Behavioral Psych Studio

Category: by Avery Carmichael

  • Self Compassion

    Self Compassion

    Recently, in an off-handed, quasi-self deprecating way, a dear friend remarked to me, “If I were to speak to others the way I speak to myself, I don’t think I’d have that many friends.” I was struck by the statement, as my assumptions about this individual ran wholly counter to her internal experience. 

    “What do you mean?” I asked. (As we know in Dialectical Behavior Therapy, it’s ever-important to check the facts, lest our interpretations and assumptions run wild.)

    “Oh, I just…I’m pretty cruel to myself. Just a lot of me judging me for being me.” She continued with specifics, and I was dumbfounded. All this time, my dear friend, the ‘Queen of Pep Talks’ as we call her, was evaluating herself — and not positively. At the very least, not in a fact-based light. 

    And you know what happened? Essentially right after I registered that I was experiencing surprise? I had a rapid fire series of thoughts, noticing this one in particular: ‘Even with my training and experiences in social work, I totally assumed that she was inured to this type of evaluation and labeling. Wow.’ I judged myself. 

     

    Well, well, well. 

     

    Upon further reflection, as well as additional use of my Mindfulness WHAT and HOW Skills, I came to a conclusion that I hadn’t yet named for myself: Perhaps I am also my harshest critic. Perhaps many of us are. (And yes, I’m going to be transparent in naming that I subsequently judged myself for coming to this conclusion, as I had the thought: ‘Duh, Avery.’) 

    Knowing how much we lose by judging our perceived flaws or missteps, how much pain this can bring about, and how both of these things can prompt maladaptive behavioral responses, what’s to be done? How do we tackle the seemingly automatic judgments and self-criticisms that many of us have towards ourselves? A potential answer resides in the work of Dr. Kristin Neff, a pioneer in the field of self-compassion.

    Self-compassion is a Buddhist psychological construct that acts as a healing balm, a salve, in the face of self-criticism and judgment. It is something that can be practiced, flexed like a muscle, and it is best summed up — funnily enough — by treating yourself like you might treat a loved one. It is made up of three components: 

     

    • Mindfulness or bringing a balanced awareness to the present moment (consider your mindfulness skills!)

     

    • Self-kindness or offering ourselves warm, gentle acceptance and comfort (consider your self-validation skills!)

     

    • Common humanity or recognizing that pain and challenges are part of the shared human experience (consider radical acceptance!) 

     

    A blogpost is not sufficient to encapsulate all the tenets of what self-compassion is, what it is not, and how to practice it. AND, to begin seeding that habit of self-compassion, a new behavior to learn and nurture, I am sharing two self-compassion exercises to get you started. These are inspired by, although slightly modified from, Dr. Neff’s work.  

     

    Exercise 1: Loving Kindness Meditation

    In a space that feels safe and comfortable for you, position yourself in a mindful, wide awake position. Remember: No past. No future. Just the present moment. Let your mind run away. Catch it — and return. 

     

    Take several deep breaths in, and repeat the following phrases, or modifications that you prefer, to yourself: 

     

    May I be happy

    May I be healthy

    May I be at ease

    May I give and receive warmth 

     

    Notice any thoughts, emotions, physical sensations, judgments that come up for you. Stay with this, or direct your loving kindness to others. 

     

    Exercise 2: Supportive Touch

    Offering yourself a form of supportive touch is shown to release oxytocin, enhancing security and calming distress. Try any of the below motions, after taking several deep breaths, and notice what comes up for you:

     

    One hand on your cheek

    Cradling your face in your hands

    Gently stroking your arms

    Crossing your arms and giving a gentle squeeze

    Gently rubbing your chest, or using circular movements

    Hand on your abdomen

    One hand on your abdomen and one over heart

    Cupping one hand in the other in your lap

    As a note, there is a clear and marked overlap between the foundational components of DBT and self-compassion. This infusion may be fruitful, and I highly recommend exploring Dr. Neff’s website, here, alongside the following texts:

     

    For Children

    Listening with My Heart (Gabi Garcia)It’s Ok: Being Kind to Yourself When Things Feel Hard (Wendy O’Leary)

