Overcoming Unbearable Thoughts SP 27Oct09

8/13/2019 Overcoming Unbearable Thoughts SP 27Oct09

1/31

A GUIDE TO MANAGING

UNBEARABLE THOUGHTS,

FEELINGS AND

DESTRUCTIVE BEHAVIOURS

1

May 2009


2/31

CONTENTS

Acknowl!"#n$% 3

In$&o!'c$(on 4

C)a*$& + States of Mind and Response-ability

6

C)a*$& 2 What is Borderline PersonalityDisorder?

11

C)a*$& What is therapy about? 18

C)a*$& - risis Mana!e"ent ##

C)a*$& . $ life %orth li&in! #'

R/&nc% 3(

#


3/31

Acknowl!"#n$%

)n this boo* %e are not presentin! ne% ideas or infor"ation+ ,his boo*let isour atte"pt to pass on %hat %e ha&e found useful in linial pratise+ ,heideas and pratie ad&ise dra% lar!ely fro" Dialetial Beha&ioural ,herapy

.DB,/0 o!niti&e $nalyti ,herapy .$,/ and $eptane and o""it"ent,herapy .$,/+

ro" %ithin our or!anisation %e ha&e benefitted fro" the %or*in! praties ofthe )ntensi&e Psyholo!ial ,herapy Ser&ie .)P,S/ under the leadership ofProfessor Sue lar*e+ With than*s to all the staff %ithin this depart"ent+

,he boo*let has been prepared for you by2-

Dr Stuart Purell onsultant Psyhiatrist %or*in! %ithin an $dult o""unityMental ealth ,ea"

Dr Sophie Rushbroo* linial Psyholo!ist %or*in! %ithin )P,S

$bby Webb Ward Mana!er %or*in! %ithin an $ute $d"issions 5nit

3


4/31

In$&o!'c$(on

)o (% $)(% 1ookl$ /o&)f you are readin! this boo*let you are li*ely to be sufferin! fro" a &ariety of

o"ple proble"s+ ,his "ay be fri!htenin! to hear but startin! to loo* atyour proble"s and !ettin! help %ith the" is a neessary step to%ardsbrin!in! about a positi&e han!e in your life+We %ill be assu"in! that you ha&e been !i&en this boo*let if at least onehealthare professional has be!un to thin* that so"e of your proble"s "i!htbe lin*ed to a ondition that is %idely desribed as either BorderlinePersonality Disorder .BPD/ or 7"otionally 5nstable Personality Disorder.75PD/+ urther on in this boo*let there is lots of infor"ation on this ondition+

)f BPD is part of your proble"s then it is i"portant for you to *no% that "anypeople ha&e benefited fro" therapy pro!ra""es and ha&e "ana!ed to turntheir li&es around+ ,he sientifi e&idene also su!!ests that "any people%ho ha&e this ondition are able to "a*e substantial han!es to their li&es forthe better+

Unc&$a(n A1o'$ 3o'& 4&o1l#% an! D(a"no%(%

)f you ha&e o"ple proble"s0 then you are li*ely to ha&e proble"s in anu"ber of areas in your life+ ,hese "ay inlude2

Relationship diffiulties

Proble"s %ith ontrollin! your i"pulsi&ity suh as !a"blin!

Doin! thin!s on the spur of the "o"ent %ith lots of re!rets later

Dru! and alohol proble"s

Destruti&e beha&iour suh as self har"in! and &iolent outbursts

)f you do ha&e proble"s in "any areas of your life0 then it is li*ely that thehealthare professionals in&ol&ed in your are %ill ha&e identified a nu"ber ofdifferent dia!noses to eplain your proble"s+ )t %ould not be uno""on for

a person to ha&e dia!noses of reurrent depression0 dru! and aloholproble"s0 eatin! disorders0 obsessi&e o"pulsi&e disorder0 post trau"atistress disorder %ith or %ithout borderline personality disorder+ )f you areunertain about your dia!nosis0 %e %ould enoura!e you to read throu!hhapter # on Borderline Personality Disorder and then !o ba* to yourhealthare professional to disuss thin!s further+

