To the person that had a slip during Dry January:
2023 rolled around and you set your sights on not drinking for the month of January.
Congrats! That’s a great intention to set to start off your new year. Perhaps you started off
strong, noticing the incredible impact of no alcohol on your system. You wake up earlier,
without a hangover, and head to the gym. You notice you don’t have to drink to have fun in
social settings. As the days go on, you slowly start to see the stress build up as you go back to
work, school, family life, etcetera. The January blues roll in, and the sun sets at 4:45 pm. On
certain days, your fitness routine is swapped out for sitting at home to manage your stress. Then,
you find alcohol in your fridge that you didn’t intend on thinking about this month, and you
drink it. The day is long, you’re stressed and tired, and you go back to an old buddy that you
relied on for so long. And the alcohol worked for coping! Until it didn’t, and perhaps you’re
feeling guilt, shame, or frustration because you slipped up and drank.
Pause. Deep breath. You are okay. Slips happen! Progress is absolutely not linear.
Humans go to what is engrained and what “works”. Whether that’s alcohol, drugs,
shopping, food, relationships, gambling, overworking, overexercising, the list goes on. So many
of our coping skills, which take the pain away, actually detach us from our reality. Humans
struggle with accepting and listening to the feelings we have, the feelings are uncomfortable, and
they make us face a reality that we so desperately avoid. Instead of sitting in the emotions, riding
the waves that come, and allowing them to pass – we avoid them. And of course we avoid, we
aren’t given a guidebook on how to cope in a way that feels authentic and healthy. Yet we are
still left with those thoughts, feelings, and quite often, behaviors that keep us in an old cycle of
dysfunction and dysregulation.
So, what do you do if you slip? Well, I’m here to say that you are not a bad person for
slipping up and drinking. You continue on, reminding yourself of the initial intention you set
when you were curious about Dry January. Perhaps you realign your intention, reminding
yourself that your goal is to re-evaluate your relationship with alcohol. Maybe you want to
decrease the number of days you drink, or the amount you drink in one sitting. Your goal of
wellness is a fantastic goal. You don’t have to be perfect. You are already doing so much by
acknowledging and increasing your awareness of the reality you are in. Perhaps you 6 months
ago, or 2 years ago, would’ve never thought to evaluate your relationship with substances!
Search inward for that compassion and love for trying your best.
Enjoy that mocktail. Today is a new day.
Red flags don't feel like red flags when they remind you of home. Somewhere along the
way you may have learned that chaos, self-abandonment, harm, and pain meant love.
Probably this was picked up in your earliest relationships with your caregivers, whether
this was subtle or acute, we developed an anxious-avoidant attachment style. This
means that once you start feeling close to someone you may feel triggered, either that
you will lose the other person or lose yourself. Fight or flight kicks in alongside intimacy
and maladaptive protective measures follow suit. It causes an individual to connect part
or whole of their self-worth in their partner and engage in behaviors such as obsessing,
avoiding, ditching, and fighting. Moving towards safety in partnership takes a lot of work.
You won’t get there in a day. In therapy, you, alongside your therapist, can identify old
patterns that get you stuck, develop healthy coping mechanisms and find new ways of
communicating your needs and boundaries. You will come to recognize you are worthy
of love and worthy of being fully seen, not only by our partners but by yourself as well.
Attachment styles start to form in the very first year of life. This is when we begin to
learn: am I loved? Is someone there when I need them? Do people hear my cries? Am I
worthy of attention and care, do I matter? The information we receive as infants may
impact our relationships for the rest of our lives. Of course, as we grow so do our beliefs
about self and our understanding of how the world responds to me, and what does that
say about me. Every fight or argument may affirm, I am bad or I am too much. And we
may be left with that all too familiar feeling of being hopelessly, excruciatingly,
Children are appropriately very egocentric. Unlike adults, children aren’t able to look at
the bigger picture of a situation. So instead of understanding, mom is busy working and
doesn’t have time for me, children think, mom isn’t paying attention to me, I must not be
worthy of her attention. Additionally, children will do anything to preserve the
relationship with their caregivers including making wild excuses for abuse and neglect.
