Chain Analysis...yes please
08/04/2022While it can be a laborious tool, it is such an important and vital DBT tool. When we are stuck in that belief that it is all automatic and we "have no control" over our reactions it's time to bring out the chain. It is important to have a good understanding of why we are doing a chain and most important for a therapist to embrace the process as well because we never want it to feel like punishment. Chains are an opportunity to explore our behaviors and vulnerabilities around those. While it is so important to be able to tell our story in a chain, we also want our clients to know that their stories matter to us. That we [therapists] care about what they have to share and want to help them to learn from their chains and in learning about themselves learn more effective ways of sharing and communicating our emotions, wants, needs and limits.
It is a pretty tall order to place on a chain analysis but the benefits of our dedication to the process is AMAZING!! Remember, we can change what we are not aware of.
Here are some helpful YouTube videos and remember dbtselfhelp.com and behavioraltech.com
Toy Story BCA
https://youtu.be/yAHAyjn7Ca8
https://youtu.be/FZRjsOlh4qI
Emotions are Helpful (ALL of them)…What?!?!?
06/05/2022Ahhhh….my favorite module in DBT. No really, it is such an empowering module. Maybe because it was an Emotion Regulation training that I first met Marsha Linehan in person. Ok, met may be a bit of an overstatement since I may not have actually spoke with her personally, though she was really facilitating the training and it was a very big deal to a young new therapist:).
“DBT thinks emotions as a brief and voluntary full system responses to stimuli, either internal or external. The average emotion lasts for 90 seconds.”
So let’s take a moment to think about it…what if every single one of our emotions had a purpose in our life and we could learn something from them. What if we could unlock the reason to the urges we have around our emotions. what if we could look at all of our emotions as something that really added meaning and understanding to lives. Something that gave us the tools to navigate relationships, with ourselves and others?? Would you believe me? Guess what??? We can!!
If we can learn to understand the function of emotions, how emotions help keep us safe and communicate to us, we can react more effectively, tend to relationships in a healthy way. We can learn that by just taking care of ourselves and being kind and compassionate, we are reducing our chances of having negative reactions.
While this is not easy it is worth it. Remembering that we have had a life time of reacting without thinking or using feelings as facts, ie. “I am afraid, so I should not do it”, “I really like/love them so they must be trustworthy/good” or “I don’t have a choice, __________ (add feelings or behavior here) just happens automatically”. These learned automatic reactions to our emotions can be changed. Building these new neuropathways is a commitment.
So, if all, and I do mean every single one, emotions serve a purpose, how do we honor that communication with ourselves? Since our emotions are are sending out messages how do we listen and understand them? Some people don’t want to “listen closer” to something that they may be interpreting as painful. Some may not see really big emotions coming until they are are reacting, often doing so in grand fashion. Or maybe we just want to avoid or dissociate. These may have been helpful responses when we were young, not so helpful now.
So by learning skills like PLEASE, ABC, building mastery and pleasant activities we learn how to be kinder and more compassionate with ourselves. We learn what helps us be more (or less) skillful with our emotions.
It is important to remember that regardless of why or how we find ourselves struggling with our emotions, because of DBT we can now learn a different way of doing things.
The What and How Skills....wait why?? 5/30/2022
05/31/2022So, wait...are you telling me how to be in the present on purpose. Really?? There are rules to this? This can be some of our obstacles in achieving this wonderful place of acceptance, being non-judgmental and effective. How can something so simple as being in the present moment be so very hard to do? In a really over simplified explanation, it is important to learn how to override a very complex system that our brains have been trying to adapt to since prehistoric times. Our brain is such an extremely complex system that has evolved in such dramatic ways and has not in other ways. Our brains naturally are hard wired to recall the "bad" things in life to help with basic survival. To recall where the man-eating animals are, or the poisonous plants are vital to our prehistoric ancestors for survival. There was not a lot of need for complex emotions that we are so in need of for survival in present times. So, what if we grow up in a chaotic environment in which we are chronically invalidated, or that expressing or showing emotions or expressing ourselves were not modeled for us? How do we gain the knowledge of emotions and do it in such a way that will help us cope and do so in a healthy way?
