DBT Skills Group Week 1: Wise Mind and Mindfulness

Weekly Diary Card

This is what we went over today, after going over all the group rules and standard do’s and don’ts of being in a psychiatric setting such as keeping information about the other patients private, and not having sexual relationships with one another.

The first picture is the weekly diary card we use for our group. We have to go through each day and mark with skills we used that day. We also have to mark how many times we used the card. Ideally, they want you using the card each day, but you can technically use it once a week. Then we went through what mindfulness and the Wise Mind are. On Mindfulness Handout 3, you can see a diagram of the Emotion Mind Trap. That’s basically when it’s raining (you’re full of emotion) and there’s a trap door in the well that leads to the Wise Mind and the emotion gathers on top of the trap door and you mistake the rain water for the well water, confusing your emotion for your Wise Mind.

Mindfulness Handout 3A has different ways to practice mindfulness that helps bring you to your Wise Mind. The homework (Mindfulness Worksheets 1 & 3) asks you to make a pro/con for practicing mindfulness and not practicing mindfulness, and to pick some of the different ways to practice mindfulness and to practice them.

One of the simplest mindfulness exercises I know is the one where you breathe in and focus on “Wise” and breathe out and focus on “Mind,” so I did that one for a few minutes earlier.

I find mindfulness very helpful, yet I almost never remember to do it. Especially when I need it most. I’m hoping having a couple weeks focusing on mindfulness will help me get better at it.

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Hospitalization: Part 8

Journal entry from my fourth day on the psychiatric wing.
**Self-harm trigger warning**

Today was hard. My depression was high, my self-harm urges were high, my suicidal ideation was high, and my anxiety was high.

Having so many strangers (visitors) all over the place had me on edge, and not having a private place to go had me frantic. I wanted to cut., I wanted to hit walls and cause bruises, I wanted to bang my head against a wall, I wanted to stab myself, I wanted to cut my throat, I wanted to take the knife from dinner and use it to cut.

I was given Ativan. It helped mildly. It took the very edge off, and that’s all. Not what I was hoping from an anxiety medication.

I want to cut. So badly. I’m going to try to sleep instead.

Hospitalization: Part 7

A journal entry from my third night on the psychiatric wing.

Saturday is long and pretty boring. I was really down most of the day and was close to tears a lot. During my meeting with my counselor he talked about how I’m brave for being here. I found it hard to agree.

We talking about my bulimia and my history of sexual abuse and rape and he thinks I need to see a trauma specialist. He agreed with me that all the counselors have it backward — you can’t take away all my coping mechanisms and then get into the trauma. That’s when I freak out and get overwhelmed and attempt suicide and shut down.

I feel like things are finally starting to click here. I feel like these are the highest quality counselors I’ve ever worked with. And as strange as it seemed at first, I like having a new counselor every day. Each one provides fresh perspective.

Tonight’s also wants me to start overeaters anonymous for my bulimia. I didn’t know you could go to that for bulimia. I might give it a try.

Hospitalization: Part 5

From the afternoon of my second day on the wing.

During the 2nd group, the facilitator kept using an example of being overweight and needing to lose weight, how if you’re overweight you aren’t exercising and you eat an unhealthy diet, how you lack self-discipline. It was so wrong and triggering, and since I was the only overweight person in the room, it felt like a direct assault.

Just over halfway through, my growing anxiety over his topic triggered a sudden-onset migraine. It was a good excuse to leave the group. I went and got meds from my nurse and lay down. I stayed in bed until lunch, ate a slow lunch, feeling bogged down by both the migraine and the meds, then headed back to my room to purde. While in the bathroom, my roomie came back and needed to use the bathroom, so I exited. She stayed in the room afterward, and I felt awkward going back into the bathroom again to purge, so I didn’t.

My potassium and iron are low, despite taking supplements daily for both. I had to take an extra “booster” dose of potassium and it’s so gross.

I rested again for a bit after lunch, then played King’s Corner with a couple other ladies with a cobbled together deck of cards. After that, we had art for about an hour. Now I’m just trying to stay awake while I wait for my dad to visit.

Hospitalization: Part 4

From my second morning on the Psychiatric Wing.

