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 ZimetbaumAn 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. Guest writer: Anastasia Polar-Vivona, MHC-LP
Cope Ahead is a Dialectical Behavioral Therapy (DBT) Emotional Regulation skill. We are currently in the holiday season, which can bring up some uncomfortable emotions. The holiday season is a time where we are around our friends and families, which for some can bring up uncomfortable and overwhelming feelings and thoughts. During these times, it can be common for us to resort to ineffective coping methods. Does this sound like something you have experienced or are currently experiencing? The Cope Ahead skill could be for YOU! Cope Ahead: 5 Steps With these five steps, you can learn how to prepare for difficult situations.
Cope Ahead can be a challenging skill to practice. Like with practice of any skill, you will feel more confident over time. The more we practice, the more we feel in control of our responses! IMPROVE the moment is a distress tolerance skill in Dialectical Behavior Therapy (DBT). It is a skill to help us in the midst of challenging times. It doesn’t necessarily mean that we automatically feel better, but it can help us from feeling worse.
I: Imagery Use imagery to help you cope. You can imagine yourself in a safe place. You can imagine yourself coping with the difficult situation you’re experiencing in an effective way. You can imagine a place that makes you feel happy. Any images that help you feel safe and calm. M: Meaning Make meaning out of your pain. This can be a challenging skill, because at times, we aren’t ready to make meaning. There are times, however, when we can look at a painful experience, and see what we can learn from that experience or how we can grow. We can also make meaning by finding moments of gratitude within our pain. For example, we can express gratitude for a friend or loved one who supports us in our pain. P: Prayer Prayer can mean many different things! It can be praying to God, or it can be praying to a higher power. Prayer can be connecting with Wise Mind, meditating, or setting intentions. It can be going on a hike and taking in nature. It can be volunteering and connecting with your larger community. Prayer can be anything that allows you to connect with a higher power. R: Relax Engage in relaxing activities. Take a gentle yoga class or practice deep belly breathing. Try a half-smile meditation. Take a hot bath or shower. Drink a cup of your favorite tea. Hug a friend or family member. Watch your favorite movie snuggled up in your favorite blanket. O: One Thing in the Moment Similar to the DBT mindfulness skill, One-Mindful, be mindful of what you are doing, and only do one thing at a time. So often, we multitask. Instead, put down your cell phone, stop scrolling through social media, turn off the television, and just do one thing in the moment. V: Vacation Give yourself a vacation! This can be a week-long European destination trip, or it can be a brief 10-minute vacation in your mind. It could be imagining yourself going on a dream vacation, or it can even be giving yourself a few hours, removed from work, and watching your favorite TV show. E: Encouragement Be your own cheerleader! Talk to yourself the way you would your best friend who might be struggling. While this can be challenging to do, tell yourself all of the ways you are coping well. Encouraging statements like, “you got this!”, or “you’re doing a great job,” can help us in challenging times. Therapy is great! It gives us the space to process our thoughts and feelings in an unbiased, judgment-free zone. It helps connect our thoughts, feelings and behaviors in ways that we might not otherwise notice. And, it allows us to see patterns in our behaviors that can often impede our growth. But sometimes, we simply need to feel better. We need to soothe ourselves, or regulate our emotions, in order to do some of that processing and connecting work. That’s where a Dialectical Behavior Therapy (DBT) skills group helps. DBT is an evidence-based treatment that helps us with mood regulation, mindfulness, impulsive behaviors, and strengthening our relationships. It provides us with active and behavioral skills and tools to use when we are feeling emotionally heightened. When we feel like we are ready to explode, breakdown, scream, or punch a hole in the wall, that is not the time to process and explore our feelings. We do that after we’ve had some distance from our emotions, because we have to be vulnerable and willing to be curious about why it is present. But when it’s present, it feels all-consuming, and our main task is deescalate. Then, we can do the other work! But in order to get there, we have to use some DBT skills first. How does it work? DBT is split into four skill modules: mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. In each module, one learns over 70 skills! Mindfulness covers skills that