Tag Archive for 'shame'

DBT’s Interpersonal Effectiveness: Building Mastery and Self-Respect

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“Do you think it’s important to nurture genuine respect for oneself?” I would be shocked/stunned/mind-boggled if the majority of people to whom I asked this question replied with some variation of, “no, thanks, it’s been quite pleasant disrespecting myself and my beliefs and sincerely thinking that I am incompetent.” In fact, while it might be almost impossible to believe, most of the people who walk into my office voice some type of desire to feel good about who they are and at peace about the decisions they’ve made with regard to their interactions with others.

So, just how important is self-respect? Let’s look at a recent situation in my personal life that pertinently and efficiently reminded me of the vast importance of self-respect. Recently, I found myself in a situation with a friend that, over a two-week period, proved to be particularly distressing. Two weeks prior to this realization, I identified my need to express my feelings about his actions, or in this case, lack of action. However, I wanted the discussion to take place in person, not via some sort of electronic medium, and I wanted to find the appropriate time, a combination of desires that proved to be especially difficult to attain as day after day blew by.

Upon his most recent departure from an in-person interaction between us, during which I, again, could not seem to recognize this seemingly elusive perfect time, I found myself bombarded by uncomfortable thoughts/feelings. The most common thought: “You failed. Once again, he left and you did not say anything,” followed closely by the feeling of shame. Then, I watched, mindfully, as the thoughts/feelings cycled through my mind. Shame triggered the thought, “you’re weak, you’ll never find the right time. You’re using this right time notion to avoid talking to him,” followed closely by more shame, who brought with it its two acquaintances, guilt and sadness (nice to see you, again!).

And that’s when it hit me. Why wasn’t I eagerly having this seemingly necessary conversation? Well, that was a fairly easy one for me…fear. Fear that he wouldn’t like me. Fear it would ruin our relationship. Fear that he’d leave. And I didn’t want to discount, invalidate, or avoid this fear, as the fear of losing or damaging significant relationships in one’s life can be daunting, vastly uncomfortable, and even paralyzing. However, what was the cost? By avoiding the first situation of having a discussion due to potential negative consequences, I was causing other, very real, negative consequences to occur in the place of ones that had not even occurred yet, and might not even occur. Based on consequences that had a 50% chance of materializing (It might ruin our relationship, it might not. He might leave, he might not.), I was creating a second situation with a 100% chance of damaging my self-respect…and I still didn’t even know what might or might not happen in the first situation!

The founder of DBT, Marsha Linehan, describes mastery as doing something that increases one’s feelings of competence, and sometimes, if you fail, doing it over and over and over again until you succeed. With regard to self-respect, Linehan notes that one builds self-respect when he/she acts in ways that support his/her personal beliefs, morals, and opinions. Mastery builds competence. Competence builds self-respect. Take the example of a newborn learning to walk. When little Joey takes his first steps and falls, what would happen if he never got back up? Would he ever learn how to walk if he never tried again? How would he feel about his walking abilities? Furthermore, would he be more or less likely to get up and try again if he were to succumb to his inundating thoughts of, “I’m a failure. I’ll never learn how to walk. All the other babies will learn how to walk and I’ll be stuck here, crawling on the floor, forever (insert sad-face emoticon here).” I’m concerned about Little Joey’s self-respect already.

It’s not easy to do things we perceive as potentially threatening, and it’s also not easy to deal with the inevitable thoughts/feelings that show-up when we don’t take action when we want to (or act when we don’t want to). And while the blow to our self-respect can be equally devastating, we deny ourselves the opportunity to learn how to skillfully manage difficult situations.  So, the next time you find yourself in a particularly tough situation with another person, just remember this is probably not the last complicated situation/interaction you’ll be faced with in your lifetime… AND every difficult situation you encounter is another opportunity to build your mastery at effectively handling tough situations and to enhance and deepen your self-respect! Be kind to yourself, validate your fears, and grow.

Julie

Published on Tuesday June 21, 2011 in Dialectical Behavioral Therapy (DBT). 0 Comments Tags: , , , , , .

Your Say Yes to Life Monday Motivator: V is for Validation, Part One

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This month we continue our exploration of Borderline Personality Disorder (BPD) and its effect on BPD sufferers and their families.

As you may recall from last month’s posts, May was Borderline Personality Month. BPD is now known to be a brain-based emotion regulation disorder that often begins to arise in early adulthood and affects more women than men. The disorder manifests in a devastating emotional sensitivity that makes it difficult for some and impossible for others to maintain the type of close, nurturing, mutually supportive relationships that make life feel worth living.