)o5% /a'l$ (% ($ $)a$ I )a6 $)% *&o1l#%ften the proble"s %e eperiene as people are not diretly our fault and yetit is us that ha&e to ta*e on the response ability for sortin! thin!s out+ ,his

"ay feel o"pletely unfair and is perhaps the reason %hy so"eti"es aspeople %e !et au!ht up in not "o&in! on+ We "ay spend lots of ti"eprotestin! at ho% unfair this is and0 in a sense0 %e %ould be 9ri!ht:+

4


5/31

$t so"e point0 ho%e&er0 %e ha&e !ot to really !rab hold of our proble"s andstart "a*in! han!es in our li&es+ ften that "eans reahin! out and usin!help that is around+ o"ple proble"s annot usually be sorted out all onour o%n+ ,hin* of suessful football tea"s; they all ha&e "ana!ers+ ,here isno Wi"bledon ha"pion %ho has not had a oah+ Suessful business

people all ha&e "entors+

)t is not a si!n of %ea*ness to be !ettin! help fro" others+ )n fat0 it is usuallyre%ardin! to be in&ol&ed in helpin! so"eone else %hen they start to benefitfro" the help !i&en+ We hope that no% %ill be the ti"e for you to "o&e yourlife for%ard+


6/31

C)a*$& +7 S$a$% o/ M(n! an! R*on%8a1(l($yS$a$% o/ M(n!

Dialetial Beha&ioural ,herapy .DB,/ is a therapy speifially desi!ned andno% sientifially researhed for people %ith o"ple proble"s and0 inpartiular0 for people %ith Borderline Personality Disorder+ .Marsha =inehan1>>3/+DB, has a useful %ay of thin*in! about ho% %e0 as people0 an flip fro" onestate of "ind to another+ Most of us ha&e had the eperiene of flyin! off intoa ra!e or into a state of despair or aniety and then later0 as our e"otionssettle0 %e loo* ba* and thin*0 9What %as ) doin!?:0 9What %as ) thin*in!?: orha&e the thou!ht that 9) %asnt "y usual self:+ ur 7n!lish lan!ua!e is alsofull of phrases suh as0 9he %as beside hi"self: or 9thats @ust not ho% ) *no%her: or she %as 9out of her "ind:+

,he dia!ra" belo% fro" DB, is one that usefully depits different "ind statesthat %e an be in2

6


7/31

Marsha Linehan 1993 The Guilford Press

)n this "odel Marsha =inehan desribes three ore "ind states2

+ Ra%ona1l M(n! is eplained as follo%s0 9,his is your rationalthin*in! lo!ial "ind+ )t is that part of you that plans and e&aluates thin!slo!ially+ Reasonable Mind an be &ery benefiial+ Without it peopleould not build ho"es0 roads or ities; they ould not follo% instrutions;they ould not sol&e lo!ial proble"s0 do siene or run "eetin!s+

Reasonable Mind is easier %hen people feel !ood and "uh harder %henthey dont:+ Reasonable Mind on its o%n0 ho%e&er0 doesnt allo% forpeople to ta*e into aount the intense e"otions that olour and shape ourli&es+ ,hin!s suh as resuin! a hild fro" a burnin! buildin!0 et+0 %ouldnot ta*e plae if %e only funtioned in reasonable "ind+ 7Aually0 fallin! inlo&e is so"ethin! %e probably %ouldnt do if @ust usin! Reasonable Mind+Reasonable Mind needs to be balaned %ith 7"otional Mind+: :Linehan1993)

2 E#o$(onal M(n! is eplained by Marsha =inehan as0 9ou are in

7"otional Mind %hen your e"otions are in ontrol %hen they influeneand ontrol your thin*in! and beha&iour+ 7"otional Mind an be &erybenefiial+ )ntense lo&e fills history boo*s as "oti&ation forrelationships+ )ntense lo&e .or intense hate/ has fuelled %ars+ )ntensede&otion or desire "oti&ates stayin! %ith &ery hard tas*s0 sarifiin!oneself for others0 e+!+ "others runnin! throu!h fires for their hildren+ $ertain a"ount of 7"otional Mind is desirable+ People hi!h in 7"otionalMind are often passionate about people0 auses0 beliefs0 et+ Proble"s%ith 7"otional Mind our %hen the results are positi&e in the short ter"but ne!ati&e in the lon! ter" or %hen the eperiene itself is &ery painfulor leads to other painful states and e&ents+: :Linehan 1993)