allow us to be present and identify what we are feeling. Emotion regulation skills help us stay calm and collected, and help us identify when we need to decompress. Distress tolerance skills help us get through times when our emotions are really heightened, but we are in a place where we can’t address them (say, in an important meeting with your boss). And interpersonal effectiveness skills are tools that help us maintain and nurture our relationships. At a DBT skills session, participants complete a weekly diary card that tracks the intensity of one’s moods, as well as which skills one uses throughout the week, and how helpful those skills are. Each session also covers skills to practice. Outside of the sessions, participants receive 15-minute coaching calls with an expert therapist (the therapist leading the sessions) to help review use of skills in challenging situations. Why join a DBT group? DBT is helpful for people experiencing anxiety, depression, eating disorders, and impulsive behaviors. It helps us identify skills that we can use in the moment to alleviate our symptoms and strong emotions. DBT also helps us effectively set boundaries with others, and create that self-care/wellness plan that we can never quite seem to put into place, despite our best intentions. Taproot Therapy is running a DBT group starting October 13! We love running DBT groups, and are excited for our next group. This group will run virtually for 10 weeks, every Wednesday from 5:30pm-7pm, and will be led by our lead clinician and DBT expert, Erin Iwanusa, and co-facilitated by therapist, Bridget Carey. During this group, we will complete diary cards, learn skills in each of the four modules, and leave you with a plan to utilize these skills. For more information, click here! For more DBT skills check out our DBT blog, or listen to our podcast, Taproot Therapy: A Mindful Moment (we even have a DBT challenge that's available on our podcast!). When our emotions become overwhelming, it can be hard to respond to them. If we feel depressed, we might feel stuck or trapped, and all we want to do is sit on our couch and mindlessly scroll through Instagram. Other times, we can feel so angry that we want to punch a hole in the wall.
But, instead of getting stuck on our couch, we call a friend and go for a walk. Instead of punching a hole in the wall, we pause and take some deep breaths. This is the Dialectical Behavior Therapy (DBT) skill, Opposite Action to Emotion. Opposite Action to Emotion is a skill that helps us actively and behaviorally do the opposite of what we are feeling. Our emotions can often attempt to dictate our behaviors. And, our behaviors can directly impact our moods. Thus, if we do the opposite of what we are feeling, we will change our mood, and start to feel better. How Does it Work? Our thoughts, feelings and behaviors are all connected. For example, if I think, “I’m a loser, I have no friends, and everyone hates me,” I will start to feel sad or depressed. As a result of feeling sad or depressed, I might pull away from those who love me. I might binge eat, or misuse substances. But, if we were to change my thought to, “Right now, I feel lonely,” we might reach out to people we trust. How to Practice Opposite Action to Emotion First, identify what you are feeling. Name your emotion: sad, angry, depressed, anxious, worried, irritable. Once we can label our emotion, we know what we need to do to change it. Next, do the opposite of what you are feeling. For example: If you're feeling sad, do something that makes you happy: go for a walk, pet your dog, call your best friend, or watch a funny movie. If you're feeling angry, do something soothing: wrap up in a soft blanket, light a candle, drink a cup of hot tea, or meditate. If you're feeling anxious, do the thing that makes you anxious (but be safe. If you are anxious about walking home alone at 3am, don’t walk home alone at 3am)! If you are scared to speak to someone, speak to them. If you are nervous to go out, go out. If you are scared to ask for a raise at work, write out what you want to say and then ask for that raise! The idea is that we stop engaging in behaviors that amplify our unwanted feelings, and start engaging in behaviors that help us feel better. As with all DBT skills, this takes time and practice in order to see results. Create your own list of actions you can take when you are experiencing difficult feelings. What are the things you do that are opposite from how you are feeling? Self-soothing is a distress tolerance skill uses our senses to calm ourselves. We use our senses to soothe ourselves when we are feeling on edge, nervous, distracted, dissociative, or any other unpleasant feeling we might be experiencing. Our senses can ground us in the present, and help us regulate our emotions. When using this skill, try different methods to soothe using your senses. You might find some techniques are more effective than others.
