How DBT Helped in Labor (TW)

This is a bit more of a personal post and has been an ongoing struggle to write.   Up until this month I felt like as a therapist it was unprofessional to write such an intimate blog post.  A student at DBT Path is also pregnant due in a few days and I felt like it would really helpful to share my birth experience with her.  The more I thought about it, started to write then stopped the more I realized it is not unprofessional to write a personal blog post, but rather professional and sincere to share what might be a post that is helpful to others.   Here we go- My Birth Story and how DBT Skills Kept Me Sane

TW- Although I do not get into medical detail, this can be uncomfortable to read for some.

Once I found out I was pregnant I was on what I called the “hippie mom bandwagon.”  I researched doulas in my area and had narrowed down my birthing options to two; home water birth and hospital water birth.  After talking it over with some “hippie mom,” friends I decided the latter provided some reassurance just in case something happened I wouldn't need to travel in the snow last minute in to the hospital.  Little by little my plan came together through talking to close friends, discussing it with my Midwife, endless blog posts, scientific articles and of course good ole’ Google.  I was to have a water birth as well as a four page birth plan I printed off a site that sold organic baby products.  I spent hours preparing for this event; creating a You Tube playlist of both calming mindfulness and upbeat songs for the big push.  I included You Tube videos of DBT skills I planned on using as I packed my hospital bag of herbal medication, lavender and healthy snacks in a cooler. I was prepared at 34 weeks with 6 weeks to spare. I spent the last few weeks on a yoga ball, practicing breathing, taking evening primrose, drinking Red Leaf Raspberry tea (with local honey of course!) and watching more You Tube videos of natural birth than I thought possible.

At my 38 week appointment I had been suffering from an ongoing headache and my blood pressure was elevated, they re-tested and it remained high.  I had some blood drawn to test for preeclampsia and told to call back at 3 for results.  It was unlikely, but I might be induced soon.  I went home and called back.  That was New Year’s Eve and was told to relax, lie on my side, deep breathe and take some Tylenol.  The headache would not go away and I continued to check my blood pressure at home and it remained very high.   I called back the next day and told Labor & Delivery at my hospital that my blood pressure had hit 174/129 and was told to come in for an induction.  I was immediately admitted and told I was suddenly “very high risk,” and might have a seizure at any moment. 

My dreams of a water birth surrounded by the scent of lavender and mindfulness exercises was thwarted when I was put in some heavy duty blood pressure medication and told I was not able to leave the bed, eat or drink until I gave birth and 24 hours after that to continue to prevent seizures.  I took their medical advice (I did try talking them out of how serious it was to not avail) and began a hefty regime of medication.  The cure for preeclampsia is delivery and the OBGYN (buh-bye Midwife) was trying to get my son out ASAP.  The next few hours were a blur or ongoing medical check-ins, a one-on-one nurse, hunger and medication that made me sick to my stomach.  I was admitted at around noon and that night was being told I was not allowed the “hippie haven,” I created.   I panicked and kept thinking suddenly things would be different and I would wake up in the birthing pool to deep breaths and the smell of fresh baby.  

At 10pm that night I had a breakdown- I felt hopeless and skill less.  I had not planned for this and had no clue what to do. I felt like I was losing my sense of control by going along with the process of medical intervention.  My husband slept in the couch next to me in the dark, fresh off of his dinner of a soda and a Snickers bar while I sat and waited and mourned.  I cried, a lot and asked him to hand me the iPad.  I had not updated anyone on what was happening and was unable to see straight because of the meds.  The first thing I did was play my business partner, Debbie Corso’s Conveyor Belt exercise video knowing I needed to begin separating the racetrack of thoughts coming my way.  I shut my eyes and listened, creating buckets including “medical concerns,” “worst case scenarios” and the biggest bucket of them all “the unknown.” I listed to that video twice.   From that I was able to notice that my major fear was the unknown ahead of me and was able to use the Function of The Emotion and identify it as survival and work on Fact Finding- noting I was safe and being well cared for. 

