Dead Panic, Ice Cubes, and Walkabouts

This morning I was supposed to start my intensive outpatient program, the one I’ve been putting off since October.

Note the use of the words “supposed to.”

I woke up in a dead panic about my day. I think it started when I realized that I would be out and about and away from my checklists, which have become my life manager these days, and that I would need to pack certain things to go with me to the hospital. What if I forgot something? What if I didn’t hear an alarm? What would I need to change to make my day a success?

This led quickly to me in a bawling heap on the couch, absolutely terrified of what I was going to do. I was scared to move, scared to think, and especially scared to make any decision whatsoever. Being asked a question – any question – was a fight/flight/freeze trigger, and I was being asked entirely too many of them. I froze every time.

By the time my wife was off to work, I had made the decision that I would spend the day trying to achieve as many levels on one of my DJ game avatars as I could. Then the servers went down around 9:00 local time and didn’t come back up for nearly six hours. Which led to more panic, though of a lower level. I finally decided my solution was to sleep through the waiting, and that seemed to finally reset my panic-o-meter. As I write this, I’m sitting on the couch watching the indoor cat watch the outdoor cat eat, sipping on a cup of decaf. Life is … well, not good, but at least content again.

When I first posted something about this on Facebook this morning, I got a lot of commentary along the lines of “be easy on yourself.” And that’s where I ran into a roadblock.

“The DBT Skills Workbook” talks about distracting behaviors when someone is in a mindset of self-harm. But they almost exclusively refer to situations where “self-harm” includes activities such as “cutting, pulling out hair, or self-mutilation.” I’ve never cut or self-mutilated once, and I don’t have any hair to pull out (maybe in my case self-harm means growing it out?) so I’m at a loss as to what I can do to distract myself from the type of self-harm that I engage in, self-neglect.

Today I recognized that I needed to self-soothe, another technique that’s used in DBT, and so I decided to bury myself into a computer game and distract myself with that. But during those times of self-neglect, I won’t allow myself food, water, bathroom breaks until it’s almost too late to avoid an accident, reading, watching movies or television, computer games, sleep, or anything else that might be a self-soothing mechanism or a distraction. Or I overeat, to the point of pain and nausea, which over time has led me to becoming morbidly obese. So I’m not sure what to do when my mind slides into self-neglect mode, since it’s much more insidious and stealthy than cutting or mutilation. The same activities that would normally be used to distract me from my form of self-harm are the exact things that my self-harm will not allow me to do.

There is one technique that is recommended in the workbook that might work: holding an ice cube in my hand until the urge to self-neglect passes. If I hold it long enough, I’ll have no choice but to practice self-care, as my hand will be too cold for me to do anything else but see to warming back up. I have to hold it over a sink since I’d be dripping melting ice water over everything, and by staying in one place with nothing to trigger me but the dishes, I’m not stimulated by little things stacking on top of one another in my environment. (When in the state called “emotion mind,” which is where I almost always am when I practice self-neglect, it’s easy for one little thing to become huge, and for several little things to become mentally crippling. The goal, I believe, is to pull yourself out of “emotion mind” and into either “reason mind” or “wise mind,” where you can look at triggers more objectively.) There’s little chance of actual injury from holding ice in your hand (unless you do it for hours at a time) and the aftereffects are much less harmful than stuffing my face to the point of agony. Plus I have permission to pee.

Another might be to have something – just one thing – that is permitted no matter what, so that I can allow myself enough of a distraction to reset my “emotion mind.” I don’t think being on the computer should be this thing, since there’s oftentimes so many negative stimuli coming from news and social media that it becomes one of those stacking situations I spoke of earlier. Walking, perhaps, should be that always-allowed distraction. It gets me out of the house without making me face the public except in passing; it gives me the distraction of my walking playlist to listen to and silently sing along with (I’m in too bad a shape to walk 3 miles an hour and sing; just … no); it releases endorphins that naturally serve to chemically soothe me.

In a short time, physical exercise has gone from something I avoid at all costs to something that I’m using as a soothing technique. If there’s no other indicator that I’m getting healthier, this is it.

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