

I have talked about the distress tolerance skills but, since this came up and we are actually teaching distress tolerance, I want to revisit it. Distress tolerance skills are not ways of ‘fixing’ anything. They won’t make my client’s relative to not be psychotic and they won’t give me 20/20 vision. What they are are strategies for enduring.

With distress tolerance skills, we get to hunker down and survive the storm, not make the storm go away.

Also said this before but I will say it again: one of the tenets of DBT is “I am doing as well as I can, but I can do better”. No one wants to be a screw-up. We can pretty much guarantee that under their present state of circumstances, most people will be doing the best they can. Given new circumstances and a new skill set, they can do better.

How that figures in here is that I don’t want you to think that using distress tolerance skills to endure means you stop trying. Offered a viable treatment, I, for one, would take it in a heartbeat. Treatment would be the new skill set and how I could ‘do better’. However, until that day comes, I am stuck enduring.

There are several pages on which I talk about the DBT skills IMPROVE and ACCEPTS. IMPROVE skills are used when we are in the midst of a crisis. The letters stand for imagery, meaning, prayer, relaxation, one thing in the moment, vacation and encouragement. [Click here for one of Sue’s past pages on IMPROVE.] ACCEPTS skills are used when we are trying to endure in the long term. The letters stand for activities, comparison, contribute, opposite to emotion, pushing away, thoughts and sensations. [Click here for one of Sue’s past pages on ACCEPTS.]

Lin will probably put the links in, but if not, just search the keywords. There really is something you can do when there is nothing to be done.

Keep on keeping on. Continue reading “Keep On Keeping On”