I then decided I needed to Radically Accept the situation- it was beyond my control and the more I tried to fight it or continued to hope that I would wake up in a lavender tub it was not happening.  I cried some more, mourning this lose.  The OBGYN came in to check on me and asked what I wanted to keep in my birth plan- I was shocked.  My black or white thinking lead me to believe I had to give it all up.  I noticed using Wise Mind that I was thinking and acting very emotionally and not being skillful.  I re-drafted my 3 page plan into three important bullet points including having immediate skin to skin contact with my son.  This made me feel more in control of the situation even if I had not moved from the bed in 12 hours.   

I also noticed I was being less than kind to the nursing and other medical staff, partly due to side effects from the medication and a larger part was me being willful and grumpy.  The nurses had done nothing wrong and since I had one-to-one care they were actually being very kind and gentle.  When the nurse returned that morning I used GIVE to ask if I could have some ice since I was so parched and not allowed even water.  She checked with the doctor and I received two cups of joy.   With staff I also utilized Opposite Action and remembered to be kind to others even if I was not feeling well.  I knew I had a long day ahead of me since I was assured I would probably deliver my son next day and knowing I was unable to focus for very long on the iPad screen I googled mindfulness music and listened with my eyes closed until I fell asleep.   I utilized PLEASE skills as best I could and was able to get a few hours of sleep.  I also utilized Building Positive Experiences by trying my hardest to notice the positives; I was healthy and being well cared for, the staff was friendly and knowledgeable and most of all I was going to meet my son soon.    

For the next few hours I focused on Mindfulness and Distress Tolerance skills.  I self-soothed by holding the lavender in my hands and breathing it in as well as listening to some of my favorite songs.  I used the ice in the cup to remain focused, I utilized Mindfulness What skills to observe, describe and participate by releasing the pain with my breathes.  I utilized IMPROVE and took a vacation thinking of the summer’s I spent with my family as a child while it was snowing 6” outside, as well as encouragement by telling myself I can do this.  I utilized DEAR MAN with my husband by telling him to encourage me and even though he is squeamish he was able to help me cheerlead and validate my feelings.  I utilized Half Smile with staff in order to be in a place where I could get my needs meet and be kind to others.   Using Ride the Wave allowed me to handle the physical pain a bit better as well as some of the sudden changed in my treatment that had to be made for the safety of myself and my son.  Lastly I focused on an object in the final moments of labor, which the nurse initiated by telling me to look at her while I pushed.

At 10:17am my son, Javier was born to a set of parents who were able to make the best out of a less than pleasant experience.

How to Find a (Good) DBT Therapist

One of the most common e-mails I receive at DBT Path is asking for a referral for DBT counselors in their areas.  It can find like a needle in a haystack to even find a DBT counselor let alone one you connect with.  Don’t fret there are options out there and some don’t involve leaving the house.

1.  Behavioral Tech

The Good:  This list is of those formally trained though Behavioral Tech.

The Bad: Many DBT Therapists are not trained through Behavioral Tech (myself included) and it includes mostly DBT Clinics over individual counselors.

2.  Google

The Good: It’s simple and it might bring up therapists who willing to do sliding scale or starting a practice than those who pay to be on search sites.

The Bad: It’s google, so anything with “DBT+ Phoenix” will come up, including a band called Drive By Truckers.

3.  Good Therapy

The Good: Easy to use search engine just for therapists.  You can search for DBT-specific therapists and see short bios and pictures.

The Bad: Same as with other search engines for therapists, they pay for the advertisements so small practices might not advertise.

4.  Psychology Today

The Good: This is the top site for searching- more listings and more detail in profiles.

The Bad:  Same as good therapy regarding therapists paying for their listing.

5.  Live Person

The Good: It’s online, via e-mail or make a phone appointment so stay in your PJs also some therapists profiles say “live now,” which means if you want to talk to someone at 3am they might be someone there (it’s not crisis counseling.)  Therapists do not pay to be listed and they have reviews.

The Bad: Many people like face-to-face therapy and the prices are a bit steep if you are looking for ongoing help.  There are also less than 10 DBT Therapists listed right now.

