Tag Archive for 'Dialectical Behavioral Therapy (DBT)'

Your “Say Yes to Life” Monday Motivator: Interpersonally Speaking

Welcome to week four of our discussion about Dr. Marsha Linehan’s Dialectical Behavioral Therapy (DBT).

Over the last three weeks we have addressed three of the four core modules that make up the DBT Skills Training –Mindfulness, Emotion Regulation, and Distress Tolerance. For our final week of exploration, we will tie it all together with an adventure into the fourth and final module – Interpersonal Effectiveness.

For many students of DBT, interpersonal effectiveness can feel like the most challenging module of all, because even if we think that the issues that motivate us to seek out the help of therapeutic professionals are caused by other people, we eventually discover that they are best solved by strengthening our relationship with the most important person in our life – ourselves.

So in the first three modules of our DBT work, we get to examine our traditional mental, emotional, and relational responses to the day-to-day experiences we have in our own lives, and then from there we begin to explore how adding new skills can increase our self-confidence and efficacy in meeting our own personal goals.

In the final module, we get to “take our skills to the streets”, so to speak, as we apply our newfound intrapersonal skills to learning the art of interpersonal effectiveness.  For most of us, when we take a closer look at how we have been approaching and managing our relationships, we realize there is a lot of room for improvement. But if we have been faithfully studying and applying the skills we’ve learned in the first three DBT modules, by the time we get to the fourth module we have a foundation of confidence that allows us to tackle this final challenge with our awareness of the payoff for doing this hard work firmly in place.

So when we first begin studying DBT’s interpersonal effectiveness module, we begin with a self-assessment of how we have traditionally handled issues like conflict, asserting our opinions and preferences, and meeting our needs in relationship with others. We look at whether we have been able to attract and foster relationships that are healthy and stable, weather tough times while keeping the connection and respect we feel for ourselves and others intact, and achieve personal satisfaction and fulfillment in the midst of interpersonal growth and development.

We then begin learning new ways of addressing interpersonal issues we have identified as less than satisfactory.

For instance, let’s say your spouse has a habit of barking orders at you the moment you walk in the door. You are usually tired when you get home from a long day at work, and after fighting to make your voice heard with your boss and co-workers (an opinionated lot to say the least) you have little energy left over to make the same degree of effort with your husband.

But now, with your newfound interpersonal effectiveness training, you understand that not speaking up for yourself actually takes more out of you, and uses up more valuable energy, than staying quiet. The next time you come home and the barking orders commences, you lay a hand lightly on your husband’s chest, meet his eyes directly, and calmly and clearly say, “I am tired. I need to shower, change into my comfy clothes, and have something to eat. You are welcome to sit with me while I eat and unwind. But I cannot talk with you about what you need from me until after I have had a chance to rest a bit from my day. Do we have a deal?”

From there, depending on how your spouse responds, you can progress accordingly with rolling out your new interpersonal effectiveness skills. Furthermore, since DBT training is most often conducted through a combination of weekly individual and group meetings, with optional individual telephone sessions for added support, you have the support of an entire team who is working with you to help you refine, manage, and develop your skills for the benefit of all concerned.

So give yourself the gift of new, shiny interpersonal skills in the New Year. Relationships are the heartbeat of what makes life feel like living, what motivates to us to crawl out of our warm beds on cold mornings, what encourages us when our job doesn’t deliver on its promises or our boss has a bad day, and what keeps our chin up when the economy takes a nosedive or natural disaster strikes. We naturally turn to our relationships for support, comfort, meaning, and reconnection – to share both sorrow and joy – and to remind ourselves that all the hard work we do throughout the rest of each day finds its fulfillment in the rewards of our relationships with ourselves and others at day’s end.

At Southlake Counseling, we have been studying and teaching the four core modules of DBT for more than two decades. We have seen hundreds of amazing transformations as individuals have learned, participated in our groups and in individual therapy sessions, and emerged to experience all the wonderful benefits that DBT skills-building has to offer. If your New Year’s intentions or resolutions include strengthening and deepening your relationships with loved ones, colleagues, friends, and family, we look forward to hearing from you at www.southlakecounseling.com very soon!

Be Well,

Kimberly

Published on Monday January 25, 2010 in Dialectical Behavioral Therapy (DBT) and Monday Motivator. 0 Comments Tags: , , .

Your “Say Yes to Life” Monday Motivator: Dealing with Distress

This Monday finds us kicking off week three of the New Year. For those of us who made New Year’s resolutions or intentions, this is the week when we may be starting to see cracks in our resolve, chips in our optimism, doubts where just a few days before, confidence was our daily companion.

Enter “distress tolerance”. This technical-sounding term comes courtesy of Dr. Marsha Linehan, the founder of Dialectical Behavioral Therapy (DBT). Distress tolerance is commonly defined as an ability to refrain from resorting to impulsive behaviors to manage strong emotions.

