AUGUST 26, 2016

About 4 years into my sobriety I became bored. Although I considered my 12-step program to be strong, something was missing. I was attending meetings, working with a sponsor and doing everything I knew to do, yet I was dry. My Spiritual life was on hold and my luster for life had become dull, flat and boring. After attending a weekend convention I called my sponsor to ask for his guidance.

“Something doesn’t feel right” I said. “I don’t know what it is, but I just feel stuck. I’m not necessarily unhappy, but, I mean…is this all there is?”I told my sponsor I thought I needed to work through the 12 steps again (sponsors love it when you tell them what you think you need). My sponsor asked me how much I was meditating. “Um….well..I think about meditating a lot”, I said.”Yeah”, he said, “that sounds about right. I tell you what, I don’t think you need to re-work the steps, I think you need to spend some time on step 11.

My sponsor has always given me strong guidance and this time was no exception. Step 11 suggests “prayer and meditation” in an effort to improve our spiritual lives and although I am not a religious person, prayer was a pretty regular part of my routine. Meditation however had been something I have conveniently overlooked.

So we began to meet weekly to investigate meditation together and this was the beginning of something that has improved the quality of my life more than I could have even imagined. Now don’t get me wrong, my meditation practice is far from perfect. I am not a meditation master nor have I had mystical experiences, but I have experienced a profound shift in my thinking and my reaction to life. In other words I can tell a difference in my life during times when I am meditating on a regular basis versus times when I am not.

The effectiveness of meditation led me to begin studying mindfulness which is the foundation of all Dialectical Behavior Therapy. Mindfulness is defined as “a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique.” DBT is that delicate balance of acceptance and change; a dance between the ability to accept ourselves (and our thoughts and emotions) exactly as we are in each moment, without self-loathing, self-pity or judgement and the ability to work towards changing problems in our thinking and behaviors that lead us to suffering, acting- out and negative consequences

So often it seems we go through our busy lives unaware of what is going on in our minds and in our hearts; we are all on a fast track to the next appointment or obligation forgetting that we are human beings with thoughts and emotions that if left unchecked spiral out of control or at best keep us stuck in unhealthy thinking patterns that prevent us from moving forward in our lives.

To put it in DBT terms, DBT believes that “All people at any given point are doing the best they can” and “people need to do better, try harder and be more motivated for change”.

DBT was created by Marsha M. Linehan, PhD and focus on learning to balance the acceptance and change through four modules of therapy: Mindfulness, Interpersonal Effectiveness, Distress Tolerance and Emotion Regulation. Each module requires mindfulness practice as the foundational skill for that module. To quote Lenehan, ” We can contrast mindfulness with rigidly clinging to the present moment as if we could keep a present moment from changing if we cling hard enough. When we are mindful, we are open to the fluidity of each moment as it arises and falls away.” What has been discovered is that DBT, an evidence based treatment, is effective in helping people with addiction learn to become mindful of triggers, emotional upsets and unhealthy thinking patterns and learn the skills necessary to become effective in their lives in recovery. DBT shares many views and beliefs with Cognitive Behavioral Therapy, noting that unwanted thoughts and behaviors are learned and reinforced. DBT believes that the interaction between two factors increases the chances of persistent mental health issues:

Emotional vulnerability.
Invalidating environments.

Someone that is emotionally vulnerable will feel like their life is turbulent and extreme, and they will be quick to respond with strong emotional reactions. This vulnerability can be caused by traumatic events or from the individual’s natural disposition ( i.e. they are simply born that way). An invalidating environment is where someone is consistently made to feel as though their feelings are wrong or “bad.” A lack of kindness, respect, acceptance or simply not understanding the person with emotional vulnerability can produce an invalidating environment.

DBT includes a level of optimism that is not found usually in CBT. DBT conveys that:
People are doing the best they can in their current situation.
They want situations to improve.
People are capable of learning new behaviors to change their lives.
The problems are not always the person’s fault, but it is their duty to resolve it.

As mentioned, DBT is focused on creating an effective environment for the client to learn and practice skills. The primary skills addressed in DBT are:

  • Mindfulness. This is the act of being completely aware and engaged in one’s current setting. People with mental health or substance use issues often spend increased time distracting themselves, thinking about the past, or worrying about the future. Mindfulness is the practice of being fully immersed in the here and now, with kindness and curiosity towards one’s current experience.
  • Distress tolerance. When people experience distress, there is an urge to reduce or change it immediately. Using a substance during periods of stress is an example of an unhealthy way to manage distress. Distress tolerance teaches how to accept and tolerate distress rather than escape from it.
  • Interpersonal effectiveness. When communication and conflict resolution skills are lacking, problems increase. DBT teaches people to learn how to have happier, more fulfilling relationships through effective interactions with others.
  • Emotional regulation. This is another example of dialectics. Distress tolerance moves towards acceptance while emotional regulation works to identify unwanted feelings and find ways to change them.

These skills are so effective that other styles of therapy have borrowed them and currently use them in a number of settings.

DBT Skills Training in not group therapy and processing of important client issues are reserved for individual counseling. The Skills group focuses on teaching DBT skills with homework given and participants practicing each skill between sessions. Homework review with each client sharing his or her experience utilizing the skill is done at the beginning of each session followed by discussion and teaching of the next skill. It is a requirement in most DBT Skills groups that each participant have an individual counseling session each week.

Clearly, I am excited that Full Life Counseling is offering the first DBT Skills module Thursdays, September 15-November 3 from 6pm-7:30pm. The group will be facilitated by myself and Jamie Robertson, MSW, LCSW. and will be followed by the remaining 3 modules in 8 week sessions. Anyone interested in more information or for an assessment may call (336) 923-7526.