Category: Cognitive Therapy

Helping Myself

AMD is a long-term distress to be tolerated. I have been using my distress tolerance skills to get through day-to-day. The one I like and use a lot is activities. I like to keep busy.

However, since my husband is incapacitated, things have gotten harder. I might be a bit too busy. Just as an example, I have the added need to visit him in the hospital but I have lost a major source of transportation.

I have FINALLY been approved for the public transportation. They have a weird schedule, though. I could only go to the town where the hospital is early in the day and could only get a ride home before mid-afternoon.

After that my coach apparently turns into a pumpkin. Don’t any of the people riding this service have lives? Apparently not.

I have made reservations for rides to work Thursday and Friday. It is against my better judgment to start with something important like that. I have the terrible feeling I am going to be late even though my pick-up time is a full hour before my work day starts.

I have to take some of the burden off of my friends, though. They have been incredibly supportive during this crisis but these are extra trips are out of their way. I know it will become vexing. I love my people and I believe my people love me but I cannot just collapse and expect them to totally support me.

God helps those who help themselves, I have been told.

Yesterday my friend and her husband took me kayaking. Yes, an activity but also a ‘pushing away’ distraction. Once I was on that river I mentally put away everything that was happening on shore. It was a very nice hour.

My friend had volunteered to drop me off at yoga but I declined. I could have gotten a ride home from there but I decided not to go. The Beastie Baby had been spending too much time alone for one thing. I had to go home and ‘contribute’ to her. Taking care of others is a good distress tolerance skill.

I also had to take care of myself. I have been dropping weight on the ‘macular degeneration diet’, unable to get to my sources of Chinese take-out and ice cream. These past few weeks have been worse. I have not been getting much to eat that wasn’t ‘junk’.

So, ignoring that it was after 8 pm and the fact I really did not want to cook, I made myself a nutritious meal. Semi-proper eating, good food at a bad time. It is the one E in PLEASE.

After that it was a hot bath and off to bed. Soothing through touch and proper sleep. That is the S in PLEASE, of course.

Feel guilty about taking care of me? Nope. Yes, I could have worked the phones and begged people for rides to the hospital. It is walkable in about 90 minutes, I could have put on sturdy shoes and walked. The problem was, I was already stressed and tired.

The only way to contribute and support others is to support yourself first. A caregiver who collapses from self-neglect cannot support others. Last evening I just took for me.

written 8/17/2016

Continue reading “Helping Myself”

I Love My People

This page is in praise of community.

Sometimes we older folks get it into our heads to move away from home. Florida? Arizona? It is warm and look at that view!

In 2010 US News and World Report did an article on this. The title was “Should You Move After Retirement?” (OK, it is an old article but it was the first one I found and it backs up my point. You might be able to find something more current.)

We have discussed it. My husband likes the idea and I hate it.  Hate it for a variety of reasons. Since I am as old as dirt and have been in my profession since the Wisconsin glacier (a few irrelevant references don’t hurt), I was grandfathered in with my license. I practice in Pennsylvania or I don’t practice at all.  I want to work as long as possible. As long as my vision allows.

Bringing me to another point. How many places have world-class eye hospitals as close as Wills Eye Hospital is to here? Where would I be able to get into a clinical trial? I have done the legwork here and been promised a call as soon as something happens. (Squeak out to you, ‘my’ research person! ?) I am not commuting from Arizona!

We have a decent place – paid for – and it is full of stuff. It will take me two years working full-time to sort it all out. Like I said, a variety of reasons.

But the big reason? Here, I got PEOPLE. I LOVE my people.

Hubby is back in the hospital. He ‘blew out’ his back and it is going to be a bumpy ride. He won’t be able to drive for a while and may need surgery.

I have been texting and working the phone pretty much constantly. I have things to cover! Hubby’s friend took us to the hospital yesterday. Nephew #2 brought me home nine hours later. Hubby’s friend had taken care of the Beastie Baby and was mowing the lawn when I got home. Thank you.

Nephew #1 is taking me to the hospital this afternoon. My friend the accountant will bring me home.

Tomorrow a co-worker is picking me up and taking me to school. My usual ride will bring me home. Accountant friend will drop me off at the hospital and my yogini will pick me up. Then we go to hip hop! She has wanted to go for some time so we are both benefiting. She flies. I buy.

Still working on Tuesday but Wednesday my ‘little boss’ will take me to DBT so I can teach and another co-worker will bring me home.

In other words, the girl has people. Anywhere else in the world? Not so much. Strangers are good. They are often great but someone said home is the place where, when you are down and out and pounding on the door, they have to take you in. Where I am at feels like home.

Thanks, guys!?

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Crazed Puppy

Back to looking at my mindfulness lesson. I found the slides on the ‘wild horses’. Frankly I dislike that analogy. To me wild horses are, well, wild as in free. The concept of controlling your mind as if it were a herd of wild horses is just plain wrong in my not always so humble opinion. It is my mind, free and independent, as well as often scattered. No bronco bustin’ required.

If you like dogs and like to giggle, there is a website called Dogshame. Some people think it is cruel. I am not sure I see that but I know it can be funny.

“I thought you were never ever ever coming home so I panicked!”

Be that as it may, I got what I consider to be the perfect photo to illustrate the concept of mind training off of Dogshame. It is a photo of a fluffy, small, white dog in the middle of chaos. The caption? “I thought you were never, ever, ever coming home so I panicked”.

That, to me, is the perfect representation of a mind in need of mindfulness training. The mind is not a wild horse to be broken through mindfulness. It is a scared and crazed puppy who needs to be soothed and regulated.

And how do kind masters (and we all need to be kind masters to our own minds as well as to our animals) train a pup? Catch the transgression at the start. Calmly lead him to where he should be. Praise. Repeat. Repeat. Repeat. As it has been said, Rome was not built in a day. Patience is a virtue I somehow think I lack but patience is necessary when training a mind.

Mindfulness practice? It’s akin to housebreaking. Keep kindly and patiently working on it and you will get there.

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Best Laid Plans

I was supposed to be going on my first ‘big’ adventure today. I was supposed to take the bus to a resort town and meet my friends. Not happening. My husband has had some health complications. Probably should stay close to home. Also, no ride to the bus station at the crack of dawn.

Oh, I finally should be able to add another option to my transportation choices. I called the public transportation people AGAIN. This time I was told I would have my approval by Tuesday. Let us see what happens.

I think I told you before it is a wise idea to get these things in place before you need them. I tried. I filled out my application in early March. It is now June and still no subsidized transportation. Scary to think how it could have been if I really needed it three months ago.

Cautionary note: put things in place even if they are not needed now. You never know when they will be. Plan ahead seems to be a must when you are visually impaired.

Anyway, no trip today. I am disappointed. How to handle that? I called my Saturday morning Zumba class ride to un-cancel so I will go to class. A friend who knows my dilemma said she and her husband might be able to get me in a kayak on the river tomorrow. My favorite distress tolerance skill at work, distraction through activity. If you keep moving, the illegitimi can’t get you.