Picture this: you are at home minding your own business, when all of a sudden your friend calls with some very disturbing news. She starts to cry, and before you know it you are tearing up with her. Her emotions continue to spiral as crying turns to sobbing, and by the time you get off the phone all you can think of is that you need a glass of wine. One glass turns to one bottle….several hours later you wake up on the couch and realize you have forgotten to pick up your son from daycare. You are overcome with shame at your behaviors, followed by fear for your son’s wellbeing, and then a growing anger and frustration directed at yourself. Again.

Worst of all, the painful and sad emotion you drank the wine to avoid having to feel and deal with has come back tenfold – and this time it has returned with several of its best friends in tow.

In this hypothetical scenario, we can see a classic pattern of distress-avoidance emerging:

  1. A situation arose during the course of your normal day which triggered strong emotions
  2. You perceived the emotions as intolerable
  3. You impulsively turned to alcohol (other impulse decisions could include substance abuse, binging/purging, spending, etc.)
  4. You experienced a reliable and thus “trustworthy” short term payoff from your retreat to the impulsive behavior
  5. You ultimately emerged from your attempts to elude your own emotions feeling even more out of control than before

This is just one of many scenarios in which cultivating improved distress tolerance skills can literally save the day. With distress tolerance skills training, you can learn to manage, feel, and release strong emotions without resorting to destructive behaviors.

DBT’s distress tolerance skills are designed to build resilience in the face of intense emotions we perceive as intolerable. There are four core modules of distress tolerance skills-building that are carefully designed by Dr. Linehan to build in positive copings skills where self-destructive tendencies used to rush in.

However, distress tolerance does not in any way translate into distress avoidance, and it is important to recognize that building your skill at tolerating emotion still requires that you feel and deal appropriately with emotions as they enter your sphere of influence.  In this way, you can think of distress tolerance skills-building as the safety net you need to begin to learn how to feel and deal appropriately and self-respectfully without fearing your own destructive tendencies.

At Southlake Counseling, we have more than two decades of experience teaching and guiding individuals and groups in learning to implement the powerful principles and practices of DBT. We are the foremost provider of DBT-based individual and group services in the Lake Norman area, with a full range of services for females and males of all ages and from all backgrounds and walks of life. If you are determined not to greet one more New Year fearing what emotions each day may bring, contact us at www.southlakecounseling.com for more information about how DBT can help you say “no” to distress avoidance and YES to distress tolerance – and your own wonderful LIFE!

Be Well,

Kimberly


Published on Monday January 18, 2010 in Dialectical Behavioral Therapy (DBT) and Monday Motivator. 0 Comments Tags: , , , .

Your “Say Yes to Life” Monday Motivator: Making Friends With Our Emotions

So here we are again, in week two of a brand new year!

How is it going so far? How do you feel about those New Year’s Resolutions you probably couldn’t resist making a week or so ago? Is the New Year already shaping up into all that you hoped and dreamed it would be – or simply delivering more of the same?

It is so tempting to study our outsides for telltale signs of change. We have grown accustomed to seeking exterior affirmation, confirmation, or negation of the changes we dream of making. We look around and either see positive changes or we don’t.

But in doing so, we consistently forget to remind ourselves that all real change starts within.

In Dialectical Behavioral Therapy, or DBT for short, one of the four cornerstones of successful transformation lies in mastering the art of what founder Dr. Marsha Linehan terms “emotion regulation”. 1

Well, this sounds good, doesn’t it? But what does it mean?

The best place to start in conducting our investigation is to look at what is meant by the word “emotion”. According to a commonly-accepted definition of the term, an emotion occurs whenever there is “a mental state that arises spontaneously rather than through conscious effort and is often accompanied by physiological changes.”

Put this way, the appearance of an “emotion” sounds sort of like a sneak attack, doesn’t it!? And since sneak attacks usually are not particularly pleasant or welcome experiences, especially when they are accompanied by frightening-sounding “physiological changes”, it is not hard to see how a system that was originally intended to serve as a reliable guide through life begins feels more like an inner enemy stalking and scaring us at the least opportune moments.

What is most important for us to recognize, however, is that when we begin to distrust and even fear our own emotions, it becomes increasingly hard for us to remember that we and not our emotions are the master of our lives.

Here is where learning the DBT skill of “emotion regulation” can come to our rescue. When we become skilled in emotion regulation, we can train ourselves to be less vulnerable to the continually shifting play of our emotional landscape. By applying DBT skills designed to enhance our ability to regulate our responses to our emotions, we become proficient in identifying and labeling emotions, identifying where we tend to become emotionally “stuck”, increasing our affinity for positive emotional states, bringing mindfulness into our emotional lives, and other wonderful life skills that can make the experience of feeling and experiencing our own emotions beneficial rather than detrimental to our growth and well-being.