     

    For Teens

    The Self-Compassion Workbook for Teens (Karen Bluth)

     

    For Adults

    Self-Compassion: The Proven Power of Being Kind to Yourself (Kristin Neff)

    Radical Acceptance: Embracing Your Life with the Heart of Buddha (Tara Brach)


     

     

  • 3 Skills for Responding to Invalidating Environments

    3 Skills for Responding to Invalidating Environments

    Invalidation is one of the most corrosive factors in any given relationship. After all, chronic invalidation resides at the heart of DBT’s Biosocial Theory, which expounds upon why one may struggle to control one’s own emotions and actions. Invalidation, at its core, “tells you your emotions are invalid, weird, wrong, or bad” (Linehan, 2015). It can take many different forms, and while the intention may not be harmful, the impact very well might be. Whether at home, at work, in school, or at a social gathering with friends, it is possible that invalidation will arise.

    Some examples of invalidation might look like being ignored, receiving unequal treatment, or being told any iteration of the following:

    • “Stop being such a drama queen!”
    • “You have to move on from this. Normal people don’t care this much about _____.”
    • “It’s not that bad.”
    • “You’re seriously overreacting.”
    • “Just get back on the horse.”

    People in your life who invalidate you are typically doing the best they can in the given moment. Perhaps they aren’t sure what or how to validate you, or they’re experiencing distress watching your distress, and are seeking to ameliorate it as quickly as possible. For example, I distinctly recall driving to prom with my very well-intentioned mother when I was 18 years old. I was feeling insecure and uncomfortable in my own body, and when I shared this, my mother said: ‘You look great! Don’t worry about it!’ My distress was so discomforting to her that, rather than validating my emotions, she proffered a different form of invalidating feedback. This makes sense, in so many ways. Who wants to witness their own child in pain? And, this wasn’t what I needed in that moment, and only furthered my sense of distress.

    Oftentimes, people who invalidate others grew up in invalidating households or social environments. This behavior was learned, over time, and it’s not uncommon that the individuals invalidating you may also be persistently invalidating themselves. This consideration can be a useful tool for building compassion in the face of invalidation, and for removing the inclination to judge and blame — which only contributes to further suffering. Whatever the cause, we have collated three of our favorite skills for responding to an invalidating environment. ​

    Skill 1: Self-Soothe

    While it may be difficult to self-soothe in the presence of the individual who has invalidated you, take some time in the wake of the invalidation to practice self-soothe. You are feeling pain, and that make sense! Practice self-soothing with the six senses (sight, touch, smell, taste, sound, and movement) to re-regulate, and move forward effectively. Sometimes this requires planning ahead with some self-soothe objects or materials. As a starting point, take a look at these ideas for each sense:

    • Sight: Watch a funny YouTube clip from your favorite television show. Go outside and catch the sunset. Pull up a picture of a time that made you feel safe and content.
    • Touch: Purchase some silly putty or a fidget spinner. Pet your cat or dog. Take a nice, long bath or shower.
    • Smell: Brew some fresh coffee or light a candle that you love. Put some hand lotion on and notice the smell.
    • Taste: Mindfully eat a favorite food or drink a healthful beverage that you enjoy.
    • Sound: Listen to your favorite playlist, or pull up a recording of a stream, rainstorm, or bird calls.
    • Movement: Go for a walk outside or try a minute of jumping jacks or burpees. Dance in your bedroom!

    Skill 2: Self-Validate

    While we may be skilled at validating others, it’s often the case that we forget to or struggle to validate ourselves. Use the Six Levels of Validation on yourself, just as you would with a loved one.

    Skill 3: Radical Acceptance 

    Radical Acceptance is a key component on the path towards minimizing suffering. While pain is a fact of life, suffering is a choice. Acknowledge and validate the pain of the invalidation you’ve experienced, and then practice exercises like turning the mind, willing hands, or half-smiling to bolster your pursuit of relief from pain. It may be useful to imagine the invalidating person in your mind’s eye while practicing willing hands or a half-smile, for example.

