Myschizlife

Crisis Prevention: Experience Intense Sensations

Coping Strategies, Dialectical Behavioral Therapy (DBT), Distractions, Mental Health

Experience Intense Sensations

Sometimes generating intense physical sensations can distract the mind from painful emotions. This helps explain why many people resort to cutting or hurting themselves in other ways: because it can actually help them feel better temporarily. Obviously, the key here is to help identify intense sensations that aren’t harmful. Think about physical sensations you can generate that might take your mind off a crisis. For people who engage in self-harm, try holding an ice cube in one hand. This can cause physical pain if held long enough, and the sensation is intense. For some people, this can take the place of self-harming behaviors. Here are some examples of other things you might do to get your mind off a crisis:

Take a hot or cold bath or shower.
Keep a rubber band on one wrist and snap it—not so hard that it causes a lot of physical pain, but hard enough to generate a sensation that will temporarily occupy the mind.
Chew on crushed ice or frozen fruit.
Go for a walk in cold or hot weather.
Lie in the hot sun (with sunscreen on!).

Again, add whatever intense sensations you can think of to your list of activities to help survive a crisis.

Sources: DBT Made Simple

Austen Riggs Center Psychiatric Hospital

Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Family Therapy, Mental Health, Psychiatric Hospitals

The Austen Riggs Center is an open psychiatric hospital and treatment program that promotes resilience and self-direction in adults (18+) with complex psychiatric problems. They specialize in the long-term treatment of psychiatric disorders with intensive psychodynamic psychotherapy and a full range of psychiatric services, offered in a completely voluntary continuum of care that includes inpatient, residential, and day treatment programs.

They treat the individual, not the diagnosis. Diagnostic labels cannot capture the essence of an individual’s struggles or strengths, and they often obscure what people have in common. Many of their patients have multiple diagnoses, and many have been identified as “treatment resistant” in the past. Often they seek psychiatric treatment at Riggs because they need a different approach, and many opt to stay in our long-term residential treatment program following an initial evaluation and treatment period.

All patients have intensive psychodynamic psychotherapy four times a week with a psychiatrist or clinical psychologist. The goal is to help the person expand their capacity for work, play, and love by fostering improved self-esteem and resilience, and by helping them acknowledge and come to terms with whatever has previously blocked their development.

Recognizing the importance of the social context, they offer in-depth family evaluation, support for family members, and family therapy, as well as a robust Therapeutic Community Program in which patients can develop supportive peer relationships and learn about themselves with others. They offer opportunities for participation in patient government, in social and recreational activities, in reflective process groups, and in health and wellness activities such as meditation and yoga.

The Erikson Institute for Education and Research of the Austen Riggs Center studies individuals in their social contexts through research, training, education, and outreach programs in the local community and beyond. Part of that offering includes an Adult Psychoanalytic Training Program and Fellowship in Hospital-Based Psychotherapy for psychiatrists and psychologists. The program takes a systems perspective, emphasizing cultural and familial contexts, as well as individual development across the lifespan.

The basic ingredients essential to fulfilling the Center’s mission are:

Treatment organized around an intensive individual therapeutic relationship, focusing on the patient’s recognition and tolerance of experiences of conflict and pain, leading to the development of a sense of perspective on the illness
An open therapeutic community involving all staff and patients
A careful assessment phase, including psychological testing
A range of programs, geared to individual levels of capability and need
Continuous treatment by the same multidisciplinary team as patients move between programs
Psychopharmacologic treatment
Group work, substance use treatment, family treatment and help with reintegration into the external community
A broad activities program offering creative expression, with patients in the role of student, and in a “treatment free zone”
Ongoing staff training, research and education to further the primary clinical task
Recruitment and retention of quality staff

Vision:

In an increasingly complex and fragmented world, the dignity of the individual, the importance of human relationships and the centrality of a sense of community are more difficult to find. The focus and traditions of the Austen Riggs Center orient the staff to help troubled patients meet these and other rapidly changing psychological challenges of contemporary society. We will continually build on our distinguished past, helping our patients develop personal competence in a completely open setting that emphasizes the individual’s capacity to face and take responsibility for his or her life—past, present, and future. We nurture our patients’ strengths, foster their social functioning and encourage family collaboration. Through our research and training programs, we educate professionals in our psychodynamic perspective, applying this learning to a broad range of psychosocial problems. Finally, in this time of diminishing mental health benefits, we will continue to develop cost-effective treatment settings that focus on individual psychotherapy, community living and that attend to resource limitations as both reality to deal with and metaphor for other limits and losses.

