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Behavior Change: Data Collection Journals & Charts

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A huge body of research on behavior modification reports that individuals can replace old habits with new behavior. The goal of this site is to offer you healthy lifestyle behavior changes, which include implementing new behaviors in exchange of letting go of habits that no longer serve your best interest. After learning about the healthy lifestyle habits you will need a way to document your progress of changed behaviors by collecting some data. The process of change will run into some barriers and some data can allow you to problem solve so you can make individual adjustments. 

I will provide plenty of information in the blogs to assist you in reaching your lifestyle goals. You will also find on the site brief overviews of the lifestyle changes/ activities to implement. The lifestyle activities have some basic order, it starts with sleep, then nutrition, exercise and after that any order can be successful. I will provide many tools that can be used to track implementation of the activities, tools to monitor progress and problem solve bumps in the road.

Please do not get alarmed by the word “data” for the purpose of this context it will be easy such as making a tally, marking a + or -, or using symbols like a check mark. It is simple and the charts are already made for you. (The charts will be added in April 2021). We are going to start with the first and most important lifestyle change, sleep. I will introduce you to two forms of data collection for sleep.

Sleep Logs

The sleep log  is the most important collection of data you can keep. It allows you to collect meaningful information to share with your doctor. Many symptoms can be related to medications, such as, the time you take them, feeling sleepy/groggy, too energized at night, and indicators of upcoming episodes.

You can significantly improve your health and functioning by taking the short amount of time, less than 10 seconds, to jot down the information. It made the biggest impact on my health. If your sleep is not right, you will not  be able to implement healthy life changes and maintain them. For individuals with mood disorders, and many mental health illnesses, sleep is negatively impacts quality of life and overall functioning. 

I kept a journal too that documented the quality of sleep I had each night. 

  • Documented my sleep hygiene. [turned off my phone and other screens an hour before bed, limited caffeine intake to 10 am, took a shower right before bed, and practiced some meditation (counting) to try and initiate sleep.] I journaled if I did it or portions of it each night.
  • Difficulty falling asleep, 
  • Difficulty staying asleep
  • Difficulty waking up 
  • The number of times I was awake and out of bed, and if I was able to fall back to sleep. 
  • I noted symptoms, like sweating and chills
  • Waking feeling drugged, and not able to hold my eyes open
  • Waking and not being able to stay awake and get out of bed
  • Did I go back to bed right away, how long did I stay there
  • Did I wake with too little sleep and felt energized, if that lasted all day and into the night 
  • If I napped, and how long (did I feel rested of groggy)
  • Recorded what I did when I was up in the middle of the night, did I need to change a pattern (like eating, or getting on my computer) with a more relaxing activity like reading. 

As a result, with all my new data, I went to my doctor with a lot more information than just saying, “I can’t sleep”. The data allowed us to problem solve the situation and come up with better  solutions. As a result, the information led to me changing the time I took some medications, and we added a sleep medication to help me stay asleep. 

My sleep improved and I could function and actually do healthy activities. After overcoming that battle, I felt like I had some control of my life, a basic need was met and I could keep a sleep routine which set the tone for my day. Being sleep deprived limited me from having the energy to exercise and the deprivation of rest made make unhealthy food choices. I began working on exercise and nutrition activities next and found success because I had the energy to engage and saw the efforts come to fruition. 

Data

There are two ways that I collected the sleep data, one was a journal and the second was a daily chart that resembles a calendar. I started with the journal to just document what I observed happening. After a week or two of review I found a few patterns that I wanted more information on. Information I knew that I needed to be able to have a conversation with my doctor about. You will find copies of examples of the charts in the store (in April 2021) but I will describe them here.

Feel free to make your own way to keep information, (we will cover them later). People often want to avoid anything that has to do with data, but it is nothing to worry about. We will learn how to take journal entries and transfer them into graphs. Ones you can draw or if you prefer we can use fancy one from some software or google docs/sheets. I’ll provide options later.

The Journal

The journal can be a notebook or an actual journal. I just made daily entries about the information I was collecting. Here it was for sleep. 

