Therapeutic Tool Box

DBT skills help us to navigate difficult emotions in the moment. When practicing the four modules of DBT, we learn to step back from our emotions, observe them non-judgmentally and make wise choices. DBT teaches us to get through the moment without allowing negative emotions to control our behaviors. In practicing DBT skills, we learn to experience our emotions as a wave, coming and going, rather than as a fixed part of who we are. Beyond navigating the present more effectively, we also learn to reframe our relationship with negative emotions. As opposed to trying to rid ourselves or avoid negative emotions, we observe them to learn about the underlying needs which they communicate. Letting go of emotional suffering by acceptance what is, rather than fighting reality, is also central to DBT. Through the practice of DBT we learn to experience our emotional life without being imprisoned by it.

Early on in my career, I received specialized training in DBT and have enthusiastically used it ever since! I have found DBT skills to be tremendously useful, particularly for individuals who struggle with impulsivity (i.e. anxiety, anger, addiction). Through practicing DBT skills, I noticed that clients became empowered by the realization that they have a choice, that they are in control of their emotions and behaviors and not the other way around.  

We know that our behaviors are a product of our thoughts and feelings, but are thoughts and feelings always a reliable source of information?! For instance, because we are terrified of flying does not mean that flying is dangerous. Likewise, because we are convinced that others have a certain opinion of us does not mean that it is so. CBT helps us to recognize and challenge automatic thoughts or feelings that often serve to misguide us. These thoughts and feelings can be very sneaky as we tend to accept them as fact without question; and we do so because past experiences have formed these perceptions. While these thoughts and feelings may somehow have served us in the past does not mean they continue to do so! Restructuring our life requires that we practice willingness to challenge the unhelpful, automatic thoughts and feelings that reinforce our patterns.  

Understanding how our past shapes our current behaviors and feelings is naturally an important part of therapy. We do not experience uncomfortable symptoms or have maladaptive behaviors because we are weak or inherently flawed; these external markers are merely a testimony of ones efforts to survive a difficult situation! Our pesky trauma symptoms (ie. self-loathing, shame, anger, depression, co-dependence, numbness, anxiety) are important clues about survival strategies we employed earlier in our lives to overcome adversity. While they may have served to keep us safe at one point, they are now a nuisance, that interferes with our ability to live a life that we love. Gaining insight about our younger parts that struggled to cope, gives us information about unmet needs and encourages feelings of compassion rather than shame for the expression of these parts. This process of becoming acquainted with our parts enables us to step back and “unblend” from them thereby regaining our sense of self. As we begin to understand the experiences that have shaped our world view, only then can we begin to conceptualize a healthier path forward by restructuring the way we choose to think, feel and behave. 

In the “old school” world of Psychology we talk about all the D words: disease, deficit, dysfunction, and disorders. We talk about “fixing what’s broken”. Positive Psychology is a relatively new school of thought that challenges us to think differently about improving our mental health. Rather than stirring around in problems and trying to correct our weaknesses, Positive Psychology encourages us to cultivate strengths and pursue that which brings meaning and purpose in our lives. The goal of Positive Psychology is to increase positive emotions by building positive relationships, practicing gratitude, building on talents/strengths, and being mindful in the moment.

The strength based approach is very powerful in the therapeutic forum. It is my experience that, clients who have learned to identify themselves as a disorder or who find themselves swimming in feelings of hopelessness and inadequacies have benefitted significantly from identifying their strengths. I have observed improvements in both mood and confidence as well as a better sense of direction in clients whom worked diligently to foster their strengths. It’s an intuitive concept; if we focus our energy on what we need to change, we are more likely to develop a core belief that something is inherently wrong with us. As I like to tell my clients, stirring around in poo just makes it smellier!  On the contraire, if our mission is to build on strengths and pursue a life of purpose, the assumption becomes that we have not honored our needs when we experience symptoms of anxiety or depression.    

Nutrition and lifestyle have become a big discussion in the landscape of modern psychology. The idea that people with mental illness have a “chemical imbalance” in the brain is being brought into question as we are now beginning to understand the complexity of the interaction between mind and body. For instance, the connection between gut dysfunction and the brain in now well documented. Research has shown an undeniable link between chronic illnesses that are rooted in inflammation (poor diet) and mental illness. This has shifted our perspective of depression and anxiety, as opposed to the traditional disease model which isolates the brain from the body. We are now understanding that many factors play a role, including the impact of lifestyle choices.

While I am not a certified nutritionist, I am deeply passionate about prioritizing health, both in the form of preparing whole foods daily and exercising regularly. Being a functional medicine enthusiast, I have learned from my own personal journey as well as scientific literature that we enable our body and mind to function optimally when we nourish our system. Though it is not within my scope of practice to advise you about nutrition, I find it important to have a running discussion about how you are caring for your body as well as exploring any impact it may be having on your mental/physical health.