You know there aren't any great idioms or quotes to be had about urges, which makes writing a podcast description challenging. This episode, I process some some self-destructive urges via a bit of self-inquiry. I ask the urges what they're trying to do for me, I sit with some shame that comes up, use the urge-surfing skill, and finish it up by going over a TIP skill to get rid of the nervous energy that's left in my body.

Helpful resources from this episode:

DBT references

DBT Skills Training Handouts and Worksheets – online pdf version

DBT Skills Training Handouts and Worksheets – buy the manual from a Black-owned book store!

DBT handouts used in this episode

Mindfulness Handout 3 – Wise Mind: States of Mind

Mindfulness Handout 4A – Ideas for Practicing Observing (By Coming Back To Your Senses)

• Observe urges to do something

Distress Tolerance Handout 6 – TIP Skills: Changing Your Body Chemistry

Emotion Regulation Handout 6 – Ways to Describe Emotions

• Shame

Emotion Regulation Handout 8 - Check the Facts

Other handouts/graphics used in this episode

Wise Mind Venn diagram

Box breathing video

---------

More resources are available at https://therapize.joygerhard.com/

Please rate, review, and subscribe to this podcast wherever you listen.

Follow me on Facebook, Twitter, and Instagram.

Like what you hear? Support me and this podcast on Patreon.

Swan Lake by Tchaikovsky

You've got shit. I've got shit. We've all got shit. So, let's therapize that shit, with your host, me, Joy Gerhard.

Please note: I am not a therapist. I cannot and do not diagnose anyone, or prescribe anything. This is just me – someone who struggles with my emotions and with intrusive thoughts – sharing what skills I've used and how I've used them.

Also, a trigger warning: in this podcast, I talk about sensitive topics including: mental illness, suicidal ideation, self-harm, rape, childhood sexual assault, trauma, and more. I also swear here and there, so listener discretion is advised..

Welcome, welcome. Guys, I have been avoiding this episode for a very long time. I edited the last two episodes – episode 9 and 8 – kind of in one big bonanza of editing, turned them into drafts, and got them all ready to publish, and published them, and then just started dragging my feet because I really didn't want to deal with this episode.

I know I put a trigger warning at the beginning of each episode. I'm going to repeat it here with extra emphasis because there is a lot of discussion about sexual assault and rape in this episode. I'm not going to get graphic or into specifics at all, I talked about the fact that it happened quite a bit.

I talk about it quite a bit and it happened quite a bit. Those lovely dangling modifiers. Anyway, I think I talk about self-harm, or at least I allude to it.

Yes, all the trigger warning. Do please take that under advisement, I guess. I also wanted to mention – because I realize I've been forgetting to do this at the beginning of episodes – I'm taking a lot of information very heavily from Marsha Linehan's DBT manual. It's linked in the description, it's linked on the website.

If you ever hear me reading – and you'll know that I'm reading because I added a reverb to my voice and I sound like I'm in a bathroom or a large, very glorious, very stately cathedral, whichever floats your boat. If I'm reading from something, it's typically from that manual, so I wanted to make sure to give proper attribution to that and let you know where you can find what I’m reading.

So, today the topic is urges. Let's define an urge, shall we? From the Merriam Webster Dictionary, the noun for urge, so an urge is: “a force or impulse towards an activity or goal.” The verb, like “I urged you to do something,” is: “to force or impel in an indicated direction, or into motion or greater speed.”

I'm going to say that again, because it's kind of a big deal. “To force or impel in an indicated direction, or into motion or greater speed.” So, an emotion will urge us towards certain emotions or certain behaviors.

On a more psychological note, here's a definition from https://changingminds.org: “urges are felt as a tension, often as a kind of emptiness, such as when we feel hungry or lonely; or pressure, such as to fight or run away. When we satisfy an urge, we feel the closure of fulfillment or contentment.”

Guys, I felt that in my body. There's something really relieving about this definition, because I've struggled to explain what an urge is, and what my experience of an urge is. And it really is a tension. That's exactly what it is.

If you've ever shot a rubber band at somebody, like you pull back the rubber band. You create tension and you can feel that when you do it. You can feel tension on your fingers if you're shooting a rubber band at somebody; you can feel tension on springs. There's all sorts of things we can feel tension on.

And that is exactly what it feels like. And then finally, from the DBT manual, “the action urge is one of the parts of an emotion, and each emotion has a typical action urge.”

I'm going to say that again. “The action urge is one of the parts of an emotion, and each emotion has a typical action urge.” That's from page 199 of the DBT handbook.

That's also kind of a big deal. I just figured at the beginning of my episode about urges, I would talk about the definition of urges. And then realized that I've never actually defined it for myself. And this is all actually making a lot of things make sense.

So, every emotion will elucidate... Is that the right word? Will cause an urge. That is a component part of an emotion is that urges come along with it. And you can see the different urges for each emotion in Emotion Regulation Handout 6, because each emotion has a typical action urge associated with it.

So, the urge I'm going to be talking about is a self-destructive urge to get on dating apps and have one-night stands. And to be clear, before we get any further, I'm very much sex positive. I'm not slut-shaming. I don't think promiscuity is a thing. I don't think “slut” is a thing.

