Archive for May, 2010
I take the pills
May 23rd, 2010 | 
Author: I take the pills
Fuck this – I just can’t stand feeling this bad. I’m going to take these pills. At least I’ll be somewhere different than this place.
Next day:
Well, I took the pills, and here I am in the hospital, again. I really don’t like this place — it’s too loud, and there are a lot of weird people in here. I’m just kind of wandering around, waiting for the nurses and doctors to decide what they’re going to do with me this time.
I just couldn’t stand how I was feeling last night. So I got some of Tina’s vodka and used it to wash down about half of the pills – it was hard to swallow them, and I just kept staring at them. I don’t really like vodka much, I was still feeling lousy, but I started to get sleepy, and then I called my mom. She was mad when I told her about taking the pills, but she called Tina, who came home early from work. My mom called Michael, too, and he and Tina talked about whether she could take me to the hospital or the police and an ambulance were needed. It turned out Tina was able to get me into her car and we went to the ER, so at least I don’t have to pay an ambulance bill. But Tina’s mad at me for stealing her pills, mom’s mad because I made another suicide attempt, and I can’t talk to Michael until tomorrow morning because of the goddamned 24 hour rule*.
So, as usual, I have just made things worse. I still want to die, but I’m in a hospital where I can’t do that. I guess maybe I didn’t really want to die, or not enough when it came right down to it. Michael says our minds are more like parliaments than dictatorships – there’s lots of different groups voting about any behavior. There weren’t enough votes in my brain for really dying, but there were enough of those votes to mess my life up worse. I hope I don’t lose my job over this – I’m supposed to be there today for the big project. I suppose Michael will tell me he’s glad there were lots of votes for staying alive. He’s trying to create votes for doing DBT skills. I wish I had called him and tried some skills… Crap!!
END OF CHAPTER 1
To return to beginning of Chapter 1, click here.
*24 Hour Rule: In order to avoid reinforcing self-harm behaviors, DBT protocol forbids the therapist to discuss anything with a client for 24 hours after self-harm behavior, except for helping the client get to the hospital if necessary.
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I refuse to try skills
I refuse to try skills
I said I didn’t want to try any stupid skills — I just wanted to die.
Michael said, “Fair enough, that’s where you are right now. So, the problem you’re trying to solve is feeling so bad about the fight with Cheryl, on top of everything else wrong with your life right now. You’re thinking that being dead will stop you from feeling so bad, and maybe that’s true, although we certainly can’t know for sure, as we’ve discussed other times. Nobody knows what happens after death, though most people believe we continue on in some way, and a lot of the time you believe that too. With the way things have been going for you lately, it would be just your luck that there is an afterlife and you’ve screwed up worse.
“But one thing we can find out for sure is whether there are other ways to stop feeling so bad. Would it be alright with you if there are ways I can teach you to get out of such a shitty emotional place?”
I had to think about that for a minute. When I get in certain moods, I really don’t want to feel any better, though I wish I did, too. I told Michael I wasn’t sure.
He said, “Sure, that makes sense. We all get into emotional spots where we’re just not ready to let go of where we are. It’s kind of like a tantrum that needs to run it’s course for awhile – I definitely get into places like that with my wife sometimes, where I know I could make it better by apologizing, or changing my attitude, but I’m just not ready yet. DBT calls this “willfulness”, as opposed to “willingness”. Do you remember seeing that in the Distress Tolerance packet?”
I told him that willfulness sounded vaguely familiar, and felt pretty familiar, too.
He said, “Well of course it does. If you’ve been told all your life that you shouldn’t feel things so intensely, that you should just snap out of it, then you’re going to be a little defensive about changing how you feel. Anybody would.
“But willfulness can certainly get in your way. It’s gotten in mine. So let me ask again, now we’re seeing that very human tendency to dig in, whether it could be okay to have ways to calm yourself down, not because somebody else wants you to, but because the wisest part of you, your “Wise Mind” as we say in the DBT trade, wants to be calmer, maybe even peaceful. What do you think?”