This is an adaptive feature of the mind that just goes to show how vital attachment is in
childhood. In fact, that fear of abandonment stems back to a primal part of our brain. In
adulthood that fear of abandonment can feel like excruciating death and that’s because
at one point it did mean death. When we are small, being abandoned by our caregivers
does mean we could die. We are helpless and completely depend on adults to survive.
That intense fear of being abandoned is stored in our bodies and can get activated as
Attachment wounds or relational trauma? Can we recognize that not having what you
need in early childhood is a complex trauma? Living every day not knowing how you will
get your needs met does wreckage to the body especially during development.
Insecurity takes a toll on the nervous system. Overactive fight or flight kicks in and you
begin to develop on survival mode. Excessive and constant flow of cortisol through the
body in childhood has been linked to several medical issues in adult hood such as
autoimmune disorders, heart disease, diabetes, IBS, asthma and more.
All of this is to say, this matters. We live in a culture that dismisses people as being
needy, over-emotional, dramatic etc. And I am here to say the big reactions are
warranted and that I see you. In fact, can we thank these big reactions for telling us
where to look, for being our clue that something deeper is going on? Can we start in the
place where it all went awry? By seeing ourselves for the very first time by saying, “you
are not broken, thank you for telling me”. When we say this we open worlds and close
loops.It’s time to put an end to the narrative that something is wrong within yourself and
you just need to get over it – you were never meant to bear the burden of the world’s
limitations, you were never meant to shrink yourself and self-abandon in order to
receive love and care. Yes we have a responsibility for our healing today but no you
didn’t get here by yourself. The first step in untangling all of this attachment work is just
in seeing and acknowledging ourselves. Your little one thanks you.
We all have heard about the benefits of mindfulness exercises as part of adult therapeutic practice. But, we aren’t quite aware that mindfulness practices are highly effective with children as well! A child-friendly explanation of mindfulness would be- paying attention to what is happening in the present moment. Studies have shown that integrating mindfulness or meditation exercises into a child’s routine can prove to have copious benefits.
First and foremost, children can use mindfulness to deal with the stressors of their life. (Yes, children most definitely experience stressors in their lives, although they may be different than adult stressors). Along with this, they learn important skills such as being present in the moment, self-compassion and openness. Practicing mindfulness also leads to improved concentration and self-control.
As children learn primarily by observation, parents and caregivers are a significant source for modeling these practices to children! These activities need not necessarily be something lengthy or fancy. It can be as simple as taking a walk, having a calming uninterrupted playtime with the child or reading/ drawing together. Remember that the purpose of the exercise is to be fully present in the current moment!
A simple mindfulness activity for children is a body scan. Ask the child to lie down in a comfortable position. Introduce deep breathing and then ask the child to pay attention to different parts of the body from their head to their toes. Ask them to notice all the sensations they experience including temperature, texture and weight. This exercise helps children be more mindful of what’s happening in their physical bodies.
Lastly, another simple activity is the 4 square breathing exercise. Ask the child to sit in a comfortable position. Ask the child to imagine a square in front of them. Now trace along the height of the square while taking a deep breath through your nose for 4 seconds. Now, trace along the width of the square while holding the breath for another 4 seconds. Exhale through the mouth as your trace along the height of the square and then hold the breath for 4 seconds as you complete the square. Repeat this deep inhalation, hold, exhalation and hold for four or five more times. This helps the child practice deep breathing to calm their mind and body.
Some feelings and emotions are difficult to articulate through words. Sometimes we might not know what exactly the feeling or the emotion is that we are experiencing at the moment. Art is a tool that one can use to express those unresolved and unexplained feelings. There is no right or wrong way to express one's feelings through art. Hence, there is no right or wrong answer in art. And that is the beauty of it.