The reason I label this as a self-destructive urge is not because of the activity itself – of having sex, of having one-night stands. It's because of how I use the activity and why.

It's kind of analogous to the difference between somebody who gets off work and has a couple of drinks to kind of blow off some steam versus somebody who is actually incapable of functioning without drinking and who uses drinking as a way to avoid emotions or to dissociate.

Like those are two very different things, even though technically both involve the process of drinking alcohol. It's the how, and it's the why, and it's what I'm using – in my example here – what I'm using to avoid things I wish to avoid.

It's not that the sex is the problem, it's how I use sex. That's what we're going to be talking about today. Fair warning, I am in a pretty miserable place in this episode, because I'm about to play for you a recording from the past. We're going to be doing some more time travel. And where are we going to, Joy? Let's find out.

We are going to... I'm recording this on December 27th and we are going back in time to November 29th of 2021, a little under a month ago. At that time, I was in a pretty miserable place on that particular day. The best I could do was label my thoughts as thoughts, label my judgements as judgements, and observe how my brain was doing.

It's a bit of a mess because I'm figuring out my... checking in with myself as I go, and asking my emotions what they're trying to tell me, and listening, and paying attention to my body, etc.

It's a bit all over the place. I have a summary and I was debating whether to put it at the beginning or whether to put it at the end, and I think I'm going to do both.

Because it's really actually very interesting, and I thought you might enjoy it as well. I wanted to put it at the beginning to kind of give you a road map of where we're going to go. And then I also wanted to put it at the end as a summary of where we went.

But what's really interesting – and why I'm going to do it in both places – is because I'm going to summarize this in two paragraphs. And it is 45 minutes of me talking. It's a great example of how it's possible to leave a therapy appointment, and have someone go, “hey, did you have any epiphanies?” And I can say a single sentence.

And then, “Really? You were there for an hour and you got one thing out of it?” It takes a lot of time. A lot of this introspection or self-reflection or self-interrogation (interrogation is a really strong word), but you know, asking questions of myself and kind of listening and paying attention.

It's very much like digging up dinosaur bones with a toothbrush. It's very slow. In any archaeological dig, you're moving more dirt than your moving bone. And in this episode – and in really any kind of inquiry like this – there's a lot of thoughts, there's a lot of emotions, there's a lot of stuff that I'm sifting through that aren't the big epiphany or the Ah-ha moment, if you will.

So, it takes a while to get there and I thought it was fascinating. Because it was all over the place, I decided to actually try to do a summary. As I was writing the summary, I'm like, “why did it take me 45 minutes to actually articulate this?” And then I remembered what I just told you. So here is the summary:

I'm going to start by going over the urge that I'm dealing with: the urge to get on dating apps and then have one-night stands with people. And I'm going to go over my history of having that urge, and what it's looked like in the past, how it's impacted me, and the sort of patterns of behaviors that I developed. And then I get into what that urge does for me.

All urges are typically trying to get a need met, but usually, the need is targeted at things that yield short-term relief rather than addressing long-term goals. So, I asked my urge what need having one-night stands was trying to meet.

Sat with that for a while, and some thoughts came up, including that one-night stands were meeting my need to feel attractive, desired, and to be intimate without being vulnerable. Sitting with that, it opened up something that's unhealed, something that I need to address, which is that I feel kind of hopeless about having a future relationship.

I have a lot of self-judgment for where I am. And I was having the thought that I have nothing to offer. And that thought opened up – or made me realize – that I have a compulsion to contribute to others as a way for compensating for my perceived lack of desirability.

And I sat with that for a while, and asked what that compulsion to contribute was trying to do for me. What came up there was that I was trying to protect me from being a burden on other people. Because it doesn't feel OK to ask people to contribute to me.

And then, a bunch of shame came up because I have a lot of judgments about where I am right now. I sat with that for a while and looked at the prompting interpretations for feeling shame, and validated it, and it kind of settled on down.

I took a break for a second and, while on break, had a realization: I noticed that my urges spike when I'm not paying attention to my emotions. Kind of like a toddler that I keep dismissing who finally throws a tantrum. Like, “you weren't listening when my emotions were small, so how about I screaming them at you by way of an urge?”

And this reminded me of something I discussed with one of my therapists: that my self-destructive behavior is my way of communicating to myself that my pain is real. I realized that I use one-night stands as a way of dissociating so that I can relate to people without emotions.

So that's great. In the process of doing this whole thing, it kind of transformed my urge from a super urgent feeling to more just nervous energy. So, I finish up by going over a quick skill to process that energy out of the body. And then I went and ran stairs. I didn't record myself running stairs because it would just be a lot of heavy breathing and swearing.

Something to note before we dive into it here: I'm leaving pauses in when I'm scanning my body to demonstrate that it's not necessarily an immediate, “Oh, I know exactly what emotions I'm feeling and what body sensations I'm having.” That's not immediate. Sometimes it takes me a while, so I left those in there to make the recording a little bit more authentic.