6.  Look for a non-DBT Therapist.  : I know this seems weird, but hear me out on this.

     The Good:  Many counselors who are not DBT Therapists are still great counselors.  If you are looking for help      with trauma and sharing diary card/homework accountability, a non-DBT Counselor might be a great fit.  Yes,      you won’t talk DBT the whole time, but you might get great non-DBT coping skills.  This opens up the number      of local Mental Health Professionals exponentially.

     The Bad: It’s not DBT-oriented.

So now you have some names and numbers of DBT Therapists so where to start?  There are many articles on how to find a “good” therapist.  This site has a great list of what to ask so I am going to focus on what to ask a “DBT Therapist.” 

I put “DBT Therapist” in quotes for a reason.  There are many great therapists that have some training on DBT and list DBT in their profiles, but then don’t have much knowledge of it.  Many of the search sites have check boxes and I think many therapists get “click happy.”  I am not saying these are not great therapists, but if you are looking to talk DBT, review diary cards and talk skills these counselors might not be a good fit.  Here’s a list of what to as a “DBT Therapist to ensure they are DBT Counselors:

·         Give them a ring, not an e-mail.  Sounds sneaky but try to catch them a bit off guard so their answers are not prepared even if they end up calling you back.

·         Take the free meet-and-greet.  If you are searching someone in person, most offer an initial consultation on person or on the phone- take them up on it and be prepared with questions.  Consider this a job interview and you are the boss!

·         What training do you have specific to DBT?

·         How many clients who have (your diagnosis or primary issue) have you used DBT skills with?

·         Have you ever facilitated a DBT group?

·         Are you familiar with DBT Diary Cards?  Emotion Regulation 1a worksheets?

·         How familiar are you with specific skill?  Heck name a few major skills (i.e. Wise Mind and Opposite Action) and see if they can keep up.

You are the consumer and deserve the best- be assertive!  Ask for exactly what you want to work on.  If you are struggling with relationship issues and past trauma issue start the conversation with, “I am working on relationship issues and handling past trauma that is interfering with my life.  I am looking for more accountability and skill building one-on-one.  I have found wise mind, radical acceptance and mindfulness most effective and could use more depth in my learning of these skills.”  A good therapist who isn't well versed in DBT will re-direct you to someone else.

No matter which way you go, if you need help be EFFECTIVE and find it!

Family and Loved Ones with Emotional Regulation Issue Seminar

A week from today Sunday 9/29 from 4-5:30PST Debbie Corso from Healing from BPD, myself and guest Dr. Perry Hoffman from NEA BPD (National Education Alliance for Borderline Personality Disorder) will be facilitating an global seminar for family and loved ones of those with Emotional Regulation Issues.  We will be talking about how loved ones can help, what resources are available to both clients and their families and have an open Q&A session.  

There are 2 days left to get the discounted price.

If you have any questions e-mail dbtpath@gmail.com

Ask Any DBT or BPD Questions This Weekend!

Hi All,

Quick note.  This weekend I will do a Q&A on twitter.  Feel free to ask me any questions about DBT or BPD.  Tweet them @apazma, DM me to be anonymous, e-mail or leave them in the comments below.  I will re-post all questions (minus names) here after I am done.

Great way to get some professional information!

Profiles of Borderline Personality Disorder: Tess Smith

Misdiagnosis and Invalidating Environment

Tess Smith was diagnosed with Borderline Personality Disorder in 2006 after 16 years of treatment for dysthymia, anxiety, and obsessive compulsive disorder.  A misdiagnosis that resulted from her lack of trust in adults as a child, and miscommunication with therapists as an adult. "In 2006 my primary diagnosis was BPD in addition to depression, anxiety and OCD. I started seeing a therapist when I was 14, it took many years for them do diagnose me correctly because I didn't trust anyone enough to admit I was a cutter.  Growing up mental illness was not anything we talked about in my family. When I was first diagnosed (with depression, anxiety, and OCD) my mother didn't want to discuss it or even look into it. She told me I was “in control of my feelings” and I “just needed to get better”, so for many years it was a dark secret. I hid it from everyone, I didn't talk about it, and I sure didn't look for others like me. There’s a lot of shame in a mental illness diagnosis."  

