I’ve done two solid years of DBT, the acronym of Dialectical Behavioral Therapy. And thanks to the groundbreaking work of Marsha M. Linehan, I’m here today. I can say, with utter truth, that DBT played a huge and integral part in my recovery, and has really shaped me into the person I am today. DBT took me from a place of impulsivity to one frequent peace with myself and my emotions. It wasn’t until after DBT that I began to apply a great deal of importance to inner peace. I want to share these things with people who may also benefit from them. With that said this is Lessons from DBT: Wise Mind and Mindfulness.
Wise Mind is this beautiful intersection between Rational Mind and Emotional Mind. These two mind states can wreak havoc on your life in you exist too extremely in on or the other. For example, finding yourself only existing in Rational Mind, you might be cold, withdrawn, and lacking empathy. You could be slow to act and struggle to make decisions. While existing only in Emotional Mind you could find yourself acting emotionally impulsive. Jumping to conclusions and letting your emotions dictate your actions. You can see how an unbalanced life could quickly spiral out of control.
This is where Wise Mind comes in. Offering a way to draw from both mind states while not relying on one or the other too fiercely. When I started DBT I was trapped in Emotional Mind nearly all of the time. Acting on one impulsion and then another. Following my psychotic delusions to their end. And, ultimately, putting myself in danger.
I think Marsha Linehan put Wise Mind best when she says, “Wise Mind is like having a heart, everyone has one, whether they experience it or not.” I found, when learning about Wise Mind and becoming acquainted with it, it was best to start with breathing exercises. If you can imagine Wise Mind at the bottom of your stomach you can almost feel Wise Mind growing inside of you as you breathe. Sort of like the calm after the storm.
Try to recognize when your mind state is tipped in one direction or another. I great way to do this is practicing writing down what you are feeling when you are upset, feeling anxious, in crisis, or in my case, experiencing hallucinations. This way, once you have recognized your mind state Rational Mind or Emotional Mind, you will be able to take a step back and begin practicing breathing exercises. Imagining Wise Mind growing inside of your body and bringing with it a calm.
Try the 5-7-5 pattern (it’s a personal favorite). Which is inhaling on the 5, exhaling on the 7, and inhaling again on the 5. This exercise should be repeated for as long as you need it for and until you find yourself in a better place and you can think more clearly.
Fifteen-minute wellness checks are to guarantee you won’t hang yourself with your blanket. Everybody gets them, all night long. Nurses walk the halls, spectral energies trapped in tired bodies. Trained eyes lolling in trained skulls. Not predators but prey. Cats and canaries, if not queens then mercenaries. Nurses like hawks circling with rays of light. Every room, every fifteen minutes.
Even as I lay on the hard bed, eyes shut against the dark, the nurses came and went. My door opened from the hall and shut again. Light creeping up my torso and then sliding away like a yellow-bellied snake. There and gone. I’m not a deep sleeper so light the woke me as I rolled between fifteen-minute intervals of sleep. As my door opened again it brought with it a cloud of cold air that met the warm air of my bedroom like oil meeting water. I pulled my blanket over my face and rolled onto my other side, away from the door. I hated the nurses and the medication (which I would often spit into the sink). I hated the monotony of the psychiatric hospital. The same things day in and out, only clothed in different names. CBT group and DBT group. Art therapy. Individual counseling and casework. Medication and meals. Sleep, and hygiene. As you can imagine the days fell together like a house built on a bad frame. The nights one long night.
I shut my eyes and rolled onto my other side, peering out into the dusty, bone dry parking lot. A cold wind blew white heaps of snow around what cars remained parked there. With daylight, more cars would come. More doctors and dayshift nurses. People would arrive and leave like the ocean ebbing between low and high tide. Not me though. I wasn’t going anywhere. College would roll on without me and life would continue outside the hospital.