Black and white thinking says things like always and never. “I am handicapped now, so people should always satisfy my needs.” “I will never get to have any fun now that I have macular degeneration.”

Those black and white thoughts come up when there is disappointment. Best to recognize them and lose them.

When you are disappointed and thinking in absolutes, shoulds and musts, it is easy to lose perspective about other people’s situations. This is not a perfect world. Things happen. Getting angry and accusatory won’t help. No one in the world can satisfy all the needs and desires of someone else. Disappointment is inevitable.

Have I been disappointed before? I suspect I have been. Remembering I have been disappointed and lived to tell the tale can be helpful.

There was life after that disappointment and there will be life after this one. I am pretty strong and I suspect you can be too.

So here I am home when I had hoped to be on an adventure. Cannot be helped. Might as well accept it. Disappointment is part of life and I suspect the frequency rate picks up when you have a visual handicap. I have lived through disappointments before. I believe I can handle a few more.

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Dog and Pony Show

Hi. I got a call from my BVS case worker today. He wants to come out and bring his supervisor to meet me. Apparently it is annual review time and I am to be an example of his good work.

I don’t mind. I can put on a dog and pony show with the best of them. Also my case worker is a good guy and I have no reason not to cooperate. He has been infinitely helpful to me.

My question was “why me?”. The response was “you are using what you were given.” Well, yeah, isn’t that why I have it?

I know better, I really do, but I always think using what you are given is a no brainer. I think “doesn’t everyone do that?” Of course they don’t, silly girl.

Not using what you are given has been a problem for a long time. For those of you of the Christian persuasion, do you remember the three servants and the talents? It’s Matthew 25: 14 -30. The master was peeved at the servant who buried his coins and did not use them to good advantage.

Why would that happen? Looking online I discovered a list of a few reasons students don’t use assistive technology (in the article Resistance is Futile). I think these reasons might apply to some of us older folks as well.

Some of the reason may be poor training or a feeling you are somehow cheating. It may be using the technology seems like too much work or you had a bad experience and technology is really scary.

There is also the grief factor. Loss is tough and some people get willful. Somehow they believe if they give in and use technology and other assistive devices they have admitted defeat. Admitted they are handicapped.

Willfulness can be nasty business. It not only stops you in your tracks but it – admit it – makes you look pretty dumb.

There you are staring at something that will make your life ten times easier and you are refusing to use it! Really????? What is up with that?

Once again, accepting reality does not eliminate the pain but it does eliminate the suffering. I am still going blind. I am just going blind more comfortably and more productively than people who reject help.

My case worker asked me why I have embraced the technology. My answer: the alternative sucks more. (DBT alert. Comparison skill there.)

So there you are. I am to be the client he shows off because I use what I was given. I still think of that as a no brainer. How about you?

Continue reading “Dog and Pony Show”

Whirling Dervishes and Others

I was working on my next lesson. We have done the two, introductory lessons and we are getting ready for mindfulness, lesson one.

I throw a lot of extra ‘stuff’ into a lesson. I was looking at information related to the origins of mindfulness and mindfulness meditation. Mindfulness meditation has a rich and ancient history rooted in the religions of the world. There are mindfulness mantras in many religions.

A mantra is a repetitive song. “Om Shanti Om” is the peace chant of Buddhism (but if you want something really wild, click here for the “Om Shanti O” song on YouTube. Holy Bollywood, Batman!). [Lin/Linda here: the video is indeed a Bollywood version. I recommend this version by Deva Premal. Best to listen to it with headphones, she has a very incredible lyrical voice.]

Gregorian chants can be seen as Christian mantras. Click here for one video. There are many others.

You use your voice and a repetitive song as the focus for your attention. Sound meditation as prayer.

For Whirling Dervishes, part of the Sufi tradition, the focus of attention is on the repetitive spinning….and on Allah. Movement meditation as prayer.

In short,  it dawned upon me mindfulness practice – including repetitive, rhythmic stimuli – and prayer seem pretty closely linked. Mindfulness can focus attention necessary for prayer, for example. Prayer can be used as a point to focus attention. Repetitive stimuli can calm lower brain centers  which in turn allows you to be more mindful and pray. Hmmmmm…how about that?

DBT lists prayer as a distress tolerance skill. It is a way to get through a crisis with as little suffering as possible.

Linehan lists three types of prayer. Linehan talks about “why me?” prayer. To me, this sort of prayer sounds pretty whiny. It sounds like plenty of suffering has been attached to the pain. Why? Because the person is fighting reality.

Remember: it is what it is. There really is nothing that can be done to change reality.

DBT suggests we don’t fight reality. The opposite of fighting reality is acceptance. In other words, thy will be done. I accept things are the way they are. Remember acceptance does not mean approval. It just means you are willing to accept and operate within the new rules of the game.

Psalm 40 verse 8 is about accepting and acting in accordance with the will of God for example. Psalm 37.23  is another example. There are probably dozens if not hundreds of other examples in the world’s religious tradition. These may help keep you from the suffering fighting reality brings.

Another thing about acceptance through prayer? If you are a person of faith, there may be a little internal voice that says to you “I’ve got this.”  When you are dealing with something above your capabilities, it is nice to feel you have some ‘expert’ help available.

Linehan also talks about the distress prayer. Her distress prayer is pretty much an extended version of my “Oh, s***! Help!” prayer, with the distress prayer asking for solutions over time.

My “help!!!” prayer is usually uttered in the face of imminent disaster!

I am not a religious scholar by any means but in my lexicon there are two more types of prayer. They are “Wow! Nice job!” and “Thanks”. In other words, they are praise and gratitude prayers.

Praise and gratitude prayers are positive things. They help us recognize we really are not bereft of all good things. In the cases of many of us reading this, AMD may have taken many things away but many wonderful things and many things we can be grateful for still remain. Sometimes we just need a reason to notice them.

List good things for a gratitude prayer.  Close to the idea of accumulating positives; yes? Yes!

So repetitive, rhythmic stimuli/ movement, mindfulness, acceptance,
praise, gratitude, accumulating positives… they all seem to come together in prayer. Cool.

Continue reading “Whirling Dervishes and Others”

Boot Camp

Waiting for a ride here. Looking through the allaboutvision.com site. Some interesting articles.

All About Vision is a decent site. That is my first point. Second point? Never have nothing to do. Waiting for people can be deadly when you have nothing to do. Third point: be ready to jump up and run when they finally do get there. Make sure whatever you are doing can go away in 15 seconds or less.

So that is my visually impaired lady wisdom for the day. Back to all allaboutvision.com. They have an article saying physical health, cognitive ability and emotional health need to be considered when dealing with the visually impaired. I really want to say “no s***” and label it a no brainer, but maybe people really don’t realize how important those factors are to a good adjustment.

Total human being here. The days of believing in the separation of mind and body are long gone.

Sort of like PLEASE in DBT. Take care of your health. If you don’t maintain your ‘vehicle’ you are going nowhere. There are plenty of data about the benefits of staying fit and strong. Vision loss is plenty. I, for one, do not need to add heart failure or diabetes to the list.