(% M(n! is eplained as0 9the inte!ration of 7"otional Mind andReasonable Mind+ ou annot o&ero"e 7"otional Mind %ith ReasonableMind+ Cor an you reate e"otions %ith reasonableness+ ou "ust !o%ithin and inte!rate the t%o:+ :Linehan 1993)

A S$a$% o/ M(n! E;&c(%

'


8/31

8


9/31

E;a#*l% o/ !(//(c'l$ S$a$% O/ M(n!% (ncl'!2

1/ Bein! in a state of ra!e#/ Bein! in a state of despair3/ Bla"in! e&eryone else - as if it is $== their fault4/ )n a state of sha"e and bla"in! yourself - as if 77R,)CE is your

fault


10/31

"ore upset and "o&es the person further a%ay fro" effeti&e %ise "indthin*in!+ )f this sounds fa"iliar you are !oin! to need help re-diso&erin! yourability to thin* in non @ud!e"ental0 %ise "ind %ays+ $ll effeti&e therapies %illhelp you de&elop your thin*in!Grefleti&e abilities and this is the s*ill that %illhelp you "a*e positi&e han!es to your life+

$ final thou!ht; Stephen ayes .#((8/ re"inds us that responsibility does not"ean 9its "y fault:+ Response-ability is about re-onnetin! %ith our ability torespond effeti&ely to the diffiulties %e fae .%hether or not %e aused the"in the first plae/+


11/31

M(n! Ma*

D*&%%(6 S*(&al

V'ln&a1(l($y Fac$o&%

I )n -lose relationships has felt

re@e-ted e+!+ by parents0 at

s-hool and by first partner

I De&eloped fears about bein!

un%orthy and 9nobody -an lo&e

"e+:

I =earnt to -ope by pleasin!

others and al%ays doin! her

best for others+

4&c(*($a$(n" Fac$o&%I =ost Hob as a arer

I So"e -onfli-t in se-ond

"arria!e

When Hane feelslo%Gdepressed0 she has

no ener!y0 stops doin!

thin!s that usually

pro&ide @oy0 is less able

to ta-*le proble"s in her

life and so sin*s lo%er in

to depression+

1eelin! a%ful0 Hane

fears that partner %ill

lea&e+ Sin*s further in

to despair+ Starts

thin*in! of sui-ide and

tal*in! of sui-ide+

1or a fe% "o"ents0feels a bit betterJJ

Kas if in -ontrolK

Kas if other people no%

really -areK+

But other people feelfri!htened and in ti"e0

either pully a%ay or try

to -ontrolGta*e o&er+

$s a result0 Hane is left

either feelin! re@e-ted or

o&erly -ontrolled as if she%as a -hild and not an

adult %orthy of lo&e+

11


12/31

C)a*$& 27 )a$ (% Bo&!&l(n 4&%onal($y D(%o&!& :B4D=

How $o Rco"n(% B4DPeople %ith Borderline Personality Disorder often desribe2

My life is @ust one risis after the net+

My e"otions s%in! fro" one etre"e to the other+

$s a person ) a" sensiti&e0 !et easily upset and stru!!le to al"do%n

) ha&e been told that ) ha&e unrealistially hi!h standards andepetations of "yself and others+ When these are not "et0 ) easily

!et upset0 "a*e harsh @ud!"ents about "yself and others and then )"left %ith intense feelin!s of an!er0 sha"e and self-hatred+

When o&er%hel"ed0 ) ha&e deliberately har"ed "yself by o&erdosin!0uttin! or burnin! "yself0 star&in! "yself or deliberately puttin! "yselfin har"s %ay+