This explains why, out of the 18 million Americans who have BPD, 10 percent will commit suicide before adequate diagnosis and treatment is offered. Additionally, current statistics state that 33 percent of all youth who commit suicide are found posthumously to have displayed symptoms characteristic of BPD that went undiagnosed.

In my work as Program Director with Southlake Counseling, I have seen firsthand how a lack of knowledge, lack of or improper diagnosis, and inadequate or improper care can lead to the tragic loss of a loved one who has BPD, and the unnecessary total breakdown of family systems. I say unnecessary, because there are some practical, accessible skills that loved ones of a BPD sufferer can begin to employ right now to ease the tension in their relationships and restore valued connections.

In this post, I would like to introduce one such technique: Validation.

Validation is a term that was first employed in Dialectical Behavioral Therapy (DBT), which is a therapeutic method designed by Dr. Marsha Linehan specifically to treat BPD. Validation is a DBT-based technique that is carefully designed to counteract the natural emotional response nearly every important communication has the potential to evoke in a BPD sufferer.

In the normal world of a person with BPD, their brain is not wired as sensitively to relational cues as a non-BPD individual’s brain is. So it is much easier for a BPD sufferer to feel invalidated or rejected by even a mundane or routine interaction with a loved one.

Validation is a direct counter to the BPD individual’s assumption that every communication is invalidating until proven otherwise. The rage, the suicidal actions, the emotional outbursts, the self-harming behaviors, the expressed fearfulness and the impulse control issues all stem from a feeling of being rejected, abandoned or invalidated by a person who holds an important role in the BPD individual’s life.

Learning how to successfully communicate with a loved one who has BPD is based upon understanding their inner emotional landscape and working with rather than against their BPD-influenced perception of relationships and events. Using Validation promotes that awareness and understanding, and opens up the door to better communications between the BPD sufferer and those who share their life.

In our next post, we will explore how to use Validation to facilitate communications with a BPD sufferer. So stay tuned!

If you or someone you care about is suffering from symptoms that appear to be related to Borderline Personality Disorder, don’t wait! Seek help right away as BPD can be life threatening. At Southlake Counseling, our staff has received extensive training from Dr. Linehan’s Behavioral Tech Institute. We have more than two decades of experience successfully treating BPD through Dialectical Behavioral Therapy. We also offer supportive DBT-based skills-building groups for family, loved ones, and friends of BPD sufferers. Learn more at www.southlakecounseling.com.

Be Well,

Kimberly

 

Published on Monday June 20, 2011 in Borderline Personality Disorder. 0 Comments Tags: , , , , .

Your Say Yes to Life Monday Motivator: Good News – BPD Brains ARE Different!

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This month marks the 4th anniversary of May as National Borderline Personality Awareness Month.

Borderline Personality Disorder, or BPD, is a serious psychiatric illness which affects an estimated six percent of the population – approximately 18 million Americans. BPD is an excruciatingly painful emotional dysregulation disorder that can be both debilitating and deadly.

Affected individuals frequently first begin showing signs of the illness in early adulthood, often suffering for five years or longer before an accurate diagnosis is made. In that time period, BPD sufferers are 400 times more likely to commit suicide than non-affected peers. Affected individuals often cycle in and out of psychiatric care centers, encountering blame, shame, and stigma instead of the knowledgeable treatment BPD demands and deserves.

Symptoms of BPD include recurrent suicidal urges or attempts, chronic emotional instability, relational chaos, intense and persistent fear of abandonment (real or imagined), impulse control issues, rageful outbursts, and self-harm. While some BPD-affected individuals are able to function well in certain areas of life, others are unable to hold down a job or maintain basic relational connections.  Medical professionals estimate that as many as one in five out of every patients admitted to psychiatric care centers are suffering from undiagnosed BPD.

With these statistics, it is clear that much work remains to be done to better understand the origins and development of BPD, and what type of treatment most effectively assists affected individuals with recovery.

What is already known is that BPD is often passed from parent to child, with a nearly 70 percent likelihood that an affected person has had a parent who also suffered from the illness.

What has not been understood to date is whether or not there are true grounds for treating BPD as a brain-based illness, but recent studies at Baylor College of Medicine and The Mount Sinai Medical Center are now changing that.

In 2008, Baylor College of Medicine conducted a first-of-its-kind research study that aimed to identify whether the brains of BPD-affected individuals function differently than the brains of non-affected peers. This study paired a BPD-affected individual with a non-affected partner to play a game of trust. Researchers used fMRI (functional Magnetic Resonance Imaging) scans to measure how the brains of BPD-affected individuals processed emotional and relational cues from their non-affected partners as the game progressed.