  • Write down the date, 
  • Details about my sleep routine.
  • Add information about the number of times I woke, 
  • Write the time I actually fell asleep and woke, 
  • Ass any details listed above. 
  • Note how you felt during the day (energized, fine, groggy, moody, etc.) 

The purpose of the journal is to gather information. For example, I later reviewed my week and looked for patterns. Maybe I’d find that I drank coffee at 3pm everyday, or had to nap and felt worse when I woke. I found a few problems and decide to make a chart so I could see how frequent it was a problem. In the example below I chose: difficulty falling asleep, difficulty staying asleep, difficulty falling back to sleep. I also kept some notes, I was interested in how long I was staying awake. I knew my doctor would want to know what time I was trying to go to bed and wanted to wake, so I also noted that information each day.  

The Chart

I was looking for a pattern of frequent behaviors that were the most problematic for me. I documented the sleep patterns, difficulty waking, the number of times I woke and how long I was awake when I woke. I found that I was waking very often and staying awake for more that 3 hours. I did have difficulty falling asleep some but the other behaviors ocured more frequently. 

I used a calendar like chart that had the date in each square. I made a symbol for 🔲 difficulty falling asleep, 🔴 difficulty staying asleep ◃ and difficulty falling back to sleep. Then I wrote the hours I stayed awake, the amount of time I slept, noted when I tried to go to bed and when I wanted to wake up.

Example 

Entry: Date/2/15/21  Date of Behaviors: 🔲, 🔴, Notes: 4, 3hours, 8:00 – 5:00. 

I will show you later how you add this into a chart so  your doctor can take a look and see the pattern easily. That’s important because your doctor is not going to have time to read a month worth of journaling, typically you have 15min so a single graph does the trick. That will be a future blog in April 2021. So be looking for that information. It can really help getting the care you need.

I didn’t realize that I was struggling to stay asleep before I collected the data, and I was actually telling the doctor I couldn’t fall asleep. After we reviewed my chart the doctor had accurate information. As a result, we found the right sleep medication to help me stay asleep, and like magic I was sleeping. I kept the chart and found that I was not doing the sleep hygiene routine consistently. I was drinking coffee late in the day, I didn’t follow the routine at night, (screens off, brush teeth, drink some weather, listen to a book, shower and go directly to bed.) I made adjustments and held myself accountable and guess what, I started falling asleep right away. 

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Vulnerability

Vulnerability is the only authentic state. Being vulnerable means being open for wounding, but also for pleasure. Being open to wounds of life means also being open to the bounty and beauty. Don’t mask or deny your vulnerability; quake and shake in your boots with it. The new goodness that is coming to you in the form of people, situations and things can only come to you when you’re vulnerable, i.e. open

Stephen Russel.

Being vulnerable can suck.

I’ve spent the majority of my life being guarded and unavailable for authenticity. During recovery I’ve learned to tolerate it in small batches. My batches are bigger now that I’ve found safe people to be authentic with. Not everyone is in a situation to be vulnerable. It can be dangerous. I’m not sure what the path is, I think it is uniquely different for each one of us. I know for me I was finding some safe people to try it out with. I found my first experience with a group I joined hosted by a church. I do not have a habit of going inside a church, but for some reason I did. It was a class and it involved groups it was outside my comfort zone, but I enrolled. We learned about how to belong, and I needed that after spending a few years on my own, meaning shut up in an apartment, avoiding people in general.

Safe People:

So I think there is this wisdom of the importance of vulnerability, but it should come with a caution label. You have to find safe people. How, right? There are safe people out there. Look for people with these qualities;

  • they practice boundaries
  • they don’t gas light,
  • they can talk about emotions,
  • they do not try to fix you,
  • they can sit with you through tough and painful emotions.
  • They respect your boundaries. Encouragement and pushing is very different.

