emotions Archives - Jefferson Park Counseling

DBT, or Dialectical Behavioral Therapy

Let’s continue our look at different therapy approaches, starting with Dialectical Behavioral therapy. Dialectical Behavioral Therapy is considered a newcomer to the field, despite it being around since the 1980’s. Dr. Marsha Linehan developed DBT as an offshoot of Cognitive Behavioral Therapy to treat those diagnosed with Borderline Personality Disorder. BPD was considered extremely difficult to treat, and the success of DBT didn’t stop there. Dialectical Behavioral therapy is empirically proven to work with addictions, self harming, substance use, and is appropriate for anyone with emotional regulation issues. It takes the established strengths of Cognitive Behavioral Therapy and infuses Mindfulness techniques, helping patients make behavioral change while sitting through intense emotions.

The four areas of DBT

DBT starts from four main tenets: Emotional Regulation, Distress Tolerance, Interpersonal Effectiveness, and Mindfulness. Put together, this lays the foundation that preaches sitting with and through emotions, staying balanced between ration and emotion, and pragmatism in our interactions with others. DBT is highly effective and is often taught didactically, through workbooks or modules.

Mindfulness

DBT starts and ends with mindfulness. Mindfulness is the practice of increasing awareness. Paying attention to ones thought, nonjudgmentally, helps control one’s thoughts and become more intentional and calm. Being mindful of thoughts can assist with all forms of emotional regulation, including anxiety,pain, anger, or depression. Mindfulness is also useful for withstanding physical symptoms like panic attacks, dissociation, trauma responses, or chronic pain. Mindfulness takes from many eastern philosophies and religions and challenges us to be more contemplative and intentional, whether it be practice regular meditation, recognizing and focuses the sensations occurring in our body, or slowing down to pause from our busy lifestyles for a moment of peace and clarity. Mindfulness doesn’t require any belief in an omniscient being but does recognize the tenets of Eastern philosophies.

Emotional Regulation

Most therapy modalities work to control emotions, but they go about it different ways. Cognitive behavioral therapy challenges the thought that causes the emotion, intending to the change the emotion. Dialectical behavioral therapy teaches to accept the emotion and to ride through it. Acknowledging the emotion allows separation between actions and feelings, providing the ability to be intentional and mindful of our choices. This segues very well into emotional regulation, stopping impulsive and emotionally driven reactions and instead encouraging pragmatic thought. Dialectical Behavioral Therapy uses techniques like Wise Mind to help balance emotion, where the person is asked to step back and examine their thinking. Wisemind is the idea of dividing our brains into two halves, emotion and reason. The ideal space is a perfect balance between, which is “Wisemind.” It asks that we look at where we are in the current moment, a mindful check in to see if we are using our rational and reasonable half or our emotional half. Then we look to adjust and find that harmony of balance and make decisions from the “wisemind.”

Distress tolerance

Distress tolerance is the idea of building our resilience to stressors, in order to improve our ability to withstand them. Distress can be anything from anger, anxiety, chronic pain, or self harm ideation. Dialectical Behavioral Therapy uses techniques like grounding to sit through the emotion and surf the feeling until it ebbs. Instead of confronting and challenging the emotion, DBT teaches to outlast it and ride the wave until it leaves. It also recognizes that distress level is dynamic, rising and lowering throughout the day and emphasizes the use of self care activities or meditation to not only return to a calm center but also bolster yourself against future stressors. DBT treats distress tolerance like bandwidth, where we have our limits but can also plan ahead strategically to help with unavoidable stressful situations.

Interpersonal Effectiveness

We all live in relation to others and so do our problems and conflicts. DBT looks at how we relate to and interact with others and tries to improve that. Stemming from its beginnings working with those diagnosed with Borderline Personality Disorder, DBT tries to avoid tumultuous conflicts and problematic relationships that often accompany those diagnosed with BPD. This tenet does extend to those who do not fit that diagnosis, as poor emotional control often comes at the cost of relationships. Outbursts of anger are often directed at those we are closest to and cause rifts in our relationships, both personal and work. DBT works with several techniques that teach staying objective in conflict, working to keep consistent with values, and to accept disagreement. Again, a key diagnostic criteria of Borderline Personality Disorder is unstable and intense relationships, where an extremely close relationship may end with high conflict and zero communication. Dialectical Behavioral Therapy has been empirically shown to improve behavior and relationships.

DBT is a very sought after and in vogue therapy modality now and with good reason. It takes simple and self driven steps that are objective and modularized to reach empirically proven results. It has changed Borderline Personality Disorder from a diagnosis previously thought to be extremely challenging to one that has clear and simple steps to an achievable success. Better yet it has since been shown to be highly effective with all populations, and a myriad of disorders. Dialectical Behavioral Therapy is straightforward and clear. It uses mindfulness tools to better control our emotions and to improve our relationships and stress tolerance. If you are interested in learning more about DBT, check out these links below including the creator of DBT herself.

https://behavioraltech.org/about-us/founded-by-marsha/

https://www.family-institute.org/therapy-programs/dialectical-behavior-therapy

https://www.dbtcenterchicago.com/

How mindfulness can help control your anger

Anger management is one of the most common reasons people seek therapy. Whether anger comes out as aggression, violence, or irritability, it can be damaging to our professional and personal relationships. We understand the consequences of our anger and try to control, yet it sometimes seems insurmountable to change behavior that can feel so instinctual. Anger is definitely a learned behavior, but that also means it can be unlearned. Let’s look at using mindfulness to help control our anger and find peace in our lives.