Tess's secret kept her sick and her environment growing up was very invalidating, "my father died when I was 12, he was sick for years so growing up I wasn't close to any adults. We weren't able to ever express how we were feeling, it was always very important to look perfect. There were several situations in which I felt I had been lied to and my trust betrayed. I never felt like I could trust my mom, and her reaction to my initial mental illness diagnosis made it clear she wasn't going to be very supportive.” Tess's secret mental health issues continued throughout her teen and early adult years, " In my teens I never felt like I could talk to anyone about what I was doing without them telling my mother... and when I became an adult, no one ever came out and asked me if I was a self injurer."  It has taken Tess a long time to get to where she is today, “22 years of off and on therapy and prescriptions for Prozac, Wellbutrin, Remerol, Ambien, Xanax, Clonazepam, and Trazadone."

BPD and Stigma

In 2006 Tess found little information about her diagnosis online, "I had never heard of it... and when I found out what little there was out in the mainstream media about it - it wasn't easy to wrap my head around.   The movie everyone knows is Fatal Attraction... no one wants to be that crazy chick... and accepting the diagnosis is one of the hardest things - but the first step I think in getting better."  

Treatment & Hope

When she was diagnosed in 2006, she was referred to Dialectical Behavioral Therapy.  Unfortunately, the first class was full, then there weren't any that met her work schedule, and then she lost her insurance coverage.  When she again had coverage to attend DBT classes, she couldn't get time off of work to go. At that point Tess took her treatment into her own hands, "I did my own research and thank gods for the internet in 2011 because it gave me access to self help and the DBT tools I needed to at least get going. This is a long term thing… something I will have to manage for the rest of my life. Has it improved? YES! Simple skills I was able to find online have helped me when interacting with everyone and in almost every situation. My personal relationships have improved and are more stable and I find myself willing to put a little more of myself out there, in order to improve life. I do continue to take Prozac to alleviate the symptoms of anxiety and depression, but use DBT skills to manage my Borderline Personality Disorder."

Relationships

Along with Tess's new coping skills, she is also developing friendships, "I'm very careful with whom I let get close... I've surrounded myself now with a handful of friends who I depend on.  I'm better with some distance though... I don't talk on the phone or hang out - I text, IM online... I don't go out.  I am more comfortable when I can control my environment and who I am with.  I don't seem to have conventional relationships...I've been married 4 times, and the longest relationship I've ever had is with my cat."

Ongoing Struggles

For Tess the hardest part of her BPD diagnosis is the emotional dysregulation, "my rapid and intense mood swings. I go from loving the ground you walk on to 'I can’t stand the sound of you breathing' in 2 seconds flat.  It’s hard for me to pin-point what I'm feeling, and then I have to figure out why I'm feeling it... every swing is an internal dialogue.  It’s hard to just 'be'… it seems like I’m always trying to figure out what I’m feeling and if it’s appropriate.  I feel tired a lot."  

Successes

For Tess getting the right diagnosis made a big difference, "it helped because I finally knew what I needed to do. My life was always on reset about every 4 years; a new address, new husband, and a new job. I didn't feel like I could be anywhere for very long without destroying everything. I had a stressful job, the diagnosis made me realize that maybe I liked what I was doing but not the position I was in, because it was just too demanding. I’m not built for that kind of long term exposure to stress. I now have a career in the same type of industry, but my day to day is very different. My interpersonal skills have improved, and I'm able to communicate what it is I want - instead of just being upset about not getting what I need. This whole time it’s been like being lost... and then getting a GPS.”

What would Tess like those without Borderline Personality Disorder to understand about those who do have it? "I’d like them to know that we don't mean to be cruel. It’s a protective mechanism that's a knee jerk reaction - we don't aim to hurt you.  We can seem distant or self-absorbed… if you get burned you pull away and it looks/seems like were lashing out. I think the main underlying issue of BPD is that we grew up in an environment we didn't feel safe in, and no one ever taught us coping skills - so we made our own."

