Today Sadie asked me which part of my treatment plan I want to start working on first. I stalled. I asked if we could post it on the wall and throw a dart at it. I begged her to choose something for me. Ultimately I was forced to make a choice, and as a result I chose the thing that seemed least difficult. Well, aside from “graduate from DBT group” as that’s just going to happen on its own without any intervention from Sadie.
We proceeded to spend the rest of my appointment creating a hierarchy of steps to work through in an effort to reduce my anxiety about driving. We started with the ultimate goal of driving 45 minutes on the interstate to attend the NAMI Peer-to-Peer classes, then made a list of other steps and then organized them from least to most anxiety-inducing. This will be rather cryptic since I don’t want to include the real place names, but here’s a rough idea of what we came up with.
- Drive to the bank down the street in the dark.
- Drive to Kroger in the next town in the dark.
- Drive to White Castle by the interstate in the dark.
- Drive to a friend’s house in the next state in the dark.
- Drive all the way around the interstate loop around the nearest metropolis, with occasional passing and lane changing.
- Make left turns off of US highway when not at an intersection.
- Make turns onto US highway crossing traffic.
- Drive somewhere new locally.
- Drive somewhere new in town where doctor is located.
- Drive somewhere new in town where dentist is located.
- Drive somewhere new on the interstate.
- Drive somewhere new locally in the daylight and come back after dark.
- Drive somewhere new in town where doctor is located and come back after dark.
- Drive somewhere new in town where dentist is located and come back after dark.
- Drive somewhere new on the interstate and come back after dark.
- Drive somewhere new locally in the dark.
- Drive somewhere new in town where doctor is located in the dark.
- Drive somewhere new in town where dentist is located in the dark.
- Drive somewhere new on the interstate in the dark.
- Drive to location of NAMI classes in daylight.
- Drive to location of NAMI classes in daylight and come back after dark.
- Drive to and from location of NAMI classes in the dark.
I have expanded the list of steps and reorganized it a little since the version I gave to Sadie this afternoon. There were only 15 steps in the original, but I realized as I was typing it that I had missed a few things. My deadline for completion is January 25, 2016, as that is the date of the first class. In the slightly over a week before my next appointment, I have committed to completing the first four steps – driving to familiar places in the dark.
I have actually driven to all those places in the dark before, but wanted to include them here as they still make me anxious and I need to practice having cars behind me in the dark and not completely freaking out. I always think they are going to either run me off the road or follow me to my destination and kill me, so I end up driving faster trying to escape. At times, I’ve even considered driving past my destination and circling back around, although I do manage to overcome my paranoia enough to avoid doing that.
Sadie and I discussed DBT skills I could use during this process. I named off TRUST first – trusting myself to be able to do it. Then Opposite to Emotion, because I’d be acting opposite of the anxiety by making these drives anyway. ABC (the “Coping Ahead” part) to prepare for things that could go wrong, like car trouble. Sadie reminded me that I’d just called Square Breathing my go-to skill for anxiety. Then she suggested Self-Soothe. My first thought was soothing music, as music tends to distract the part of my brain that worries about what could go wrong while driving. Her suggestion was taking a soothing drink along. I exclaimed, “I can’t drink and drive!” and she dissolved in a fit of laughter.