Lessons from DBT: Wise Mind and Mindfullness.

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 For example, finding yourself only existing in Rational Mind, you might be cold, withdrawn, and lacking empathy.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.



Skeleton Bones, Poorly Oiled

The only thing that wakes me is a cold wind intruding on the warm, late night air of my hospital room. The change in temperature is noticeable, like oil in water. A bright light from the hall. A nurse, curly haired and round, pokes her head in, makes a note on a clipboard, and then vanishes behind a closed door again.

Fifteen-minute wellness checks grow tedious.

I shut my eyes against the darkness and roll onto my other side. Windows look out onto a dusty parking lot. Empty of the many cars the daylight would bring. In the morning the hospital would be full of doctors and nurses. People would go and come. But I would remain for, at least, a week. That’s what my doctor had told me, at least a week.

Tomorrow would bring art therapy group and CBT. I’d meet with a doctor. Be given medications. And work with a caseworker about a discharge plan. When I’d be leaving, where I’d be going, what my new medication regime would look like.

I sighed opening and closing my eyes again. I didn’t want to stay for another week. The monotony of the place ironically maddening. I threw my arm over my eyes, the crook of my elbow settling across my forehead. I bit at my lips. And then, as I finally felt sleep close by, another column of light slunk into my room and the same nurse looked in.

“Please!” I groaned, “Leave me alone!”

“Just doing my job dear.”

Darkness again.

In the hall, I heard two nurses in an exchange. A midnight but ultimately momentary admittance would arrive. They were not to remove his restraints. I thought back to my own admittance. Cowering beneath a tan Egyptian cotton blanket. Arms restrained to the stretcher which I was brought in on. Legs left free and pulled inward.

I begged for sleep, the nurses chattering on outside my door. The Zolpidem which they had given me to help me sleep had since worn off.

“I guess this guy is gonna be committed, we just have to hold him for the night.”

With my eyes shut I wrinkled my brow. Committed…?

“He killed his parents,” and I felt my mouth run dry, “said something about them being the devil’s work.”

I rolled back over, away from the door.

“Found him covered in his parent’s blood.”

A third voice now, “All the people that come through here are fucking psychos. If you ask me they should all be committed.”

My pulse, already high, threatened to break my ribs. I felt a hot bed of tears beginning to form at the edge of my eyes. I wasn’t in the right place to hear any of this. I was the youngest crazy kid on the adult psychiatric ward. Confused, distraught, suicidal, irrational, and impulsive. I thought, in that moment, that maybe I was destined to become the guy who would murder my parents. Maybe some day I’d show up covered in the blood of someone I loved. Maybe it was only a matter of time before I went crazy enough. In a silent rage, I brought the pillow from above my head over my face and screamed into. Emptying my lungs and then my throat, leaving my respiratory tract scratched and raw. I couldn’t have known I had five more of these hospitalizations ahead of me. That I’d almost die. That I was Schizoaffective. I couldn’t have known all the sad music views I’d see 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…

Just 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 skeleton bones, poorly oiled, on the clean hospital lelonium. Click, click, squeak.

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. Pale Maine hands.  His face empty, eyes empty. A lost look plastered to him like a missing person’s ad. And as the entire stretcher passed my door I didn’t see a single drop of blood.




But what else is there to do with this type of pain?

Give in?

Give up?

Certainly not.

Not while those with mental illnesses are still mistreated. Not while we are still killed by police who aren’t trained to handle situations of mental health crises. Not while more of us are in prisons receiving treatment than in hospitals. Not while treatment is so inaccessible. Not while mental illnesses are so misunderstood, and not while there is so much misinformation.

Not while we can’t talk about it.

And not while we can talk about it but don’t know what we’re talking about.