"I used to think having a mental illness made me weak... I felt emotions more than other people and it made me different. I've learned now to look at it as a source of strength, my perspective has changed. With tools, friends, and willpower - I am strong enough to get better."

Why I needed a Twitter-cation

After being away from Twitter, other social media and MIA from e-mails for a week, I returned this Sunday to peak back out and say hello.  I also decided to write a brief explanation of why I needed a break from anything besides my 9-5 job.

The Bad:

• As a Counselor on twitter, it's hard to continue to be engaged.  I often felt like I worked 8 hours then came home and kept working on twitter; interacting and (hopefully) helping with people with mental illness.
• My passion for helping people became overwhelming and I was staying up late to finish a conversation, complete a blog post of think about someone on twitter.
• The (TW) ongoing suicide, self harm or pro-eating disorder posts; as a Counselor in person if someone is going to hurt themselves there are things I can do and feel powerful and in control.  On twitter, especially with the high rates of those with BPD and self-harm/suicide I feel hopeless and ignoring certain people or posts was still not preventing me from sleepless nights or thinking I should have done something to help at 2am.
• My 9-5 job is very, very stressful.  If you are unaware I work as a Dual Diagnosis Counselor in a Women's Prison.  Until this evening at 8pm, I was 6 months behind on filing- now I am 2. 40 hours a week doesn't cover the workload and I mostly refuse to stay much later for my own sanity leaving me with heaps of work that sits, stresses me out then gets noticed by the boss.
• I have "too much compassion," this might sound weird, but I begin feeling too much for people (maybe the honest words is co-dependent) and I was struggling with drawing a boundary.
• Having boundaries is difficult online for me, and I found myself not being able to say no to the many requests for help.
• Essentially I was not going a good job of self-care and didn't feel like I was ever "off the clock."

Moving Forward:

• Although I will be back on twitter, I am going to set some self-limits on how often I am on.  Checking twitter while I do my 9-5 is no longer going to happen. Just morning, evening and maybe a check in during lunch.
• I will continue with the contests (I really enjoy it) but need to figure out some online format that is simple for me to track.  I will not be mailing books out, as that turned out to be more expensive than I presumed as well as it taking 4 weeks. The last contest probably took 6 hours to tally, choose, order, mail, track and in one case even re-order.
• I plan on continuing to respond to DM's from those I know, or answering brief questions, I am no longer responding to people in crisis- but refer elsewhere for their help.
• If anyone posts about suicide or anything I feel I can not handle, I will *edit* Report to Twitter to follow and possibly re-tweet for others to help, but not give support myself and not engage in any "therapy-like" behavior.  If the same person has ongoing SI or ED chat, or continues to post pictures I will "block" them for my own safety.
• I will continue the BPD Interviews, but only set-up one a week.  If it takes 6 months to get them all done, so be it.
• I will be in bed by 10pm if I have work early the next morning, midnight if I do not.  
• I will drink 6-8 glasses of water and weekly Vitamin D supplements.
• I will eat better, consume less caffeine and spend more time playing with the dog than hitting refresh.
• I will stop from extending myself too far and pull away before I feel overwhelmed.  
• If I need to take a break, I will not beat myself up or feel like I let anyone down.
• I will read a book every 2 weeks to once a month.  These books will not ALL be mental health or addiction literature.
• I will be more gentle with myself.
• I will remind myself that I am not a masterpiece, but a work in progress.

Mental Illness and Self Identity

Since the book contest has been going on for a week (congrats winners!) I have not been blogging, but now my ideas are running amok so it's time to put down on paper what's swirling around my mind.

I have been getting a lot of questions about the new changes to the BPD diagnosis in the DSM5 coming out in May 2013, which was just finalized this weekend.  The new diagnostic criteria for BPD in my opinion is vague and covers too many people.   But what if looking at the current criteria, and after years of therapy, DBT, CBT, therapy, heck even EMDR therapy you now meet 1 or 2 of the criteria when 5 or more criteria equals a Borderline Personality Diagnosis?  Well, first off you no longer have a BPD diagnosis (per the DSM IV-r) but does this make you "cured?"

