Archive for the 'Dialectical Behavioral Therapy (DBT)' Category

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Your Say Yes to Life Monday Motivator: Self-Care During the Holidays

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Your spouse just told you that your in-laws are coming to your house this year.

Again.

But what is different this year than before is that your cousins have decided to caravan down with them and come to your home for the holidays too.

Furthermore, since you have a large backyard, they have decided not to kennel their two dogs, one gerbil, and three cats. No need – your house has enough room for them all!

As your spouse relates all of this to you, you feel your blood pressure starting to rise.

You try to explain, but your spouse just doesn’t seem to get it. And it is little wonder that he doesn’t – you can still remember last year, when you envied him his stressful, hectic city job that allowed him to escape the bedlam and chaos that was your home this time last year.

He didn’t see how demanding his folks really are of you. He didn’t realize how worn out and exhausted you felt at the end of every day – how spent, and drained, and just ready for the whole thing to be over.

You are dreading it at a level you didn’t even think you were capable of. The holidays haven’t even started yet, and already you are ready for them to end.

Luckily, you have been taking a group therapy course in Dialectical Behavior Training (DBT) over the past several weeks, and what you are learning is giving you a fresh perspective on how to handle the family situation this year.

First things first – practicing mindfulness, you note your reactions to your spouse’s announcement. The rage. The frustration. The resentment. The air of finality to it – you are being told, not asked, if it is okay to host his extended family this year. You bring your newfound ability for “radical acceptance” to bear on the situation – calmly, you practice simply accepting the moment for what it is, rather than what your mind thinks or wishes it to be. First, accept. Next, work to change.

That accomplished, you pull out mindfulness’ trusty sidekick, emotion regulation. Using your new skills in emotion regulation, you begin to name each emotion objectively, like a witness or observer, rather than an active (and highly emotional) participant. Yup, that really is rage. Yes, there is frustration too. And resentment. Definitely resentment. Some sadness too – when will you and your spouse ever get a chance to enjoy the holidays just relaxing together? Okay, and relief is also coming up – because this year, you have a plan to use your new DBT skills to transform events in a way that includes your need for self-care and alone-time, as well as couple time and family time, into the mix.

Next up is distress tolerance. You realize you are feeling a lot of distress due to all the emotions suddenly arising and colliding within you. You take a deep breath, relax into an awareness of a bigger picture behind your momentary stress, and then let your breath out again, dropping your shoulders and softening your facial muscles as you do so. You remind yourself that you can deal with this situation, you do have it in you to find a workable solution, and you are okay, even in the midst of some significant emotional distress.

Finally, you begin to pull it all together into interpersonal effectiveness. Now is the moment when you will assert your needs – and household ground rules – with your spouse, sharing with him how you are feeling, what you need, and what you can and cannot offer to make the holidays with his family a success this year. You decide that you will initiate a calm, objective conversation with your spouse, free from excess emotion or last year’s holiday baggage, blame, or shame.

Still very calmly, you ask your spouse if he could join you at the kitchen table for a few moments to strategize. You share with him that you did not enjoy the holidays last year and have a plan for how this year’s time with loved ones can be different. You outline what you are willing and able to do to support his in-laws’ visit, and what you need from him in terms of his participation in the family holiday preparations. Then you ask him how he feels about participating in the ways you have outlined, and whether it is something he can commit to. You ask for his feedback as well, and together, you begin to open up to one another and admit that having the whole family in to stay is stressful for you both.

In other words, as you open up, mindfully, with calmness, centeredness, focus, and objectivity, sharing what you need as well as what you wish to offer to make the family holiday season a success, you give your spouse permission to do the same.

Together, using DBT as your guide, you begin to talk through creative ways to turn last year’s holiday woe into this year’s holiday wonder.

If you are finding that you are struggling this holiday season to find the wonder in the midst of the woes, Southlake Counseling can help. Our compassionate and skilled staff has more than two decades of experience with guiding individuals in how to effectively use the DBT principles of mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Learn more by visiting us at www.southlakecounseling.com.

Be Well – and happy holidays!

Kimberly



Published on Monday December 13, 2010 in Dialectical Behavioral Therapy (DBT). 0 Comments Tags: , , , , , .

Your Say Yes to Life Monday Motivator: Turning Holiday Woes into Holiday Wonders

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Oh boy. The holidays are here.

Again.

You are not sure whether you have been anticipating this moment all year, or dreading it.

Or maybe a bit of both.

Nevertheless, here they are again – upon us for yet another season, and once again before we are ready for them to come. So now the question becomes not “where can I hide?” but rather “what am I going to do differently this year?”

That is what we are going to discuss in this month’s blog series “Turning Holiday Woes into Holiday Wonders.”

