Willingness vs. Willfulness

One concept of DBT is that of Willingness vs Willfulness. Willfulness is stubbornness, it is cutting off your nose to spite your face. It is doing what doesn't work. Willingness is openness. Willingness it engagement. Willingness is doing what works, even when you would rather be doing something else.

The first time I encountered DBT, I did not have a good experience with it. I think there were really 3 reasons. First, and perhaps most importantly, I was not in the right place for it- I was too deeply depressed, I was too suicidal- I wasn't sure I wanted to live. My questions were existential- did I want to live? And here DBT was trying to teach me how to get through the moment. I didn't know if I wanted to get through the moment.

Secondly, I think the program wasn't very good, and wasn't explained very well to me. The second time around, 12 years later, it was a very good program. These people lived and breathed DBT! And it made a lot more sense to me.

But thirdly, the second time I was willing, and the first time I was willful. I can only say that in hindsight, because I didn't know those terms at the time. But I had a different attitude. My first time with the program, I did the exercises expecting them not to help, almost to prove to myself that they wouldn't help. 

After my latest hospitalization, I was referred to an IOP program that was DBT based. I had very low expectations, because the groups in the hospital were so terrible. I told myself that I would give it a couple of weeks- and if the groups were equally terrible, I would quit. But I would try it. And if they were good, I would stay the whole 6 weeks. And just that willingness to be open, to give it that 2 weeks, and to really work it- that was enough.

I was in a different place that second time. I had decided that, at least for the moment, I wasn't going to kill myself. I had a job to go back to. I was not feeling as desperate. 

DBT was designed for people with borderline personality disorder, although now it is being used for a lot of other things. It is designed for handling mood swings. I think that it can fall short for dealing with severe, prolonged, depression. But maybe I am just not doing it right.

As time passes since I was in the program, I think I am using some of the concrete skills less and less- but some of the big concepts just as much. Mindfulness. Radical Acceptance. Wise Mind. Willingness vs. Willfulness. And appreciating the dialectics in life.

The skill I continue to practice is Opposite to Emotion Action. Part of me says, well, of course. If you have spent much of your life depressed, you have spent much of your life doing opposite to emotion action if you have any kind of life. But the difference is to do it more mindfully, and with an acknowledgement of the emotions that you are experiencing, so that it does not feel like such a denial of self to carry on.

Managing Expectations

I will be discharged from my day program soon and going back to work. My leave of absence is almost over.

I know that I am so much better than I was when I went to the hospital. I really am. And yet, there is a part of me that is disappointed in myself. There are things I wanted to accomplish during my leave of absence that I didn't. Studying, hiking, going in to the city, etc. It seemed like if I was only doing a program 3 days a week, I should have all this time- and yet, I didn't do a lot else. Some thing, yes. And probably a lot of things compared to how I had been living my life recently. But I certainly did not become superwoman.

And then there is the realization that, despite DBT, I will continue to have a good deal of angst in my life! And that the DBT strategies can feel pretty tiresome when I am having a really bad day. Like when I hardly slept for 2 days after dental surgery. By the second day I was having massive anxiety and mood swings over really nothing, and DBT wasn't working too well. Or maybe it did- I can't know how I would have felt if I didn't try, maybe it would have been a lot worse.

I don't know why I didn't sleep- I really wasn't in much pain, as long as I took Tylenol  So I started to wonder if the tylenol was causing insomnia. The third night I didn't take it, and slept fine. And the next day, all was well with my mood.

I guess I am just wishing I had made better use of this time, and come further. But really, I came pretty far. I really did. I just have this fear that the only reason I am better is that I am not working- and that as soon as I go back to work it will all fall apart again. But only part of me thinks this. Another part of me is really ready to get back to "normal life," whatever that is.

I think I am ready to be done with the program. But not DBT, just the day program. DBT I will keep using.

The Dialectic

I am in a day program right now that is very DBT-based. And I am liking it. Which is strange, since the last time I tried DBT, at least 12 or more years ago, I hated it. But I think it was a bad program, and I was in a very different place. They even kicked me out of the group!

My therapist would kill me. She has been trying to talk DBT with me for a while, and I have been resisting it. And now I am open to it. I am just in a different place.

DBT is all about dialectics. And I think I was missing something about DBT. I thought they were telling me to not judge- which is just idiotic. For me the dialectic is that I can't judge in the moment, minute by minute, second by second of my life. That is not being mindful, not being effective. That is not even possible- in the moment you can't judge what is effect very often. But eventually you do have to judge. you do have to make decisions.

So if my first day of the program I had decided to judge whether or not the program would work, I really wouldn't know. I might have said no. Or yes, but I really wouldn't have known. But a few weeks into the program, yes it is time to judge. Is it helping? If not, then I have to make decisions, do something else. Like when I decided to leave a job I hated.

Acceptance vs Change. Judging vs Non-judging. Living in the moment vs planning for the future. Letting go vs Control. Some of the dialectics.

I do like DBT, and I really didn't think that I would.