"Recovery may seem like an illusory concept. We still know very little about what this process is like for people with severe mental illness. Yet many recent intervention studies have in fact measured elements of recovery, even though the recovery process went unmentioned. Recovery is a multidimensional concept: there is no single measure of recovery, but many different measures that estimate various aspects of it. The recovery vision expands our concept of service outcome to include such dimensions as self-esteem, adjustment to disability, empowerment, and self-determination. However, it is the concept of recovery, and not the many ways to measure it, that ties the various components of the field into a single vision. For service providers, recovery from mental illness is a vision commensurate with researchers’ vision of curing and preventing mental illness. Recovery is a simple yet powerful vision  (Anthony, 1991.)"

I have worked with many people whom were diagnosed with a mental illness, and though therapy, groups and sometimes medications, were doing better; holding down jobs, attending college, making friends and felt like they were lost for a while, "I have been Bipolar for so long who am I now?"  I think this mindset can be especially true for some with BPD, since the therapy is so intensive and the community is so tight-knit.

Take for instance a client I worked with whom had Bipolar disorder with psychotic symptoms; he had been attending NAMI groups for years, most of his friends were from the mental health clinic I worked at, his calendar was filled with Bipolar workshops, meetings, and events he had been attending for years.  After years of therapy and medication he was still attending these events and at some point I told him he was the poster child for "Bipolar Success."  He was confused by this term "success," he asked, "am I cured?"  I opened the DSM IV-r and read through the criteria for his current diagnosis- he meet 2, when 5 was needed.  After I assured him that he was not going to be dropped from services due to this (oh, insurance woes,) we spoke about if he should continue to spend 20 hours a week surrounded by those with a mental illness he no longer has? Should he drop all his friends? Was it appropriate to discuss at NAMI meetings issues surrounding a mental illness he no longer has? Should he tell people?

After a 50 minute session and a follow up phone call (he was "freaking out!") we decided his plan of action; it is okay to continue the relationships he has created, he can be a role model for others regarding what recovery looks like; attending NAMI meetings-okay BUT new doors are now open he didn't think were when he was diagnosed before; college classes, a healthy relationship (he was too embarrassed prior to have one,) and  full-time employment over collecting disability.  He was (understandably) so attached to his identity that he didn't know who he was without it.

I understand this isn't the case for all people with Mental Illness, as some hide their mental illness from others, are not properly diagnosed and some even avoid the reality of their illness.

Here is a great list of people's stories regarding their mental illness recovery Connections: Stories of Recovery from Mental Illness:

"Today, LeRoy doesn't see any doctor for therapy. He sees his doctor simply to refill his prescription when needed. His treated Delusional Schizophrenia affects him as much as treated diabetes or high blood pressure would. He takes responsibility for it, and life goes on.  "I take my pill at bedtime. I haven't really had any side effects," he says.  But perhaps there has been a side effect his job. As a survivor of a mental illness, LeRoy realized he now has a responsibility not only for his own recovery, but for the healing of others. So he's made a career of it. LeRoy helps other people with mental illnesses, called clients, as they walk their own road to recovery.  He says he may be making less money than he set out to earn, but he's helping more people than he ever thought he could.   In addition to mentoring and supporting people with mental illnesses, LeRoy tries to teach the public about mental health issues. He speaks to churches, schools, and practically any group or individual who wants to hear about the bravery of those who battle mental illness.  It's easy for LeRoy to talk about bravery, because it's bravery that helps him accept himself, accept his diagnosis, and go forward.  "You can't deal with your mental illness until you can agree with yourself that, 'Hey, I have a mental illness so I need to be responsible and take care of it.' "  He's brave. He's responsible. He's taken care of it. LeRoy Simmons is a survivor, (pg. 13.)"

 I would love feedback from anyone who no longer meets the criteria for BPD regarding how they got recovery and how (if at all) their identify was wrapped up in their diagnosis.

Book Contest Winners!