For our series, you have been my inspiration, because each one of the woes I have selected is one I have heard you share with me in private session year after year, right around this time.

For instance, you have shared with me how hard you find it to carve out time for self-care while feeling called to take extra special good care of others as well.

You have told me that sometimes it feels simply impossible to locate the fine line between treating yourself to holiday goodies and maintaining your physical health and nutrition.

And you have confided that you sometimes – often – find it incredibly difficult to release a whole past year’s worth of errors and triumphs only to discover an entirely new, sparkling fresh year sweeping down on you before you have had any time to prepare for its arrival.

So this month, we will examine strategies to turn each of these woes into wonders, one week at a time. To do this, we will revisit one of my favorite therapeutic approaches for recovery and life – Dialectical Behavioral Therapy, or DBT for short.

DBT is a wonderful pathway to effective daily living authored by Dr. Marsha Linehan. The focus and goal of DBT work is to stay centered, present, open, and willing to do our best in every moment.

The teaching tools that DBT uses include mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Each tool builds upon and integrates with the others, and when used together can produce a centered, balanced, present-focused approach to daily life during the holidays and at every moment of the year.

So before we begin our “woes to wonders” adventure together, let’s just take a quick review of each of the four key DBT tools we will be using:

  • Mindfulness training equips us to take back control over our mind’s thoughts and our reactions to those thoughts
  • Emotion Regulation teaches us to name and experience our emotions without allowing them to overtake us
  • Distress Tolerance cultivates our ability to stay present and focused for each moment of our lives regardless of what the day may bring
  • Interpersonal Effectiveness helps us to develop assertiveness skills to ask for what we want and need in safe, healthy, and affirming ways

It is easy to see how each of these tools becomes particularly essential during the heightened energy and emotion the holiday season ushers in. During the next few weeks, we will look at how to apply each of these skills to transform a traditional holiday woe into a true source of delight and wonder.

If you are finding that you are struggling this holiday season to find the wonder in the midst of the woes, Southlake Counseling can help. Our compassionate and skilled staff has more than two decades of experience with guiding individuals in how to effectively use the DBT principles of mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Learn more by visiting us at www.southlakecounseling.com.

Be Well – and happy holidays!

Kimberly

Published on Monday December 6, 2010 in Dialectical Behavioral Therapy (DBT). 0 Comments Tags: , , , .

You’re Talking, But Am I Really Listening?

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You’re talking, but am I really listening?  

Too often couples are seen in therapy due to communication problems. Phrases like, “he/she just doesn’t understand me,” or “I just don’t feel like he/she is listening to me,” are all too common phrases.

Many times when we are in heated discussions with a loved one, we are thinking about what we are going to say next, or trying to jump in to get our point across. Subsequently, we are not being “mindful” of what the other person is saying. Being “mindful” is being fully present in the moment you are in just as it is unfolding in front of you.  If while your loved one is speaking, you are thinking about what you are going to say, you are already in the future and not in the moment.

Mindfulness is a skill that is the core of Dialectical Behavior Therapy (DBT). It’s a skill that requires practice because our society tends to promote being “mindless” by encouraging multi-tasking. One way to get started in becoming more “mindful,” or more fully present in the moment when having a neutral or pleasant discussion, (for both parties) with your loved one is to focus on what they’re saying, pay attention to their tone, and focus on understanding. If you feel the urge to “jump in” to assert your view, just notice that urge, but bring your attention back to what your loved one is saying. Feeling understood and listened to are powerful tools in strengthening relationships.    

Shannon T. Brewer, M.A., L.P.A.

Published on Wednesday December 1, 2010 in Dialectical Behavioral Therapy (DBT). 0 Comments Tags: , , , .

Love and Support in Action

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On a recent weekend I had the great fortune of being at the Susan G. Komen Race for the Cure in Charlotte. Every year I’m amazed at the wonderful outpouring of support and love that I see at that event. I believe that 16,000 people participated and 1.6 million dollars were raised, of which 75% stays in the Charlotte area. As I was surrounded by all the love and support generated by all those people walking and running for their mothers, sisters, aunts, nieces, and friends, I thought about what a great way to ”cope” with a sometimes devastating illness.

In Dialectical Behavior Therapy (DBT) Skills Training, the module on Distress Tolerance teaches various skills used to cope with painful situations and/or emotions. DBT operates on the principle that pain is inevitable, but suffering is optional. One of the skills featured in DBT is ACCEPTS. ACCEPTS is an acronynm standing for Activities, Comparisons, Contributing, Emotions, Pushing Away, Thoughts and Sensations.

Fundraising, walking and/or running for a cause such as the Susan G. Komen is an excellent example of something that involves Activities, Contributing and Comparisons, which is why an event like this and others like it are such a huge draw for so many, on so many levels. If you would like to learn more about DBT and the skills training group contact Southlake Counseling for more information.