Values:

Affirmation of the dignity and responsibility of the individual
Recognition, appreciation and enhancement of individual strengths
Importance of human relationships
Respect for individual differences
Centrality of the psychotherapeutic relationship
Learning opportunities in a community of differentiated voices
Importance of examined living
Attention to the conflict between individual choice and the requirements of a community
Openness to innovation and creativity
Open setting to promote personal responsibility and freedom of choice in treatment
Importance of recognizing and preserving multiple roles, including those of student and community member
Provision of treatment based on quality and outcome, not profit

Located in the small New England town of Stockbridge, MA, three hours from New York City, two hours from Boston, and one hour from Albany, NY, the Austen Riggs Center is fully licensed by the Massachusetts Department of Health and accredited by the Joint Commission.

National PTSD (Post Traumatic Stress Disorder) Awareness Day

Anxiety, Mental Health, My Schiz Life, PTSD, Trauma

It’s National PTSD (Post Traumatic Stress Disorder) Awareness Day! Please don’t tell someone just to get over it that it’s in the past or they can’t allow it to define them! Do you honestly think they haven’t tried that? So what does that mean, what are the symptoms…

—> Intrusive memories

~ Recurrent, unwanted distressing memories of the traumatic event
~ Reliving the traumatic event as if it were happening again (flashbacks)
~ Upsetting dreams or nightmares about the traumatic event
~ Severe emotional distress or physical reactions to something that reminds you of the traumatic event

—> Avoidance

~ Trying to avoid thinking or talking about the traumatic event
~ Avoiding places, activities or people that remind you of the traumatic event

—> Negative changes in thinking and mood

~ Negative thoughts about yourself, other people or the world
~ Hopelessness about the future
~ Memory problems, including not remembering important aspects of the traumatic event
~ Difficulty maintaining close relationships
~ Feeling detached from family and friends
~ Lack of interest in activities you once enjoyed
~ Difficulty experiencing positive emotions
~ Feeling emotionally numb

—> Changes in physical and emotional reactions

~ Being easily startled or frightened
~ Always being on guard for danger
~ Self-destructive behavior, such as drinking too much or driving too fast
~ Trouble sleeping
~ Trouble concentrating
~ Irritability, angry outbursts or aggressive behavior
~ Overwhelming guilt or shame

Schizoaffective Disorder and Atypical Depression

Atypical Depression, Depression, Mental Health, Schizoaffective Disorder

People with schizoaffective disorder, like those with bipolar disorder, may experience depression differently from people who have unipolar depression. It is common for people with schizoaffective disorder to experience atypical depression, which means that instead of experiencing insomnia, loss of appetite and being sad and tearful, which are common with typical depression, people feel the need to eat and sleep more and tend to feel very flat and slowed down when they are depressed. Other hallmarks of atypical depression are fatigue and being sensitive to rejection.

Not being able to feel
A lot of people with schizoaffective disorder experience what they describe as an absence of feeling as part of depressive episodes. This is sometimes also described as feeling flat or empty.

Not caring about anything
People suffering from depression often state that they are unable to care about anything, even things that used to be important to them.

Losing interest and motivation
People with schizoaffective disorder frequently experience a loss of interest in, and motivation to do, things. The things that they used to enjoy don’t give them pleasure any more.

Feeling tired and drained of energy
It is common for people experiencing an episode of depression to feel tired all the time. Some people have described this as feeling as though they have just run a marathon and have no energy left.

Feeling worse at particular times of the day
People experiencing an episode of depression may find that they feel worse at particular times of the day. For some people, mornings are worse, whilst for others it is during the evening that they feel worse.

Feeling worthless
People with schizoaffective disorder who are depressed often suffer from feelings of worthlessness. Their self-esteem drops considerably, leaving them lacking in confidence and feeling as though they are useless. Depression can make people forget about their strengths and make them only focus on their weaknesses.

Feeling guilty
Guilt is a very common problem for people experiencing an episode of depression. People tend to feel excessive guilt for minor mistakes and normal human errors.

