Author: Lexie Manion
Therapy has been a part of my everyday life since I was a teenager seeking help for my eating disorder and self-harm for the first time. When I first began this healing process, I was ambivalent and distrustful. The first therapist I saw for a short period of time told me because my restricting and purging just began recently that we would “nip it in the bud”. This angered my inner demons. I already felt attached to my negative coping mechanisms and I was terrified to let them go and face my bleak reality of lack of safety at home.
As an adult, I was finally diagnosed with bipolar disorder five years ago. I believe I was misdiagnosed with solely depression, where the mania was missed — I struggled with both. However, I hid the paranoia and underlying distress well. I didn’t want to be perceived as “crazy,” so I kept quiet much of the time — until my struggles boiled over and the kitchen (my amygdala) caught on fire.
Therapy was always a challenge for me growing up because I struggled verbally. Some sessions I would talk very little or not at all. I would also dissociate. It took me years to find my footing and begin to unfold my inner truth.
Once I found my voice in therapy, I began finding skills that served me well. I really appreciate CBT and DBT. Not every skill fits, but the distress tolerance and mindfulness practices make me feel capable and strong. My favorite skills are radical acceptance, paced breathing, opposite to emotion action, visualization, and dialectics.
Dialectics in particular has been life-saving. While therapy is the place I learned these skills, these practices are my way of living — I live and breathe them.
When I started out in therapy, there was a detachment from my weekly sessions to my everyday life outside of treatment; I was unable to make the connection to my life outside of session. When home does not feel safe, we may lean on maladaptive skills such as an eating disorder, self-harm, or drug-use to cope. It makes so much sense that we are looking for a bit of calm amongst the chaos. Once I got into a safe living environment, I was finally able to breathe. And once I could breathe, I was able to put all my learnings to the test.
It is imperative in therapy to be able to implement the skills we learn in session out in the “real world”. We will not have our therapist there to sort out the knots of our yarn of life, so it matters to practice skills even when we are not in distress.
One of my favorite therapy practices are breathing exercises. I like paced breathing where you breathe in for a certain count, hold for a count, and then lengthen the exhale. For example, the count can be “breathe in for 4 seconds, hold for 7, and then exhale for 8”. This breathing exercise has been found to drop our heart rate and initiate relaxation in the body. Years ago, I would only utilize paced breathing when I was in distress. It was helpful in the moment. In recent years, I practice breathing exercises every day to encourage my resilience and my ability to grab at a skill quickly and efficiently when I need it the most. With my bipolar disorder, I can be quick to emotional reactions, so slowing down and knowing I am safe and will be okay is helpful.
In addition to my breathing skills, my therapist is helpful in problem-solving struggles that come up in my everyday life. When my therapist suggests something I could do to help myself, I make every effort to try it. In the past, I’ve had a therapist have me practice mindfulness meditations before going into work — even on those good days — to help me feel grounded. Recently, I woke up from a nightmare and truly felt I was unsafe in my body, ten years in the past. Through my sobbing and still half-asleep mind and body, it was challenging for me to realize I was okay. I shared with my therapist that I use grounding techniques such as 5-5-5 and reminders to feel safe again, but none were working. She offered that I place a calendar next to my bed, so when I wake up, I see the date and the year and know that it’s 2024 and that I am safe right here, right now. This method has been working well for me and I really appreciated her support, as well as my willingness to try something new.
The days leading up to my therapy sessions, I work through meditations and consider what I want to discuss. Usually it is work stressors or preparation for grad school that I am processing right now. I think through what I want to share during the week and offer in session what has worked and what I still need support around. At the end of each session, my therapist reiterates what we went over to initiate closure and remind me of what I’m working on. In between sessions, I am checking in with my friends about things I’m working through. I am also consistently journaling. Being able to talk and write about how I’m coping reinforces the work and encourages my brain to continue processing. By the end of my sessions, I feel like a weight has lifted from my chest as I take a deep breath and recognize I have a plan on what to address next. Taking life one step at a time in therapy has been life-changing.
While it is wonderful to be able to implement these therapeutic skills in our everyday lives, it is understandable if it is too difficult for some to follow through immediately or every single time. Give yourself grace and know that you are trying your best. It has taken me ten years to be able to find safety in my mind and body again through support of my chosen family and therapist. Finding wellness is an ongoing journey and never a simple destination. In time, we will get to where we need to be.
