Making A Plan

[Sandstone]

Crumbs, @joeylittle that was a roller coaster! I looked at the outline, and thought it all looked a bit simple and obvious. Then I thought that it would provide a way to respond to some of the questions I posed earlier

I'm feeling reasonably strong now...[but] I will get less stable and less determined.

• How shall I deal with the fading stability?

There will be things missing that a T would provide

• How do I judge when to push myself and when to hold back?

There has been past concern about a lack of a crisis plan. I still have no crisis support - or any other - so if I precipitate a crisis in myself, I need a more effective strategy than taking enough anti-histamines to knock myself out. I also need to be able to do whatever it is as things build up. At best, I usually only report it retrospectively. Usually I just ignore it completely.

• How can I recognise when the build up to crisis starts?
• How can I act when it is there?

Then I felt first sad then angry that I don't have any of the resources suggested in the crisis plan, then ovewhelmed at the sheer scale of it. Not simple after all.

This morning that has settled to concluding that I need the sections on
early warning signs subtle signs ... of a possible worsening of symptoms like nervousness, sleeplessness or fatigue...a plan, to help ... to avoid further difficulties. .. might include getting extra exercise, seeing your counselor, avoiding caffeine and doing some peer counseling with a friend.

when things are breaking down... symptoms that indicate that the situation is worsening,...may include crying all the time, sleeping all day, being very irritable ..write a very intensive plan that would help relieve these symptoms, like taking three days off from work, asking a family member to take over your household responsibilities and spending two to three hours doing something you enjoy.

I think knowing those signs will help me recognise the slide down, which I so often miss, and having planned responses will make me feel less defeated about it. If I see those warning signs or symptoms, it will be an indication that it is time to stop pushing and hold back for a while.
Also that I do need the crisis plan too, but will need to find a gentle way to work on it without distressing myself more over how little support there is. It will do me good, though, to think about ways I can communicate to OH about crisis, because I know he would like to help but doesn't know how, and I get beyond asking him as things worsen.

So I'm adding to my plan

• Write a Wellness Recovery Action Plan, focussing first on the Wellness Toolbox and the Daily Maintenance
• As I learn and practice more Distress Tolerance skills, move on the other sections of the WRAP. Writing it will be a chance to use those skills.
• Approach the crisis plan with caution, but aim to get started on it between now and November.

 

[Sandstone]

This is starting to feel rather good. I'm beginning to do some of the things in The Plan, and have set myself a slow steady schedule for building more of it.

I realise that I'm writing mostly to myself, but never mind, it keeps my thoughts structured. Thanks to those who have and are reading and giving me so much help. I'm going to go on adding bits of the structure of The Plan here, and record the significant bits of implementation in my Diary, flagging achievements in bold there.

I've written before about the risk of this illness becoming a hobby. It's interesting to learn the theory, useful to refine diagnosis and categorisation, and I sincerely hope productive to work on recovery. Yet those things don't come anywhere near a complete life. So I need to add these, without making them into a duty.

Do things I enjoy

• making things - quilting, Zentangling, crochet, felting
• DIY - current list - altering frames and hanging pictures, sanding the bathroom floor.
• Gardening
• Reading, both "safe" 1920's style murder mysteries and more challenging novels
• Youtube, crafting and tiny homes are great escapes
• Cooking and eating for pleasure not duty
• Do logic and number puzles
• Watch comedy. Is One Foot in the Grave on Netflix or similar? Where else can I find well written non-aggressive comedy?

 

[joeylittle]

You're doing great work, @Sandstone. I wanted to reinforce your post, above. When I was first learning to make daily goals (timely, achievable, realistic) - it was so important that I made it a daily goal to do things that were intended to be recreational, in some way. My personal daily goals, when I'm struggling, would only be 5 simple things - but making sure that I did stuff that wasn't about just coping or keeping up with existence - that really mattered.

Things will occur to you to add to the list over time, too.

I'm glad the wellness action plan turned out to be helpful!

Then I felt first sad then angry that I don't have any of the resources suggested in the crisis plan, then ovewhelmed at the sheer scale of it. Not simple after all.

And I wanted to share that this upsets me a great deal as well. I'm very fortunate to have my therapist as the crisis plan - but before that, when it was just about the hotlines or calling the ambulance, or going into the ER - I feel for you, how upsetting that is. But you're working it out, which is great and important.

And yeah - these things always look so obvious, but when you sit down to do them, they become deeper that you think. I expect you'll have the same (or similar) experience with the DBT work you'll be doing.

This thread is great - major thumbs up :tup:

 

[illusionist]

Hats off to you! @Sandstone . I'm genuinely happy for you....cheering you on.

 

[Sandstone]

Last week I re did the Recovery Star assessment. The first one I did was back in 2013, so it was interesting so see what had changed. I gave myself the same, reasonably high scores on Living Skills and Responsibilities, and the same, low scores on Social networks, Work, Identity and self-esteem.
I was pleased to see I'd moved up slightly on Managing mental health, Self Care, Addictive behaviour, Trust and Hope, but I've dropped back on Relationships because I isolate from more people.

Those domains include most of the areas I've included already in The Plan. From those, I've picked out three areas where I want to set goals for the next month. Managing Mental Health where I want to move up to level 5, believing things can be different and knowing how to make changes. My main tools for that will be the workbooks I've started on.
In Physical Self Care I also want to get to level 5, and there my aims are those I listed in post 6 above, plus showering 3 times a week

For Social Networks, I want to move to a consistent 3 - " you have a really strong feeling that you want things to be different. Change may seem impossible or frightening and you may not know what you want, but you know you don’t want to carry on living as you have been"
I've set myself goals here of

• go out alone once a fortnight ( shops, library, beach etc)
• go outdoors four times a week - only aiming for the garden here
• initiate contact with a family member once a fortnight
• keep on Tai Chi
• add volunteering

These feel huge, but I'm going to see what I can do this month as a baseline, and be prepared to tweak them if needed. I've made myself a little tick chart for each week, so I can record the successes but not need to note any that I can't manage.