Becoming more sensitive
When people are depressed they tend to become much more sensitive to both criticism and rejection.

Irritability
It is common for people experiencing depressive or mixed episodes to become much more irritable than usual.

Feeling hopeless and helpless
It is very common for people experiencing depression to feel extremely hopeless about the future and helpless because of feeling unable to change the way they feel.

Feeling worried and anxious
Worry and anxiety are common features of depression. Anxiety can be very disabling for some people. It can be ‘global’, where everything is a worry, or specific, where anxiety is focused on certain things, for example physical health.

Feeling lethargic
Lethargy, feeling tired, slowed down and unmotivated, is a common symptom for people experiencing episodes of depression. Lethargy can make people talk much slower than usual, use shorter sentences and move around more slowly. In severe forms, lethargy can make it difficult for people to get things done – or even to get out of bed.

Withdrawal and avoidance
It is common for people suffering from depression to withdraw from the things that they used to enjoy doing. They may also start to avoid social situations and turn down invitations from friends.

Thinking negatively Everyone can think negatively from time to time, but depression has the potential to make people think negatively all the time, or the majority of time. Rumination about past failings is also common in depression.

Sluggish thoughts
One of the hallmarks of depression is the way that people feel as though their head is full of fog. This causes them to have difficulty remembering things or concentrating on things a lot of the time. It can also make decision making and planning very difficult.”

Sources: Schizoaffective Disorder Simplified by Martine Daniel

Distress Tolerance Skills: Reframe

Coping Strategies, Dialectical Behavioral Therapy (DBT), Distractions, Mental Health

Reframing refers to changing one’s perspective about something—in other words, helping make lemons out of lemonade or helping to see the silver lining. Of course a therapist, has to be careful that in doing so they don’t invalidate patients or minimize their worries. Here’s an example:

Patient: I can’t believe that I’ve been in therapy and doing all of this work for almost two years, and I’ve started bingeing again. What’s wrong with me that I can’t stop? I know how unhealthy it is, and I don’t want to gain weight again!

Therapist: Yes, you’re struggling, Anna, but it makes sense given all of the stressors in your life right now (validation). If this was two years ago, how do you think you’d be coping with everything that’s going on?

Patient: Well I’d probably be in the hospital already. At the very least, I’d be feeling suicidal and wouldn’t be functioning very well.

Therapist: Right. So even though you’ve gone back to an unhealthy behavior, you’re not where you were two years ago. In fact, you’re coping quite a bit better than you were back then, right?

Patient: Yeah, I guess you’re right.

There are many different ways to reframe. The above dialogue is an example of a patient comparing herself now to how she was in the past, at a time when she wasn’t coping as well. This can often help patients acknowledge the changes they’ve made, even though they may still be struggling.

The way patients talk to themselves about what’s happening in their lives can also change the way they think and feel about things. Often, especially when depression and anxiety are a problem, people tend to get fixated on the negatives. They focus on how bad the situation is and catastrophize or think about the worst possible thing that could happen. If you can change how you think about the situation, you’ll find that it’s more bearable than first imagined and you will be more likely to get through it without engaging in behaviors that could make it worse.

To help with self-talk, you should write out coping statements to use when you get into situations that you’re struggling with and that trigger intense emotions. That way you won’t make it worse with self-talk and can actually help yourself cope more effectively. Here are some examples:

I can get through this.
The emotions are intense and uncomfortable, but I know they won’t hurt me.
This pain won’t last forever.

Sources: DBT Made Simple by Sheri Van Dijk

Exercise as a Coping Strategy

Coping Strategies, Distractions, Mental Health, My Schiz Life

Exercise is, of course, a natural antidepressant. It leads to the release of endorphins, those chemicals in the brain that help us relax and feel happy. Exercise also simply helps people feel good about themselves because they know they’re acting effectively and doing something that’s good for them. Some studies suggest that exercise is as effective as antidepressant medications at reducing symptoms of depression among adults diagnosed with major depression. Both the biological effects and the psychological effects (increasing self-efficacy and self-esteem and reducing negative thinking) of exercise are thought to be responsible for its positive influence on mood.

In addition, there is abundant evidence that exercise has positive effects on blood pressure and cardiovascular disorders, improves learning and memory, delays age-related cognitive decline, reduces risk for dementia, and improves medical conditions such as diabetes, osteoporosis, and Alzheimer’s disease.