So yes, that is the journey you're about to go on. And I will check in with you when it's done. Bon voyage.

Swan Lake by Tchaikovsky

So, I'm going to get... I don't know if “vulnerable” is the right word, but I'm going to get something for a second here, and talk about some urges I've been experiencing over the last couple of days.

Some back story that's really... I don't know if it's relevant to the urges, but I figured I'd explain it to the listeners, you, so that you kind of knew what was going on. I was raped for the first time as an adult in 2012.

And I think it was New Year's 2015, very, very beginning of 2015, that I... I’d been experiencing symptoms of PTSD for about 6 months at this point, and I got on dating apps. And kind of cut a blue streak through them.

To be specific, I would match with people and go meet up with them almost immediately, with no interest in getting to know them, in having any sort of long-term relationship or even a short-term relationship. I wanted to meet up with them, have sex, go home. I did that a lot with a lot of different people.

And that was a hard, hard thing to break. A hard... I don't know if “addiction” is the right word here. I know that sex addiction is a legit thing. I think for me it was a coping mechanism similar to self-harm in so much as it met a long-term need in the short term.

It did something for me immediately, but didn't actually address a deeper problem. One of the things that I realized was really important in all of this was being able to leave at the end, because my first rape in 2012, I was visiting somebody. Had flown in, didn't have a way to leave really... an accessible way to leave, I think is more accurate.

I didn't have any money. I didn't have a smartphone yet, so it was... I felt stuck. That was my interpretation of my experience. I couldn't think of any alternatives, so I stayed. In having these interactions with people several years later, back in 2015 and ‘16 and ’17, that was one of the lovely things about meeting up with somebody – having a one-night stand – was that I got to leave at the end.

It met that need. It was kind of like a controlled reliving, if you will. This is what I was getting out of it: being able to put myself back in that situation in a way that I thought was safe, and getting to change the outcome. Now, was it actually objectively safe? You know, actually at the beginning it was, and then it was not.

But I developed this habit, and that's kind of how I related to people that I was attracted to. I don't even know if attraction was necessary at that point.

I created this habit, ways of relating, that became very, very challenging to break. It was easier for me to have sex immediately upon meeting somebody, because it didn't require really any vulnerability on my part. It allowed me to get what I wanted rapidly and then get out.

And I was really super transparent about it with all my partners, that I didn't want to... This isn't like a wine-and-dine sort of situation. I didn't want to go out to dinner or go for drinks. It was, “Ok, can I come to your place, or can we go to a hotel, and then have sex, and then I'll leave. And I'm not interested in seeing you again.”

It met a need for me, and I think I did it in as ethical a way as possible, being super transparent and upfront about what I was looking for and what I was not looking for.

Yes, I developed this pattern. Even more recently, it was kind of a batch during a two year period when it happened a lot. I would match with people on Tinder or whatever dating app. And then go meet with them and have sex with them, and then leave and not want to communicate with them again.

And then I stopped. Was doing stuff in therapy and trying to develop a more healthy way of relating to people that was more in keeping with my long-term goals for my life, that I actually wanted to have a relationship and I wanted to relate on a more intimate level emotionally.

And then of course, I met my former partner and was with him for a little over 2 years. Since the break-up, I've had these urges again. And it's tricky because on the one hand, getting on a dating app is not a problem.

It feels a lot more nuanced than say like self-harm. Self-harm, there's no nuance there. I just don't want to be doing that anymore. Whereas I want to be able to date, meet people, chat with people online or on dating apps, do those sorts of things. Just not the way that I had been doing it.

Part of the problem with the way that I had been doing it is that I didn't really care all that much about my safety. After a couple of years of doing that, I experienced several more rapes and sexual assaults in a row. I had been going out with the person for a couple of months, and then one night, they raped me while I was sleeping. That happened with three different people. Yeah, it's a conundrum.

And I began to have the belief that there's just no way to know if somebody is safe or not, if somebody is going to take advantage of me and assault me or not. I didn't see any red flags, and to be very, very honest looking back on them, I still don't see red flags.

I don't know if it's because there weren't any and they're just really, really, really good at what they do. Part of the problem with PTSD is it's like having a check engine light on all the time.

And if the check engine light is broken, you stop paying attention to it. Then there's the day when something actually is wrong with your engine, and you don't pay any attention to it because you're like, “Oh, yeah, that's just. That's what the light does.”

So, PTSD creates hypervigilance, and I just stopped paying attention to it. I stopped paying attention to my gut because my gut was, by and large, really, really wrong. I would have panic attacks in the gym in the middle of the afternoon. I would have panic attacks in yoga.

All of these situations that are objectively safe. I had the experience that I was in mortal danger, a lot of the time. I remember having a massive panic attack when on a business trip with my boss and several coworkers. I had another one at work outing where we went to a baseball game, and at the end of the game I had this massive panic attack.

These are situations, again, where I'm objectively safe. And so, I just stopped paying attention to my gut, because I had the belief that my gut didn't know what on Earth was going on. Couldn't tell you whether I was actually in danger or not in danger.