) often thin* of endin! "y life and ha&e tried to do so in the past+

)n addition to the abo&e0 people %ith Borderline Personality Disorder are often

desribed as sho%in! s%ithes bet%een2

$pparent o"petene .!ettin! on %ith thin!s0 bein! suessful %ithtas*s/+

$ state of hopelessness+ )n this state0 people desribe feelin! helplessand ha&in! diffiulties ati&ely sol&in! their proble"s+ ,his leads to ano&er-reliane on others to sort thin!s out+ When other people oror!anisations annot sol&e their proble"s0 people %ith BorderlinePersonality Disorder "ay eperiene intense disappoint"ent andan!er %hih often pushes a%ay those &ery people that the person is

loo*in! to !et help fro"+

Le"otional shutdo%n+ $ "ar*ed tendeny to try and a&oid all ne!ati&ee"otions+ )n the lon! run this need to ut off fro" feelin!s often leadsto people desribin! a sense of bein! Lnu"b and ha&in! lon!-standin!feelin!s of Le"ptiness+

1#


13/31

,he dia!nosti and statistial "anual of "ental disorders .DSM)/ desribesBorderline Personality Disorder as2

1+ 9$ per&asi&e pattern of instability of interpersonal relationships0 self-

i"a!e and affets0 and "ar*ed i"pulsi&ity be!innin! by earlyadulthood and present in a &ariety of ontets0 as indiated by fi&e .or"ore/ of the follo%in!

#+ ranti efforts to a&oid real or i"a!ined abandon"ent+ No$7 do notinlude suiidal or self-"utilatin! beha&iour o&ered in riterion < #+

3+ $ pattern of unstable and intense interpersonal relationshipsharaterised by alternatin! bet%een etre"es of idealisation andde&aluation

4+ )dentity disturbane2 "ar*edly and persistently unstable self-i"a!e orsense of self+ )"pulsi&ity in at least t%o areas that are potentially self-da"a!in! .e+!+0 spendin!0 se0 substane abuse0 re*less dri&in!0bin!e eatin!/+ No$7do not inlude suiidal or self-"utilatin! beha&iouro&ered in riterion 'nc o/ T)&a*y

=i*e "ost thin!s in life0 han!e often brin!s about onseAuenes that

%ere not Auite planned for+ han!in! the %ay you li&e your life isbound to ha&e so"e pros and ons+

So"e of the pros inlude ha&in! "ore effeti&e %ays of "ana!in!

your thou!hts and feelin!s0 your relationships and yourself+ ,herapyan brin! "ore hoies to you+ )t is not al%ays about !i&in! up all theold %ays of opin! but addin! ne% s*ills and ne% tools %hih offeryou "ore hoie+

,herapy %ill also brin! to you a better understandin! of %ho you are0

ho% you !ot to be as you are and "ay help you to be learer about%here you %ant to !et to in life+

So"e of the do%nsides are that therapy an "a*e you feel "ore

unsettled for a ti"e+ ,herapy an also brin! about han!es in you%hih "ay surprise other people+ ,hose lose to you "ay not li*e

so"e of the han!es that ta*e plae+ ,herapy %ill also inreaseepetations you ha&e of yourself+ ,his an be a !ood thin! but analso lead to aniety+

inally0 bein! a learner "eans feelin! li*e a be!inner and that is

al%ays a hallen!e and an be dauntin!+How (% T)&a*y Don

Most therapies inlude indi&idual %or*; usually this is a fifty "inute

session one a %ee*+

Suessful therapies usually also in&ol&e other "odes of therapy

inludin! !roup therapy0 art or dra"a therapy or teahin! inlassroo"G!roup settin!s+ )n Dialetial Beha&iour ,herapy .DB,/there is an epetation that you %ould attend both an indi&idualsession a %ee* and a !roup session a %ee*+

Most suessful therapies %ill offer bet%een si and ei!hteen "onths

of therapy+

ou %ill usually !et your therapy fro" a speialist therapist+ ou %ill

usually !et your "ediations0 soial support and other "edialre&ie%s &ia a o""unity "ental health tea" or your EP+

)n therapy there is an epetation that you %ill pratise the therapy

s*ills bet%een therapy sessions+

#1


22/31

A%%'#*$(on% (n T)&a*y :a% !%c&(1! (n D(alc$(cal B)a6(o'& T)&a*y=

9Patients are doin! the best they an+:

9Patients %ant to i"pro&e+:

