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You’ve just been broken up with. You have a huge test tomorrow. You failed that huge test you had yesterday. Your OCD or anxiety is flaring and everything is closing in on you, or threatening to burst. You feel a panic attack bubbling and brewing. You may have self harm urges or suicidal ideations. What, in these acute moments, are you “supposed” to be doing?
Marsha Linehan is the founder of perhaps the most common therapeutic model, Dialectical Behavioral Therapy. Dr. Linehan is a former mental hospital patient, although back when she was an adolescent the treatment was much more electric. Her modern model contains dozens of specific therapeutic skills, many of which are famously given acronyms, but it can also be boiled down to the intersection of two concepts: acceptance and change.
The latter cannot be achieved without the former. You cannot heal from diagnoses you don’t accept that you have. You can’t mend an interpersonal rupture that you don’t agree was harmful. You can’t stop a behavior you don’t accept is negatively impacting you. Behind every attempt to change ways there is a successful attempt to sit in the ways, first.
Dr. Linehan’s framework proposes four “modules,” two of which are geared towards acceptance, and the one that I observe as often undervalued is Distress Tolerance. It is a module geared towards surviving crises, and there are six basic skills within its purview. In my experience, DBT is best absorbed in a re-arranged manner. It’s got all you could need, but you have to find a way to digest it that your brain will accept. Everyone learns differently.
I’ve found the most solace in a set of activities that are guaranteed to do some kind of alleviating when I’m in a crisis. Crises, for me, range from sobbing fits to flashbacks, OCD itches to panic attacks. When I’m in the deepest throes of these experiences, it’s hard to pull myself back, but if I can catch my mood before it really gets going, I have a list of go-to’s that I hope you find some truth in.
1.) Watch a Netflix comedy special
When I’m in an acute crisis mode, the battle is in getting through it, hour by hour, second by second. All I want to do is succumb to the destructive action urge: yell, lash out, go for a run, hurt myself, send that text, pick, think suicidally. I need to fill my seconds with something that will snatch my attention and that is radically opposite of my mood. That’s where Netflix comes in.
Think about it; the comedy specials are perfect. All you need to do is find someone you like (this shouldn’t be hard, Netflix is a comedy special churning machine) and you’re set. Every bit is between, I’d say, two and ten minutes long. That’s all that your brain has to zero in on. Your lips many not even crack a smile, but you’re watching something amusing, and in short doses. Comedians move quickly, they reel your attention back in when it’s lost. They’re real, down to Earth. They provide perspective that can drag you right on out of a crisis, if sustained for long enough (which short bursts help with). Sometimes it’s just about riding it out. The emotion’s acuity will fade over time.
Recommendations: John Mulaney’s Kid Gorgeous, Hasan Minhaj’s Homecoming King, Michael Che’s Matters, and Mike Birbiglia’s My Girlfriend’s Boyfriend.
2.) Play The Sims
This possibly could work with other video games, but I’ve only ever played Mario Kart Wii, The Sims, and Whale Trail mobile in my entire life so I can’t attest to that. This game is perfect for my OCD. Large parts of my day are comprised of my attempting to rid myself of obsessions, performing compulsions, or avoiding things that will make me want to obsess or perform compulsions. Control is everything, and if I can’t pour it into my disorders (ex: anorexia!) then it needs an outlet. Surprisingly, The Sims proves itself a worthy adversary.
In the game, you can craft your character’s lives in all-controlling ways. Feel left out at school, lonely? Make your character popular, have a partner. Can’t get to school? Make your character a nerdy do-gooder. Having home troubles? Create a solid familial unit. Feel lost, purposeless? Literally check off life goals for characters that you can specifically mold in your image.
I don’t like to mold my characters in my image, but I do love to play out what I’m missing in my life within the confines of my laptop screen. This is one that has to be done in careful moderation; I’ve seen those I care about become obsessed and/or addicted with/to video games. The Sims is ideal because it contains natural ending points, no competition, and absolutely zero violence. Not only can you play out your compulsions, their opposites, and your greatest hopes and dreams in it, but the game is focus-intensive, so you’ll be hooked for as long as it takes for your crisis level emotion to subside.
3.) Journal your heart out
There is a reason that every mental hospital in the country encourages journaling. By nature, it triggers introspection and is a primal release. Humans rely on language to change their surroundings increasingly in the modern age, as opposed to brute force of our early existence. If we’re looking for a change, yelling it, writing it, singing it, any kind of expression will do the trick, in some way. However, what we’re looking to avoid when you are in a crisis situation is acting out in a negative way. If you try to change anything in your surroundings, you will likely not behave in your ultimate self interest, purely based on how acute your emotions are. You aren’t thinking clearly. So how are you to express? To yourself.
I’m a writer, pretty obviously. My brain is always rambling, churning out thoughts and composing sentences as long as a CVS receipt, with the glamor just as sparse. Being able to put pen to paper, or in my case fingers to keyboard (my rambling novellas would be way too hard on the wrist bones…) is a compulsion of mine, to rid myself of obsessive thoughts. Usually it’s a very positive compulsion. I can channel my obsessions into a medium that is just for me (or for my therapist) and in a way that hones my writing skills, all while feeling a sense of relief when I’m done composing that is paralleled by little. And composing it is; every sentence of mine must be a little masterpiece, as my junior year English teacher once commented.
Writing isn’t just for people with obsessive brains. Journaling forces you to step outside of yourself and describe your daily happenings and introspections as an objective observer. In this practice, people often find that they discover something new about what they were feeling, come to a revelation, or at the very least, are comforted by the pure expression of their acute emotions. Journaling is best used in the early stages of crises, but it is excellent for warding them off.
Recommendations: iPhone notes app, an email chain with yourself, a Google doc, a pretty, gold-flecked journal from Papyrus. Or one adorned with soccer balls, if you have masculinity issues and can’t just enjoy shiny things, goddamnit.
4.) Take medication
Yes, this is a coping skill. Knowing when to take your sedative medication is a skill, and allowing yourself to be overtaken by this medication requires an intentional act of release that many people find difficult.
If you’re having issues with acute anxiety, panic attacks, flashbacks, or anything I’ve described or that is similar, and you haven’t yet been to a doctor, this is where doing so will really come in handy. Sometimes you just need to rely on a medication to emerge from an emotion; coping skills will not always address it, and using a prescribed medication is something of an airlift from the situation. I’m prescribed Xanax for this very reason, and once I’ve taken it, I’m sleepy and mellow within fifteen minutes for around four hours. It’s only somewhat helpful in panic attacks, which for me last about ten minutes on average, but in many situations where I’m at risk of performing “problem behaviors,” it throws me a rope and finagles me to safety. Consult your doctor to see if a sedative medication is right for you!….
I hope that this list has either given you an idea of something you can use to persist through your worst moments or, at least, gotten your creative juices flowing about the subject. Maybe you wanna journal about some ways this article has inspired you to calm yourself in fiery moments?…