What it’s like to Need Unmediated Medication

I didn’t know I was going to grow up to be Schizophrenic. I guess the warning signs were there. Depression, anxiety, self-harm, magical thinking, self-isolation, and poor social skills. A preoccupation with death and a delusional fascination with religion. Even so, at eighteen and hardly an adult, the transition from neurotypical to Schizophrenic broke me. But then, no one plans on growing up to be sick. Young adulthood snatched away from me by madness and medication. Frequent psychiatric hospitalizations and a few suicide attempts dotted my calendar. Eventually, my illness changed from acute to chronic. Four years later and I’m twenty-two going on twenty-three. I’m a college dropout. I’m on disability. I take medication five times a day to function well enough to live on my own. But after all the medication I still hear voices all day every day. I can’t read, and I can hardly write.

These days I walk the line between Bipolar and Schizophrenic. I exist in a gray space called Schizoaffective. I spend most days at home with my two tabby cats, while my husband goes to work. I don’t feel young. I’m tired. I’m… sexless, achy, and confused. My brain feels like it’s full of sand. And my psychiatrist says that it’s normal, that it’s all normal. Normal for a Schizophrenic. It’s the anti-psychotics she says. She says that when my brain feels full of under-cooked bread that it’s normal too. And like so many, many Americans, I hate medication.

Or… I used to.

Because while it may have taken four years to find the right medication. I can say now that Seroquel has saved my life. I lost almost everything to Schizophrenia and then Schizoaffective Disorder. Nothing seemed sacred. Not family, not friends, not time or perspective, not school or reputation. Nothing.

The last thing to go was my faith, which I lost right around the same time I started anti-psychotics. In that way I was different I supposed, while most people find faith in dire times, mine was unredeemed. Which meant for me, and so many other Schizophrenics, that God was a chemical imbalance. A product of the over-pruning of the synapses in my brain. A product of delusions and hallucinations. Of my ill-equipped Schizophrenic brain trying to make sense of this tremendous epigram. This transition into a faithless existence happened slowly at first and then all at once. A building reversal in which I found myself back peddling. Scampering away from what had been a fascination with religion.

Yet with this new high dosage of antipsychotics, I felt a calming inside of myself. A settling of the churning psychotic debris. And although I wasn’t free of Schizoaffective Disorder, these days I am less of a slave to it.

So why do I still hate my medication? Why do I loathe my pills as I organize them into weekly and daily sections? Why do I frown as I set alarms to remember to take them? Without them, I would become an incoherent mess. The CDC says that almost fifty percent of us (48.7%) take at least one prescription drug. Strange that antidepressants are one of the most frequently prescribed medications. Yet, it seems like everyone condemns prescriptions for mental health conditions. “Big Pharma,” they say. “You don’t really need those meds.” “You could stand to come down a few milligrams.” “Aren’t you cured yet? After all those medications you take?” “Those meds turn you into someone else.” “Nobody needs antidepressants.” “Get out more.” “Exercise.” “Just be happy.” “It’s all in your head.” “Get over it.”

But to myself, I say “It’s not that easy…don’t you see…it’s not that easy.”

A patient cured is a customer lost…

Don’t you see it’s not that easy….

How can I practice acceptance and accept my antipsychotics in an age of pharmaceutical phobia? From the beginning of my journey with mental health medications, they were always bad. After all, how could I be myself if my medications changed the way my brain worked?

But it’s not that easy. You don’t get to see what an unmedicated Schizophrenic looks like. Unless you’re the one who is going to drive me to the ER in the middle of the night. Unless you’re the one calling 911 because I’ve stopped making sense and I’ve told you I’m going to kill myself. Most people haven’t seen me hiding in the closet. Covering the windows. Tearing apart my living space looking for hidden cameras. Most people haven’t heard me yelling about voices, or aliens, or the things that try and read my mind. You haven’t seen me restrained. Or in the back of a cop car. Or in the psych hospital with bandages covering my forearms. You haven’t seen me getting shots of Haloperidol in the middle of a psychotic episode. You weren’t there the first time I overdosed and you weren’t there the second time either. Few people I’ve let see this side of me… and because you haven’t I’m going to venture to say that you don’t understand.

So, to the people who think that ‘Big Pharma’ does nothing more than create customers, you forget the lives it saves.

You forget that it saved my life.

Though maybe you didn’t forget, maybe you just don’t know..