There is not much you can do about exceeding the smarts God gave you, but you need to remember what was given to you is actually a range. Biology sets the range and the point on that range is determined by the environment.

The point you are at can be up to you. Try to function towards the top of that range.

Don’t quote me but I think I read something like 80% of what we learn comes through vision. The flow of knowledge has been blocked for us. We now have to actively work on learning and staying sharp.

Emotional health, read depression and anxiety, can be a serious factor when you are visually impaired. We talked about loss before. Don’t let anyone downplay it. Vision loss is a death. Grief is natural. Depression is not uncommon. The number I read was 30% of people with vision loss are depressed.

Anxiety is pretty natural, too. My panic attacks were not fun but they could have been predicted. The article said that people who only have AMD in one eye are often more anxious because they are waiting for the other eye to fail. Will today be the day? Will today be the end ?

So do these factors truly affect your resilience? Duh, yeah! Therefore, it is time to go walk that mile. Solve that puzzle. Accumulate positives by doing things that make you happy.

This is AMD boot camp. Let’s get prepared! There is a campaign ahead.

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How’s Your Balance?

DBT has a thing for balance. It is sort of in the name: dialectic. You remember. Dialectics are all about avoiding black and white thinking, finding balance, coming to a consensus.

Anyway, DBT is worried about balance in other ways. One of these ways is having enough to do. Or having too much to do. It is good to have the choice.

Everyone has different tolerance levels and different requirements. My tolerance for crazy is pretty high. In fact, I crave it. Pack my days and I am one happy camper. Someone else may need a lot more down time.

One of the things that terrified me about losing my sight was the potential of being ‘grounded’, my wings clipped. Not my style. Another person – maybe one of the caregivers out there, for example – might be finding himself overwhelmed with all of the demands being put on him. If it is too little or too much FOR YOU, it is not a good thing.

DBT interpersonal effectiveness has some skills to help both of these situations. Let’s take a quick look at increasing demands first.

DBT suggests that people who have too much time on their hands build structure and increase demands. On themselves, that is, not on others. We talked a little about the benefits of schedules and routines. Have things you ‘need’ to do throughout the day. Volunteer. Invent a project for yourself.

How many random acts of kindness can you do in one week, for example? Get committed! What you do is pretty much up to you.

What about those who have too many demands on themselves? DBT says ‘just say no’. Well, maybe not ‘just’; there is some art to it.

DBT suggests you weigh how much the factors involved are actually ‘worth’ to you. How important is it to do what you would have done instead of complying with the demand? To maintain the relationship? To maintain your self-respect?

It also suggests you consider how capable you are of fulfilling the request. Is it coming at a good time for you? Do you have a clear understanding of what you are being asked? Does the requester have authority over you? Does he have the moral right to ask this of you? Will you need something from him in the future? Will doing as requested get you any closer to your own goals?

There is actually a tally sheet that helps you rate each of these factors and come to a decision. Should I refuse? How adamantly? That chart can be helpful when you have time to sit down and weigh your options. Other times just a quick, mental review of the above points can be helpful. If nothing else, you are making a well-thought out decision and it is your choice.

There is a lot to be said for having a choice.

Continue reading “How’s Your Balance?”

Out of Milk and Eggs

Morning!  This may ramble a bit. Be prepared.

First thing: we had another car vs bicycle accident. The bicycle lost. In fact she lost big time. She was killed. Why mention it here? Well, probably because the driver was 85. I do not know but I would suspect vision was a factor.

Sour grapes? She was driving; I am not? Maybe a little but I have no intention of topping off an otherwise successful life by killing someone. I will take my situation over hers right now. Comparison skill. It is the second C in ACCEPTS.

I kept asking myself what would compel someone who probably should not do it to get the behind the wheel. I came up with a few answers. Doctor’s appointments for one.

Which brings me to my first tangent. About 12 weeks ago I gave my ophthalmologist my form for public transportation. Don’t think anything fancy here; OK? Short bus. ‘Flexible’ time schedule. Now to give the devil his due, dear ol’ doc took two weeks to send the form in. Just the same: 12 – 2 = 10; right? Where is my acceptance? Older people with health problems can have a lot of health appointments in ten weeks. Gotta get there somehow.

Convenience was an idea I came up with yesterday. My husband had to go into the hospital (thank you…long story, short page). He had insisted on dropping me at work on the way. That meant I was several miles away with work stuff, vision stuff and even yoga stuff stuffing my cart. I also had to stop at the pharmacy for medication.

OK. Here come the planning skills. I had a co-worker drop me off at the pharmacy. I got my meds, changed in their bathroom, did some shopping (more to carry, but I was there) and sat on the sidewalk listening to my BARD book for an hour.

Bless people. Even though it was probably somewhat startling to see a nearly 63-year-old woman in pink and black yoga tights sitting on the sidewalk next to a packed cart (remember this is small town Pennsylvania not Manhattan; we don’t have many street people), there was only one person who said anything and she wanted to help.

Help me find the nearest psychiatric ward? Maybe but she was concerned.

My yoga instructor arrived before the police or the men in the white coats and she took me to class with her. My brother-in-law picked my up after class and brought me home. Wow.

So what do people without supports and creative problem-solving skills do? I suspect they try to drive.

The last idea I came up with was basic necessities. I am running out of milk. I can walk three blocks to the convenience market for that. Not everyone has that option and, to quote my parents, on some things, the convenience market charges three prices!

I looked on line for local food delivery places. None of the groceries advertise that service. Maybe if I called and asked they would have it. Dunno.

The first one I found was Schwan’s. I know nothing about them except I see their trucks moving around the area. Their website looked like it is a lot of prepared, heat and eat stuff. They advertise a partnership with AARP and it seems you can get a discount if you are an AARPer. Might be worth checking out for some things. Let us know. [until 8/31/16: save 50% off your first purchase plus free delivery–click here.]

Then just on a whim, I went to – one guess – Amazon. I discovered Amazon sells groceries! It is not just the Japanese Oreo cookies and $132 seafood dinner for two although they are offered. They sell canned veggies and laundry detergent and hundreds of other things you would find in your basic grocery store.

If you add delivery costs, the fees might get a little salty, but that is often the price you have to pay for convenience – and safety and being able to sleep at night for whatever time you have left.

Milk, eggs? Not on Amazon.  They may be some things the neighbor picks up for you. Also, I know the local agency for the blind takes people for groceries once a month. Better to have milk for half the month than not at all, I guess.

Feels better knowing I will have a way to eat if I can’t drive. How about you?

Continue reading “Out of Milk and Eggs”

Rated R

One of the DBT ACCEPTS, or distraction, skills is sensation. I have not been all that crazy about that one because the standard examples are things like holding an ice cube, taking a freezing shower or snapping yourself with a rubber band.

I don’t do cold and I generally don’t do pain. Those suggestions are not interesting to me at all!

But I have a confession to make: I may have been using sensation for the past 8 years and never realized it!

