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DahliaDeVille
Casual Contributor

Advice around positive reinforcement

Hi all,

My partner has recently been admitted to a psychiatric hospital for a few days after a particularlly scary episode. He is doing some DBT therapy and one of the things they are learning is that positive reinforcement of positive behaviour is a good way to change. I'm planning on using the time apart to organise some things for him to do when he is distressed, eg. Getting a punching bag and organising some sort of a rewards system for good behaviour and choices. What I'm struggling with is making the rewards system seem actually rewarding and not condescending. My partner is actively suicidal and has lost interest in things he would find enjoyable. Any ideas or advise would be really appreciated. Thank you 

4 REPLIES 4

Re: Advice around positive reinforcement

Gee, it sound really tough. I hope what I'm going to write, well, please take it with a big grain of salt, since my experience is of suicidal ideation and not being actively suicidal. It's hard for me to imagine what it's like for your partner, although I can imagine it's incredibly distressing for you.
When I was feeling suicidal some time back, the thoughts just kept popping into my head, because I felt trapped and helpless, even though I knew I didn't want to act on them because of my children and my family. After weeks of struggling with the thoughts and feelings, and feeling bad about having them, I decided to allow myself 5 minutes at a time every now and again just to have those thoughts without judgement or criticism, and for the rest of the time, to work on distracting myself with other things, even housework, mowing the lawn, small jobs where I could see I had accomplished things or helped the household in some way. Allowing myself to have the thoughts, while also thinking or writing about how I didn't have to act on them, released some of the pressure of feeling that way. Making it okay to feel that way, like it wasn't taboo, helped me. And it was kind of its own reward. But the deal with myself is that I would make an effort to distract myself for most of the rest of the time. This helped motivate me. But the less I felt it was wrong to have the thoughts, the less power they had, and the quieter those voices became.
anyway, I get the sense that your partner's situation is more severe and volatile so I'm really cautious in writing this.
To summarise, my reward system was 'make an effort to do an activity for as long or short as I feels okay, and the reward was to allow myself just to sit down in a funk with the depressing thoughts and feelings for a while.' Kind of counterintuitive, but it worked for me. Obviously, safety is the number one priority for you and your partner, and in that case, maybe that approach might not work for him.
I hope you don't mind me sharing this with you. All the best.

Re: Advice around positive reinforcement

Thank you so much for your comment. I'm so glad to hear that strategy worked for you and you're in a better place now. Trying to break up the thoughts seems like a really great idea. It may not work for him at the moment but I'll keep it in mind for when he's feel less actively suicidal. Thank you for sharing 

Re: Advice around positive reinforcement

Hi @DahliaDeVille ,

 

Thanks for your post.

 

In my field of work, I do a lot around positive reinforcement, intermittent rewarding, fading etc.

 

I'm not so sure as to whether positive reinforcement works when someone is so actively suicidal (?). Being actively suicidal is a very triggered/heightened stage and often beyond the 'reasoning brain'. To me, it seems like a reward system is more to do with being proactive in reducing the likelihood of the behaviours. 

What I've known to work is working with the person to come up with strategies that fulfil the same function as the behaviour you want to reduce - that looks at the function of behaviour and works to provide a replacement behaviour that gives the same/similar relief, but in a less harmful way?

 

I hope this makes some sort of sense. I know I'm talking technical...but it's hard in text form.

 

BPDSurvivor

Re: Advice around positive reinforcement

What is best when someone is actively suicidal? Just be normal, softly spoken, boring, don't talk unless they want to? Have food in the kitchen and TV in lungeroom? I have a 15yr old son so it goes without sayting he doens't want to talk. House is calm and safe. Less is more? [horrendous expereince in ED and PECC last week. NEVER again]

thank you

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