We do it with mindfulness and that is the How and What skills.
The What skills are:
Observe~ simply put, noticing what is currently happening in the current moment without placing words to it. just being aware of our environment without attaching thoughts, feelings or labels. This is the fundamental skill in mindfulness and is vital in teaching us how to live with our eyes wide open.
Describe~ is being able to put words to our observing though we are not placing judgment or opinions on those descriptions. We are not assigning thoughts or feelings... just the facts... yes please:)
Participate~ This done completely. Not with a little chatter going on in the back of our mind. This is being so caught up in the current moment that we lose track of time and do just one thing at a time. That then brings us to the how skills.
The What skills are done one at a time. We can vacillate though them and back again, though we only do one at a time.
How skills are:
non-judgmental~ this is sticking to just the facts. If you did not experience it personally with one of your senses, it is NOT a fact. Feelings, thoughts and opinions are all judgments and NOT the facts. This is much easier said than done.
effectiveness~ this is about doing what works. Not getting attached to who is right or wrong rather doing what works. We work on trying to not get caught up in the rules rather what will be most beneficial. We can often get caught up in the "right" thing to do without the thought of doing what is most appropriate for the situations. If someone is tailgating us on the freeway because we are going slower than them (regardless of our speed or the speed limit) we can get annoyed (at times rightfully so) which is not helpful and does not accomplish anything, so getting over when safe can alleviate grief for all involved. We have no idea what is happening with others, and we are not the police of the rules/laws. There are so many things that could be happening with those individuals. Someone could be hurt, and they are trying to get to the hospital, or they can be someone that is not stable or safe. Let's not get caught up in the drama of it and focus on the work of being effective.
One mindfully~ this is basically self-explanatory. We can only do one thing at a time. Therefore, multitasking is a myth. I repeat that multitasking is a myth. Research shows over and over again that our accuracy, efficiency and speed is compromised greatly with multitasking.
All of the How Skills need to be accomplished to be mindful which is different than the What Skills which we do one at a time.
YouTube videos you might find helpful for mindfulness:
https://youtu.be/qRfLVNR2Hog
https://youtu.be/PCJ0R6vAUnw
https://youtu.be/vE6_YDUrwTs
https://youtu.be/w6T02g5hnT4
The Gift in Wise Mind 5/26/2022
05/30/2022Have you ever been told that you are too sensitive and/or felt that your emotions were a lot more intense than average (emotion mind) or that you were able to cut off from feeling (rational mind)? These situations are not always unhealthy. In relating with ourselves we sometimes we can get distracted with the ruminating thoughts in our head or spending much too much time actively avoiding or distracting from our emotions and thoughts. Affirmations often refer to our inner wisdom by asking us to “listen closely because it whispers”. In DBT, we refer to this inner wisdom as “Wise Mind” and as DBT therapists we believe that everyone has inner wisdom. Providers also believe that there are ways, actually well researched ways, that individuals can regain access and build new neuro pathways to that wisdom (Wise Mind).
Some individuals have a more intense experience with emotions, we get easily annoyed or irritated, we can snap or be overly excitable which can leave one feeling “different” or anxious. Others may feel like they cannot connect with their emotions (Spock from Star Trek) which can cause issues with connecting with others or being able to read the emotions in the room. It’s important to remember that there are situations in which being in either emotion mind (birth or other celebrations) or being in reasonable mind (when balancing a check book or handling a crisis) is preferred. The goal is having the ability to balance the states of minds. Being able to have this skill and know when you are or are not in wise mind helps to teach individuals to be better able to validate their own intense emotions and by making sure that the long term and short-term goals are being considered prior to acting out. Using wise mind can assist individuals with awareness of impulsive behavior and the impact it can have on choices.
It is also helpful to remember that the door to Wise Mind is mindfulness. Hence the importance of being able to being mindful. Mindfulness helps individuals become more aware of their blind spots in awareness and increase the ability to control impulses and mitigate any problems with reactive behavior.