Where: 

Honestly, people in addiction and recovery groups have been my safe people. They have provided a place where I have found safe vulnerability for the first time. I do not have addictions, I have chronic mental health issues, but not a classic addiction, regardless, fate landed me there with great groups of people. I learned how to be a safe person there. I tried out this thing called authenticity. As a result I made a few good friends as a result, how to be one too. There are groups for mental illnesses, and I’m sure there are good ones, I just never found any. The majority of it was people talking about symptoms and how life sucked. I think group therapy can provide some safe opportunities. I’m sure there are good groups out there somewhere.

How:

It’s not the same for everyone, but this was my approach. After I felt like I had a few good experiences I took my vulnerability out into the community. I volunteered and interacted with people struggling more than myself. I allowed myself to interact and connect with people. I would have not done that prior. Then I co taught some art groups. I’m not a teacher, an artist but not a teacher. So when a friend asked I wanted to say no right away. I had previously told myself that I was going to say more “yeses” that year, so I said yes. The groups went really well and because I was vulnerable I was able to experience some pride and a  deeper connection with my friend. 

Now I’m working. After being away for 5 years I have all kinds of insecurities from interacting with others to my skills as a psychologist. Each day I try to be authentic, and it is terrifying. The effort is working out because my confidence is building little by little. I’m making authentic connections with coworkers and the people I serve. Before the last big episode I lived in a constant state of fear. The antidote to my fear is being open, and allowing myself to experience vulnerability.

It didn’t happen overnight, it took 5 years of experiences to get me to a  place where I can tolerate vulnerability:

  • Where I’m ok not knowing what to do or say
  • Being kind with myself when I’ve made mistakes,
  • admitting I do not know,
  • asking for help,
  • sitting without knowing what tomorrow will bring.
  • reaching out to close friends when I need company sitting with an overwhelming feeling
  • and for me seeking out a power greater than myself

My best advice for starting or deepening your journey with vulnerability is to seek some spiritual guidance, find safe people and be willing to feel awkward and uncomfortable. The benefits outweigh the discomfort

  • Deeper relationships
  • Skills to navigate difficult emotions
  • Closer relationship with your higher power
  • Ability to take risks for building a better, more positive future.

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Spirituality: Gratitude

Spirituality takes on many different forms for people. Some turn to organized religion, some connect with nature, others use aspects of many, and some find individual practices to connect to something greater, or the universe. All are expressions of us realizing we are not on our own and belong to something more, something greater. When you have an illness in can be easy to disconnect for a number of reasons. I did for a good period of time due to my psychosis involving religious delusions and hallucinations. I wanted a far distance between the illness and reality for the fear I could hit a point where I could not tell the difference between them. I found my way back slowly. One way I started was developing a practice of gratitude. 

Gratitude plays a significant role in relationships, health and spiritual connection. There is a large body of scientific literature on gratitude; two main contributors are Robert Emmons and Michael McCullough. 

Gratitude is defined with in the body of scientific research as:

  1. “Recognizing that one has obtained a positive outcome, an affirmation of goodness, there are good things in the world, gifts and benefits we have received.”
  2. Recognizing that there is an external source of goodness outside ourselves

Gratitude

  • Gratitude can be one way to practice the element of joy, Spirituality.
  • Gratitude is both an emotion and an act. 
  • Gratitude can be felt in real time when we recognize a blessing, a kind act, a memory, seeing a small child playing, hearing a loved one’s voice, tasting your favorite food.

“Joy is the simplest form of gratitude.” – Karl Barth

Benefits

All of these things, and many more, can result in you feeling a fleeting emotion of gratitude. Whenever you receive kindness or give it away you may feel gratitude, and its presence can spark the experience of joy. Gratitude has more to offer than just an experienced emotion.

  • Gratitude can shift moods which is an important skill to have.
  • It can prevent a bad day from taking away your opportunity of joy.
  • It gives you a tool to connect with others when that seems too overwhelming.

Relational Connection

Gratitude, in its authentic form is relational, serving important role in building and maintaining healthy relationships, with your connection to God, nature or the universe. When I was ill I lost my interest in connection. I avoided opportunities and isolated. Gratitude for things in my in my life was a simple way to make an effort in connecting with others. I started with God and eventually worked my way out to feeling gratitude of those in my life. That lead to me stepping out and starting to try to connect. Individual work and interaction with others provides a full spectrum of experiences.