    Remember, some skills work for some people some of the time, so practice makes progress with all of the above!

     

  • There REALLY is No Place Like Home for the Holidays

    There REALLY is No Place Like Home for the Holidays

    Perry Como wasn’t wrong when he sang those iconic Stillman lyrics. “There’s no place like home for the holidays.” Really. And whether it’s your biological family, your chosen family or your new partner, home (for the holidays) carries a weighty pressure that perfectly encompasses Dialectical Behavioral Therapy’s (DBT) core dialectic of acceptance and change. 

    (‘What the heck is a dialectic?’ you may ask. Head here for a deeper dive into this term.) 

    As much as I love my family, and I really, truly do, there’s an unshakeable reversion to childhood patterns that the holiday season, and subsequent return home, can provoke in us all. (Adding another escalating ingredient to the mix is COVID-19.) I’ll spare my family the indignity of revealing too much about our interpersonal dynamics on the internet. However, I will say that we all come home for the holidays carrying our own baggage — both literally and figuratively. This can be baggage that’s been simmering for a few days, months, or years. Sometimes it’s baggage that’s entirely irrelevant to the individuals sitting around that open fire roasting chestnuts — I’ve literally never roasted chestnut, and I simply couldn’t begin to tell you how to do that. Other times, it’s baggage that has absolutely everything to do with a very particular scenario, involving a very specific individual, who’s watching that ball drop beside you on New Year’s Eve. 

    And, it’s at this moment that DBT’s core dialectic comes into play. Accept? Change? Sometimes, we accept. For those who are considering this course of action, because yes, acceptance is a choice, I recommend reviewing some of DBT’s Distress Tolerance Skills. In other circumstances, perhaps when we’re looking to obtain a specific goal or objective, we pursue change. 

    This holiday season, if you have a specific goal or objective, once you’ve clarified your priorities, consider DEAR MAN. This is one of my personal favorite skills in the entire DBT repertoire, as I have found it to be particularly effective for me. Surely, contacting your individual therapist, or diving more deeply into DBT Skills Training at BPS will support this process in greater depth, and, for now, with just a few days before heading ‘home,’ I’ve included a very quick primer on DEAR MAN. 

    My sample situation? My sister repeatedly takes my clothing from my closet. My objective?  Get my sister to stop taking my clothing. 

     

    D – Describe the Situation 

    • Ex: I’ve noticed that you have taken a few articles of clothing from my closet without asking me in advance. 

    E – Express Clearly

    • Ex: I feel anxious when I can’t find a missing clothing item. I wonder where it has gone, and whether I’d brought it back home in the first place. 

    A – Assert Wishes

    • Ex: I would like you to stop taking my clothing. 

    R – Reinforce

    • Ex: My hope is that we can figure this out so that we can minimize our bickering during this trip. 

     

    (Stay) M – Mindful

    • This is the part of the conversation where I would emulate a broken record, continuing to express my opinion in spite of any diversions or deviations from my sister. 

    A – Appear Confident

    • While I might be nervous to make this ask, using a confident tone of voice and physicality will better support my efforts to obtain my objective. 

    N – Negotiate

    • If my ask or refusal appears to be hitting a wall, I must be willing to give to get. For example, if I’m comfortable with this alternative, I might ask my sister to, at the very least, ask me before taking my clothing. 

    As with every skill, practice, practice, practice! 

  • What the Heck is the Biosocial Theory?

    What the Heck is the Biosocial Theory?

    What the Heck is the Biosocial Theory? 

    We’re talking about the biosocial theory today, and as with the concept of dialectics, the biosocial theory is a fundamental underpinning of Dialectical Behavior Therapy (DBT). Therefore, whether you’re considering DBT for yourself, or you’re interested in learning more about this treatment in general, an elementary grasp on the biosocial theory of Borderline Personality Disorder (BPD), and other problematic behaviors associated with emotional dysregulation, is a good starting point for all that follows in treatment. In fact, it may provide a healing and illuminating explanation for why one functions the way one does! 

     

    Let’s start with a definition, shall we? 