That's problematic because I think our guts are actually really intuitive and valuable sources of information. I think I was already primed not to trust my gut. And then of course, having PTSD exacerbated it. I really just stopped paying attention to signs, red flags. I don't know that I've ever actually regained that ability.

Because it was actually really disconcerting, I had a lot of distress about this with my former partner. He was not at all abusive in any way, shape or form. Actually really great about honoring my boundaries and checking in and communicating.

And I don't know how I did that. I don't know how I found somebody who was not abusive because I'd had so many people in a row that were. And I don't know that I changed anything or shifted anything.

And that worries me. I have some concerns about that because, if I don't know what I did, how I found him, I don't know how to replicate that. It's scary because I don't want to put myself back in a situation again where I'm setting myself up for more abuse and more sexual assault. I don't know how to avoid it.

So I think that's actually one of the things that's causing – or contributing to these urges – is this sense of, “Well, what's the point? You are going to get hurt either way. There's no guarantees. There's no way of knowing for sure whether somebody is safe, so you might as well just do whatever throw the rulebook out”

Yank the indicator lights out of the dashboard, and be like, “Since I can't trust this check engine light, I might as well just not even bother paying attention to my gut and not even bother asking the question of whether I'm safe or not.”

I don't think that's effective. I'm having the thought that it's all I have access to right now. Just because I have the thought that there's no other way doesn't make it true that there's no other way. I think there are other ways because I have friends who know how to date people who don't abuse them.

I have friends who have been sexually abused who know how to date people who don't abuse them. So, having PTSD from sexual trauma isn't a life sentence to always be in relationships with people who are abusive.

There's a way, and I don't know what it is. That lack of certainty or lack of knowing, I guess, is what has it feel kind of like Russian roulette. Like, just go ahead and pull the trigger. There's no way of being able to tell which chamber the bullets in. It's a very violent metaphor.

But the urges have been pretty strong because I think that they do something for me. It's a way of being intimate without being vulnerable, not emotionally vulnerable, I guess.

It's a way to get a couple needs met: being touched, being seen being acknowledged, being desired, feeling attractive. Which to me, if I'm sitting in a place in my Wise Mind... which we haven't actually gotten into all that much yet.

If you want to look it up, Wise Mind is a Mindfulness skill. We'll get into it in much more detail, but if you're interested in knowing what it is more now, Wise Mind is on Mindfulness Handout 3 in the DBT handbook, which is linked in the description and on the website.

Wise Mind is basically comprised of two parts: Thinking Minds – the part of you that thinks; and Emotion Mind – the part of you that feels. I know that a lot of people draw it as Wise Mind is the intersection of the Venn diagram of those two things.

My first DBT instructor actually said, “Throw that out,” and drew the Wise Mind circle encapsulates both thinking and feeling. He's like, “Why would you purposefully not use some of the information that you're getting?

“Use all of it. Include all of it. Don't discount and be like, ‘Oh, that's Emotion Mind, and I don't really want to pay attention to that.’ Or, “Oh, that's Thinking Mind, I don't want to pay attention to that.’”

So I love that. I love that Wise Mind is like, “No, use every tool at your at your disposal. And validate them and ask questions: What is this emotion or this thought trying to do for me?”

So, when I'm sitting in my Wise Mind and not in Emotion-urge-need-to-get-on-an-app-must-feel-attractive Mind, what the thought that comes to mind is: I need to work on my own acceptance of myself and how I feel about myself. Oh yuck!

OK, I'm experiencing disgust right now, and some self-judgment. I'm just aware of... I'm annoyed. I'm aware of some of the thought patterns that I've been having that were just kind of automatic about feeling a bit helpless – hopeless really, not helpless – hopeless about this whole relationship thing. Feeling pretty sad about it ended with my last partner.

And how I had these thoughts and hopes and wishes for our future. So, I've been feeling kind of hopeless already, and not thinking I'll be able to find somebody else who will want to have a relationship with me and to build a life with me.

Where my brain kind of automatically goes to is to a lot of self-judgment about all of the reasons why somebody wouldn't want me. It's automatic. I am mentally ill, I have two mental disorders, I live in my parents’ house, I don't have a job.

I'm having the thought that I don't have anything to offer anybody. I'm having the thought. Just because I have the thought doesn't make it true. And yes, I'm having the thought that I don't have anything to offer anybody. Over the holidays, I was hanging out with a couple of my really, really close friends and their kiddo and just watching myself not be able to sit down,

Like this kind of compulsion to do things to contribute, to clean, to organize, to help. And I'm going to cry now. Because I really want to contribute, and I don't feel like right now I'm contributing to anybody or that I have anything to contribute. I'm having the thought that I don't have anything to contribute of value.

I certainly have judgments around types of contribution, that there are valuable types of contribution and they're unvaluable types, types that are like, “yeah, that doesn't do anything for anybody.”

I'm certainly have the judgment that in order to be of a contribution, there has to be something you can see. You know, “Here's a thing that was dirty, and now it's clean.” I'm very aware that the biggest – not the biggest, but some of the most significant – contributions that people have made to me have been things you can't see.