By now I was actually feeling a little calmer, as usually happens when I talk to Michael. It helps that he seems really calm, pretty much no matter what is going on with me. And he doesn’t blame or judge me like my family does. Anyway, I said that yeah, I’d like to be able to be more in control of how I feel, especially if it’s for me, and not for somebody else.
Michael said, “Okay, then what we want to do here is help you focus your attention on something else besides your problems for a little while, so your body can calm down. Once you get into a more peaceful place, it’s easier to see what to do that will help things get better. So we could focus on almost anything else besides what you think, but I have a few favorites, like “counting colors” and “sound symphony”. Would you be willing to give them a try?”
IT’S YOUR CHOICE – What will I do?
I agree to try some skills on the phone
I agree to try some skills on the phone
Michael asked me to look around the room and tell him some of the colors I could see. I started with the purple of my bedspread, and the shades of blue in my favorite picture on the wall. He asked me how many different shades of blue I could find in the picture; I said about seven. He asked if there was anything else blue in my room, and I said there were lots of blue things, because blue is my favorite color. He had me describe each item, and then asked me what I noticed in my body.
I was surprised to discover that I felt calmer, and even a little excited, like being on an Easter egg hunt. But I wasn’t sure I was ready to tell Michael that, so I said, “I don’t know”. He said, “Okay, your voice sounds a little more relaxed, but let’s try another exercise.”
He asked me to listen to the sounds in the room as if I was at the symphony. He said there would be different pitches, high or low, there’d be rhythm of sounds occurring, there would be the timbre of whatever was making noise, just like in the symphony there’s the difference between an oboe and a tuba. He suggested I try to move beyond identifying what was making the noise to really listening to the sound, just for a couple of minutes.
That one was harder for me to get into, because I kept getting distracted by remembering what Cheryl had said to me. I told Michael that when he asked me after a minute or two what I had experienced. He asked me if I had been able to listen to any sounds at all, and I reported hearing a clock, the sounds of traffic outside and the faint sound of my neighbors’ radio next door. He said that most people reported noticing more thoughts in this “sound symphony” exercise than in the “counting colors” one, but that it was very good I was able to come back to noticing some sounds.
He asked me whether I felt a little better than before we started trying the skills. I had to admit I felt calmer. He asked me where I was on the 0 to 5 scale of urges to die, and I said I was down to 3.5, which is where I almost always have been since Peter left me six months ago. Michael asked if maybe I could take my evening medications, go to sleep and be safe through the night, if we agreed to figure out what to do about Cheryl in our appointment on Thursday. I thought about it for a minute, and said that I probably could do that.
He asked if I could promise to be good to myself, and avoid doing anything to hurt myself until our Thursday appointment. I said I wasn’t sure I could be safe that long, so he said how about until tomorrow evening. I said okay, I could promise for that long, and we agreed to talk tomorrow night at 9 after his last client.
So I took my sleep meds and went to bed. I still have a fairly constant urge to die, but at 3.5 on the scale, I’d rather go to sleep right now than do anything else. I’ve still got Tina’s pills, and can kill myself if I have to. But I do secretly hope that Michael is right when he says I can have a life I’ll want to live if I work hard enough at DBT.
END OF CHAPTER 1
To return to beginning of chapter, click here.
For more on mindfulness and distress tolerance skills, click on the underlined words.
Look for Tina’s pills
This set of web pages intends to create an opportunity to learn emotional regulation skills in an interesting way, by following the story of a suicidal young woman named Amy as she makes choices about what to do to either calm down or try to kill herself. Like the choice adventure books my kids read in the 80’s, these pages allow readers to periodically decide what path to follow, and experience the consequences of their decisions.