To do this, Baylor research scientists measured blood flow to the anterior insula of the brain, the region that is thought to be responsible for sending up a “red flag” that something is wrong.  As the games of trust progressed, fMRI scans showed that when trust was broken, the anterior insula in the brains of non-affected individuals would register increased blood flow. No such activity was measured in the brains of BPD-affected game players, which for scientists was a clear signal that BPD sufferers do not process relational cues with the same acuity and intensity as non-affected peers.

The outcome of the Baylor study showed that BPD-affected individuals lacked the basic ability to pick up on social cues from their non-affected partners. Scientists now believe this difference in brain function is responsible for the persistent and often pervasive relational instability which BPD sufferers exhibit.

In a second study conducted just one year later in 2009 at The Mount Sinai Medical Center, research scientists snapped into place yet another piece of the brain-based puzzle that is BPD. In the Mount Sinai study, researchers set out to discover why BPD-affected individuals experienced chronic inability to self-regulate emotions. Paired against a control group of non-affected peers, 19 BPD sufferers viewed a series of pleasant and disturbing images, and researchers used fMRI scans to measure blood flow to the amygdala, or emotion processing center of the brain. When BPD-affected participants viewed the disturbing images, blood flow to their amygdala far outpaced amygdala responses of their non-affected control group peers.

Mount Sinai researchers are using this information to better understand the origin of the extreme emotional reactions BPD sufferers often display. The hope is that in the future, this information can be used to target medications and treatments to better serve the recovery needs of BPD-affected individuals.

Both the Baylor and the Mount Sinai studies offer good news to BPD-affected individuals and their loved ones. With now conclusive evidence that brain-based differences exist between BPD sufferers and non-affected individuals, a new and hopeful horizon for better treatment options for BPD sufferers is coming into view.

To read more about the Baylor study: CLICK HERE

To read more about the Mount Sinai study: CLICK HERE

If you or someone you love is suffering from BPD, or if you have or observe in a loved one symptoms that match those outlined in this post, I urge you to contact Southlake Counseling today for assistance in recovering from this painful but very treatable disease. Learn more at www.southlakecounseling.com.

Be Well,

Kimberly

Published on Monday May 9, 2011 in Borderline Personality Disorder. 0 Comments Tags: , , , , , , .

Your Say Yes to Life Monday Motivator: Putting Fear in its Place

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Many of us have been shamed at one point or another in our lives for the simple expression of fear.

Feeling fear – it is something that animals, small children, birds, express so naturally. They feel fear, recognize it for the messenger that it is, and do the next right thing. This is because in its primal state, fear is built into our primitive limbic brain – the part of the brain that is wired to alert every sentient being to danger and give us a head start in finding safe shelter.

So how did fear evolve to the point where the simple expression of feeling fear can lead to shame, a desire to hide, or a need to camouflage fear with anger, rage, sadness, blame, or various addictions, just so we won’t be found out?

The actual definitions for fear range from an unpleasant feeling of perceived risk or danger, real or not to a reverential awe.

One interesting question I often ask those I work with is – “who told you fear was unpleasant?” Who would we be in the presence of our own fear if we weren’t so keen on labeling it as unpleasant? These are interesting questions to ask.

Another revealing question those I work with sometimes find helpful is, “since when is risk or danger ever perceived?” By this I mean that when we say these things to ourselves, we are in essence saying to ourselves, “I don’t trust you.” This is very frightening, and our fear only grows.

The truth is that when we feel fear, it is real to us – period, the end. We won’t accept others’ assessments that we really aren’t afraid when we are. We don’t have to stop and ask ourselves, “are you sure you are afraid?” We know. Questioning our fear shames us, and cuts us off from taking the necessary action to move through our fear towards resolution.

Similarly, when we spend precious moments believing that the emotion of fear is unpleasant, unwanted, unnecessary, or untrue, we resist the fear and….you guessed it….become even more afraid.  It is at this point where we may find ourselves turning to various thought or behavior patterns or addictions such as drinking, drugging, using other people’s bodies, stuffing our own bodies when we are already full or not feeling hungry, watching hours of mindless television programs, losing ourselves on the internet, or otherwise “checking out” from our own lives and the people around us.

We are afraid. We don’t want to feel afraid, we don’t know if we can trust that that feeling is fear, we judge ourselves for feeling the fear, we resist feeling the fear….and yet still we are afraid.

I’d like to propose a simpler way to put fear in its place. Let it stay where it is.

Fear is there, knocking on our awareness, for its own reasons. It has a message for us. It comes respectfully, and not without its own trepidation given the often cold reception we offer it. Yet it continues to come. Fear is kind. Fear wants us to deal with what is causing the fear and find resolution and peace.

So the next time you feel fear, before you move on auto pilot into arguing with its presence, discounting it, shaming or judging yourself for feeling it, blaming someone or something else for inducing it in you, hiding from it, or drowning yourself in addictive thought and behavior patterns to escape it, try this.