At Southlake Counseling, we understand how challenging it can feel to forge an alliance with our ever-changing emotions. We also know that emotions in their essence are helpful guides and teachers that can lead to more fulfilling lives. Our professional and compassionate staff has more than two decades of training and expertise in helping you apply the life-changing principles of DBT for improved health, growth, and well-being. If you are struggling to understand and manage your emotions, don’t let another year go by before you take action on your own behalf. Contact us today at www.southlakecounseling.com to say “no” to emotional distress and YES to your own full and vibrant life!

Be Well,

Kimberly


1 Marsha Linehan, PhD, Dialectical Behavioral Therapy Founder

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

Your “Say Yes to Life” Monday Motivator: The Helping Hand Mindfulness Extends

Well, here it is – the first week of a brand new year!

Exciting, isn’t it!

Or maybe a little nerve-wracking….stressful….already packed full of resolutions, expectations, old memories of what not to do from the barely-departed previous year (aka baggage), and more than a bit of fear.

Enter “mindfulness”. Mindfulness is a powerful tool that can facilitate the kind of positive life change that resolutions seldom do. Best known as one of the four core tenets of Dialectical Behavioral Therapy (DBT), mindfulness is commonly defined as “awareness without judgment of what is, via direct and immediate experience”1.

How can mindfulness help you in 2010?

While resolutions and expectations are born of past experiences, and thus are colored more by painful remembrances of how we did not measure up to our own standards or others’ in the past, mindfulness keeps us anchored here in the present, which is the only place where any true change is possible.

The first step to using mindfulness as a tool for positive change is to be able to distinguish it from what we normally do. So let’s take a common New Year’s resolution as an example – a resolution to adopt healthier eating habits.

Without mindfulness, here is what you might expect to happen on January 2nd, when, full of good intentions and steadfast resolution, you approach the refrigerator. You open the door and stare in at the new healthy selections you just purchased, sitting there on the shelf next to last night’s party leftovers. Your hand shoots resolutely towards the healthy side of the shelf. Your mind says, “You know you won’t be able to keep this up. You might do okay for a few days, but sooner or later you are going to break your resolution. You might as well just go ahead and eat those party leftovers anyway. They are going to spoil otherwise, and it is wasteful to let perfectly good food spoil just because you are trying to eat healthier. You can eat the healthy stuff you bought tomorrow.”

Does any of this self-sabotaging dialogue sound familiar?

With mindfulness, you do not waver between the past and the future, trying to predict the probability of an outcome that is only possible here, now, in the present moment – an outcome that you are in charge of and are perfectly well-equipped to determine.

So now let us take the same example, but apply the tool of mindfulness to achieve a different outcome. There you are, standing in front of the open refrigerator door. Your eyes fall on last night’s leftovers, and then on the new healthy items you have just purchased.  Your hand reaches toward the healthy side of the shelf, already anticipating the crunch of the sautéed bell peppers with chicken and seasoning that you are going to make for dinner. Your stomach grumbles. You begin gathering all the ingredients to make your meal. Happily, you unwrap your new sauté pan that you got for Christmas, add a little olive oil, and start chopping vegetables. Thirty minutes later, you sit down for a lovely, healthy meal that is both delicious and satisfying. You clean up, and head into the living room to catch your favorite television show.

What just happened here? With mindfulness, you sabotaged your saboteur by simply staying present. You didn’t allow your mind to wander back to the past, which is forever out of your control, or to the future, which is not yet within your control. You stayed true to the reason you visited the refrigerator in the first place – to fuel your body with delicious, healthy nutrients per your New Year’s intention NOW, in THIS moment, to offer yourself the gift of healthy eating habits. You chose tasty ingredients, enjoyed putting them together into a meal, ate them with gusto while you were hungry, stopped when you were full, cleaned up, and moved on to the next activity you had planned.

Mindfulness hands back on a silver platter your power to make new, self-affirming choices in the present moment. Mindfulness is your best friend in a season too often filled with recriminations, regrets, fears, self-doubts, and atoning resolutions. The past is in the past, right where it belongs. And the future depends on the choices that you make right now, today.

So take mindfulness by the hand, and walk confidently and positively forward together in the present moment to greet the New Year.

At Southlake Counseling, we understand how New Year’s resolutions can often collide with last year’s regrets. This is why our staff of trained and experienced clinicians have dedicated over two decades to the study and successful application of Dr. Marsha Linehan’s Dialectical Behavioral Therapy (DBT) treatment methods. If you are struggling with maintaining a positive outlook about making good choices in 2010, we are here to help.  If you would like to learn more about Mindfulness or our DBT program contact us today at www.southlakecounseling.com to learn more.

Be Well,

Kimberly 

1 Marsha Linehan, PhD, Dialectical Behavioral Therapy Founder

Published on Monday January 4, 2010 in Monday Motivator. 0 Comments Tags: , , , .