Let’s say that you are given a blank canvas and some paint. That canvas is wholly yours to use. You don’t need to be an artist or even creative to be able to use art as a tool. Everything that you draw, paint, create, build, and pour into the canvas is your own unique piece of art. This is your opportunity to concentrate on yourself in a creative manner. You own that canvas, and you get to choose the colors, shapes, images, and symbols that fit your own ideal world.
Through self-expression you will learn more about yourself, and be able to communicate unexplored feelings, emotions, thoughts, and problems in a non-judgmental manner. It provides you with freedom to show your true self. It is a stress reducing and self-esteem and self-awareness increasing activity that anyone can engage in. Followed with the completed art piece you will also be given guidance that will help you furtherly explore your unconscious which will be a healing process.
Art is a beautiful tool that everyone regardless of their age, gender, race, and cultural background can be engaged in. The beauty of having no wrong or right answer will provide the space for personal growth.
Pros and Cons can function as a beneficial distress tolerance skill in DBT. As with other distress
tolerance skills, Pros and Cons are often used in crisis situations. It can aid in helping us avoid
acting impulsively while weighing the pros and cons of the impulsive decision at hand. Instead
of acting impulsively, making the pros and cons list can help us act skillfully. It shows us that
better results pan out by making a skillful decision with our pain, rather than an impulsive
decision with our pain. It’s most common to use pros and cons when we have to participate in
something that we really don’t want to do.
The most common way to use the pros and cons skill is to make a pros and cons list. Most
people, at one point in their life, have made a pros and cons list about a decision. In DBT, we can
make a pros and cons list of our impulsive decisions and maladaptive behaviors.
In order to make this list, we can pick a maladaptive or impulsive behavior that we typically
engage in. First, we would make a pros and cons list of specifically engaging in the behavior. We
may ask ourselves, what good can come out of engaging in the behavior, and what negative
consequences can result as a part of engaging in the behavior? Then, we would make an
additional pros and cons list. This list will be for the same behavior, but we would evaluate the
pros and cons of not participating in the impulsive behavior.
While making the list, we can also consider both the short and long-term consequences of
engaging vs. not engaging in impulsive behavior. A way to do this on this list would be to signify
“ST” for short term, and “LT” for long term next to specific statements on the list. This shows us
that our behaviors can provide short-term relief, but may cause long-term conflict. By labeling
behaviors as short-term or long-term, we can also identify maladaptive patterns within our
behaviors, and learn to challenge them. Once we identify these patterns, we can skillfully find
ways to integrate new coping strategies in replacement of maladaptive and impulsive behaviors.
Pros and cons lists are often created before a behavior occurs, likely in therapy with a DBT
therapist. The list can then be used in a moment of distress, when there is an impulsive urge to
act upon a behavior. We can refer to the list that we made in a time of clear-minded thinking,
instead of using an emotional mind to make a decision.
Play-Therapy for Children Written by: Maitreyee Sathe, Clinical Trainee specializing in play therapy
Just as adults tend to talk about their feelings and emotions, children act them out in play! Play is
a child’s natural way of communication. Children use toys to express themselves including their
needs, wishes and wants. They use toys as a medium to make sense of their life experiences. For
children, what seems unmanageable in reality, becomes manageable in play! Children externalize
their emotions and thoughts with the help of toys and hence experience a sense of relief through
Play therapy is an evidence based approach with solid research to support its effectiveness for
many populations and concerns. Children experiencing social, emotional or behavioral
difficulties use the playroom as a safe space to comprehend their struggles, express their
emotions and explore possible solutions. The children use the toys in the playroom as a form of
communication with the clinician. These toys include real life and nurturing toys such as doll
family, doll house, puppets, cars, money, medical kit, food; Aggressive toys such as toy soldiers,
plastic guns, animals and aggressive puppets; and finally expressive toys such as sandtray, paint,
clay, musical instruments and, dress up clothes.