Quick review – in DBT  we use sensation to overcome strong emotions and urges. These emotions and urges may be so strong we feel the only way to deal with them is self harm or something equally as damaging. Sensation may be enough of a shock to the system to dislodge the thought of self harm.  I may not have mentioned it before but DBT was initially developed to help people who have volatile emotions and often engage in self harm. Part of the reason it works so well is it was developed to have enough power to help people with serious mental conditions.

So how do I, someone who does not have a serious mental condition (truly; believe me), use sensation? Is it good even if you are not thinking about suicide or cutting?

I mentioned I am back in yoga with ‘my’ yogini. I adore her. What I did not mention is that it is a sadomasochistic relationship. She kicks our asses and we say “thank you” and come back for more. I had a good buddy, a fellow student, who called our yogini his dominatrix.

You never thought this page was going to be X rated; did you?  No X, just R. The point is not that we are kinky people.

The point is we are being pushed to our edges in every class, liking it and using it to our advantage.

What made me think about it is this: I am sore and rung out. We did an hour of a very challenging power flow tonight. We moved! Asana to asana. Position to position. I am the oldest person in the class and really don’t ever expect to keep up with the youngsters, but I try to work to my edge. Better the bar be too high than too low.

“A man’s reach should exceed his grasp or what is a heaven for?” – Robert Browning. I like quotes; remember?

Anyway, I put forth effort. I challenge myself physically, emotionally and cognitively. I think about the sequence of the positions in the series. How the hey did she get from that position into THAT one????? (That one is T in ACCEPTS for thoughts, btw). And I practically never think of my problems. My yogini is giving me problems enough!

Sensation? Yep. I am breathing hard and sweating. My muscles are screaming and I am trying not to lose my balance. Right now I know my left arm is going to be very tender tomorrow.  We did some things I have  not done in a long time. I felt my arm ‘fail’ so I was not thinking about my eyes. Ouch.

Am I suggesting you go out and beat yourself up? Absolutely not. That is reserved for a few select crazies like me. But with the APPROVAL of your DOCTOR, you might find some exercise routine that is a little challenging, a little uncomfortable. Something that has you breathing a little too hard or stressing your muscles a little too much. Having a little good pain may keep you from dwelling on the bad/sad pain.

And if you cannot stress yourself physically, remember you have other options to shock you out of self harm and/or excessive stress. A cold shower is probably a possibility. Hot sauce may do the trick. Sensation is to shock your system out of thoughts of damaging actions and distract you.

Me? I have a perfectly good sadomasochistic relationships I can depend upon! Namaste.

Continue reading “Rated R”

Rock Your Cares Away

Just looking ahead in my mindfulness notes and I came upon something I had half forgotten about. Rocking! Huh?

I suspect many of you are parents or have cared for a fussy child sometime in your lives. What is the first thing most people do when they pick up a crying infant? They rock, of course. It is almost instinctual to do so.

When big people are in a state of panic, the ‘new’ reasoning brain shuts down and the ‘old’ emotional and reactive brain takes over.

This old emotional brain does not calm well through words or reasoning but it does calm well with rhythmic activity.

The rhythmic activity can be walking, dancing or even just swaying back and forth. It can also be regular, deep breathing or something called a butterfly hug.

What is a butterfly hug? It is a self-soothing technique. You link your thumbs and put your hands on your upper chest. Then you rhythmically tap your shoulders, or as close to your shoulders as you can get.

Something else you can do for stress, when your old brain is working overtime, is sit in a rocking chair and rock. Once more grandma had it right and she never knew it, or at least we never gave her credit.

Rocking in a rocking chair has been found to have great physical and emotional benefits. it increases muscle tone. It calms dementia patients so that they require less medication. Rocking speeds recovery from surgery. It is a natural way of regulating the lower brain areas, calming things down and getting them in sync.

And why do I mention rocking when I teach mindfulness? Because it is a soothing, repetitive activity on which to focus your attention. When your mind starts to wander bring it back to the squeak of the chair, the feeling of your calves slowly pushing and releasing, anything soothing and repetitive.

Rocking allows you to activate some of the natural brain pathways that sooth. It gives you something to focus on when you meditate. Like any of the skills I use, it is not a cure-all, but it helps.

Continue reading “Rock Your Cares Away”

Getting out of Dodge

Sunday. Starting another week. Time does fly. I think it does because I use my distraction skills. The big one for me, of course, is activities. That has always been my favorite. Yoga has started again. I finished The Steel Kiss, my first Talking Book. Yesterday at Walmart I saw the new Sanford novel, Extreme Prey, was out and i downloaded it from BARD. I am excited about starting that.

I looked over my lesson plan for my first DBT class since my vision loss. Cope ahead. I think of myself going in there and teaching well. I visualize myself doing a great job.

Don’t think about screwing up – ever!  Practicing failure in my head will lead to failure in real life.

I am also doing the first C in ACCEPTS. That C is contribute. Some of you are sending kind words. Thank you. That makes me know my contributions through these pages have value. It does lighten the load.

All told, things are not awful. I try to think things out ahead of time and anticipate problems before they occur. I try to swallow my frustrations and accept and correct mistakes. I also try to establish small challenges, goal, rewards along the way.

I am easily bored and need variety now and again.

Initially I had a plan to explore this town. I have lived here over 25 years but I felt for sure there were interesting places I had never seen. There are a few options but I quickly discovered there was not enough to keep me satisfied all summer long. If I were not to die of boredom, plan B was needed.

My high school friends and I have devised a plan to get me “out of Dodge”. I have never EVER been a bus person but drastic situations require drastic measures. There is a regional bus line that will take me to a resort town a ways away. The bus can get me home that evening. My friends can meet me for lunch and shopping.

Since this is a resort town, I can check on some other options. For example, renting a bike and being transported to the rails-to-trails path.

Yes, I am still determined to ride a bike! I am nothing if I am not determined.

If this trip goes well, maybe I will try something more ambitious. If I can get to NYC or Philly, I can get to the World! ?

Ok. Maybe a little ambitious for right now, but it is a thought.  See how this first trip goes.

Continue reading “Getting out of Dodge”

I Screwed Up

I screwed up today. More accurately I realized I screwed up. I had not proofed a report as carefully as I might have and let a mistake slip through. Grrrrrrrr. I hate it! I hate it! I hate it!

Before, I would have rolled with it better. Poop happens. Now I doubt myself.

Would this have happened before? Is this a sign I should retire? One little screw up and the self-doubt starts.

Just one little screw-up? One? Do I anticipate this is just the tip of the iceberg? Absolutely! I am too blind to know I am messing up. People are too kind to tell me. They are coming along behind me cleaning up my messes but no one is letting me know! I can think up all sorts of scenarios, all of them bad.

“When you doubt your power, you give power to your doubt.” – Honore de Balzac.

I like quotes. I like that one. I just found it when I started a search on self-doubt. Being able to even FIND that quote is actually a plus, a self-esteem builder. My vision stinks but I am starting to be able to use what is left a bit better. In February I had lost the ability to do any web searching at all. Now I am doing a bit.