My closest friends that I chat with regularly are incredibly validating and supportive and funny. I feel very seen and understood, and that is incredibly valuable. You can't put a price tag on that.

There's no amount of money that I could pay somebody that would have someone show up the way my friends do. So clearly, they're contributing to me in non-tactile ways, and I value those ways. And I am having the judgment that the ways in which I contribute doesn't count unless it's tactile.

If I ask that judgment what it's trying to do for me, I think it's trying to make sure I'm not taking advantage of people. Because I'm in a position right now where I kind of feel like I'm a leech. I'm having the thought that I'm a leech. I'm just taking a lot without giving back.

And I don't want to create an uneven relationship with any of my friends, so because I have that concern, I'm overcompensating really, really strongly.

What there is to do there is to check the facts. The friend that I spent Thanksgiving with, he actually checked the facts first. I kind of blew him off.

He was noticing how much I was doing around the house to help, and he was like, “You know, we actually love having you here. We enjoy your company. You don't have to do things. We just like you.”

And I'm having emotions come up. There are tears. So what is that? Sadness, I think. Just feels really vulnerable. I guess I'm having the thought that I don't believe that. I don't believe that just my company is enough.

I have been watching, actually noticing this. A friend of mine got a car and it kind of bummed me out because for a while I got to serve them by driving them places. I hadn't realized how kind of dependent I was on that as a way of contributing to them.

I've been having the thought that I'm a bad friend ever since they got a car. Someone getting a car has no basis on the quality of my friendship, so checking the facts there. Yeah, I'm very concerned right now that I'm not contributing to people – to the people that I care about – and so I am kind of overcompensating.

I think that's another reason that the urges are really starting to get back on dating apps. Because it doesn't feel OK to ask people to contribute to me. My parents are already letting me stay here and supporting me in that way. It doesn't feel OK to ask for them to contribute in other ways.

I'm having the thought that it's not OK to ask for people to support me right now. So, the dating app one-night stand thing is a way in which I can have a need met without really having to give much back.

Which sounds really selfish, which is why it's really important to me (it had been in those circumstances) to be really transparent about what it was and what it wasn't because I didn't want to lead anybody on. I still make sure that they are fulfilled. I certainly am not in the kind of the typical ways that we measure fulfillment in sexual relationships.

But I do get something out of it that's not orgasms. I get control. I get to leave at the end of the night. I get to dictate the terms of the relationship, however short that it is. I don't have to do any emotional labor in these interactions. I don't have to take care of them.

I don't have to validate or any of this other stuff. It can be strictly physical, and then I can leave. So that does give me something. I'm now having the thought that I've been using contribution as a... what's the word? Transaction.

Even with my friends, I've been transacting. Having the thought that I need to contribute a certain amount before I can – have so much money in the bank, if you will – before I can take anything.

Having the thought that it's wrong to take anything, to take up space. Especially since the breakup, because I kind of feel like... I'm having a thought that I am just this morass of negativity, and that it's not fun to be around me right now.

I certainly am not having fun being around me right now. So, I'm having the thought that I need to make up for that when I'm talking with friends or spending time with them. This is not effective.

As I'm just saying all of these things out loud and actually describing the facts of what I'm doing and the thoughts that I'm having, it doesn't feel great. Because it's not the sort of relationship that I want to have with the people that I love and that I care about. And I know that it's not the sort of relationship they have with me, which is why...

It's one of the reasons why we're friends. I'm friends with the people that I'm friends with is because there is a deeper level of connection and understanding and validation and emotional intimacy and understanding and honesty.

I know this is not how I would want them to show up. And it's not how I want to be showing up. Oh, fuck. This doesn't feel good, is it shame? I think there's some shame there. I'm not liking the way I'm showing up, not liking this behavior.

Feels bad, feels like I'm bad, which I think... Yes, that is shame. So, let's talk about shame for a second. I'm looking at the Emotion Regulation Handout 6, which is that big-ass one that lists all the major emotions.

And shame is on page 9, out of 10 on Emotion Regulation Handout 6. I don't think there's any prompting events for feeling shame. I think it's my interpretations.

“Some interpretations of events that can prompt shame are: believing that others will reject you; judging yourself to be inferior, not good enough, not as good as others; self-invalidation; comparing yourself to others; thinking you're a loser.

These are interpretations again.

“Believing you're unlovable [vocalizing]; thinking you're bad, immoral or wrong; thinking you are defective; thinking you're a bad person or a failure; believing your body, your body part is too big, too small or ugly; thinking you've not lived up to others’ expectations of you; thinking that your behavior, thoughts, and feelings are silly or stupid.

“Biological changes and experiences of shame include: pain in the pit of your stomach; a sense of dread; wanting to shrink down or disappear; wanting to hide or cover your face and body.

“Expressions and actions of shame or urges include: hiding behaviors or a characteristic of yourself from other people; avoiding the person you've harmed; avoiding people who've criticized you; avoiding yourself; withdrawing; covering the face; bowing your head; groveling; appeasing; saying you're sorry over and over again; looking down and away from others; sinking back, slumped with rigid posture; halting speech; lowering volume while talking.

