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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Dinah on July 22, 2003, at 19:21:25
I have very poor self soothing skills. Two rough sessions in a row, and I just end up with SI urges, sleeping for hours, and taking some extra klonopin.
If I am going to do the deeper therapy work, I'm going to need to develop a wider range.
Posted by slinky on July 22, 2003, at 19:37:43
In reply to Need self soothing help, posted by Dinah on July 22, 2003, at 19:21:25
> I have very poor self soothing skills. Two rough sessions in a row, and I just end up with SI urges, sleeping for hours, and taking some extra klonopin.
>
> If I am going to do the deeper therapy work, I'm going to need to develop a wider range.Hi Dinah,
Hard to find answer..usually I take xtra med or try over counter suppliments but 'normal' people I suppose have a stiff drink..or smoke pot.
SI urges..I only know goes when medication does it's job:-(
Sorry, sweet you're feeling this way.
Posted by Tabitha on July 23, 2003, at 0:49:02
In reply to Need self soothing help, posted by Dinah on July 22, 2003, at 19:21:25
does your therp know you have such a strong reaction after the session? Maybe he can wind down earlier and end on a more positive note. Mine used to do a guided meditation thing where we went to my 'safe place', and at a differnt time she used EMDR techniques on me. It did seem to leave me in a more comforted state at the end of the session.
Inablity to soothe myself is one of my core issues too.
I just bought this book in the bargain section at B&N called "The Power of Focusing" that has a technique for facing strong emotion. I'm not sure if it helped much but it was a distraction this weekend when I was upset. It's kind of a checking in with your body type of exercise.
I'm usually at a complete loss how to handle strong upset, except to grit my teeth and endure, drink or try not to drink, call the therp, or drag myself for a walk. Nothing really helps much. For lesser upset I bury myself in books, movies, or internet.
Posted by fallsfall on July 23, 2003, at 3:09:25
In reply to Need self soothing help, posted by Dinah on July 22, 2003, at 19:21:25
I can tell you what I do (your milage may vary).
1. Journal (helps me think things through and identify what is really bothering me)
2. Call a friend (I don't do this and I should)
3. Read Psychology books
4. Computer games (Mah Jong and Snood are my favorites)
5. Watch a movie
6. Draw a picture or make a sculpture (Art Therapy)
7. Color a picture (makes me feel in control, crayons smell really good)
8. IM with friends either about my problem, or more likely about theirs (Usually done with #4)
9. Read Babble continuously
10. Nap
11. Cuddle with my dogs
12. Walk through a craft or bookstore looking at everything
13. Play guitar (Girl Scout camp songs. I bring my guitar with me when I go to the hospital)You can find other ideas in "The Women's Comfort Book". I recommend this book highly. Also, DBT has a section on Distress Tolerance.
Most of these ideas are either to get the feelings out or to distract yourself from them.
I find things like taking my dogs for a walk a bad idea because it gives me too much time to think without generating something tangible (journal or picture etc.). For me, that is a bad idea.
I agree that you should make sure your therapist knows how much you are bothered.
I hope this helps.
(((((Dinah)))))
Posted by Dinah on July 23, 2003, at 9:32:00
In reply to Re: Need self soothing help » Dinah, posted by fallsfall on July 23, 2003, at 3:09:25
I have that women's comfort book. Or maybe the pregnant women's version. I can't recall. I'm beginning to think this is related to the nortriptyline though. This morning, I'm feeling that unmistakable artificial feeling of agitation and arousal. :(
Posted by Penny on July 23, 2003, at 11:04:19
In reply to Re: Very good ideas, posted by Dinah on July 23, 2003, at 9:32:00
I definitely agree with the winding things down earlier suggestion. After leaving my therapist's office in a terrible state early on in our relationship, I told her (though it was hard for me) that I needed to try to end on an up note, or at least calmer, so I wasn't driving home looking for something to run into. I did the same thing, especially toward the end, with my old therapist. We would try to end in a more positive way, regardless of how painful the therapy session was. It really helped me.
And, of course, there is always ice cream...
Hope you're feeling better.
