What do you think of when you hear the words “self-care?”
Social media can make it seem like self-care is all about pampering oneself, bath bombs, chocolate, getting a mani-pedi, and retail therapy. While these can all be valid forms of self-care, this is not the only way to practice it.
Self-care is something everyone needs to practice, whether they have a mental illness or not. If someone only focuses on their work or their studies, for example, they will soon experience burnout. If an individual only engages in self-destructive behavior, such as injuring themselves, excessive alcohol consumption, etc., and rarely or never does anything healthy and pleasurable, they will not feel good about themselves and will be ineffective at the demands of life.
Self-care is different for everyone. I have stacks of papers from various treatment centers listing positive coping skills and pleasurable activities in the name of self-care. I’m not the kind of person who, when in distress, wants to light a candle and sip a cup of tea. In fact, this would probably only agitate me further: I’m angry and scared, now there’s fire and I have leaf water. Great! This does nothing to actually address the problem.
One thing I learned in my last stint in treatment was that coping skills and self-care need to be practiced in order to be effective. This is where I have fallen down in the past. “Nothing is going to replace the instant gratification of self-harm,” I’d argue with therapists. “Why would I want to hold a frozen lemon or rip up paper when that’s not going to do what self-harm does? How is any of this shit going to help?”
A fellow group member at this treatment center had suffered severe anxiety, which ultimately resulted in a suicide attempt. This person would have hours-long panic attacks over seemingly nothing, and he thought nothing, except medication, would help him. Over the course of treatment, I watched him learn grounding and self-soothing skills, which he practiced daily, to quell his anxiety. He described how practicing skills like grounding on the way to work, on his lunch break, and in other downtime moments helped him to pull himself out of high-anxiety instances that could have otherwise left him in a panic attack.
So of course, when it came to my unique situation, the struggle between the familiar urge to self-destruct and the small (but growing) desire to be kind to myself, I learned that I had to start at the beginning. I could not go from self-destructive maniac to master of zen overnight. Neither had I gone from smart, regular kid to depressed, self-loathing Katherine overnight. First, I had to believe I was worth it. Voices in my head, both real and hallucinatory, told me I deserved to be in pain, to suffer, and that the abuse I have gone through was deserved as well. I can’t do much about hallucinatory voices (aside from taking my medication regularly), but I do, in fact, have control over the way I talk to myself.
Recently, I was diagnosed with a personality disorder by the Mayo Clinic. This diagnosis came from several hours of testing that consisted of memory challenges, puzzles, and number games. I spoke with a psychiatrist for about fifteen minutes, and then filled out a questionnaire, which I believe was the MMPI.
I neither agree with or like this diagnosis. Perhaps it’s my own bias against people with this particular disorder, the stigma that they are “bad people,” or maybe I am more attached to the schizoaffective disorder than I am willing to admit. Regardless, change may be the only constant in life, but I still don’t like it.
Either way, the treatment for this alleged personality disorder and PTSD are the same: dialectical behavioral therapy (DBT). I did a course of DBT when I was in outpatient treatment during my senior year of high school. I didn’t like it at the time because I felt that it only addressed surface issues and didn’t get into the feelings that I needed to process.
However, I am more open to alternative methods of treatment these days. Sitting in therapy once a week and discussing years-old hurts, my unhelpful coping mechanisms, and general unhappiness hasn’t been helping for a while now. So, I dug out the old green DBT workbook that’s been sitting on a bookshelf for the past year, and it’s actually not so bad.
Believe it or not, I have a better day when I’m not constantly berating myself in my head. I casually mentioned this to a friend, and she said, “I know! It used to be like, I wake up and then, ‘Oh, and you’re a piece of shit, too!’ But it’s not like that anymore!”
I’ll be honest, I skipped a lot of pages in the workbook. There were several meditation exercises that didn’t interest me. I’ll calm down when I’m dead, thanks. However, I found the “alternate coping statements” section interesting and useful. Once, a therapist in a treatment center asked me, “Are you a perfectionist?” “No,” I told her. “I never do anything right.” She struggled to keep a straight face as she said, “I’m just going to mark that down as ‘yes.'”
Sometimes, I feel like this book was written just for me. There was a page that described how many people with overwhelming emotions feel that they are bad people, and alternate statements to say to oneself when presented with the thought, “I am a bad person.” One of them read, “I am becoming a better person every day.” I immediately took this to mean, “I started out bad, and as I progress along the scale of goodness, someday I’ll be perfect,” which I do not think is what the book intended for me to take away from this.
I remember crying in Lisa’s office, the therapist at my last treatment center, telling her I’ve always felt like I’m “recovering,” not “recovered,” and that I just wanted to be done working on my mental health. Lisa basically told me, “That’s life! Nobody’s ever ‘done.'” And she was right. The definitions of “good person” and “bad person” can vary greatly. There is no universal truth.
For many years into the journey of mental illness, I felt that my sadness defined me. I heavily identified with the “tortured artist” stereotype, and genuinely felt that I could not write poetry (or anything, for that matter) if I wasn’t miserable. While it may be harder to write about happiness, or harder still to find inspiration in stability, I am up for the challenge. When I was younger, I did not want to get better because I didn’t know who I would be without mental illness.
Today, I realize that although I cannot ever eliminate mental illness from my life, it is not the most interesting or important thing about me. Despite what the diagnosis may be, the treatment is working. And I am a whole person outside of a mental health diagnosis. Even if my personality is disordered, I am still worthy of happiness and confidence.