But as usual, I digress. At least I am consistent.?

Anyway, I found a blog written by Bruna Martinuzzi, president and founder of Clarion Enterprises. Forgive my ignorance but I have no clue what that is. I like some of what she says, though. In 8 Ways Highly Successful People Overcome Self-Doubt, Bruna – may I call you Bruna? – says some interesting things.

For one thing she says not to make excuses. She refers to “transparent justifications”. Hmmmmm. Bruna does not exactly say this, but I think she would agree we should own our mistakes. Back to the acceptance and change thing. Can’t fix it by making excuses for it.  Also excuses make us look and feel weak. Don’t want that.

She also talks about self-awareness. Be aware of what situations make you doubt yourself. If that area is weak, work to strengthen it. Find a way to cope.I  can promise you I will spend extra time and care in proofing!

I have discovered it is a weakness. Never used to be but it apparently is now.

A big area that Bruna talks about is compassion for one self. Do I cut myself as many breaks as I maybe should? Hell, no!  I need to be Super Blind Girl. But yet there is evidence that self compassion develops resilience, that bounce back ability we are all going to repeatedly need as our AMD progresses.

Maybe I should work on letting me be a little less ‘perfect’.

Although Bruna really did have 8 points, half of them were related pretty exclusively to overcoming self-doubt in business so I am going to mention only one more. To paraphrase, “just do it.” Stop wondering how successful you will be or what people will think and just do it. Do not let self-doubt paralyze. Maybe you will do better than you think.(BTW, in DBT speak this is called participate).

So I screwed up. I regret it but it happens. I need to accept responsibility and work on the problem.  I also need to be kind and compassionate with myself and don’t let my fears paralyze me. I should try not to let self-doubt undermine me. Pretty tall order but I guess it is worth a shot. Continue reading “I Screwed Up”

It Is What It Is

I am running off my mindfulness PowerPoint slides. Guess who starts teaching in a week and a half.

It is a little scary. Not sure how I am going to organize my space, for example. I am going to need to have my CCTV and my notebook and the computer arranged somehow. I need to become efficient in flipping the CCTV camera around to see students and then flipping it back to see what I am teaching. I don’t want to be fumbling around but I can practically guarantee I will be.

Which brings me to concept 1 in DBT! (Bear with me. I need the review. I haven’t taught this module in nearly a year.) The concept is….ready? “It is what it is.”  Sounds simple, but like so many things in life the simple is actually profound.

“It is what it is” means no amount of denial is going to change the facts. I may deny I am anxious about going back into the classroom with my vision loss. I may wish I did not have the complication of the vision loss but ultimately, yep, I really do have it. No sense ignoring it.

No sense getting peeved and denying it. It is what it is and I feel the way I feel. That is the way it is. Acceptance of what is important.

This is the dialectic part coming.  Accepting things as they are makes it possible to change them. You cannot fix something you won’t acknowledge is broken. Why would you fix it? You are denying it needs to be fixed!

Acceptance of a crappy circumstance opens the door to change.

I am going to give you one more dialectic behavior therapy  concept but first I want to remind you what a dialectic is. Dialectics maintain there is a grain of truth in every position. It involves acknowledging your opponent may have a point. It’s avoiding adamant black or white thinking. It is the middle path.

The concept is: “I am doing the best I can but I can do better.” Remember that one? I mentioned it before (maybe. I think.)

I am doing the best I can under the circumstances but I  can learn to do better with support and skill training and practice.

So I go back to class knowing I am going to have glitches. I go back accepting I am going to be anxious. I go back knowing I am going to have to lean on my students more than I did.

Acceptance of my problems will allow me to start looking for ways to get around then. Acceptance will clear the road for change.

 

Continue reading “It Is What It Is”

Being Square

I am getting ready to teach mindfulness again. In DBT it is often referred to as core mindfulness because it is the basic skill in the program. Sine qua non – without this nothing.

Mindfulness is learning to be in control of your attention process. It involves what you pay attention to and how long you pay attention to it.

When my vision got bad in February I thought of little else but not being able to see. That was my focus. It was hard to take care of myself and calm myself down because I kept coming back to “I can’t see!” I suspect some of you have been there. That thought was not overly helpful and I really had to get away from it.

I was driving myself crazy over a situation I could not change!

Mindfulness is not easy, however. My mind bounces around like a ball in a pinball machine to use an old fashion simile. And this is with ten years of yoga under my belt. I say that because I don’t want anyone to get discouraged because they cannot go into a yogi trance the first or second time they try. Mindfulness is not a trance anyway. Again, it is focus.

So how did I get my mind off my vision? By putting it somewhere else. In the case of this ‘lesson’ (getting ready to teach, ya know) that somewhere else is the breath.

Square breathing
Square breathing: Breathe in 1-2-3-4 Hold your breath 1-2-3-4 Breathe out 1-2-3-4 Hold your breath 1-2-3-4

I already talked about square breathing. Square, or four-part, breathing is a perennial favorite. Make sure your breath is slow and deep. Believe it or not there is actually a ‘right’ way and a ‘wrong’ way to breath. You want to belly breath. This means pulling down the diaphragm and pushing out your abdomen. Short, rapid breathing in your chest is a no no. That makes you more anxious.

As you breath you can try stretching out your exhales. Add a sigh like you might make just as you fall asleep. It doesn’t matter if you really don’t feel that relaxed. It is part of a feedback loop and you really can fake out your body and mind to believe you are much more relaxed than you are.

Other than four-part breathing you can try alternate nostril breathing. Some days I like that better because it has the added attention demand of keeping your fingers going in the right way!

No matter what you do to become mindful, remember mindfulness is HARD. Every time you go off focus kindly, lovingly, patiently and non-judgmentally put yourself back on. Note the stray thoughts. “Stray thought there”. Then let them go.

Lastly, remember to practice daily. A skill has to be well learned if you are going to be able to use it when distressed.

I have a few other topics to cover in the next few pages. However, since I am teaching mindfulness for the next three months I will probably keep coming back to the topic. Hope that is OK. I find it useful and I suspect you might as well. Continue reading “Being Square”

My Family of Choice

When we were small our very survival depended upon our being around, and being cared for by,  others.  Now that we are older, our very survival depends upon our being around, and being care for by, others.

A 2013 study done in Britain showed that socially isolated people die prematurely regardless of their underlying health issues. Lack of social supports is linked to increased depression and decreased cognitive functioning. Yikes. Not much of an advertisement for becoming a hermit; is it?

It does not take a rocket scientist to guess what happens to people when they develop visual impairment. I suspect everyone out there has had some curtailment in his social network.

A little or a lot, we became more socially isolated. Not a good thing.

A little autobiographical data here: I have no children and I am an only child. In fact, on one family tree line I am an only child, an only grandchild and an only great grandchild. I like to say they believed in quality, not quantity?.

In any case, blood relatives are in short supply for me. But do I have family? Sure enough. I have been assembling my family for the last 50 years or so.