While there are guidelines about how much exercise people should get, anything more than what you’re currently doing is a great start. This perspective helps take the pressure off and makes it more likely that you’ll actually increase your exercise, whereas telling yourself you need to exercise for twenty minutes three times a week could overwhelm you and result in not exercising at all. Of course, if you are working to reform an eating disorder, you may need do the opposite and reduce compulsive or excessive exercise.

Source: DBT Made Simple, by Sheri Van Dijk

Serious Mental Illness By The Numbers

Bipolar Disorder, Justice System, Mental Health, My Schiz Life, Psychiatric Hospitals, Schizophrenia, Self-Care, Suicide

Serious Mental Illness By The Numbers:

Prevalence and Treatment Rates*:

~ 8.3 million adults with schizophrenia or bipolar disorder mental illness (3.3% of the population)+

~ 5.5 million – approximate number with severe bipolar disorder (2.2% of the population), 51% untreated+

~ 2.8 million – approximate number with schizophrenia (1.1% of the population), 40% untreated+

~3.9 million – approximate number untreated in any given year (1.6% of the population)+

Consequences of Non-treatment*:

~ 169,000 homeless people with serious mental illness**

~ 383,000 inmates with mental illness in jails and prisons

~ 50% – estimated percentage of individuals with schizophrenia or bipolar who attempt suicide during their lifetimes

~ 44,193 suicide deaths in 2015

~ 10% – estimated percentage of homicides involving an offender with serious mental illness (approximately 1,425 per year at 2014 homicide rates)

~ 29% – estimated percentage of family homicides associated with serious mental illness

~ 50% – estimated percentage of mass killings associated with serious mental illness

Numbers and percentages of US adults
+National Institute of Mental Health, 2016
**2015 Annual Homeless Assessment Report

Confessional Poetry

Confessional Poetry, Literature, Most Admired Authors, Poetry

Confessional poetry is the poetry of the personal or “I.” This style of writing emerged in the late 1950s and early 1960s and is associated with poets such as Robert Lowell, Sylvia Plath, and Anne Sexton. Lowell’s book Life Studies was a highly personal account of his life and familial ties and had a significant impact on American poetry. Plath and Sexton were both students of Lowell and noted that his work influenced their own writing.

The confessional poetry of the mid-twentieth century dealt with subject matter that previously had not been openly discussed in American poetry. Private experiences with and feelings about death, trauma, depression and relationships were addressed in this type of poetry, often in an autobiographical manner. Sexton in particular was interested in the psychological aspect of poetry, having started writing at the suggestion of her therapist.

The confessional poets were not merely recording their emotions on paper; craft and construction were extremely important to their work. While their treatment of the poetic self may have been groundbreaking and shocking to some readers, these poets maintained a high level of craftsmanship through their careful attention to and use of prosody.

One of the most well-known poems by a confessional poet is “Daddy” by Plath. Addressed to her father, the poem contains references to the Holocaust but uses a sing-song rhythm that echoes the nursery rhymes of childhood:

Daddy, I have had to kill you.
You died before I had time–
Marble-heavy, a bag full of God,
Ghastly statue with one gray toe
Big as a Frisco seal

Another confessional poet of this generation was John Berryman. His major work was The Dream Songs, which consists of 385 poems about a character named Henry and his friend Mr. Bones. Many of the poems contain elements of Berryman’s own life and traumas, such as his father’s suicide. Below is an excerpt from “Dream Song 1”:

All the world like a woolen lover
once did seem on Henry’s side.
Then came a departure.
Thereafter nothing fell out as it might or ought.
I don’t see how Henry, pried
open for all the world to see, survived.

The confessional poets of the 1950s and 1960s pioneered a type of writing that forever changed the landscape of American poetry. The tradition of confessional poetry has been a major influence on generations of writers and continues to this day.

Sources: Poets.org

Mad Poet’s Society: McLean Hospital, Robert Lowell, Sylvia Plath, and Anne Sexton

Literature, Mental Health, Most Admired Authors, Poetry, Psychiatric Hospitals

In suburban Massachusetts, on 240 acres of peaceful grounds, is a literary legend—of sorts. McLean Hospital, with its long history of treating the blue bloods of Boston, has become an unlikely poetry landmark after providing both recuperation and inspiration to Robert Lowell, Sylvia Plath, and Anne Sexton.