I did have a success today with the volunteering. It has taken weeks to organise, but I'm now doing one session a month of admin for a newspaper for the blind. It is very simple, repetitive stuff, exactly what I need. Yesterday OH and I practiced walking the route there. That was enough to wipe me out for the day, I had to lay down and watch sit-coms. It took me ages to work out that I was exhausted - it seems so unlikely - but once I realised I did manage to do what I needed with only a slight sense of guilt and failure. Today I went there, learned what to do and only revealed my nervousness by knocking over my cup of tea. They still seem to want me back. It was OK.

 

[Sandstone]

I need to add in

• Have up to three "down" days a month.

I want to give myself permission to go along with the days when I'm at my limit and genuinely can't do anything, but not allow that to become a regular, weekly occurrence. Today is such a day; at 11:30am I'm just forcing myself to have the first drink of the day. I'm not even going to think about washing or dressing. Everything looks and feels impossible, but I know it is because I have done a lot in the past few days.

So my objectives for today are - eat one thing that is healthy, read something not MH related, look at the paper to see the answers to the crossword I couldn't finish on Saturday, stare vaguely into middle distance.

 

[joeylittle]

So my objectives for today are - eat one thing that is healthy, read something not MH related, look at the paper to see the answers to the crossword I couldn't finish on Saturday, stare vaguely into middle distance.

This very closely resembles my list of 'goals' on days when I can't function. Just affirming that it's a reality, there are going to be days like this, and giving yourself permission to recognize that is a very legitimate thing.

If you can - consider adding one element of something physical, even if it's just walk down to the corner and back, or walk around the house and straighten piles, or, really, anything. It's going to be probably the most challenging thing, but it's a useful element. I'm not saying this to pressure you at all, and I hope that it doesn't. I'm just sharing.

My 'bad days' list was always something like - one self-care thing (like eat a healthy thing, or take a shower, or brush my teeth, etc), one physical activity, one mental distraction (like reading, or doing a puzzle) one recreational thing (like knitting) and one relaxing thing. It would easily take me all day to do these things, lots of breaks in-between.

Thinking of you.

 

[Sandstone]

consider adding one element of something physical,

Because i gave into it all day I was able to go to Tai Chi in the evening. I wasn't fully present mentally, but my body did most of the actions, even when I was retreating to the back of the classroom . I see the value in repeating something like this over and over.

I have been doing DEEP BREATHING MORNING QI GONG - Opening, Cleansing, Warming Up this rather energetic Qi Gong at home. It is a little silly, which appeals to me. I might aim try it on the days like yesterday when most things seem too much.

 

[Sandstone]

I've redone the Recovery Star assessment. That in itself is notable, as it means I have been sticking at this for over a month !!!!!!!!!!

I'd set myself goals in three areas.
Most significantly, I achieved the move up to 5 in Managing Mental Health. The guide describes this level as
I believe a different future is possible for me – it is scary but I want to make it happen
- a real belief that things could be different for you and you have some hope for the future – at least some of the time
- actively buying-in to your own recovery and the idea that you have an important role to play in it.
- may feel excited, fearful or vulnerable or all three. Your new-found hope and confidence is probably easily shaken
My goal for next month is to be hovering between here and level 6 - taking significant action, doing things differently, trying new things, taking risks which can be scary and you probably need lots of support, more assertive in your relationship with support services.

I achieved the Work aspect of my Social goals, by starting volunteering, but otherwise stayed at 2 where I was, so I'm still aiming for a 3, with the same set of actions.
The actions stay the same for Physical and Self Care too, with a tweak to the showering goal that is still escaping me
I've dropped back massively on Relationships, from 6 to barely a 4 this time. I'm afraid and avoidant, and have isolated myself from everyone. Over this month I'm aware that I have been even less communicative with OH, in particular about all I'm doing with The Plan. I'm also much more physically withdrawn. I think that relates to being more in touch with the physical impacts of trauma., but he shouldn't have to suffer because of that. I'm aiming to move back up to 5. Recognising the vulnerability I feel over MH stuff, I'm going to set action targets of me initiating hugging him five times a week, and telling him a little of the work I'm doing with The Plan twice in the next month.

I also dropped in Trust and Hope, which shouldn't be, as I know I am taking effective steps. The measure is about trust in others as well as myself, and that is very low. But to balance that, I improved in Identity and Self Esteem

So my Actions to achieve these goals over the next month are

Managing Mental Health

• Keep on with workbooks and actions arising
• Keep on with soothing and relaxation activities, breathing, metronome, Qi Gong and add Safe Place visualisation so I'm doing 2 of these as a daily minimum
• Keep developing WRAP

Social
As last month till established

• go out alone once a fortnight ( shops, library, beach etc)
• go outdoors four times a week - the garden or a walk near home
• initiate contact with a family member once a fortnight
• keep on Tai Chi
• volunteering monthly

Relationships

• Hug OH five times per week
• Talk about things in The Plan once per fortnight

Physical and Self Care

• low salt and high fluid intake for kidneys,
• taking the thyroid supplement
• continuing the bid to lose weight, slowly.
• Keep going to Tai Chi, aim to practice 3 times a week at home.
• shower every third day