The really nice thing about my family is every single one has been hand-picked by yours ever-lovin’ truly. There is not a bad apple in the barrel.

When I had my vision loss in February, I put out the SOS. I got by and kept my sanity – OK, enough with the smart comments, already! – by leaning on my friends/family. Lin and I talked every morning for weeks. People have driven 80 miles to visit. Like I said before, for awhile I thought I had a new career. It was called going out to lunch! People volunteered to get me out; bless them. I went.  [Lin/Linda again: if you haven’t read Sue’s Out to Lunch page, you really should!]

Besides my close friends, I reached out to more casual friends and acquaintances as well. I have made the comment a half a dozen times or more: people are great! They generally want to help. Give them the opportunity and they will be there for you.

And the nice thing about asking people who are not really close friends to help? You end up with more close friends!

If you do not already have a strong support system, it remains possible to build one. Churches (temples, mosques, etc) are usually receptive to requests for help attending services and social events. Although I hate to admit it, most AMD patients qualify for services and events held for the elderly. Animal rescue organizations and other charities will generally get you a ride if you want to volunteer.

The problem is, these people are not going door to door looking for isolated, visually impaired folks. It is up to you to reach out.

There you go. One more thing I did to cope. I did not let myself become isolated.

Oh, and remember opposite to emotion. You remember? Even if you are feeling like something the ‘cat drug in’ emotionally and want to stay home and cry, reach out anyway. That downward spiral needs to be broken and you are the only one who can do it. If you need it, I still have a blue, tulle tutu I could loan you. Continue reading “My Family of Choice”

Now What?

Do you ever watch sword fight movies? You know, the main character is fighting a horde of orcs, Imperial Stormtroopers, name your favorite bad guys and he suddenly runs out of bad guys. Usually the good guy looks around concerned. Where is the next one coming from? Then he looks around perplexed and a little deflated. Now what?

In every good sword fight movie there are “now what?” moments. My life is not a movie, sword fight or otherwise, but I seem to have come to one of those moments.

I am getting to my activities and to work. Missions accomplished there. Now what?

It has been two months since I completed the application for public transportation. Still not approved. I called but no immediate response. I wait. I could get all Rambo on them, but the ride situation is in hand and it might be a waste of a good rant.

I have not heard from the mobility person but I have received the invoice. I know he has been approved so I suspect I am waiting on his schedule.

My habilitation worker wants to come week after next. A definite time but it still seems so far away.

And speaking of so far away, I still have not heard a word about the clinical trial research. I looked. It has been nearly six weeks since ‘my’ researcher told me six months. I arbitrarily picked October 1 as THE DATE. Six weeks is ¼ of six months. I am a quarter through this purgatory of waiting. Maybe. They could move it back another six months and I would have no recourse but to wait. Good grief!

So I wait. I remind myself the AMD is an important part of who I am now but it is not the only part. I can use activities to distract. I can use mindfulness to stay in the moment and really participate in my life. (All DBT concepts, by the way).

Waiting – in my case lack of targets, er, I mean goals – is not often seen as distress, but it is. It’s a quiet, niggling kind of distress.

Which begs the question: what happens when all the bad guys I can defeat are vanquished? What happens when there are no other supports or treatment options to pursue?  What happens when it is as good as it is going to get?  Yikes.

The Serenity Prayer is a good one:

Lord, grant me the serenity to accept the things I cannot change, the courage to change the things I can change and the wisdom to know the difference.

Working on it. Working on it. Sigh.

Continue reading “Now What?”

Driven to Distraction

As usual, life is a mixed bag. I got my mowing done. First time for the season and first time as someone who is visually impaired. I am happy to say I still have ten, little fingers and ten, little toes. Mowing appears to be one more thing I should be capable of for a while.

I also got to Walmart and did some shopping. I used my telescopic glasses to look at some things like videos and price tags. I used the card machine without incident. Something else that seems good for now.

It is sort of strange to think of such mundane things as victories, but they are. It is important to me to stay as functional as possible. I have heard some people say any day you wake up on top of the ground is a good day. I am not sure I would go that far but any day I can take care of myself and get something accomplished is a good day for me. One less day I need to worry about.

Some days do get long though. A progressive condition like AMD makes it so, in the back of your mind – and sometimes in the front of your mind! – you are wondering when the next proverbial shoe is going to drop.

I wonder about the odd quirks in my vision. For example, I get a shimmery circle when I first go outside in the sunshine. What the hey is that? Does it mean photoreceptors are trying to fire or they are trying to die? I looked it up online but could not find it. I know it is not a visual migraine. Been there. Done that.  Probably need to message my ophthalmologist. Anybody else have the shimmery circle thing?

Maybe worrying about the progression of the AMD and everyone here being so good to me has increased my sense of entitlement (and yes, I am aware I have always had one), but I get, shall we say, cranky. I start to feel I should be exempt from the aggregations of modern life. This visually impaired nonsense should be enough; right?

For example,I got a bill for the copays for my low vision appointments. An obvious error. Those bills belong to BVS.  One more piece of happy horse manure for me to shovel.

Then I decided to schedule the shore excursions for the cruise. The website told me nothing I wanted was available! What?!? You have got to be kidding.

Of course, customer service at each of those places does not serve customers on a Sunday. No resolution for my problems for 24 hours.

I grumbled. I bitched. I complained. I moaned. Then I got out my Talking Books player and put the new Lincoln Rhyme novel in. Distraction through an activity. DBT distress tolerance skill. I really have learned a skill or two.

So, Monday came. I fought the good fight and did not once ask any derogatory questions of the vision bill lady. You know the ones e.g.”why don’t you learn your damn job?”.

It doesn’t help to be rude.

Then I called the cruise company. Computer glitch. I got my excursions. I again have some fairly short-term positives to ‘pull’ me along. Things to look forward to help get me through.

Continue reading “Driven to Distraction”

Planning Ahead

My Blindness and Visual Services (BVS) counselor stopped by this week. He had papers for me to sign. I was hoping he was going to be able to tell me about my new iPad or my mobility specialist but no such luck. The papers he had just had me acknowledge the toys I had already received. I guess that is OK because now the vendors can be paid and the stuff is really mine. “Mine, mine, all mine!” (Daffy Duck, 19??) [Sue, it was 1957.  If you are going to Quote Daffy, you gotta get it right! The correct quote is “It’s mine, you understand? Mine! All mine! Get back in there! Down, down, down! Go, go, go! Mine, mine, mine! Mwa-ha-ha-ha!”]

I asked my counselor about problems he has encountered. What difficulties has he seen people with visual impairment have?  He talked about two things, one of them being coping and planning ahead.

People with special needs don’t always have the luxury of doing things on the spur of the moment. I can’t just get in the car and drive to Wendy’s for lunch if there is nothing in the house. A student cannot just switch classes because he decides he doesn’t care for that professor. Not when he cannot get new, accessible materials for six weeks, he doesn’t.

Some of the freedom and spontaneity in life definitely suffer when you develop an impairment.

So how do we go about planning ahead?

