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We've all got goals, whether they pertain to DPAFU or not. All too often in life, though, we fall short of accomplishing those goals either because they're unrealistic, too vague, or without deadlines. While your ultimate goal in this case is, of course, a life free from DPAFU, you need to set periodic goals along the way. Setting and achieving goals will boost your confidence, which will improve your overall mood and encourage you to continue in treatment when you might have been tempted to give up. It will also allow you to see the progress you've made thus far and illustrate to you that you are, in fact, improving, even when you don't feel you are. This is the same reason that doctors frequently take before and after photos of medical procedures, and why those pictures can be a very powerful tool in advertising. It really allows you to take an objective look at where you were, and where you are now. From early on, Overcoming DPAFU recommends setting realistic goals for yourself using the SMART method, as follows:
  • Specific - Know exactly what your goal is. For so many of us, the goal is just to "feel better." But that's not specific enough. If you're not exact in what you want, how will you know when you've attained it? If, for instance, you're currently out of work due to the issues you've been facing with DPAFU, returning to a job is a specific goal.
  • Measurable - Your goals should have a quantity of some kind that can be measured. Again, saying that you wish to feel better doesn't have a specific unit measurement that can be calculated, so it's difficult to tell if you're any closer to achieving it. It would be measurable to set your goal as being DP free for one hour per day, for example.
  • Achievable - Don't set yourself up for failure. Make sure your goal is something that can be attained. By the same token, setting goals that are too small (I want to be able to go outside and get the newspaper) and too easily achieved does not challenge you sufficiently, and will stall your progress.
  • Realistic - It's important to set goals that are within your reach and attainable from your current state of mind. Don't compare yourself to others in this instance - you wouldn't expect to be able to throw a football farther than a pro NFL player. By the same token, you can't realistically expect to be able to do something that is very frightening or difficult for you simply due to the fact that others are able to do it easily. Choose something that presents a challenge, but also something that you're capable of reaching with enough effort.
  • Time-limited - Give yourself a timeframe within which the goal must be completed. It's far too easy to put off accomplishing a goal when there's no deadline. If you want to be able to complete a shopping trip to the supermarket by yourself, for example, set a date by which you will accomplish this and work your way toward it.
Avoidances and Safety-Seeking Behavior

DPAFU has a way of altering our behaviors so that we do things differently, both causing us to limit or avoid behaviors and situations that make us feel worse, as well as performing behaviors that seem reassuring, but may be harmful in the long run by making us rely on them to feel secure.

Common avoidance behaviors include:
  • Limiting socializing with friends
  • Avoiding unfamiliar places
  • Confining yourself to your house
  • Staying away from places that might have a negative memory attached
Some safety-seeking behaviors include:
  • "Checking" to see if symptoms of DPAFU are present
  • Googling conditions to reassure yourself that you do not have them (this can often backfire, strengthening the belief)
  • Seeking reassurance from others that what you're feeling is in fact DPAFU and not something else
  • Sleeping/napping frequently to "escape" your symptoms
Once you've determined which avoidance and safety-seeking behaviors you're currently practicing, you should establish a hierarchy of the ones that you feel are the most difficult for you to do (avoidance) or not do (safety-seeking), with 1 being the easiest, and 10 the most difficult. Then you need to choose a behavior to tackle - start with something low on the scale, and work your way up from there. For me, reassurance-seeking, from my fiance, fellow DPAFU sufferers on this and another forum I visit, as well as Google, was a big one that I wanted to tackle. I'd rated it a "9" on the difficulty scale. On a day when I was feeling particularly strong, I decided that I could go without reassurance seeking for a week. This was a lofty ambition from the get-go - a two-pack-a-day smoker doesn't decide to see if he can go one week without cigarettes right out of the gate. The next day, I decided a week was a bit too much, and I revised it to four days. I made it two before I broke down and begged my fiance to tell me that I was going to get through this. As it was, the two days that I made it were grueling for me - the worries nagged at my mind and worsened my DPAFU, limiting the level to which I could enjoy things. My mistake was in setting an unrealistic goal for myself, and too long of a timeframe.

If your first effort at achieving a goal didn't work out, don't beat yourself up. Making yourself feel lousy will only dig you in deeper than you already are. As with anything else, you'll probably have a lot more near-misses than successes starting out, and that's to be expected. Even the goals that you don't quite reach will give you a good idea of where you're currently at mentally and emotionally, and will help you to revise your goals to be more attainable. If you started out with something that was a "6" on your list, try doing a 2 or 3 first. If your goal was low on your spectrum, but was for too long a time period, try cutting that timeframe in half. Succeeding in a small goal is critical, especially when you're first starting out, so that you can build your confidence and continue your progress.