Play therapy helps children to facilitate communication, enhance social relationships, foster
emotional wellness and increase personal strengths. The clinician in the playroom strives to
provide the child with a warm, safe and supporting environment. The clinician provides the child
with unconditional positive regard while building a friendly and warm relationship. The clinician
maintains a deep respect for the child’s ability to solve his/her problems and gives the child the
opportunity to do so. A collaborative approach is taken with an aim to empower both the child
and the caregiver and the clinician conducts regular sessions with parents and guardians to
monitor the child’s progress.
Contact firstname.lastname@example.org to know more/ schedule an appointment!
Emotions come in waves. There are times when feelings can be overwhelming. During a stressful day, when you are feeling elevated, utilize the DBT skill STOP. Stopping involves taking a step back, observing what is happening, and choosing to proceed mindfully. It is easier said than done, stepping back involves taking a break from what you are doing, or pausing.
When you hit pause, take the time to observe. Observing involves sitting with our emotions and understanding the sensations in our body. In a way when we observe, we think of ourselves as a fly on the wall. Instead of passing a judgment about what is going on, the goal is to see the situation clearly and look at the facts. Observing also includes steering away from subjective assessment. It involves taking the facts of a situation and bearing your emotions in mind.
The last step is proceeding mindfully. Proceeding mindfully involves taking what is observed, keeping your goals in mind and bridging the gap between your rational mind and emotional mind, in other words it is activating your wise mind. When your wise mind is activated, think about what you would like to get from the situation at hand and whether the emotions that you feel fit the circumstances. When you utilize the STOP skill, think about the outcome of your actions and your goals. You can ask yourself, what would I like to get from this situation? What are my goals? What can I do that could make this situation better or worse?
In other words, proceeding mindfully involves emotional regulation, staying calm and collected when you have gathered all the information internally and externally about how it can impact your goals.
Guest Writer: Revna Ozdamar
Accumulating positives is a DBT skill that reduces vulnerability to difficult emotions and creates a barrier between you and feeling overwhelmed. Increase your pleasant experiences by building positives. Building positives refers to increasing positive emotions.
Do one pleasant event per day. Positive events can be anything of your choice examples include reading, gardening, taking a bubble bath. Create a list of things that bring you joy and practice these activities for 25-30 days. While accumulating positives, be present, and immerse yourself fully in a chosen activity. If you get distracted and worry starts to take over your experience refocus.
Refocus your attention on pleasant events and participate fully. Be present with what you are doing. Be unmindful of worrying; do not destroy positive experiences by thinking about when they will end? Acknowledge and release these thoughts.
Another way to accumulate positives is to focus on something good that happens every day. Be mindful of your positive experiences. Journaling and keeping a gratitude journal is a great practice. Accumulating positives, in the long run, requires a different skill set.
Accumulating Positives: Long-Term
Avoid-avoiding. There is a natural tendency to procrastinate on tasks that do not spark joy. Avoiding problems builds up stress and activates your emotional mind. Practice makes perfect, the more you flex your mindfulness skills and address agenda items the better you will feel. Another way to build positives in the long-term is to live a life in alignment with your values, goals, and aspirations.
Identify your goals, aspirations, and values and build a life around them. Examples include improving relationships, ending destructive ones, and spending time working on your goals and dreams.
Accumulating positives takes time and practice. Building a life worth living is a journey and experiencing positive events daily is a component of it. Baby steps pave the way for greater self-awareness and self-discovery. Creating a working list of positive activities takes time and patience. I invite anyone who is embarking on this journey to also practice gentleness. It takes time to build a life that matches your values.
Guest Writer: Molly Zimetbaum
An important Interpersonal Effectiveness DBT skill involves learning how to balance goals and priorities when we are dealing with a conflict. This skill teaches us to be mindful about our relationships and the conflicts within them, and subsequently decide how to make effective, gratifying compromises.