PLEASE BE ADVISED THAT THIS MATERIAL COULD BE TRIGGERING FOR SOMEONE WHO IS OR HAS BEEN SUICIDAL. I WILL MAKE EVERY EFFORT TO FREQUENTLY OFFER SAFE ALTERNATIVES AND SOOTHING THOUGHTS FOR READERS TO VICARIOUSLY EXPERIENCE, AS WELL AS TEACHING LIFE SAVING DBT SKILLS. DESPITE THAT, SOME OF WHAT I’M PRESENTING IS FRANKLY AND DRAMATICALLY NEGATIVE, AND PUTTING IT IN FIRST PERSON PRONOUNS MAY BE MORE TRIGGERING THAN IF IT WERE PRESENTED AS HAPPENING TO A THIRD PERSON.
IF YOU ARE FEELING IN DANGER OF MAKING A SUICIDE ATTEMPT, PLEASE REACH OUT FOR HELP AND FIND A WAY TO AVOID DOING SOMETHING FROM WHICH THERE MAY BE NO RETURN. CALL YOUR THERAPIST OR LOCAL CRISIS LINE, GOOGLE SUICIDE PREVENTION, OR REACH OUT TO A FRIEND OR RELATIVE YOU TRUST. THERE IS NEVER A GOOD REASON TO KILL YOURSELF, WITHOUT LENGTHY DISCUSSION WITH AN EXPERT MEDICAL PROFESSIONAL. GET HELP, AND FIND ANOTHER WAY!!!
I look for Tina’s pills
Okay, the pills are here in my purse. I’ve got about 15 of Tina’s sleep meds. I don’t know if this is enough to kill me or not. I hope it is… or maybe I don’t. I don’t know!! All I know is I hate Cheryl… I wish Peter were here… I wish I hadn’t told Cheryl she’s a rotten bitch… I am such a fuckup… Nobody wants to be with me, to spend time with me… I don’t know what to do… I wish I was dead! Maybe I should call Michael… Maybe I should do Pros and Cons.
IT’S YOUR CHOICE – What will I do?
Do Pros and Cons!
I do Pros and Cons
Okay, my therapist has been teaching me to draw out 4 different boxes representing the pros and cons of doing something he says is skillful, like calling him when I’m really suicidal, or the pros and cons of doing the kind of thing I have usually done in the past. He claims that it’s worth the trouble of doing all four options, and I guess I have seen a couple of things pop out when you do it that way, so maybe I’ll do it that way now.
Fuck, I hate having to think about all this when I feel so bad. Maybe I ought to just go find Tina’s pills. Well, I’ll try this for a minute or two, and then I can go get the pills.
______________________________________________________________________
Okay, advantages of calling Michael:
I said I would.
I like talking to him – he’s funny and I can tell he cares about me.
I might feel better.
_______________________________________________________________________
Disadvantages of calling Michael:
It’s 10 pm; he might be mad.
He might talk me out of killing myself.
I might feel worse.
_______________________________________________________________________
Advantages of taking Tina’s pills:
If I die, maybe Cheryl will know she’s a bitch.
I won’t feel like this.
I won’t be a burden to anyone anymore.
________________________________________________________________________
Disadvantages of taking Tina’s pills:
3 suicide attempts have failed; I always feel worse afterwards.
My mom would feel bad if I die.
Who will take care of my cat? I’m not going to let Cheryl get her!!
What if there’s a Hell? (Michael says he doubts there’s a Hell, but we might be stuck with the same problems in our next lifetime.)
Assuming I don’t die, the DBT 24 Hour Rule* says I can’t talk to Michael till Wednesday night.
_________________________________________________________________________
Shit Fuck!! I still feel like crap and wish I was dead, but as I look at this list it’s hard to believe that I would even do a decent suicide. I’d probably just end up in the hospital again, with liver damage on top of everything else that is completely fucked up. I think I’ll call Michael – he did say I could call anytime if I really need to.
IT’S YOUR CHOICE – What will I do?
You really want me to look for Tina’s pills!