Wellness checks where growing more tedious. Tomorrow heralded more treatment and a medication change. I sighed and threw the crook of my elbow over my eyes. I didn’t want to be here another couple weeks. I bit my lips, drawing blood. Then, as I felt sleep creeping up on me the door opened again and a face peered in on me. She’s still alive in there. The voices started. She’s still alive. Alive. Alive. But she doesn’t want to be. She wants to die. We want her to die. We want her to suffer. She’s lying in bed, she’s always lying there. No good piece of shit. She wanted help and look where that got her. Those voices went on forever it seemed like. Background noise sometimes. Screaming sometimes. Other times they were quiet whispers rising like bread dough at the back of my head. Telling me which way to look and when to do it. Telling me to kill myself, that I was worthless, that the people were watching, that the radio could read my mind. That last one was a big issue for me for a long time. I hated the radio, especially when it was speaking to me. Its radio voice nagging and loud.
The light from the hall lingered a while longer before the door was half closed. I yelled for the nurse to leave me alone. As she left I heard a chattering bird dialogue of two nurses in the hall, one male and one female. A midnight and momentary admittance was arriving. The nurses were not to remove his restraints. I thought back to my own admittance. Cowering apathetically beneath a tan Egyptian cotton throw. Arms restrained to the stretcher I was brought in on. My legs, unrestrained, were brought inward against my chest.
The sleeping medication they’d given me had worn off hours ago. And with the nurses chatting outside my door I wouldn’t get much sleep. My frustration mounting I forced my eyes shut.
But then I felt my mouth run dry when I heard the male nurse whisper, “…he killed his parents…” a lingering pause, “said it was the devil’s work.” Frustration traded instantly for anxiety, “Found him covered in his parent’s blood.”
A female voice now, “If you ask me, all the people who come here are fucking psychos. They should all be committed.”
My fast pulse rattled dangerously like a broken machine and I felt a hot bunch of tears starting. I was the youngest crazy kid on the adult psychiatric ward after all. And according to many, I held the greatest potential for violence. Was I destined to fall victim to mental illness stigma? Could I show up one night covered in the blood of someone I loved? Would my psychosis and irrationality get the best of me? Was it was only a matter of time. Of course, I know now that those things are untrue. But at the time these thoughts accompanied by voices had my head full enough to explode.
In a silent rage, I brought the pillow above my head over my face and screamed into. Emptying my lungs and then my throat, leaving my respiratory tract scratched and raw. I had many more hospitalizations ahead of me. But I couldn’t have known that. I couldn’t have known all the sad music views I’d seen from my hospital windows, all the sad music scenes I’d see, all the sad music medicine I’d take before I found the one that worked…
As I went in for a second scream there was a commotion in the hall. The sound of a stretcher, a sound I’d never forget, rattling down the hall. Its thin wheels sounded like dry skeleton bones on clean hospital lelonium. My next fifteen-minute wellness check came just as the stretcher made it’s way past my door. And in the hall, I saw a man pass by. His hands, though tightly bound, were clean hands. Maine hands. His face empty, eyes empty. A lost look plastered on him like a missing person’s ad. And as the entire stretcher passed my door I didn’t see a single drop of blood.
These would be the days I’d be reminded of later. My life looking like floating wreckage on the sea of Schizoaffective Disorder. Hallucinations, even on medication, are still present. At night noises of people circling the house. Distant footfalls and jawing of male voices. They almost sound like animals. Almost like… predators circling prey. I lay in bed feeling like a carcass strewn across a field. Their voices a breath away, just beyond the curtains and wooden walls of my home. The crackling of leaves is all it takes to launch me into paranoia. I choke down my nighttime dose with a half glass of water, press my lips together and listen harder. Two footsteps now. A branch cracking leaves crumbling into pieces as they’re pressed into the ground. Then silence. Their voices start up. I narrow my eyes in concentration I but still can’t understand them. I ask myself just as TS Eliot asked himself in The Wasteland, “…what is that noise…what is that noise now? What is the wind doing?” The noises dissipate as they round the corner but I know they’ll be back. I could follow them ’round and ’round our house if I wanted. Hours wasted to hallucinations.
But I won’t.