[Grumbling] OK. So yes, so I've clearly been experiencing a lot of shame since the breakup because none of this is... I'm not proud of any of this. None of this is the way I wanted my life to go. I wanted to have a job that I enjoyed, contributing in a way that was actually useful, which is what I was doing for my former partner with his small business.

I wanted to have a partner and a home that we were building together and a life we were building together. Clearly, I am having the thought that in the absence of that, I am less than. I am a single 38-year-old with mental illness who's living in her parents’ guest bedroom.

And I have a lot of judgment around that. Those are things... Even though those are the facts, those are clearly things that I think I judge, and I expect to be judged for. Certainly, the fact that I didn't choose any of this also feels... I’m having the thought that that warrants judgment too.

Like I couldn't... I'm having the thought that I couldn't even get my shit together to keep my relationship going. I'm having the thought that having a mental illness will preclude me from finding a partner who will understand and will want me.

When I check the facts on that... Just a reminder of Checking the Facts is an Emotion Regulation skill, and the steps on how to do that... As I'm flipping through my book here, it's Emotion Regulation Handout 8 in the DBT manual.

Checking the Facts. sitting here with my Wise Mind and looking at the whole thing, it was a mismatch of needs and skills, in terms of what I needed and what his skill level was.

He doesn't have a lot of knowledge or understanding about mental illness, and he doesn't have a lot of skill level... a high skill level in the areas that I had kind of serious needs. And it was my behavior that was the problem, not my mental illness.

There were things – self-harming and whatnot – that he wasn't OK with. And I still have the thought that having a mental illness will mean that no one will want to be in a relationship with me.

And of course, if I was talking to a friend who was mentally ill who said the same thing, I would say something to the effect of, “Ok, totally understand having that thought because there's a lot of messaging we get about what it means to be a good partner. there's a lot of messaging we get around mental illness and disabilities.”

So, it makes sense that this hypothetical friend would have those concerns, and it's a mismatch. And it's a matter of finding somebody who matches, somebody who understands, or is willing to learn and work with you around it.

I mean, I've had this thought a lot lately that I don't know that it’s going to work for me to be with a partner who's not in therapy, who also doesn't have a mental illness that they’re managing.

Because it's really challenging being with somebody who doesn't get it, who doesn’t get it on kind of a more profound level, a more validating level, I guess, not a theoretical level.

It also makes sense that I would be having these really strong urges to get back on dating apps because one of the lovely things about one-night stands is that typically you don't ever get around to talking about your shit.

I can just be a woman who wants to have sex with somebody, rather than somebody who has spent multiple weeks in a psych hospital this year, who had to leave her company that she founded because of mental health issues.

I don't have to explain my living situation or any of my past relationships or anything about myself. I can just be like, “Hey, here's a an interaction that is purely physical,” and then I get to go home.

So the urge makes sense, and I think it also points to something that's not... a hurt that’s not being addressed. Because the breakup really, really fucking sucks. Like it really hurts. It hurts that he broke up with me both times I was in a mental hospital.

This is me being all maudlin and like a martyr and whatever, like woe is me. I'm judging myself for feeling sad. Which doesn't work. I can be sad. I can feel these feelings. It just fucking sucks.

And the other challenge... I've just realized another challenge with one-night stands now is that I have a lot of scars from self-harm, kind of all over my body. I had forgotten that was a reason why it was hard to keep things strictly physical and not get into any sort of emotional anything.

Because, like, “dude, did you go through a meat grinder?” No, no, I didn't. I went through an emotional meat grinder. An emotion grinder. I don't know.

Yeah, it's a challenge to keep things light when my trauma is kind of written on my body. And I also have two tattoos that I didn't have the last time that I was on a dating app, one of which is actually directly related to trauma, so...

I have not practiced responding to somebody asking me about what that tattoo means, which I think would be a useful exercise to do. Anyway, the urges are strong today. So what I am going to practice doing is Urge Surfing.

And for those of you who want to know what Urge Surfing is, it's an observation skill. So it's Mindfulness Handout 4 in the DBT book. I'm flipping there now. It's a way of practicing observation and coming back to senses. Let's see here, I can find this. Ah yes, 4A. Mindfulness Handout 4A.

“When you're feeling an urge to do something that is impulsive, urge surf by imagining that your urges are surfboard and you are standing on the board riding the waves. Notice any urge to avoid someone or something. Scan your entire body and notice the sensations. Where is the body? Where in the body is the urge?”

Well, I notice an urge to avoid being alone. Because initially, I was thinking, “well, I'm not avoiding anything. I'm have an urge to seek something out.” And when I examine that a little bit more, no, it is an urge to avoid being alone and feeling lonely. Trying to avoid feeling lonely.

Trying to avoid thoughts about feeling undesirable, being undesirable. I mean that is... I will say this, I mean the attention is not great, but it is attention and it is a lot of it on these dating apps.

It's kind of like eating a shit brownie. On the one hand, you're getting a brownie, so that's nice. On the other hand, there’s shit in it, which is less nice. Which reminds me a lot of something. Our friend Kevin from The Office once said:

“I hear Angela's party will have double fudge brown. It will also have Angela. So double fudge, Angela. Double fudge, Angela. Hmmm.”