Mindfulness…just the basics ma’am (5/21/2022)
05/21/2022Mindfulness… Such a trendy word that is meant and/or perceived in so many ways. So, what is mindfulness… it is simply defined as being in the present current moment, with a choice to be there fully and awareness when your mind wonders and then refocusing again and again and again. To be truly mindful it’s important to do all this non-judgmentally. Easy right?? Not even a little bit.
While mindfulness is often presented (at least initially) rather simply. In DBT, mindfulness is broken down to states of mind, what skills and how skills. This can be overwhelming and met with skepticism, mostly because it feels like a lot to do to “simply” be mindful.
Other obstacles to being mindful is that in mindfulness is it is said to “notice” what you are feeling and thinking and bring yourself back to the moment. Well that sounds great right?? But when we are feeling overwhelmed, or we are clearly upset in “this moment”? What do we do with that? How do we “change the moment”? First, we would benefit from having some perspective. Are we truly in “this” moment or are we stuck in a thought or feeling spiral and making that our current moment? Are we are struggling and dysregulated because we are depressed and/or anxious or even having some trauma being triggered? When we are feeding those emotional spirals, we are not able to slow our thinking down enough to see that we might have the ability to do something different. We can be attached to an injustice or wrongdoing and not see that this is a memory and not what is actually happening to us in this moment.
Now I am not saying to ignore budgets, planning for retirement, planning parties, vacations and REASONABLE life events. Though being so anxious about what may or may not happen is often counterproductive. Here is a simplified example…A mom is annoyed that one of her children accidently spilled juice on their clothes and the floor. This accident has set in motion the likelihood that they will be running late. Mom gets upset just thinking about the “what ifs” of the quickly changing events and if she may or may not be late. She is so upset that her morning is starting off this way, all she can think about is how this will impact her kids being late, what the traffic might be like and what situations might arise if she is late for work. Mom is irritable about her children not moving fast enough or having all the children not being ready to go. She is irritated that her youngest is watching tv and that her other child is playing on the iPad. All of this being normal behavior for her young children in the morning and would not normally be concerning to her when they are on time. It is completely understandable right?? Being late creates justifiable anxiety it AND (there is that dialect?) it also prevents us from being effective in getting the kids ready and noticing normal things that happen in her morning routine, such as her youngest is still in their pjs and cannot find their shoes. This leads to snapping at the child and feeling upset and chaotic. It’s important to notice that her being snappy and upset has done nothing to changed her being late. Now the same situation done in a more mindful way. Mom is still likely to be late though she continues with her normal routine with feeding her children, getting everyone dressed ready and making sure everyone has their things. She is being more mindful about doing one thing at a time and while she may get frustrated that they may be late, she is able to simply notice her thoughts and know that getting upset and frustrated does not change what may or may not happen though it makes sense that she is frustrated. Mom can catch that the little one is not dressed sooner and notice the other child is about to turn on the iPad all because she is in the moment with them and not being hijacked by her thoughts.
I understand that we will not be faced with this exact scenario though I hope the example helps the concept resonates some.
Stay tuned for the 2nd part of this series where we explore states of mind.
Marsha Linehan sharing mindfulness concept
https://youtu.be/X_BmPxd0Eiw
DBT and Me (5/20/2022)
05/21/2022First and foremost, thank you for taking the time to read my blog on dialectical behavioral therapy (DBT). DBT is something that I have been passionate about since I was in grad school back in 2006. My oh my how times flies:) While we did not have a lot of training in DBT, I was fortunate enough to have a supervisor who was amazingly skilled at teaching DBT skills, and I was hooked. I was able to see the huge progress individuals made in life satisfaction in just being able to participate in a DBT skills group. Because of this experience in grad school and working with that wonderful supervisor I was able to find my niche as a psychotherapist and dedicate my career to working with individuals who are struggling with regulation and impulsivity issues. I specialized in working with individuals that struggle with self-harm and chronic suicidal thoughts and gestures. This then naturally flowed into helping those with complex childhood abuse and/or history of neglect. I have been so fortunate to have the ability to work with such a wide range of struggles and am humbled at the trust that has been given to me to walk with my clients on their path to live a life worth living.