Self-Soothing with Sight Look at images that soothe you. Find phots of a beach, a mountain, someone you love, or an animal. If you are able to, go out into nature and look at your surroundings. Watch videos of waves rolling or fish swimming. Look at photos from a vacation you took. Self-Soothing with Sound Listen to soft music, or classical piano. Listen to nature sounds, such as rainfall or ocean waves. Open your window and notice all of the sounds you hear. Play an instrument you enjoy listening to. Self-Soothing with Touch Put on your favorite sweater, or your softest pajamas. Rub lotion on your skin. Take a bath or shower and notice how the water feels. Get cozy with clean bedsheets. Pet your dog or cat. Hug someone you love. Self-Soothing with Taste Cook something you enjoy eating, and then eat it (this also can use your sense of smell!). Eat your favorite piece of candy. Drink a cup of hot tea, coffee, or hot chocolate. Eat your favorite comfort foods. Self-Soothing with Smell Light a scented candle. Bake your favorite desserts and notice the smells. Use lavender oil in an oil diffuser, or use lavender scented lotion. Smell your fresh laundry as it comes out of the dryer. Smell flowers in your yard. For more information on how to use Self-Soothing, listen to our latest episode, “”DBT Skill: Self-Soothing” on our podcast, Taproot Therapy: A Mindful Moment. We all like to feel accomplished. We like to feel that we are good at something. Knowing that we are skilled in certain areas helps us feel grounded and regulated. It can also increase our feelings of happiness.
Building Mastery is an emotion regulation skill in Dialectical Behavior Therapy (DBT), that helps us build awareness of, and practice, things we do well. Emotion regulation skills support us in both becoming aware of our emotions, and mindfully responding to our emotions. Thus, when we build mastery in something, we are able to respond to emotions in a supportive and mindful manner. There are two ways we can build mastery: 1.Recognize the things you are already doing well. 2.Learn something new and watch yourself grow. The first way to is recognize those things we are already doing well. Maybe you are really good at leading team meetings at work. Or, you cook an amazing chicken stir fry. Some of us are skilled knitters and painters. Others of us have excellent driving records. Identify all of the things that you are already doing well, and notice how you feel when you do those things. The second way we can practice building mastery is by learning new things and witnessing ourselves gaining competence in new skills as we practice them. Think about when you first learned to drive as a teenager. At first, it was a new skill, and you had no idea how to drive. You might have felt frustrated, angry, and you might have even dreaded getting into the driver’s seat! Now, think about how you felt when you passed your drivers’ test and got your license. You probably felt a big sense of accomplishment! When we learn new things, and when we watch ourselves grow, we feel excited and proud. What are some ways you build mastery? In the Netflix show, “Unbreakable Kimmy Schmidt,” the title character, Kimmy, has to turn a crank. It’s an endless and meaningless activity that she is forced to do. To get through the activity, she counts to 10. And when she gets to 10, she starts again. Kimmy states that she can do anything for 10 seconds. There’s research that supports this! Researchers estimate that our feelings only last approximately 90 seconds. It’s a bit longer than 10 seconds, but 90 seconds is astonishingly short. Practicing Riding the Wave
Riding the Wave of Emotion is a distress tolerance skill. Imagine your feeling as if it were a wave. It starts small, barely noticeable. It grows, until it reaches its peak. The peak of that wave lasts approximately 90 seconds. And then, our feeling naturally starts to decrease in intensity, until it subsides completely. While the entire wave of emotion might last longer than 90 seconds, the emotion at its most intense point will be short lived. In order to practice this skill, you simply have to be mindful of how you are feeling, and where you are on that emotional wave. This skill allows you to track your emotion as it hits the peak and declines. This skill is helpful when you are feeling overwhelmed by emotion, but aren’t necessarily sure how to respond to it. By simply being present to the wave, you are responding to your emotion! This is also a helpful skill for navigating urges. Our urges, just like our emotions, will subside. Urges can include self-harm, overeating, using substances when you don't want to, or any other habits you are hoping to break. Considerations This skill is also helpful because there are times when we want to remain upset, anxious, angry, or whatever big feeling we are experiencing. And yet, as with all things in our lives, our emotions have a natural start and end point. They come and go. And when it is time for them to subside, this skill can help us do that. If you start to feel yourself trying to climb back up to the peak of the emotional wave, remind yourself that emotions are meant to crash on the shores, just like waves. |
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Taproot Therapy, LCSW, PLLC
Office@taproottherapynyc.com 285 Lexington Avenue Suite 2A New York, NY 10016 141 E 35th Street Suite J New York, NY 10016 |