True story, Kevin, true story. Anyway, getting back on track...

“Where do I feel the urge in my body?”

I feel it kind of in the back of my throat, kind of where my throat meets my... I don’t know, my torso? And feel it kind of in the pit of my stomach. Yes, very much in the pit of my stomach, all the way down at the bottom. Kind of almost between my pelvis and my stomach.

It feels like a heavyweight. There's a lot of pressure there. There's dis-ease, like I'm not at ease. Kind of a fluttery, anxious, nervous feeling which I noticed actually accompanies a lot of my urges, both in terms of getting on dating apps, but I have that with self-harm too. There's a lot of really nervous energy around it.

And I often feel like I want to crawl out of my skin or go sprinting down the street, or, “I have to get out of here,” type energy. I think it's definitely my body trying to get my attention. There's something uncomfortable, and... fucking hell. God, I don't like this.

So, examining this and actually kind of just like wading into it a bit, it starts to bring up what's underneath it. One of the things an urge does is it tends to mask a deeper issue. Urges are very short-term.

So, there's a long-term need that's not getting met, and we go, “Hey, here's the thing that will distract me for 30 seconds or today or whatever.” And it doesn't work long-term. It doesn't actually address what's not working long-term.

So, I'm noticing I'm trying to avoid loneliness. I'm trying to avoid feeling unattractive, and judging myself for my current living situation. I'm trying to avoid sitting with the reality of my life currently. Certainly, getting on a dating app and flirting with somebody and going and having sex is a nice distraction from how much my life is not going the way I want it to right now.

Oh God, I feel it in my stomach. It really does feel like I'm... It's not nausea, but it is fluttery nerves, kind of the feeling you get right before you go out on stage to give a speech or perform.

There's a lot of anxiety there, a lot of fear, not wanting to actually look at my current life situation, what my life looks like right now. I don’t like it. And clearly, I've been avoiding it because I'm unhappy.

Swan Lake by Tchaikovsky

It's at this point that I took a little break. I don't remember what I was doing. Probably folding clothes or something. But I had an epiphany and came back to talk about it.

Swan Lake by Tchaikovsky

Ugh, I just had another thought about what's motivating the self-destruction. Typically it has to do with me not paying attention to or acknowledging my emotions. Because I use self-destruction as a way of communicating to myself and to others the degree of pain in which I find myself.

Because I have experienced a lot of invalidation in my life, as a child up to, well, now. Just chronic traumatic invalidation. And I'm not as skilled as I would like to be in validating myself.

When I'm not trying, I fall back into a pattern of invalidation because that's what I'm most used to. And I've been noticing that I am invalidating... or not even invalidating, just not paying attention to my sadness and my anger.

So typically, my urges spike because it's a way of my body going, “Hey, you're not listening. And you're finding a way to diminish it and make it seem like it's not a big deal. So, we're going to behave in a way that is a clear sign of needing help that we associate with self-destruction. “

And certainly, going and having a lot of one-night stands with people, and not caring about my safety while I'm doing it, and using it as basically a way of dissociating. Ahhh, I just had that thought that it’s a method of dissociating.

A way of relating to people without actually relating to people, and being completely separate from my emotions while I am interacting with another human. This is not effective. It's not effective for the life that I want.

Because I want to acknowledge my emotions and feel them in a healthy, productive way, and communicate them to other people. And have conversations about what I need and what I want, and make requests, and have boundaries, and all of these things.

Using sex as a way of dissociating is not effective. Also, the other problem with it is that it sets me up... It creates a pattern of behavior, because I learned how to dissociate while having sex.

Which is not great if you want to have boundaries, and be able to say no, and ask for things when having sex with somebody. And I'm realizing now this was actually a big deal when I started dating my former partner. For several months I was constantly dissociating when we were having sex.

He had to keep stopping and then kind of poke at me and be like, “Hey, are you there? Are you here? Hello.” And I would have to bring myself back. But it was a hard habit to break, because I set up this way of...

You know, people talk about, “it's really hard to quit smoking if you associate smoking with drinking coffee, and now every time you have a cup of coffee...” It was that sort of thing. Sex was dissociation, and I had to unlearn that.

And that's really challenging. It took a long time, and it put a lot of pressure on our very early relationship. Yeah. So clearly, I am not paying attention to what my body needs right now, and what my emotions need right now. Not acknowledging my emotions.

OK, well. The urge has kind of transmuted as I've been talking from this, “must do this thing, must do this thing,” to “oh, no, it's just kind of a bummer.” And now it's just kind of residual anxious energy.

And that is what we like to call in that the emotion module of DBT: an ECHO. How an emotion kind of sticks around, an aftereffect if you will.

Like how, after you go to a concert, you have ringing in your ears even though you're not in a concert anymore. One of the aftereffects of having this really strong urge is I feel like there's anxious energy in my body. So, I'm going to go take care of that right now by going and running stairs and trying to burn off some of that energy.