*The e-books were e-mailed out today and the other 2 books were ordered and will arrive shortly*

I am happy to announce the winners, whom  all have been notified.  I received 53 entries and had 12 winners in total- twice as much as November's contest.  Some of you entered here and on twitter and a few daily.  Below are the winners.  If you won Buddha and the Borderline or Gift of Imperfection please e-mail (alicia.paz.ma(at)gmail.com) or DM on twitter your physical address so I can have it shipped to you via Amazon.  I will send the e-books and 2 other books out once I get everyone's e-mail and physical addresses- hopefully Monday.) I abbreviated all names listed below for privacy.

Stop Sabotaging: 31 Day DBT Challenge to Change Your Life

• Stephanie J (Blogger)
• Jennifer C (Blogger)
• Paul K (Twitter)
• Tee B (Twitter/Blogger)
• Befuddled N (Twitter)
• The Guy... (Twitter)
• HeavensP (Blogger)
• Rhonda (Blogger)
• Cass (Blogger
• Dltd (Blogger)

The Buddha and the Borderline

• MsStitch (Twitter)

The Gift of Imperfection

• Stephanie E (Twitter/Blogger)

November Book Giveaway

Update: After seeing all the lovely comment's about Debbie Corso's work I have decided to give away 10 copies of her book instead of 5

It was a great success last month, with 5 people winning Debbie Corso's last book (1 person even paid it forward giving away another 5 copies!)  On November 30th her new book Stop Sabotaging a 30 Day DBT Challenge to Change Your Life will be available for purchase on Smashwords.

And I am happy to announce I am the introduction writer!

Starting on Friday November 23rd at 11:59pm until Friday November 30th at 11:59pm I will be giving away 10 copies of Debbie's new book as well as 1 copy of Brene Brown's The Gifts of Imperfection: Let Go of Who You Think You're Supposed to Be and Embrace Who You Are and the 1 copy of Buddha and The Borderline

There are 2 ways to win one of *10* of Debbie Corso's book:

1) Leave a comment here with an e-mail address stating which book your prefer

2) Become a fan of my twitter then tweet: "Just entered to win 1 of 10 copies of Stop Sabotaging by Debbie Corso.  Follow @APazMA and RT to enter #BPD #DBT"

There are 2 ways to win the other 2 books:

1) Leave a comment here with an e-mail address stating which book you prefer. 
2) Become a fan of my twitter then tweet: "Just entered to win 1 of 5 copies of (book title).  Follow @APazMA and RT to enter #BPD #DBT"

Rules: After I receive 200 entries or by 11/30/2012 at 11:59pm EST, whichever comes first I will contact the 7 winners and ask for an e-mail address for those on twitter so I can "gift" the Stop Sabotaging e-book to you.  I will not use your e-mail address for anything else besides sending the book and an e-mail confirming the book was sent if there are any issues.  If I can not get in touch with any winner within a week (and I will try my hardest to do so) I will give the remaining book(s) to another contestant.  The winners of the other 3 books will need to send me their physical address to have the book shipped from Amazon via DM on twitter or e-mail.  The winners will be selected at random from my blog and twitter.  2 entries per person per day allowed (1 on here and 1 on twitter, so 14 total max.) Failure to comply with rules, such as tweeting your entry more than once a day will make you disqualified.  If you have questions tweet me!

Please play fair as I plan on doing this once a month with different books I purchase.  Next month I might give away Linehan's DBT workbook & 3 months of DBT coaching for the holidays....will update!

DBT Coaching Chat

I have talked for a while about helping those doing self-taught DBT, whom are learning DBT without the benefit of a group or a DBT Counselor.  Here are some great resources for those taking this path.  I have also started a DBT Chat room so you can ask me questions and they can be answered publicly for others to see.  I will answer as soon as I can, but it might take a day to get a response.  Feel free to help each other out as well.  There is no sign-up, nothing to download and you can remain anonymous!

http://www.99chats.com/room_333142

Disclaimer: I am a licensed Mental Health Counselor in Michigan, specializing in DBT and BPD. This chat is intended to assist those doing self-taught DBT with coaching. I am not able to provide any personal counseling on this site.

*Please begin any question with "TW" if the content may trigger someone else*