P
Posted by mattdds on July 23, 2003, at 20:05:14
In reply to Re: Very good ideas, posted by Dinah on July 23, 2003, at 9:32:00
Hi Dinah,
I think you may be on to something; perhaps it *is* the nortriptyline.
The last antidepressant I ever trialed (before realizing they do very different things to me than to other people) was imipramine.
The phrase you mentioned about agiatation and arousal sounds eerily similar to when I was taking imipramine. I've never had SI urges, but could imagine wanting to really hurt myself while taking a TCA! Those TCA's were terrible drugs for me. I felt agitated and bugged (with other people) to the point of wanting to crawl out of my skin. I bet my brain was already flooded from norepinephrine to begin with, and this pushed me over.
I vowed I will never touch another noradrenergic drug again! They just aren't for me.
I don't know if this is your problem, and I know you're smart enought to figure it out eventually. But, again, this sounds so much like when I was taking imipramine.
Hope you feel better,
Matt
Posted by Dinah on July 23, 2003, at 20:30:00
In reply to Very possibly TCA, posted by mattdds on July 23, 2003, at 20:05:14
I swore the same thing after Effexor and Wellbutrin, but my pdoc said that since nortriptyline was a dirtier drug it wouldn't effect the NE as strongly. But I vowed that at the first sign of trouble I'd bail. So bail I will. I'll try again when I'm feeling really calm and if the results are the same, I'll quit for good.
I'm not feeling bad tonight, but I'm also zonked on klonopin. :) Hard to tell.
Posted by noa on July 23, 2003, at 20:41:59
In reply to Re: Very possibly TCA » mattdds, posted by Dinah on July 23, 2003, at 20:30:00
Dinah, I have recently started using the sensory integration strategy of brushing. I happen to be using a brush that is made for cleaning suede shoes, but they actually make sensory integration brushes that are softer than that.
I brush my skin, not hard--no damage or marks or anything--just gently. It is very stimulating and organizing and calming for me. I think it actually creates some of the same effect that cutting does but without the injury and danger.
I had posted the link once in the past, for where you can buy these brushes on line. If I can find it again, I'll repost it. You might be able to use a soft vegetable brush or something like that.
Also, permit me to remind you that you have used tight wrapping in a sheet in the past, and you said it helps when you are jumping out of your skin with agitated emotion.
Posted by Dinah on July 23, 2003, at 22:21:20
In reply to Re: Very possibly TCA » Dinah, posted by noa on July 23, 2003, at 20:41:59
I was good today, Noa. Knowing that I see my therapist in a few days lets me hold on much better and count the hours. That's why he wants to keep me on a twice a week schedule, even though my brain tells me it's too much time and money. But it is true that my acting out is much less this way.
I did the wrap, and also the forgetting nap, and took a wee bit more klonopin than i like to take. I'll have to try the brushing. I assume they are pretty firm brushes? Does the feeling stick around for a while? You use them on your upper arms did you say?
I'll have my husband tightly hold me tonight, and also I'm taking a break from the nortriptyline. I'll give it another try later.
Thanks, Noa. :)
Posted by judy1 on July 23, 2003, at 23:32:03
In reply to Need self soothing help, posted by Dinah on July 22, 2003, at 19:21:25
I just saw your post Dinah and I posted something under my 'called therapist' heading that may be of interest to you. take care, judy
Posted by pianolady on July 24, 2003, at 2:36:15
In reply to Re: Need self soothing help » Dinah, posted by judy1 on July 23, 2003, at 23:32:03
I've had lots of problems w/ SI over the last several years. I can't say I'm 100% over it, but it's down to maybe a few episodes a year--MUCH better. I've tried all kinds of things to stop, but the one that helped the most was spending some time in an inpatient/intensive outpatient place called S.A.F.E. The directors of the program have a book out called, "Bodily Harm" by Karen Contario and Wendy Lader. I read the book and I liked their very different approach to treating SI so I called them and I ended up going to their program (in the Chicago area). I would certainly suggest reading their book as a good starting place, but be aware that the case studies are triggering, so be careful not to read too much at one time. Also, it's probably better not to read it when you're already on-edge too much.