Mindfulness is the art of quieting our mind, being aware and accepting of the feelings and thoughts we have and then being intentional about how we want to act. The feeling of being carried away with emotion is something we all know, and mindfulness aims to stay in control of ourselves at all moments. Acting out of anger leads to destructive behaviors, hurtful words and severe consequences.

Let’s use an example. You are late for work, had to skip breakfast, and are frustrated with traffic. Out of nowhere the driver in the lane next to you cuts you off and you barely avoid a collision. You slam on the horn, yell some swear out the window and make a gesture with your hands. As if this day couldn’t get worse, and it is only 8:45am. This is the type of day that is easy to just continue, staying in a pissed off mood and lashing out at others. Additionally carrying anger long term leads to physical tension, headaches, and high blood pressure.

Examining this through a mindfulness lens, we look at three areas: emotions, physical, and mental. Performing a short check in, stopping to acknowledge the status of all three areas does not take much work and can put you in control of your anger.

First, let’s look at emotions. Put a specific name to how you feel: Angry? Frustrated? Irritated? Stressed? How about all of the above and then some more? Recognizing how you are feeling can help recognize what the triggers are for your anger. How do you experience this feeling? How does it manifest in your body?

Now the physical. Stop for a second and scan your body, head to toe. Look at where you feel tension, pain, tightness. Are you clenching your teeth? Can you feel your heart race? What muscles are engaged? Acknowledge it and take stock. What other emotions does this sensation remind you of? How severe is the emotion, and is it exhibited as it usually does? A very effective coping skill is allowing your body to feel whatever it needs. Stretching your tense shoulders, a deep breath for your constricted core. Flexing and releasing those balled up fists.

The act of recognizing the physical space and connecting it to your emotion helps provide context, and an increased awareness of where you are at. Many times the physical sensation of an emotion is the first indication we notice. By staying aware of our physical selves we can get a crucial head start on addressing our feelings.

Next your thoughts. Are you ruminating on the bad start to your day? Thinking about what you wished you had said to that driver? Are your thoughts rigid and stuck in one place, or are they floating around, taking on all the irritabilities? Are they a calm, deliberate pace or fast and flighty. Taking a second to collect this data allows you to acknowledge where you are at. Clearly you are angry, you are feeling the anger, and are thinking about what made you angry. Now you have the opportunity to refocus and be intentional with your thoughts.

You are now mindful of what you are experiencing. Even this acknowledgement allows you to pause and then plan your next move. So what is it? What is the next step that will help you let go and refresh? Maybe it is some deep breathing, putting on the radio, or calling someone to vent. Understanding what works is trial and error, but it requires the initial step of stepping back. Now you have the chance to regroup. This is no easy feat, and you question if this is even possible.

Engaging in mindfulness check-ins may sound like it won’t make a difference, but it provides huge results. Being aware of your anger building allows you to intervene while it is still manageable, instead of waiting till you are so worked up no coping skill will calm you down. As Benjamin Franklin said, “An ounce of prevention is a pound of cure.” You have to start at the beginning, and these small efforts to build your awareness helps put you in the driver’s seat, instead of being controlled by your anger.

Therapy can be a helpful environment to gain this insight, and to help discover what coping skills work for you. An outside perspective from a trained professional is extremely valuable as you try and work on controlling your anger. Mindfulness is a popular modality for a reason, and working on increasing your use of it will yield results when trying to better regulate your emotions.

The Consequences Of Ignoring Our Emotions

Suppressing your emotions?

Have you ever noticed a headache or tense neck when you were having a bad day?

Just like stage fright can cause a stomach ache, any emotion can have a physical effect on you. Emotions are very powerful, and we have a tendency to push away our feelings. Our culture constantly tells us to put on a brave face and to act as if everything is fine. A byproduct of that is that we are trained to swallow our feelings instead of dealing with them appropriately. This leads to physical, or somatic, issues.

The physical effects of anxiety are easily observed. First date jitters and test anxiety are some of the more minor issues, ones that are commonly seen and talked about. But how about back pain? Research has shown that back pain can be caused by prolonged stress and anxiety. Migraine headaches? Check. High blood pressure? Absolutely. How about gastrointestinal issues? The surge in diagnosis of Celiac’s disease and IBS is in no way unrelated to an increase in anxiety and stress. There are many cases of episodic IBS that are spurred by stress inducing events such as social gatherings. Grinding teeth is a common manifestation of stress or anxiety, and it can lead to terrible headaches and expensive damage to our teeth.

In our quick fix society it is common to see people treating the symptom, whether it is pain pills or sleeping pills. Instead, I challenge you to treat the source, which more times than not is unresolved anxiety. The takeaway here is that the effects of anxiety isn’t limited to your feelings and thoughts. It can have long lasting and expensive damage to your body. People can continue to play whack a mole by treating the symptoms, or realize the cause of these ailments and seek brief therapy with long lasting effects.