  • Having gratitude for blessings in your day.
  • Insight and connection with something larger like God, connection with nature, or with the universe.
  • Gratitude for people (and pets) is relational, and that is something that needs to be rebuilt after episodes with the illness.

Awareness that Goodness is present

There are reasons we fail to notice the good around us, one is that we are not looking. Our society funnels news of tragedy, social medias, busy work schedules, illness, hype on diet/death, etc. No matter where you look there is a message of “fear this, reject that, avoid at all costs, be distracted by this, no time for that, pursue to achieve unrealistic goals, etc.” One has to take a few mindful-moments and really think about something positive, something to be grateful for. There is a need for something structured to help you reflect, to feel positive emotions, and foster important relationship(s) with yourself, the Creator and others.

Here is an easy way to start your practice, think about the following:

  • What did I hear today that brought me joy?
  • What did I see today that I enjoyed?
  • What surprised me today, something I may have overlooked?
  • What did I smell today that I enjoyed?
  • What do I take for granite?
  • What there a problem, something I was stressing about that turned out ok for me today?
  • Did someone give me a kind gesture?
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My Story

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Onset

I live with Schizoaffective disorder and after years of trying to hide it I’m coming out with a story to tell. At the age of 20 I began having symptoms. I was in college studying psychology when things started to become…different. I starting seeing things and had periods of time where I had a lot of energy and an unusual zest for life.

I happened to be taking an abnormal psych class and material seemed familiar, as if the author was writing about my experiences. To me I seemed fine, certainly not “abnormal”. I reflected and I was able to do more art, easily made As, involved in research projects, and publishing, I felt great. Something was off but no one noticed initially, not even I.

Some time passed and I began connecting ideas that had no connection. For example, I thought if I saw a feather that a spirit was guiding me to make “choices” which would lead to enlightenment. Next, I started to become paranoid and it was very hard to leave the apartment to go to class. I started seeing beings, I was in the grocery store parking lot and people began transforming from the waist up into demons who were yelling profanity at me. I was very afraid and isolated again. During periods of isolation I managed to maintain my grades and perform my activities, so no one noticed. A couple weeks would pass and I was able to join my activities again with some ease. I slid under the radar. This pattern continued for me all throughout school.

Episodes

The next period occurred when I was trying to finish my Ph.D. program. I was gathering data and drafting chapters, finishing up interviews, and as I became engrossed in the work I began believing that government was going to be overtaken by a group of politicians. My professor and mentor entertained my ideas, there was some fluidity so he didn’t think anything of it, but I was about to spiral.

I isolated and spent hours at home researching my ideas, making illogical connections, and writing without sleeping for days. I started seeing dark figures in my house and I was convinced they were spies. I started having gran mal seizures due to exhaustion. I spent days in the hospital as everyone was trying to figure it out. No one asked me about paranoia or seeing things and I didn’t realize I needed to tell them. To me it was all real. Unfortunately, I didn’t not get screened. They found I had a seizure disorder and treated that instead.

In early adulthood, after a significant loss I experienced another episode. I had isolated and believed there were rats on the top floor of the house. I could hear them come down a d scratch my bedroom door each night. I bought traps and had friends convinced they heard them too. Somehow they went from rats to demons trying to get me. Not long after I started hearing persecutory voices and seeing beings that where not really present.

One morning at 2am the voices commanded that I go to to lake. It was below 20 degrees, and I got in my car and drive several miles to the lake. I got out walked to the edge of the lake and sat on a slab of ice because I was told to meditate until the higher consciousness was downloaded. Once the download happened I would be responsible to save humanity. Luckily a fisherman happened to be out and returned me to my car.

I was lucky to find a good doctor, that asked all the right questions, and the timing was right. I lost everything with that episode, financially, relationally, professionally because I simply could not function. I hit my rock bottom.

Recovery

My recovery included many therapies. I may be the most well adjusted human in the room now. ☺️. My recovery did not just come from a pill bottle, it came from a community. I learned a lot of skills and wouldn’t change my experience if that were possible. I have a lot of grit because of this illness.