I did want to leave... For folks who don't have access to a way to exercise like that and/or have physical limitations around being able to burn off energy really fast, if you want to calm your body down in a hurry, if you're having a lot of that nervous fidgeting, there’s a TIPP skill.

Tipp skill is a Distress Tolerance skill, and it is in the – you guessed it – Distress Tolerance module of the DBT book. It's changing your body chemistry. So, I don't know if it's adrenaline that's coursing through my body right now that's causing that kind of butterfly-ey feeling, but intense exercise – which is what I'm about to go do – is one of the things that can calm your body down after it's revved up. T

This is Distress Tolerance Handout 6. Let’s over-enunciate, Joy. Paced breathing is my favorite in-the-moment-with-the-least-amount-of-peripheral-accessories Distress Tolerance Skill. Because you can just do it while you're sitting wherever you are. I like box breathing. You inhale for five, hold for five, exhale for five, hold for five.

And I want to get into a lot of these, actually, in much more detail on a different day. But didn't want to leave you... If you're experiencing strong urges and need to get the energy out of your body, I didn't want to leave you without some resources to address that. It reduces extreme Emotion Mind fast.

I think the paced breathing is the most accessible in terms of anybody can do it. So, if you are not able to run or do an intense exercise cause you have physical limitations, or if you are at work, or have a face full of makeup and don't want to dunk your face in water, or just don't have access to ice...

Paced breathing is the thing you can do in front of people, and they won't necessarily know that that's what you're doing. So it, again, is breathing in for a given count, then holding for that same count, breathing out for the same count, and holding for the same count, and continuing to do it. Usually, when I start, I do 5s. My goal is to get to 10s, so in for 10, hold for 10, out for 10, hold for 10.

I'm going to share a couple YouTube videos where people have made graphics of that; you can kind of breathe along to a graphic. Because it's on YouTube, you can change the playback speed. So you can slow it down really slowly if you need to slow your breathing down or just get your body to calm down. So anyway, I'm going to go run now and get some of this energy out of my body.

Swan Lake by Tchaikovsky

OK, we are now back in the future, December 27th, 2021. I want to book-end this episode with a summary of the journey we just took. This is going to be very similar to the summary you heard at the beginning, but now you've actually taken the journey with me.

Let's sum up, shall we? I started by going over the urge I was dealing with, which is the urge to get on dating apps and have one-night stands. And I talked about my history of having that urge, what it's looked like in the past and how it's impacted me, the sorts of patterns of behaviors I developed.

Then I got into what those urges do for me. I sat with it for a while, and some thoughts came up: that those one-night stands were meeting my need to feel attractive, desired, and allowed me to be intimate without being vulnerable. And I sat with that for a bit, and it opened up something that is unhealed that I need to work on: feeling hopeless about future relationships.

I have a lot of self-judgment for where I am right now in my life, and have had the thought that I have nothing to offer. That thought prompts this compulsion to contribute to others as a way of compensating for not feeling all that desirable.

I sat with that for a while and asked what that compulsion to contribute was trying to do for me. And what came up there was that it was trying to protect me from being a burden on people, because it doesn't feel OK to ask people to contribute to me, which is where a lot of shame came up.

And I sat with that shame for a while and looked at prompting interpretations for feeling shame, validated a bit, and then took a break. And while on break, I had a realization: I noticed that my urges spike when I'm not paying attention to my emotion.

And this reminded me of something I discussed with one of my therapists: that my self-destructive behavior is a way of communicating to myself that I'm actually in pain, and that that pain is real, and that it matters. And I realized that I was using one-night stands as a way of dissociating so that I could relate to people without emotions.

Yeah, sitting with all of that kind of transformed the urge from this super-urgent thing into nervous energy. So, I finished up by going over some quick skills to process energy out of the body, and then went off and ran stairs. I got to say, they still suck. I've been doing them for like 6 years and they still suck.

Anywho, so that sums up this episode. Thank you for listening. Thank you for sticking with me as I fumble my way through all of the emotions and whatnot. I hope that hearing what the process can sound like is validating for you, that it's not this very linear, very quick ratatat sort of realization sequence.

It's messy and kind of all over the place, and there's, again, a lot of... It's mostly dirt and very few dinosaur bones. So... but what a great shindig it is. Hey-O! Because you're digging up shins. Never mind. It's not important.

I'm going to go ahead and sign off, but I did want to mention again, if you have any questions or any topics you want to hear, if you want to see a skill being demonstrated, I want to hear your thoughts, and what you want to hear so I can better serve my listenership.

Oh God. And be super pretentious while I'm doing it. OK and, yes, I'm just going to. There's no, I don't. I'm just going to end this super abru-

Swan Lake by Tchaikovsky

This has been “Let's Therapist That Shit!!!” with your host, me, Joy Gerhard, if you like what you heard, please rate, review, subscribe and tell your friends about it. I'll see you next time.

Intro and outro music is Swan Lake Opus 20 by Pyotr Tchaikovsky, performed by the London Symphony Orchestra, conducted by Anatole Fistoulari, released on LP by Richmond High Fidelity / London Records in nineteen fifty-two.