9Patients need to do better0 try harder and be "ore "oti&ated to

han!e+:

9Patients "ay not ha&e aused all of their o%n proble"s0 but they

ha&e to sol&e the" any%ay+:

9,he li&es of suiidal0 borderline indi&iduals are unbearable as they

are urrently bein! li&ed+:

9Patients "ust learn ne% beha&iours in all rele&ant ontets+:

9Patients annot fail in therapy+: .)f therapy doesnt %or* it is beause

the therapy %asnt suitable for the lient+ ,his state"ent doesnt"ean that other therapies %ould be suessful0 it si"ply "eans0 atthat ti"e0 %hate&er therapy %as bein! offered %as not useful+/

9,herapists treatin! borderline patients need support .this hi!hli!htsthe need for therapists to ha&e on!oin! super&ision+:

M =inehan 1>>3

##


23/31

C)a*$& -7 C&(%(% Mana"#n$

In$&o!'c$(on

,his hapter is all about risis sur&i&al+ ,he rises %e are tal*in! about arethose ti"es %hen %e eperiene our thou!hts and feelin!s as unbearablypainful and un"ana!eable; as if %e %ere 9!oin! "ad: or 9about to eplode:+We are tal*in! about those ti"es %hen life feels utterly unbearable+ $s theseti"es approah or %hen %e find oursel&es in these e"otional stor"s0 "ost ofus ha&e learnt %ays of esapin! fro" this sufferin!+ allin! on friends0deliberately distratin! oursel&es and findin! "eanin! in the eperiene are%ays %e so"eti"es ope+ ther ti"es0 %e turn to drin* or dru!s to nu"b our"inds or to other etre"e "easures suh as lashin! out0 deliberate selfhar"in!0 anythin! other than stayin! %ith these eperienes of 9!oin! "ad: or9about to eplode:+

,here are ti"es %hen these eperienes are tri!!ered by etre"e eternale&ents but freAuently %hat happens is that these e"otional stor"s aretri!!ered by internal e&ents0 our o%n "e"ories0 our thou!hts and @ud!e"entsand interpretations of e&eryday0 non-threatenin! ourrenes+ o%e&er0%hate&er tri!!ers the risis there are so"e basi priniples to sur&i&in! thesestor"s2

$%areness

Preparation

Safety beha&iours Post risis re&ie%

,hese s*ills "ost of us already ha&e and use+ ,he hallen!e is to hold thesepriniples in "ind and start usin! the" "ore often0 e&en %hen at first they donot offer Auite the sa"e short ter" esape and relief as perhaps dru!s0alohol0 lashin! out and self-har"in! "ay do+S)(* A$ Sa

Sailors settin! off to sea an teah us a lot about risis sur&i&al+ Plannin! is all

i"portant+ )s the &essel sea %orthy0 is it loaded properly0 are the %eatherpatterns suitable to be settin! off on the @ourney0 is the e"er!eny eAuip"ent.life @a*ets0 flares et/ %or*in! and easily a&ailable? )s the aptain alert and"indful of dan!ers and %illin! to at in the interest and safety of his ar!o andre%0 rather than pushin! on to the destination re!ardless? When the @ourneydoes not !o to plan and the aptain has had to all for resue0 there is al%aysa post inident re&ie%+ ,his re&ie% is not about bla"e; it is aboutunderstandin! %hat %ent %ron! and ho% an it be pre&ented in the future+

#3


24/31


25/31


26/31

4o%$ C&(%(% R6(w :C)a(n Analy%(%=7&ery risis needs a re&ie% after the e&ent+ )t is often hard to re&isit painfule&ents0 ho%e&er0 if %e %ant to !et better in "ana!in! diffiult feelin!s0thou!hts and beha&iours %e need to see %hat %or*ed and %hat %as less

effeti&e+hain analysis is a strutured %ay to thin* throu!h the o"ple thou!hts0feelin!s and beha&iours that are al%ays present in a risis+ ou %ill needso"e help doin! hain analysis at first but o&er ti"e it %ill beo"e easier+ne you are "ana!in! effet hain analysis on your o%n you an be sureyour life %ill be "o&in! in the ri!ht diretion+