  • Neurofeedback
  • Relaxation and Body Work
  • Assertiveness Training
  • Boundaries
  • Cognitive Behavioral Therapy
  • Self Monitoring Symptoms
  • DBT
  • Social Skill Groups
  • Groups for emotional regulation, executive functioning skills
  • Groups for social connection skills
  • Religious groups
  • Practicing Zen
  • My own interventions!

It was not an easy journey, and I did a lot of hard work. It has taken me 25 years to feel “put together” and I’m honestly living a great life. I finally have the right mix of medication, I learned a lot of important life skills and I put everything I learned into a daily practice. I didn’t do the work to “put things back together”, I did the work to create something new.

Things Lost

I have lost, and some of it was good looking back, but in the moment it was devastating. Things I lost;

  • Friends
  • Spouses
  • Homes
  • A job
  • Money
  • My independence
  • My dignity
  • Living a life without constraints
  • Freedom to do whatever I wanted whenever I wanted to do it

I spent a good amount of time angry, sad and feeling hopeless. I learned how to make space for those feelings and grow. I have grieved my prior life, I have given up a lot. It was a painful process, but I can look back and be grateful for every moment.

Things Gained

I was in a bad place and I walked into a therapist door thinking it was a waste of my time. I had a horrific episode, I had to resign from a job, I couldn’t pay bills and had to move. I didn’t work for 3 years, lost my independence and felt worthless. My therapist asked me, when you interview how are you going to present yourself. I was speechless.

I couldn’t think of one thing, so I just sat there. He smiled and said, “Stephanie, you just survived a horrible situation, you have grit.” He sent me home with an assignment to write my response. What qualities did I gain from surviving my illness. Well I included “grit”. This is what I came up with;

  • Authentic friends
  • Authenticity
  • Willpower
  • Perservance
  • Empathy
  • Wisdom
  • Compassion
  • Communication/Listening skills
  • Followthrough

I practiced “seeing” myself from a new perspective. I got a job with one interview and I’m eternally grateful. Recovery is tough, it’s possible and the growing pain is worth it. If you’re going to make it you have to learn about the illness, learn about the skills you need to be healthy, commit 100%, have grit and show up each day ready to work. I truly believe anything is possible and if you believe in yourself to can create opportunities to grow each day.

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My diagnosis is “human”

Invest in your future self.

-me

So, I thought about introducing myself…hello, I’m Stephanie and I have schizoaffective disorder. That seems too basic. I’m more than schizoaffective, I’m complex. Weird. Awkward. Insecure. I’m curious. I’m also human and with my eccentricities I also deserve a place at the table. This website is designed to share interventions and strategies from a peer with a mental health illness that has been in dark places and am now thriving. It is possible for everyone.

The second purpose for the site is to bring all of you to the table, to have your voices heard. I will dedicate 1/2 of the work here to helping you voice your needs, lift your head, look people in the eyes, and call out with your voice to be heard. You matter.

When I was in dark places, I looked for my kind, a story of hope, someone to identify with, how to recover. I didn’t find anything that came from the an individual like me. Books tended to be glorified train wrecks, I was living dark times, I didn’t want to read about them. I wanted the formula to get through the darkness, to walk in some damn light.

I didn’t find it, so I rolled up my sleeves and made it up myself. I’m a psychologist, an interventionist, an artist, so I’m creative and resourceful. I came across some good research and practical sense and made a way for myself. I sat down and crafted a simple intervention, so simple I thought it would be too easy and not work. I’ve named it the Elements of Joy.

My hope for the blog is to share what worked for me. It will not work unless you make it your own. You’ll need to customize it and use your will power to do the work. It consists some of the 8 different things in your life daily, on a strict routine.

  1. Outdoors/Nature
  2. Exercise
  3. Sleep
  4. Nutrition
  5. Social/Relational
  6. Spirituality/Altruism
  7. Rejuvenation
  8. Creativity/Work

This is the nutshell, you will need to follow along with me to unravel how it works.