In good health,

Shannon

Shannon T. Brewer, M.A., L.P.A.


Published on Monday October 11, 2010 in Dialectical Behavioral Therapy (DBT). 0 Comments Tags: , , .

Acceptance and My Dear Friend

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In my DBT groups, I teach skills to help clients cope with challenging or distressing situations in their lives, without making things worse. One of the skills that we work on is Radical Acceptance, which means acknowledging reality, accepting it for what it is, without judging it good or bad.  I share with clients that I understand how difficult it can be to radically accept certain things, and that this acceptance is the only way they can let go of suffering.

So now it has come time (yet again) for me to practice what I preach.  I received a phone call this week from one of my dearest friends in the world, and through tears and gasps, she told me that she has been diagnosed with stage IV colon cancer, metastasized to her liver to such an extent that the doctors say they cannot remove the tumors.  This is an extremely healthy and vibrant young mother of a precious 5-year-old, no family history of cancer, no risk factors whatsoever, and she’s one of those friends I can count on one hand – the true ones – so I’m supposed to accept this?

Trying to recover from the shock and wrap my mind around this devastating news, I pull out the “Radical Acceptance” bullet points I give to my clients when I tell them that accepting some things is very difficult…and I start to wonder if they feel as helpless and overwhelmed as I do right now. The first bullet point reads, “Freedom from suffering requires acceptance from deep within of what is. Let yourself go completely with what is. Let go of fighting reality.” Hmmm…I’m not sure I’m ready to accept this from deep within. You see, this is my friend Lea Ann. She is more like a sister to me, she “gets” me – we are so much alike we can finish each other’s sentences, so this feels too close. We’re like Lucy and Ethel, and I don’t remember either one of them ever having cancer. Letting myself accept this somehow feels like giving in, and I seem to remember my clients saying the same thing.

Another bullet point reads, “Pain creates suffering only when you refuse to accept the pain.” Okay, this one makes more sense to me. I’m no stranger to pain, and I’ve learned to feel what I feel when something is painful instead of avoiding it or pushing it away. Pain is there to teach us something, to inform us that we need to pay attention to what is going on, so what is this pain telling me?  I don’t have to search hard for the answer – my pain is there because Lea Ann is vitally important to me. She is the person who came to my side, dragging her husband and daughter, when my grandmother was in the hospital in Kentucky and I needed some answers. She was there with me when my dad died, and flew to be with me when I felt like falling apart a few months later. This pain is reminding me that what she has done for me is be there, and this is what I can do for her now – I can show up. This gives me purpose and something to do, so I start to feel better…slightly.

The last bullet point in the list reads, “To accept something is not the same as judging it good.” Oh…so I don’t have to like what is happening to Lea Ann in order to accept it…this is comforting. I hate what is happening to my friend and how it is affecting her sweet family. I hate what she will have to endure in order to have some hope of a more favorable prognosis. I hate feeling powerless and angry and sad all at the same time, and this radical acceptance thing tells me I don’t have to like it to accept it. So I go to work on accepting…

Radical acceptance reminds me of the Serenity Prayer, and I pray it a lot these days:

            God, grant me the Serenity to accept the things I cannot change,

            Courage to change the things I can,

            And the Wisdom to know the difference.

I know I cannot change my dear friend’s diagnosis nor the challenges she is facing, but I can be courageous enough to be there for her, offering all the support I can in friendship and love, which is exactly what she has always done for me. I am reminded of all the times my clients have been challenged to separate what they can change from what they can’t, and I feel more compassion than ever for how difficult this can be.

Most people aren’t familiar with the rest of the Serenity Prayer. The next lines read:

            Living one day at a time;

            Enjoying one moment at a time;

            Accepting hardship as the pathway to peace.

None of us knows what tomorrow will bring, and we can’t do anything about it until it gets here, so we might as well live in today. My friendship with Lea Ann has been blessed with enjoyable “moments” when we both howled with laughter and silliness – our Lucy and Ethel moments. Racing down Michigan Avenue before our favorite stores closed, betting on the horses at Keeneland with no idea what we were doing, jumping off a ski lift and getting stuck on the highest gondola in Canada, and savoring the times we’ve shared dessert. Such moments are the ones I remember and return to when hardship does come, for I know such is the reality of the ebb and flow of life.

If there is anything I’ve learned from my friendship with Lea Ann, it is that the most important thing I can do is be present, and live. Show up instead of sitting back, experience instead of analyze, accept instead of worry – say YES to life.

With sincere hope that my journey can inspire,

Debbie

Published on Friday August 13, 2010 in Dialectical Behavioral Therapy (DBT). 0 Comments Tags: , , , .