When you're thinking about the behaviors that you want to correct, ask yourself these questions:
  • Why do I do (or not do, in the case of avoidance) this?
  • What's the worst that could happen if I don't do it?
  • What images come to mind when I picture myself not behaving this way?
  • What would the worst outcome mean to me?
  • What would the worst outcome say about me as a person?
  • What would be so bad about that?
After setting your goal, make a prediction regarding the results. Once you've achieved your goal, make a note of the actual results, and compare them to the prediction. Did things turn out as you expected? What have you learned? Getting better results than you had initially predicted will help to dismantle the inaccurate beliefs you may have. However, if your prediction was not hopeful and you didn't achieve your goal, be careful not to let this initial lack of success discourage you and reinforce the negative belief. It's simply a sign that you need to start smaller and be patient with yourself. Here's my example of my first attempt at a goal:

Behavior: Seeking reassurance
  • Why do I do this?
    I feel as though others' thoughts and opinions are more valid than my own, or I will feel better about my current situation if someone else has gone through the same thing and has gotten past it.
  • What's the worst that could happen if I don't do it?
    I'll have to rely on my own thoughts and opinions, which I don't fully trust.
  • What images come to mind when I picture not behaving in this way?
    I imagine having panic attacks, driving myself "crazy," becoming convinced that there's something really wrong with me.
  • What would the worst outcome mean to me?
    I think it would enhance my negative thoughts and make my anxiety worse.
  • What would the worst outcome say about me as a person?
    That I'm insecure, or (my worst fear) a basket case.
  • What would be so bad about that?
    I don't want to be a basket case, and I don't want to be insecure. I need to learn to trust my thoughts and feelings, and to reassure myself without outside help.
Experiment: Don't seek reassurance from outside sources (my fiance, online community, Google) for four days.

Prediction: If I don't seek outside reassurance, my anxiety and panic attacks will increase.

Level of belief: 70%

Actual results: Was able to make it two days without seeking reassurance.

New level of belief: This was extremely challenging for me. I need to set more realistic goals.

Note the way I worded my results - I was careful not to use any negative language in my descriptions. Instead, I focused on the fact that while I didn't reach four days, I was able to reach two days, and instead of saying that I failed at the goal, or that I couldn't do it, I said that it was extremely challenging. This may seem like small potatoes, but I believe that part of my anxiety and issues with DPAFU stems from the fact that I have low confidence and a generally pessimistic outlook on things. By simply changing the way I word things when I speak and write, I'm reinforcing more positive thoughts. With a bit of practice, I'm guessing you can do the same.

Please feel free to comment on what goals you'd like to set for yourself, and whether you've had any luck with this technique!



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Haumea
Jun 05 2014 10:46 AM

Hi bluecanary,

This is good stuff and is at the core of life coaching. I would only add that it may be easier to have a coach who is going to be asking the questions, as we do not always know just the right questions to ask ourselves.


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bluecanary
Jun 05 2014 01:00 PM

Hi Haumea,

Thank you for your feedback! I should stress, if I haven't already, that I'm not a doctor, therapist, or professional of any kind, I'm currently unable to see a therapist because I won't have insurance for another month or so, so I'm trying to do my best in the meantime with self-help. When I'm able to, I definitely plan to see someone who specializes in CBT. I think the mistake I made in the past was that I expected the therapist to just solve everything for me. I didn't take enough of an active role in my own treatment because I didn't feel capable. Now I'm starting out by taking charge of my own situation. Hopefully between that and getting advice from a professional, I'll have the best possible chance of getting better.


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Haumea
Jun 05 2014 07:06 PM

Hi bluecanary,

Taking an active role is definitely a must with these things.

If you are doing self-help right now due to insurance issues, I would add this: instead of asking yourself a question and then answering it, start a dialogue with yourself using journaling to go "deeper". So you ask a question, answer it, then ask a follow-up question based on the answer and so on until you get to the very root of the issue.

Frequently these behaviors that you want to eliminate have unrecognized benefits/pay-offs even though they may seem irrational on the surface. You want to recognize the pay-off so you can overcome the behavior.
 
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