Yesterday, my counselor told me that pain is part of being human. She told me, “You can’t grieve your sister without feeling the pain and hurt and anger of losing her. And you can’t heal from the rapes and abuse unless you let yourself feel.” I know she is right, but the idea scares me tremendously.

It’s Saturday morning, 5:40. I’m waiting for 6 o’clock so I can take a shower. There are 2 showers on the wing and they don’t only let you use them between 6am and 10:30pm.

I’m tired physically, and keep yawning, but every time I lie down, I feel wide awake. Around 4:00, I got up to check the time (no clocks in the rooms) and another patient was up too. She asked if I wanted to play chess or checkers, neither of which I care for. We settled on Uno. We played several games, and both went back to bed around 5:00. I tried for 35 minutes to sleep, but was restless and just tossed and turned. It sounded like I might be keeping my roommate awake, so I grabbed my pen and paper and now I’m in the common area.

Earlier I was getting water from the kitchen when I saw a personal sized box of cereal. I so wanted to eat it. Eat it and purge it. And even though there were no other patients around to see me eat outside of mealtime, I knew there are cameras everywhere and a staff member would see me and judge me.

Ten minutes until I can shower…

Hospitalization: Part 3

A journal entry from my second night in the psychiatric unit.

Groups today were much better than last night and I got a lot out of them. However, I kept being pulled from groups to meet with different people like my psychiatrist and social worker.

I didn’t care for the psychiatrist at all, but I liked the nurse practitioner. the day got to the lowest when I met with my counselor. She was harsh and blunt and forward, but I got through more with her in half an hour than I have with other counselors in months. I also cried way more than I’m comfortable with, but I experienced a little high after, which is weird.

I suspect my new roommate may also be bulimic — she beats me to the bathroom after every meal. I was really uncomfortable having a roommate at first, but now I’m only mildly uncomfortable. I like her, which is a plus.

Earlier, one lady at lunch said, “This is so much food! How do they expect us to finish it??” Of course, after I had finished eating my tray. I wanted to say she was being triggering, but I didn’t.

Three people that seemed really interesting went home today so I didn’t get to know them. I’m glad, however, my roommate and I have many similar interests and hobbies.

I was “certified” today, meaning I’ve been admitted for 90 days. I about had a heart attack when I heard that, but they said I should be out of here in a week-ish.

Tomorrow is Saturday and I hear there’s nothing to do after 1:00pm. I hope I have a visitor. I also hope my dad brings my other book, clothes, and my slippers.

I took Ambien, so I hope I can sleep soon, and don’t get a visit from the Ambien walrus. I shall try now.

Hospitalization: Part 2

From my first morning on the Psychiatric Wing.

I hate social situations that involve a lot of strangers. This was no different. Most of the other patients were nice, friendly, and reached out to me, but my anxiety was high and I wanted to flee.

I arrived during dinner, which was bad in itself. I hate eating around others. However, I decided not to draw any more attention to myself than necessary by refusing to eat. After dinner, I promptly purged. I was so happy to have the room, and therefore the bathroom, all to myself. I then had my first shower in a few days, which made me feel worlds better. Then, off to my first group.

During my last hospitalization, I didn’t eat and I didn’t attend any groups, and that obviously wasn’t helpful. This time, I decided to attend as many groups as possible and try to get the most out of it I could. My first group had me questioning this decision as it comprised breaking up into 2 groups and playing balloon volleyball. I still don’t know the purpose of this group.

I chose not to actually participate in the game. It had been a long 2 days, I was tired and grumpy and just wanted to go to bed. I’m sure I looked terrified whenever the balloon came my way because I did not want to have to hit it. Luckily, “my” team was good and won without my help. After group, I took an Ambien and went to bed.

I woke up several times cold but was too tired and too achy to get up for another blanket. This morning, I woke up with a lot of self-loathing, wanting to die, wanting to stab myself, wishing I could destroy myself. This feeling persisted throughout the day.

At breakfast, I was tempted to take the knife with me and cut. Purging helped soothe me a bit. There are a couple ladies here I’m 99% sure are anorexic. I want to say “I’m eating, but I’m also purging everything!” I feel the need to justify eating. I am, by far, the fattest person here.

Punched in the Gut

I finally heard back from the eating disorder treatment center. They told me that they can’t help me, and suggested a psychiatric unit instead.