Sparkpeople.com suggests we consider our ultimate goal. If the goal is a bigger one, we might want to devise some smaller intermediate goals.

For example, this summer I want to work doing evaluations at an office 45 minutes away. I cannot tell them to just schedule clients for me. I have to plan how to get there. I also have to make sure I have accessible materials. These are subgoals.

We talked about plans B,C, etc. before. Anticipating roadblocks is important. I can potentially work at this other office two or three days a week this summer. A road block would be, well, my husband! I suspect he will not want to take me 45 miles, come home to do things for his mother and then come back up for me. That would be 180 miles a day times how many days I am working there. Plan B would be to stay over at a Motel 6 nearby. That would cut the travel in half or maybe even a third.

The spark people.com article veers off after those points. It goes much more into long-term life goals. Important but not necessarily applicable to planning your trips out so you can have milk and bread all week.

Looking at other articles on the web I discovered most of them talk about creativity and  – gasp! – organization.

Make a list. Plan a route. Combine trips when you can. Keep extras on hand.

Eureka! I just had a brain sprinkle…think blizzard. This is not going to help you in sunny climes, but you northerners, what would you do if the storm were coming and you had to get ready the most efficient way possible? Think snowed in for three or four or five days. What would you need and how would you go about getting it? That might just be the kind of plan ahead my counselor was talking about.

Continue reading “Planning Ahead”

It Takes a Village

It takes a village to raise a child and apparently it takes a community to take care of me!

My regular, Saturday morning Zumba driver was not available today. Family obligation. Understandable. She is a friend, not my slave.

This morning my regular Thursday night Zumba driver texted me and offered a ride. Please! Then my Monday night substitute driver called. Did I need a ride? Since I knew Thursday likes to go grocery shopping after Saturday Zumba I suggested my Monday sub take me home.

Following this so far? If you are, you are a better person than I am! I don’t have permission to use names so we are sort of stuck. Sorry for the convoluted nature of all of this.

To continue…. Cool. Planning and strategizing worthy of a military campaign but I got there and got home.

Then I found out the reason people knew I needed a ride was it had been posted on Facebook. Hmmmmm

My first emotion was dismay. Oh my God. I am a stray puppy people want to get rid of. They are even ADVERTISING to get rid of me.  Free to a good home and all that.  I was a little embarrassed. Then I decided to re-frame the situation.

(Being a psychologist I get to use all these cool, professional terms. Basically, re-framing means looking at a situation in a different way in order to find more positive interpretations.)

Everyone could have begged off and not given me a thought. They are doing me favors and could stop at any time. I am not their responsibility or their obligation.

Instead, they cared enough to try to find a substitute driver for me. They put it on social media because that is how to communicate. It is also a good way to reach a large group of people in a short period of time. I should not be embarrassed people are asking for help for me on Facebook. I should be proud and grateful they have taken it upon themselves to see my needs are filled.

A situation that had me embarrassed got re-framed into a situation that allowed me to feel gratitude.

And hitching a ride with my Monday sub even gave me a chance to pass it on. My driver has a 90-year-old friend with vision problems. She does not like to use a hand lens. What would I suggest? What would I suggest????? Oh, baby, do I have suggestions for her!

So, what did I learn today?

Take things in the spirit in which they were intended. Re-frame my interpretation as needed.

Pass it on.

Continue reading “It Takes a Village”

Come Dance With Me

There are times I don’t know where I am going until I get there. This is one of those times. In response to a request for possible coping strategies I seem to have put together a series on coping through lifestyle choices. So far I have done animals, nature and socializing. I use all of them to try to keep me on an even keel.

I am going to do one more life style choice: exercise. It is a coping strategy I use regularly. This post will focus on the benefits of one of my passions. That is dance.

I took dance lessons at 3. I suspect I had been dancing around the house for months before that.  Thus the lessons. Anyway, my recital piece was “Katie the Kangaroo”.  Maybe some of you know it.

When I was 7 my cousin was 12 and getting ready to go to dances. Since she needed a ‘practice dummy’ to work out her moves, I was drafted. It was the early 60s and I learned to jitterbug, twist, stroll, etc.

I impressed some of the ‘big boys’ with my moves but I was not going to dance with them!

When I got to junior high I found a dance partner. He was one of two black young men in my class. Being a child of the 20s and 30s my mother would ask me if I had danced with any white boys. Nope. Didn’t really want to. The white boys were awful dancers!

So we danced to rhythm and blues and ‘da funk’ in my teens. In my 20s I had what I call my ‘delightfully wasted youth’ in the discos. Three and four evenings a week I put on my 4-inch stiletto heels and my handkerchief-hemmed skirt and went off to the clubs. We danced. [Lin/Linda back again.  By the time I met Sue, she’d been dancing for some time.  I can attest to the fact that she is an amazing dancer since she ‘dragged’ me to some of those discos.  I can also attest to the fact that I am NOT a good dancer but she made the experience a hell of a lot of fun!]

A few years back I was delighted to find out dance was making a comeback! Fitness cardio-dance had taken a Latin beat. I have been in Zumba classes for about 8 years.

More recently I found a totally kickass hip hop class. It is a Japanese guy teaching black-inspired dance to a bunch of white women! I love it!

Yes, I love dance. But should a 62 year old woman be in a hip hop class? My answer is yes!

Dance is good for you physically. You improve cardiovascular fitness and muscle tone. Balance – a biggie when you are not seeing very well – is likewise improved. Lots of physical benefits.

Dance is fun! It is also otherwise good for you emotionally and cognitively. A four-month study (ideals.Illinois.edu) compared seniors being taught ballroom dance to a group of walkers. The dancers did better in reasoning, visual processing, working memory, as well as all of the psycho-social variables and sleep patterns. What were the psycho-social variables? They included anxiety, subjective feelings of well-being, and stress.

Does it matter what type of dance you do? Not a bit. Many YMCAs and community centers have Zumba Gold but it does not have to be Zumba. Ask around and you may find country line dancing, round and square dancing, clogging, whatever.

Bop until you drop! I intend to.

Continue reading “Come Dance With Me”

Laughter IS Good Medicine

We don’t normally buy tubs of ice cream but one ‘mysteriously’ showed up in the freezer this week. I was told it was my duty to help eat said ice cream.

I guess wives are supposed to help husbands destroy the evidence of their impulse buys.

I helped myself to ice cream. The next time my husband went for ice cream, he declared we were different! Well, no shit. To what do we owe this discovery? It turns out he is a ‘skimmer’ and I am a ‘dipper’. While my husband skims across the entire surface of the ice cream, I dig in!

A couple of points here. First of all, being beholden on others for rides, I have discovered how ‘strange’ other people are. They drive all sorts of different ways to places. Why they go their ways I just don’t understand. The ways I used to go are obviously superior! I have had to exercise forbearance  and not shout at these people for going the ‘wrong way’. Tolerance of differences can be tough.