)f you as* your "ental health %or*er0 they %ill be able to !i&e you a %or*sheetto help you !et started %ith hain analysis+

#6


27/31

E;a#*l o/ C)a(n Analy%(%

V'ln&a1(l($y /ac$o&%2 $lone in flat0

eaten little o&er past four days0 poor

sleep0 annabis use0 no e6erise0 bin!edrin*in! .no "oney left for food/

=o% "ood0 no 3

one ares about

"e,error

Ra!eDistress

4opelessuts ar"s0 head

ban!s0 srea"s0

,hreatens polie

)nstant e"otional

release 1eelin!s asha"ed

of DS4

4&o#*$(n" E6n$? "en he *no%s fro"

hostel enter his flat and threaten hi"+

Polie say there is nothin! they an do+

annot be re-housed %ithout losin! bond

L(nk%7

Why does

thisal%ays

happen to

"e

L(nk%7 no-one ares about

"e0 ) ha&e no%here to !o+

5r!es to self har" inrease S)o&$ $ con%>'nc%

4&o1l# B)a6(o'&7

ans%ers door %ith ut

ar"s0 threatens

polie0 head ban!s

%all %hen left a lone

Lon" T con%>'nc%7 1riends start

to %ithdra%+ 1eels "ore lonely and

re@eted+ Self estee" plu""ets+ Starts

drin*in! to nu"b distress

) an?t opeQ

Sol'$(on%

=oo*in! at the abo&e hain of e&ents in detail opens up the possibility to inter&ene

at "any le&els+ )n the abo&e ea"ple0 patient and therapist ould %or* on&ulnerability fators+ )f the patient %as sleepin! better0 eatin! better0 not feelin!hun!o&er or o"in! do%n fro" dru! use and not isolated or lonely0 it is li*ely thatthe person %ould be able to tolerate and "ana!e stressful e&ents "ore s*ilfully+

$nother option %ould be to try and a&oid tri!!er fators+ ,his an be a &eryeffeti&e strate!y+ Proble"s arise %hen tri!!er fators are not a&oidable+

$nother option is to han!e the %ay %e respond to tri!!er fators+ ,his "eansde&elopin! an a%areness of thou!hts and feelin!s so that %e dont ha&e 9*nee-@er*:Gbeha&ioural responses+ Beo"in! a%are of ones feelin!s and ur!es and

ones thou!hts a!ain0 opens up possibilities of han!in! the %ay %e eperieneand li&e our li&es+

ne in a risis0 are there better %ays of "ana!in! unbearable e"otions? )s self-har"in! the "ost s*ilful %ay of opin!? ,he use of distration and aeptanetehniAues are %ays of sur&i&in! a risis %ithout "a*in! the situation %orse than itneeds to be+ ,hese are diffiult s*ills but an be learnt+

#'


28/31

C)a*$& .7 A l(/ wo&$) l(6(n"

We in&ite you to partiipate in the follo%in! eerises+ We epet that for"any people this eerise "ay tri!!er diffiult thou!hts and feelin!s+ )t %ouldbe helpful for you to @ust notie %hat happens to your thou!hts and feelin!s in

tryin! these eerises+

E;&c(% On

We in&ite you to %rite do%n your thou!hts on the follo%in!2

1/ 9What %ould "a*e you feel proud about your life?:

#/ 9)f thin!s started !oin! %ell for you0 %hat %ould your life loo* li*e inthree to fi&e years ti"e?:

3/ 9What %ould "a*e you feel fulfilled; not @ust briefly happy butsatisfied?:

)f you are able to ans%er the abo&e0 hold onto these thou!hts as they arereally preious and %ill help you throu!h diffiult ti"es+

)f you stru!!led0 here is a tip2 9do not bla"e yourself:+ People %ho ha&estru!!led for a lon! ti"e ha&e freAuently for!otten or "ay e&en not ha&ede&eloped the ability to i"a!ine a better future+ )n a %ay0 so"e people areLfuture phobi+ or "any people tryin! to i"a!ine a better life feels intensely

painful+ Maybe it is a bit li*e ha&in! to see the thin!s %e @ust dont ha&e+,hese losses often tri!!er intense sadness0 frustration0 an!er and sha"e+