     

    Dr. Marsha Linehan posits that problematic behaviors, adapted and adopted to regulate emotions, are rooted in the evolving interaction and transaction of biological and environmental factors. 

     

    An individual’s particular biology may predispose them to struggles with emotional vulnerability and emotional modulation. For example, research has shown “…hyperactivity in the limbic system and decreased activation of the prefrontal cortex…may contribute to affective instability in BPD” (Niedtfeld & Bohus, 2018, p. 1). Say it with me (and I know this can be very, very hard!): It is what it is. This is how your biology, how your brain, functions. There is not something wrong with you. This is just how you are! 

     

    Likewise, an invalidating social environment occurs when figures in one’s life “…consistently and persistently fail to respond as needed to primary emotion and its expression” (Koerner, 2012, p. 6). Raise your virtual hand if any of the below applies to any interaction you’ve ever had with anyone (ever):

    • You’ve been told you’re overreacting to a situation. 

    • You’ve been told your emotions are, in some way, stupid, wrong, or manipulative. 

    • You’ve been ignored during a state of emotional distress, and then lashed out at by that same individual when your distress became too overwhelming for that individual. 

     

    These are just some examples of invalidation, and over time, invalidation may impact an individual’s capacity to regulate emotion.

     

    Breaking it down even further, we have the bio and we have the social, and when one pairs biological vulnerabilities with invalidating social environments, it would be reasonable (and quite natural!) to assume the development of maladaptive patterns of behavior. 

     

    As a final and important note, if we envision a scale, one’s biological vulnerabilities may weigh more than one’s invalidating social environment, and vice versa. Regardless of the source, the fallout from managing these interactions can be unbearable, and this is something that DBT seeks to address through both individual therapy and skills groups. After all, it is a DBT Assumption that, while you may not have created your problems, you do have to solve them anyway.

  • What The Heck is a Dialectic?

    What The Heck is a Dialectic?

    What the Heck is a Dialectic?

    By Avery Carmichael, BPS Social Work Intern

    Undergirding all that is Dialectical Behavior Therapy (DBT) is the eponymous concept of dialectics. I will start by saying, in full transparency, that the term ‘dialectic’ is an oft-intimidating word to define. Especially when considering its rich philosophical roots, one can easily dive deeply down the rabbit hole of Marx, Engels, Popper, and Bunge. For now, I suggest you don’t. 

    Instead, in this moment, as you read this text — presumably because you are interested in, fascinated by, or curious about DBT — let’s take things easy and begin with the following definition: Dialectics is a worldview that stresses that reality is made up of polarities. Two things, regardless of whether they are wholly opposites, can exist at the same time. For example, one can lose a loved one after a long illness and feel at once sad for the loss, and relieved for the alleviation of that loved one’s suffering. Likewise, dialectics emphasizes the interconnected nature of the world, as well as the constancy of change. You’ve probably heard it before, and you’ll surely hear it again: Change is the only constant. 

    DBT exists in the pursuit of synthesizing and integrating these polarities within the self, of engaging in an ongoing reconciliation of dialectics. It is a search for balance, an attempt at finding the ‘and’ rather than the ‘but.’ The most notable dialectic at play, within a DBT-focused therapeutic relationship, and DBT in general, is the effort to balance acceptance and change. 

    Here are some more examples of dialectical thinking and circumstances: 

    • I am doing the best I can and I can do better
    • I want to live and I want to die
    • I want to quit drinking and I want to have a drink
    • I love my partner and I hate my partner’s tone of voice when she’s angry 

    I know. A lot to take in, and that’s okay! Dialectical thinking, in its assessment of the inherent complexity of the world, is a complex concept. I just summarized an impactful and timeless philosophy, the core component of Dr. Marsha Linehan’s groundbreaking treatment, in a couple of paragraphs. Certainly, the work only starts here, and (see what I did there?) take some time to notice dialectics that exist in your day-to-day life. Speak them aloud to yourself, write them down, or point them out to a friend. Observe how it feels to insert ‘and’ in place of ‘but.’ Seek out the shades of grey, moving away from the binary.