The other point? My husband and I started laughing about the ice cream service difference. This takes me back to a point I wanted to make about laughter. To wit, laughter is one of my coping skills. In addition to reminding me to get over my big, bad self, laughter dissolves distressing emotions and helps me relax and recharge. In DBT speak laughter is an opposite to emotion response when I am really upset. Physiologically speaking, it is difficult to be angry or sad when the corners of your mouth are pointing up (remember half-smile?).

Laughter boosts the immune system and triggers the release of feel good chemicals into my blood. It strengthens the heart and other organs.

And what was I talking about when I said it helps me to get over myself? Laughter puts things in perspective. It is hard to be overwhelmed by something you are laughing at. It is hard to take yourself too seriously when you are giggling about one of your foibles or a crazy thing that happened to you.

In short, laughter is good medicine.

And the ways other people do things? Those are just strange.

Continue reading “Laughter IS Good Medicine”

Busy, Busy, Busy

Saturday and Sunday were nasty, rainy and cold. While I got up and went to Zumba Saturday morning, that was about the only structure I had all weekend. I pretty much goofed off the rest of the time. I did little substantive work on Saturday and even a little less on Sunday.

This was not me. This girl can rock a to do list. I thrive in crazy busy. My days fly when one task or obligation flows into another.

It got me thinking about lack of things to do. Lack of outside structure. Some people crave days they have no obligations and need to do nothing. That sort of scenario scares me to death. It really scares me if I think of 30 years worth of that. Yikes.

So, one of the ways I cope is to stay busy. Activities are a distraction skill in DBT speak. They come under distress tolerance. I talked about that.  But what am I going to do someday when work is done and my hip won’t hop? What will I do when I have too much free time?

Understanding Newton’s laws of motion is actually helpful here. They aren’t just for physics any more! An object in motion tends to stay in motion. An object at rest stays at rest….unless an external force is applied to it.

If I don’t want lethargy to set in, l need to keep going. If things falter,  I need to apply an external force.

A way to apply an external force is by establishing habits and routines. In speaking of recovery from addictions, the National Institute of Health declared habit and routine to be good ways of avoiding excessive free time. The addict does not need free time because he may fill it with abusing substances. If I am upset and have spare time, I fill it with negative thoughts and worry. Not a plan.

The paper from NIH goes on to say establishing routine helps you feel more in control and build confidence. They suggest a regular routine that includes self-care (eating, sleeping, hygiene), a daily practice like exercise, meditation or prayer, meals, chores, etc.

One of the things I like about routine and schedule is I always know what is coming next. You avoid the fumbling and sinking feeling of being at loose ends. Like I said before, when I am at lose ends I think too much.

The NIH paper also talks about balance. They talk about deciding how much time you will dedicate to each of the items on your activities list.

I think that is a fantastic idea. I started a variation of that idea in my own life years ago. I based mine on values: learning, nature, exercise, friends, etc. I try to do something related to each value each day. If I realize I have missed addressing a value, I purposely include it the next day. Sort of keeps things from going too far in one direction.

Activities, routine, balance. Good stuff for coping.

Continue reading “Busy, Busy, Busy”

My First 100 Days: Part 3 Behavioral Activation

Did you ever hear about something you were not all that familiar with and then run into the same thing again and again?  That is what happened with me and the theory of behavioral activation. First Lin told me I was practicing behavioral activation therapy on myself. Duh, I am? Then I saw the term in counseling files. The therapist I had ‘inherited’ some clients from was using it. Maybe I should figure out what the hey this stuff is.

It appears behavioral activation was ‘discovered’ back in the 70s about the same time CBT, cognitive behavioral therapy, was getting its start. In the race for fame and fortune CBT won out. Of course this was not before it incorporated some behavioral activation concepts into itself. (And DBT then Incorporated some CBT into itself. There is nothing new under the sun when it comes to psychological alphabet soup!)

Behavioral activation, BA, targets behaviors that are creating or maintaining depression. It then attempts to decrease these behaviors and increase pleasant activities in the depressed person’s life. BA contends that life events and biological predispositions lead to people having low levels of positive reinforcement and these low levels of positive reinforcement lead to depression. If positive reinforcement is increased, depression will decrease.

BA is said to target inertia. Remember Newton’s laws of motion? BA applies outside force by scheduling  pleasant events and activities that the client is supposed to participate in.

Never knew I was following BA. I thought I was accumulating positives and building mastery as well as using opposite to emotion a la DBT, but, as I said, there is nothing new under the sun. Just different names and packaging.

No matter what you call it, it does work. I had seen people sink into depression because of physical conditions and the limiting effects these conditions had caused.

I vowed I was not going down without a fight.

That said, I suspect I unwittingly found things that would depress me. Not working. Not going to activities. Not taking the beastie baby to the dog park. I then decided on ways  of replacing these depression-making situations with situations that would lead to positive reinforcement. Contacting BVS for assistive technology to get me back to work. Asking for rides to activities. Asking my husband to transport the dog and me to the dog park.

I would love to say there was method in my madness. Love to say I was practicing good, well thought out therapy on myself all the time but that would be a lie. The truth of the matter is I am a stubborn old bird and I had no intentions of giving up my life. I like my life (minus the AMD of course, but nothing is perfect. That is a dialectic. There is good and bad in everything)

I held on to the positives I could. Devised ways of doing what I loved. Found enjoyable substitutes for the things I could not hold on to and kept moving. When I was down? In DBT terms I practiced opposite to emotion. In BA terms I guess you could say I worked from the outside in to help me re-engage in life.

Whatever you call it, it worked.

Continue reading “My First 100 Days: Part 3 Behavioral Activation”

Cope Ahead

One of the DBT skills is cope ahead. In DBT cope ahead you imagine yourself in a situation that you expect will elicit an emotional reaction. You then mentally rehearse and see yourself having an appropriate reaction to that situation. Good skill but not the type of coping ahead I did today.

Today I was doing more of the cope ahead that my BVS counselor had in mind. Devise a plan. Gather information. Maybe do a dry run.

My husband and I needed to go to a town very near the town in which my third job is located. I want to go back to that job. It is good money for one thing. The problem, as I mentioned before, is this job is 45 miles away.

There would be a little ‘stress’ if I made my husband do that drive twice in a day a couple of times a week most of the summer. We needed to do some creative thinking to make this come about.

Today we took time and did a reconnaissance mission. I went into the lobby of a chain motel in the town. The place has not been renovated in a while but it looked clean. The price was better than I had anticipated. So far things looked promising.

Clocking the distance from the motel to the office, we discovered I could walk the distance easily. There was a sidewalk for most of the way.

If I needed to take the bus, there was a bus stop about a quarter mile away. That was going in to the office. Coming back the bus stop was on the other side of the highway. Problem there because I am not crossing streets well. I would have to either walk back in the evening or get a ride from a colleague. That would be something I needed to prepare for.

Another problem was there is no restaurant at this motel. The food places are on the other side of the highway. I will have to eat at a restaurant as soon as I get out  of work or pick up something at the convenience market to eat later.

A lot of planning. A lot of planning that was not necessary six months ago. Six months ago I got in the car and I just drove there. Not as easy now, but it can be done. Just a matter of coping ahead.

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