Some more specific things that have helped me are:
1. Listen to a quiet CD with earphones. I would rate this as number 1 for me. I have to use the earphones because it seems to block out those constant inner urgings to hurt myself. I try to close my eyes and concentrate as closely as I can on the melody of the music. It doesn't work every time, but it has worked for me many times.
2. Journal--everybody says to do this, but it does help. If you can handle it and your therapist thinks it is safe for you, write down exactly what you want to do. But then think, "why would I want to do that?", "what am I upset about?" (maybe nothing?), "what will be the consequences of acting on my thoughts to SI?" (scars, hurt other people, maybe hospitalization, etc.), "what are 5 things that I could do right now besides SI?" Some of these ideas are outlined in the book I mentioned, others are my own questions for myself.
3. Anything else that gets your mind off it (that one doesn't always work well for me, but I put it down anyway)
4. If all else fails and I know that I'm GOING to SI (and in my case that may ultimately mean hospitalization soon because of related symptoms), then I will take Xanax. I don't use it often, but when I'm at the point that I'm either going to hurt myself, go to the hospital, or take a xanax, I figure the xanax is probably worth trying. Then I try to only keep myself from injuring for say 5 or 10 minutes. I do my best to keep this up until I go to sleep from the xanax.It's a pretty long post, but maybe it will give you some ideas that will work for you.
I wish you well. SI is very difficult to overcome, but you really can make significant progress toward stopping it.
Posted by noa on July 24, 2003, at 6:18:15
In reply to Re: Very possibly TCA » noa, posted by Dinah on July 23, 2003, at 22:21:20
Good, Dinah. I'm glad you employed some of the strategies that help you through it.
>I'll have to try the brushing. I assume they are pretty firm brushes? Does the feeling stick around for a while? You use them on your upper arms did you say?
I don't know what the OT brushes feel like. The one I use is firm. I brush various places--arms, hands, legs, feet, back (where I can reach), neck, buttocks/hips (to relax glut muscles, which affects restless legs). It depends what I'm brushing for. If it is for restless legs, before bed, I do all over, but especially from the buttocks down. If it is for the skin picking problem, I focus more on neck, shoulders, arms and hands. I can't brush my face yet, I have to get my skin cleared more first. And then I use my hair brush to brush my hair. I also sometimes hold large fistfuls of hair and *gently* and slowly tug until the scalp feels stimulated--this is for the scalp picking problem.
I wonder if you would try brushing in the areas you tend to gravitate toward for cutting?
Anyway, I just started the brushing thing myself and am still experimenting. I think I will order one of the real brushing brushes. I will let you know how it is.
Just don't brush hard--you do not want to see any marks or scratches--ie, it should not be self-injurious.
Good luck, Dinah.
Posted by noa on July 24, 2003, at 6:31:42
In reply to Re: Need self soothing help, posted by pianolady on July 24, 2003, at 2:36:15
>"Bodily Harm" by Karen Contario and Wendy Lader
I read that book and agree--it's a good one.
>I read the book and I liked their very different approach to treating SI so I called them and I ended up going to their program (in the Chicago area).
Wow. That was a great thing to do!
Their SAFE program sounds very good. They also have a web site. Here is the url for their website, specifically to the page that describes a yahoo group approved by the authors/founders of SAFE:
http://www.selfinjury.com/NoFear-SAFE_Approved.htm
The website also has info on the founders/authors, the book, the treatment approach, philosophy, therapist referrals, etc.
Posted by Dinah on July 25, 2003, at 11:18:02
In reply to Re: Need self soothing help, posted by pianolady on July 24, 2003, at 2:36:15
Thanks Pianolady. I have read that book. I ran across it last night. It's been a while though, and I could probably use a re-reading of it.
My actual self injury actions have always been pretty minor. I only have two scars that haven't disappeared entirely, and they are fading over time. I know that's a bit of a rationalization, but it is true. But I made a promise to my therapist not to do it, and while I can't always keep that promise, I do most of the time.
As it happened, I took an extra dose of klonopin and took a forgetting nap which my body sometimes manages to do instead of SI.
And I feel muuuuch better off of the nortriptyline.
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