Plath was the first of the three to stay at McLean. In 1953, during a summer at home before her senior year in college, Plath swallowed a bottle of pills and crawled beneath her house. Her failed suicide attempt led to months of treatment at McLean and began her long relationship with the psychiatrist Ruth Tiffany Barnhouse. While there, Plath received insulin-shock therapy, anti-psychotic drugs, and ultimately electroshock therapy. The experience surfaced years later in her poem, “The Hanging Man,” which begins, “By the roots of my hair some god got hold of me / I sizzled in his blue volts like a desert prophet.”

Lowell was admitted to McLean in 1958, though his infamous manic outbursts had already resulted in numerous stays at other mental institutions. Over eight years, he stayed there four times, correspondeding frequently from his hospital address, and sending letters to Theodore Roethke, Ezra Pound, and even Jackie Kennedy. Written about his first stay at McLean, his poem “Waking in the Blue” mentions Bowditch Hall and was pasted on the wall of the nurse’s station there for years.

Highly competitive with Plath, Sexton tried for years to be admitted to McLean, but her therapist, aware of the high cost, refused to admit her. Sexton first entered McLean as a teacher. In 1968, she was invited to lead a weekly poetry seminar in the hospital, providing Sexton with her first teaching experience, after which she became a professor at Boston University. In 1973, a year before her death by suicide, Sexton achieved her wish and was admitted to McLean for a five-day examination.

Plath and Sexton both attended a poetry seminar taught by Lowell at Boston University in 1959. They were each inspired by his confessional poetry and the appreciation for madness that he cultivated. In “Elegy in the Classroom,” Sexton wrote about Lowell: “I must admire your skill. / You are so gracefully insane.” Through his encouragement, they began to turn their personal experiences into verse—a quality that would mark their later work.

Plath discovered she could mine her McLean experiences for literary inspiration. She wrote in her journal, “There is an increasing market for mental-hospital stuff. I am a fool if I don’t relive, recreate it.” Thus she began her famous novel, The Bell Jar. Years later, in his introduction to Plath’s posthumous poetry collection Ariel, Lowell said, “Everything in these poems is personal, confessional, felt, but the manner of feeling is controlled hallucination, the autobiography of fever.”

Source: poets.org

Knocking Round the Zoo – by James Taylor

Counter Culture, Mental Health, Music, Psychiatric Hospitals

This is an autobiographical song describing Taylor’s stay at McLean, a psychiatric hospital near Boston where he stayed while finishing high school. Taylor was attending a strict boarding school called Milton Academy when he suffered a bout of depression that led his family to pull him from the school and send him to McLean, where he took classes at their affiliated school.

In this song, he explains how it felt like a zoo, with bars on the windows and people coming to look at you – his sister Kate broke down in tears during one visit.

While Taylor was at McLean, he spotted Ray Charles, who was sent there for his heroin addiction. Taylor’s siblings Livingston and Kate also ended up spending time there. Over the next 15 years or so, James ended up in various other rehab centers and hospitals to treat his addictions.

Just knocking around the zoo
On a Thursday afternoon,
There’s bars on all the windows
And they’re counting up the spoons, yeah.
And if I’m feeling edgy,
There’s a chick who’s paid
To be my slave, yeah, watch out James.
But she’ll hit me with a needle
If she thinks I’m trying to misbehave.

Now the keeper’s trying to cool me
Says I’m bound to be all right,
But I know that he can’t fool me
‘Cause I’m putting him uptight, yeah.
And I can feel him getting edgy
Every time I make a sudden move,
Whoa, yes it’s true.
And I can hear them celebrating
Every time I up and leave the room.

Now my friends all come to see me,
They just point at me and stare.
Said, he’s just like the rest of us
So what’s he doing there?
They hide in their movie theaters
Drinking juice, keeping tight,
Watch that bright light.
‘Cause they’re certain about one thing, babe,
That zoo’s no place to spend the night, no.

Just knocking around the zoo
On a Thursday afternoon,
There’s bars on all the windows
And they’re counting up the spoons, yeah.
And if I’m feeling edgy,
There’s a chick who’s paid to be my slave,
Watch out Kootch.
But she’ll hit me with a needle
If she thinks I’m trying to misbehave.