Simply stop.

Breathe.

Notice.

Ask yourself kindly, “What am I feeling afraid of?”

Write down your own answer.

If you find you are turning towards any exterior crutches or supports, like alcohol or other people, before doing a thorough self-investigation of your fear, then notice that too, and ask yourself kindly if you can wait just a few moments to do self inquiry on your fear before you have that first drink, make that phone call, or switch on the computer or television set.

And if you find that you are still too afraid to proceed without those crutches, it may be the right moment to consider reaching out for help.

Fear is a great teacher – if we will allow it. Fear can be a good friend – if we will allow it. Fear can teach us that it is okay to reach out and ask for help, and that in the very act of asking for help, we find our first taste of freedom from the fear of our own fear.

At Southlake Counseling, we have more than two decades of expertise with guiding people just like you through the experience of their own fear towards understanding, action, and resolution. Our caring professional staff is skilled in individual and group facilitation methods which can allow fear to safely arise, deliver its message, and depart, leaving us stronger, wiser, and more confident for the experience. Contact us today to find out how we can help you say “no” to discounting, shifting or hiding from your fears, and “yes” to learning from a very wise teacher – fear itself. www.southlakecounseling.com

Be Well,

Kimberly

Published on Monday April 18, 2011 in Monday Motivator. 0 Comments Tags: , , , , .

Your Say Yes to Life Monday Motivator: Treating Yourself During the Holidays

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When you think of the word “holidays,” the vision that comes to mind is of treats.

Specifically, holiday treats.

Specifically, those marshmallow chocolate sprinkled things your mother always makes….the ones with the mint centers and gooey tops.

And the peppermint ice cream with hot fudge that your family always has as a Christmas evening tradition. And the spicy-sweet popcorn mix with extra real butter for the night you watch “Twas the Night before Christmas” with all the kids. And the annual community-wide block party with the neighbor’s homemade fudge, and the home-fried doughnuts, and the…..

Your mouth is watering already. You have been SO good all year long…. for just such a season as this. While you can already see the New Year (and the New Year’s diet) looming, that dread can be put off for a month or so yet. You tell yourself that you will tackle the diet when you get to it.

To be honest, you are aware that you tend to indulge to excess during the holidays, to the point where you have an extra set of clothes waiting in the wings – all a size larger – and you dread New Year’s Day, when you have to squirm your way into something extra-tight to go to your annual family get together.

You’re just not sure what to do about it. Just the thought – not to mention the sight – of all those holiday treats, and you seem to lose all self control.

But this year, you have a new bag of tricks up your sleeve. You have been studying Dialectical Behavior Therapy (DBT), and your group leader has told you that using the four principles of DBT might help you.

Your goal is to maintain better self-control during the holidays, but balance that with a less restrictive, treat-aversive attitude throughout the rest of the year. Your group leader thinks that with some balance year-round, and a bit more willingness to indulge in treats here and there throughout the rest of the year, you won’t be as prone to excess when the holidays roll around.

You sure hope she is right!

You start by practicing mindfulness. As your table fills up with holiday goodies each night, you simply observe, with radical acceptance of what is, that they are maintaining a presence there. You feel that familiar craving deep in your abdomen. You witness yourself imagining how each treat will taste.

From there, you notice the frustration arising within you. You want all of the treats! Now! You feel stress – which ones should you start with? How many of each? What if you overindulge again and feel guilty like you did last year? You use your new emotion regulation technique to name each emotion as it arises – not engaging, but simply naming. Frustration. Fear. Anger. Sadness. Regret. Guilt. Shame.

As the emotions present themselves and you give them names, you are simultaneously practicing distress tolerance – the ability to stand in the presence of strong emotions without allowing them to overtake you. You accept that these are today’s events, like them or not, accept them or not. You choose to learn from (if not like) them, and to accept them by reminding yourself that you are stronger and wiser than any temporary disturbance that you may happen upon in the course of a day.

Finally, you use your newfound interpersonal regulation skills to remind yourself that food treats are not the only way you can reward and treat yourself. You can brew yourself a lovely warm cup of tea. You can invite a loved one for a brisk walk and watch the snowflakes fall while the moon shines above. You can pop in a good movie that you love to laugh at. You can draw a bath…or turn in early to get a few extra winks of sleep. You can read a favorite book or snuggle with your spouse.

In this way, you begin to relate to yourself as a whole being rather than as an emotion-driven stomach, and slowly, those cravings in your abdomen begin to unclench you and leave you in peace….turning a longstanding holiday woe into a true miraculous 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 20, 2010 in Dialectical Behavioral Therapy (DBT). 0 Comments Tags: , , , , , .