29/31

L"($(#a$ %'//&(n"

=i&in! is about2

7ite"ent and diffiulties of diso&ery

allin! in and out lo&e Diso&erin! our stren!ths and %ea*nesses

7perienin! the *indness and ruelty of the %orld and the people

%ithin it

$ll li&in! is tied into dyin!; there is no li&in! %ithout eperienin! pain+ Weonly feel sorro% %hen %e lose the thin!s %e ha&e lo&ed+

5nfortunately0 there is no esape fro" painful eperienes in life+ We annotseleti&ely ta*e the !ood thin!s and so"e ho% ut out all painful e"otions+o%e&er0 %hat "any of us do is stru!!le a!ainst this+ We !et into frantistates tryin! to esape fro" painful eperienes+ ften our efforts to a&oidpainful e&ents ause us "ore har" than !ood+ )t is as if our atte"ptedsolutions beo"e "ore proble"ati than the ori!inal proble"s+ )t is thisstru!!le that auses "uh of our hu"an sufferin!+ ne %e aept this0 %ean onentrate on learnin! to "ana!e the le!iti"ate pain effeti&ely+

What any effeti&e therapy %ill do is help you derease the unneessarysufferin! you eperiene in your life+ When %e re"o&e unneessarysufferin!0 it opens up the opportunity to be!in partiipatin! in so"e of the"ore @oyful "o"ents of li&in!+

Val'% an! Goal%

)f you are onte"platin! therapy0 you %ill al"ost ertainly ha&e people tal*in!to you about &alues and !oals+ ore%arned is forear"ed2-

alues are our ability to onei&e of a purpose that is enrihin! and fulfillin! inlife+ ,hese are %hat %e %ant our li&es to stand for in ter"s of fa"ily0friendships0 areer0 spirituality0 health et+ )n order for us to han!e andhallen!e destruti&e but fa"iliar patterns of beha&iour0 %e need to ha&e a

stron! sense of %hy %e %ould %ant to han!e+ )n any !i&en "o"ent %e anidentify %hether %e are atin! in the ser&ie of our &alues or %hether %e ha&ede&iated a%ay fro" the"+ or ea"ple0 ) &alue bein! a lo&in! "u"; eah day) ha&e a hoie to beha&e and "eet !oals that are in line %ith "y &alue0 .e+!+playti"e0 oo*in! "eals0 respondin! %ith patiene/+ )f &alues are the diretion%e tra&el in then !oals are the "ar*ers alon! the %ay+

#>


30/31

E;&c(% Two

,ry ran*in! these typial do"ains in to order of your urrent &alues+.1 bein! the "ost i"portant and > the least i"portant/

Do#a(n Val' +89)nti"ate relationship

Wor*

riendships

a"ily

Rereation

Spirituality

Physial %ellbein!

o""unity ontribution

reati&ity

3(


31/31

R/&nc%

$dshead E #((1 Mur"urs of disontent2 treat"ent andtreatability of personality disorder$d&anes in Psyhiatri ,reat"ent ol' pp

4(' 416

ayes S+ #((< Eet out of your "ind and into your lifeCe% arbin!er Publiations

=eihsenrin! 7 #((3 ,he effeti&eness of psyhodyna"i =eibin! therapy and o!niti&e beha&ior therapy in

the treat"ent of personality disorders2 a"eta-analysis+$"erian Hournal of Psyhiatry #((3;16(21##31#3#

=inehan M+ 1>>3 o!niti&e-Beha&ioural ,reat"ent of Borderline Personality DisorderEuilford Press

Ryle $+ err )+ #((# )ntroduin! o!niti&e $nalyti ,herapyWiley

Shedler H #((6 Personality Disorder Prototype Desriptions5npublished

Oanarini0 M+et al+ #((3 ,he lon!itudinal ourse of borderlinepsyhopatholo!y2 6-year prospeti&e follo%up of the pheno"enolo!y of borderlinepersonality disorder+$"erian Hournal of Psyhiatry 0 16(0 #'4-83+

Overcoming Unbearable Thoughts SP 27Oct09

Documents

Transcript of Overcoming Unbearable Thoughts SP 27Oct09