*24 Hour Rule: In order to avoid reinforcing self-harm behaviors, DBT protocol forbids the therapist to discuss anything with a client for 24 hours after self-harm behavior, except for helping the client get to the hospital if necessary.
I Call My Therapist
I Call My Therapist
Okay, so I’m talking to Michael, and I’m feeling just a little bit better because I like talking to him, but I’m still pretty mad and desperate. Michael agreed that it was awful what Cheryl said to me and that I had every right to be really pissed off. I told him I just wanted to die. He told me he was really glad that I had called, even though it was 10 at night, rather than making another suicide attempt. He was glad I had kept my promise.
He asked me how suicidal I was on the 0 to 5 scale – I told him 4.5. He asked me what 4.5 was like for me; what was I thinking and doing? I told him I definitely wanted to die, and was thinking about how to do it. He asked what I was coming up with about how, and I told him, “Pills”. He asked what kind of pills I had and how many. I lied to him – I said I just had the weekly dose Dr. Cooper gave me, but I didn’t tell him about Tina’s pills.
Michael said that suicide sounded like a potentially permanent solution to a problem that might be temporary, or might have some other possible solutions. He asked what problem I was trying to solve by killing myself. I said I just couldn’t stand feeling so bad about the fight with Cheryl on top of all the other things that are wrong with my life.
Michael agreed that it sounded like I was feeling really awful. Then he asked if I’d be willing to try using some mindfulness and distraction skills for a couple of minutes with him, to try to do something right now about how bad I was feeling.
IT’S YOUR CHOICE – What will I do?
“I Feel Suicidal” – A DBT Adventure in Emotional Choices
This set of web pages intends to create an opportunity to learn emotional regulation skills in an interesting way, by following the story of a suicidal young woman named Amy as she makes choices about what to do to either calm down or try to kill herself. Like the choice adventure books my kids read in the 80’s, these pages allow readers to periodically decide what path to follow, and experience the consequences of their decisions.
PLEASE BE ADVISED THAT THIS MATERIAL COULD BE TRIGGERING FOR SOMEONE WHO IS OR HAS BEEN SUICIDAL. I WILL MAKE EVERY EFFORT TO FREQUENTLY OFFER SAFE ALTERNATIVES AND SOOTHING THOUGHTS FOR READERS TO VICARIOUSLY EXPERIENCE, AS WELL AS TEACHING LIFE SAVING DBT SKILLS. DESPITE THAT, SOME OF WHAT I’M PRESENTING IS FRANKLY AND DRAMATICALLY NEGATIVE, AND PUTTING IT IN FIRST PERSON PRONOUNS MAY BE MORE TRIGGERING THAN IF IT WERE PRESENTED AS HAPPENING TO A THIRD PERSON.
IF YOU ARE FEELING IN DANGER OF MAKING A SUICIDE ATTEMPT, PLEASE REACH OUT FOR HELP AND FIND A WAY TO AVOID DOING SOMETHING FROM WHICH THERE MAY BE NO RETURN. CALL YOUR THERAPIST OR LOCAL CRISIS LINE, GOOGLE SUICIDE PREVENTION, OR REACH OUT TO A FRIEND OR RELATIVE YOU TRUST. THERE IS NEVER A GOOD REASON TO KILL YOURSELF, WITHOUT LENGTHY DISCUSSION WITH AN EXPERT MEDICAL PROFESSIONAL. GET HELP, AND FIND ANOTHER WAY!!!
Amy’s Story
“My name is Amy and I want to die!! I’m almost 35 and I have no friends!! Cheryl and I had a big fight tonight and I hate her so much!! She’s a total bitch and I should never have trusted her. I can’t stand my life!! I think I’ll take those pills I found in Tina’s room. If l were dead, I wouldn’t feel so bad. Crap, I wish I hadn’t promised Michael I wouldn’t try to kill myself before our next session. I shouldn’t have promised I’d call him if I got above 4 on my diary card. Fuck!!! I’m so mad!! I just want to die!
IT’S YOUR CHOICE – What will I do?