Generally, within an interpersonal conflict, there are three factors we must decide how to prioritize and balance: our desire to get what we want, our desire to maintain a good relationship with the other person, and our desire to maintain our own self-respect.
Let’s discuss these factors in greater detail:
The objective: this refers to our goal, or what we want to get out of the conflict. We might want to request something effectively, to deny a request effectively, to stand up for ourselves, or for our opinion or viewpoint to be taken seriously.
(It’s important to note that, no matter how skilled we are at interpersonal communication, sometimes we simply cannot attain our objective. That’s when radical acceptance and distress tolerance come into the mix.)
The relationship: this refers to the importance of preserving the relationship despite the conflict within it. We might preserve the relationship by balancing our immediate goals with the good of the long-term relationship, or by choosing a way to communicate that does not erode respect and trust within the relationship.
Our self-respect: this refers to the importance of maintaining our positive feelings towards ourselves, and our adherence to our beliefs and values while dealing with a conflict. We might preserve our self-respect by remaining true to our morals, or by acting in a way that makes us feel competent, as opposed to lying, manipulating, or giving in for the sake of approval.
These three factors will be prioritized differently depending on the particular situation.
For example, let’s say your boss assigns you work that is far outside the purview of your job description and does not offer compensation. You don’t want to do the work, it is not fair that you have to do the work, but you are concerned with maintaining a good relationship with your boss. Ultimately, you might choose to ask for what you want, prioritizing getting what you want while communicating skillfully.
But let’s say your significant other asks you to stay home with him instead of attending a party you wanted to go to, because he had a difficult day. You might consider your own goal—to attend the party—and your sense of self-respect, which entails independence. But ultimately, you would likely choose to prioritize the relationship here.
Now, let’s say your friend asks you to help him cheat on a test. In this situation, you may be concerned about preserving the relationship, but you would ultimately prioritize self-respect and adhere to your morals, and deny the request using skilled communication.
Of course, these examples are simplified, and real life conflicts are often more complicated and involve more context. Nonetheless, remembering these factors can help us organize our priorities and make better decisions in moments of conflict with others.
Radical Acceptance is a distress tolerance skill in Dialectical Behavior Therapy (DBT). It teaches us to accept things as they are, completely and fully. It means not resisting, or not attempting to change. Rather it means seeing things as they are.
This can be a challenging skill in DBT! It can be hard to look at our problems and say “I accept it for exactly what it is.” We want to change things that are unfair, painful, or problematic. But radical acceptance forces us to look at something and say, “it is what it is.”
It’s important to clarify with this skill that it doesn’t necessarily mean that we are approving of something. Acceptance does not mean approval. It does not mean we have to like something. It simply means we recognize the facts of the situations.
Acceptance also doesn’t mean agreeing. I can accept that something is happening without agreeing with it. For example, let’s say you’ve asked your boss for a raise, and your boss says no. Despite the fact that you’ve worked late, taken on extra projects, and have definitely earned your raise. You might completely disagree with this decision, and you can still radically accept that this is the final decision.
Radical Acceptance does not mean that we tolerate abusive behavior. Radical Acceptance does allow us to recognize abusive behavior, however, and help us decide how to respond to it. Once I recognize that something is happening, once I radically accept it, I can then decide how to respond to it. Moreover, by accepting our pain, we reduce our suffering. As the famous saying goes, “Pain is inevitable. Suffering is optional.” Radical Acceptance helps us reduce suffering.
As with all of our DBT skills, Radical Acceptance takes a lot of practice. It is not easy to accept things as they are. To practice, start first by practicing small things. If it’s raining out and you were hoping to go on a hike, radically accept the weather. If you wanted to pick up a bottle of olive oil and the grocery store is already closed, radically accept that you’ll go to the store the next day. As you feel comfortable practicing these smaller instances, you’ll be able to start practicing radical acceptance with bigger issues that come up for you.