I slip into bed and soon. Before I have time to register it, there is morning light pushing through the black curtains and onto my face. My kitten urges me awake with a paw on my nose. Her tabby cat eyes still languid too. She yawns a big yawn and shows her teeth. We both lay unmoving for a while longer as she settles down again. After some time I look over to my husband. He’s sleeping next to me, face turned up in sleep. I reach above our head and turn on our heated blanket for him. Then I climb out of bed, body sore.
I take my morning dose with hot tea. Clutching the mug with both hands I try and ward off the cold Maine winter morning. I feed my cats and pull open the shades so that they can watch the bird feeders on the porch. It’s mostly chickadees these days. Though the occasional blue jay, cardinal, and woodpecker can be seen. I pick away at something for breakfast. Then, with a deep breath, I tell myself that I can deal with my illness today. I push the voices around like sticky bread dough, kneading them into submission. Then scraping them off my hands. They would, until my afternoon dose, continue to rise into a fat dough. And then I’d knead them down again.
I sit at my computer and urge the words to come. Unfortunately, most days the page stays blank. My fingers poised for no audience. I sigh and close the screen with one hand. With the other I hoist my youngest cat to my chest, kissing her between her ears. She purrs, her fame whirring like a small engine sat in the chest of her body. Her little gray form tucked up under my chin does my anxiety some good.
We stare out the window for a while together. She watches birds and I disassociate. My body and brain attached like a tin can telephone. I hang onto reality like my nervous system hanging from my brain stem. Chickadees sing outside, puffing up their chests against the cold. I’ve been building myself up too, against illness and insanity. Learning to cope instead of breaking down. I’m doing this because I have to, or else this thing is going to kill me. And I don’t want to die. Not anymore anyway.
in winter’s grasp,
expand white on white until the darkness comes.
Pine and maple,
decades in the space between.
Beyond the window, trees lie torpid.
Dusklight on my alabaster skin,
and within the hour a storm moves in,
so coats the sod in impassivity.
and bones won’t rattle here.
Despite trees as gaunt as skeletons.
Even as the wind moves between them,
there is secrecy.
Voices at the forest’s edge,
anesthetize and draw me in,
writing love letters on the surface of my skin.
As I tear away,
as the nighttime comes,
both bodies naked and infalling in the dark,
a sense of silence overwhelms,
as if noise could consume us whole.
Characterized by what doctors call positive and negative symptoms like hallucinations, delusions, and confused thoughts, Schizophrenia is still difficult to treat and not very well understood. But a new study has found links in the way the vascular system develops during brain development and the consequent development of Schizophrenia later in life. Looking at the brains of deceased people with Schizophrenia, scientists have seen differences in the vascularization of tissue. And because the interaction between blood vessels and neurons is essential for the correct development of the brain, we can see how incorrect vascularization could affect brain development.
Scientists investigated the growth of stem cells from the skin of three patients with Schizophrenia and three without. And watching how the samples grew blood vessels and grew into neural cells, it was clear that the sample from Schizophrenic patients had an impaired ability to produce new blood vessels.
“To test the hypothesis that angiogenesis was compromised in the cells of patients with schizophrenia, a second experiment was performed. It consisted in exposing human umbilical cord epithelial cells to the substances produced by the nerve cells of the previous experiment. The same was done with chicken eggs, which served as in vivo model.
The umbilical cord epithelial cells have great capacity to form blood vessels, as well as the membrane just beneath the eggshell. Therefore, those were chosen to test whether the molecules produced by the neural stem cells of patients alter the angiogenic capacity of the cells. The results confirmed the results — substances produced by schizophrenia patients’ nerve cells can hold back the angiogenic capacity of the epithelial cells.
“Advances on this subject bring new perspectives for the treatment and diagnosis of schizophrenia,” Rehen says. Soon, he and his team plan to evaluate new biomarkers — that is, biological indicators, such as molecules that suggest the presence of the disease — that can identify the disorder regardless of symptoms. “This is a completely new approach on neuro-vascular mechanisms in mental disorders,” he concludes.”