My Mental Health Journey Through an Intensive Outpatient Program – Part 17

I overslept again this morning. I was still the first person at the IOP. In fact, I was about fifteen minutes early. That’s just because I’m preternaturally on time. I still had to rush which I hate doing.

My check-in was good. I mostly talked about my weekend, which wasn’t good. I had a migraine on Friday. Saturday was uneventful. But Sunday. Sunday was difficult. I was by myself for most of the afternoon, and I got trapped in my own head. Negative thought after negative thought after negative thought. I spiraled. It was unpleasant. After one and a half or two hours, I finally said, “This is stupid,” and I called my partner. I used opposite action. The tools work, if you use them. I should have called two hours earlier, but at least I called. It was a big help.

I was discouraged at the beginning of the check-in. Sunday felt like a step backwards. The clinician had to remind me again that there will be dips, but my overall progress has been up. She’s right, but I definitely needed the reminder.

For the next two hours, we talked about some DBT tools. We started with the TIP skill. TIP stands for Tip the temperature, Intense exercise, and Paced breathing. Each one is what it sounds like. Tip the temperature means to suddenly change the temperature. You can splash cold water on your face or hold an ice cube in your palm or put an ice pack on the back of your neck. The shock of cold forces your mind to attend to your body and gets you out of whatever distress you were focused on.

Intense exercise is simply intense exercise. It’s doing jumping jacks or squats or push-ups or something. It does the same thing as the cold. It forces your attention onto your body.

Paced breathing is slowing down your breathing. It’s also deep breathing. Five seconds in through your nose and seven seconds out through your mouth. Aside from giving your brain something to focus on, it slows your heartrate and relaxes you. I should have used one of these on Sunday if I had known about them at the time.

The next skill was Radical Acceptance. There are six parts to radical acceptance:

  1. Radical means all the way – completely
  2. You let go of the bitterness
  3. Reality is as it is – rejecting it does not change it
  4. There are limitations about the future
  5. Everything has a cause
  6. Life is worth living – pain cannot be avoided

Not very poetic, is it? It’s important to note that accepting something doesn’t mean liking it or condoning it. It just means that you accept that you can’t do anything about it. This is one of the hardest skills to put into practice. It means not wondering what you could have done differently. It’s easy to say, “It is what it is,” but it’s a lot harder to live it.

Before we finished up, we set goals for the week. Mine was to spend more time with other people. I sort of did it today. I went grocery shopping and went to the movies. They were strangers, but they were people and in my vicinity. I’ll try to do better tomorrow.

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