Dialectical Behavior Therapy - Mindfulness - Chat Conference Transcript

Michael Staub M.S.: 11/1/02

Mike:

coloredbrush - did you have a question?

Coloredbrush:

I never understood what it meant when said, confusion about self, identity disturbance

Mike:

identity disturbance is when one is confused about who one is. What is my purpose? Why am I here?

Coloredbrush:

okay, thank you, that helps a lot

Mike:

a number of my clients tell me that they have no idea who they are
that they have somehow either "lost themselves' or worse yet
never had any clear sense of who they were 
this is an identity disturbance

Coloredbrush:

have no purpose, is the keyword to me, thank you

Mike:

 :-)
this may manifest itself in a number of ways, but if you'd like to know more, just contact me after this :-)
or those of you with books, open to page 109
for those you without, I want you to draw something on your paper
draw 2 circles, roughly the same size, interlocking so there is a bit in the center of the two circles that both of them share
in one of the circles write "reasonable", on the opposite side write "emotional". in the center (where the two link) write "wise"
this is our "states of mind" graphic
it is a very simple graphic for some very increasingly complex concepts
I shall start off by having ya'll help me again. 
what kinds of things do you think the reasonable side of our mind deals with?

Coloredbrush:

logic

Mike:

good. what else?

Caltex:

rationality

Mike:

okay
anyone else?

Coloredbrush: 

solving problems

Mike:

advanced thinking. For reasons that will become clear in a few minutes, I might dispute that one, though
basically, I would contend that our emotional mind could solve some problems, too :-)
that it?
okay
the reasonable side does all of that
it deals with FACTS
some examples of facts are: 
the sky is blue
2 + 3 = 5
it is raining outside
[facts are, for the most part, devoid of feeling. The two are essentially opposites.
how do you feel about the sky being blue?

Emmespalace:

Void of any feeling.

Mike:

how do you feel about a math equation?
pretty much
some things that are 'facts', that are our reality, MAY have emotional attachment
my mother died last night
is that a fact?
t may be, and we may well attach a significant amount of emotion to it

Emmespalace:

Yes

Mike:

but in general, we need to start being able to distinguish what are 'facts' and what are not
facts are what the reasonable mind deal with
the emotional mind deals with (drum roll please)........
FEELINGS
nothing more than feelings *singing*
sorry
anyway
the feelings are often what get in our way
all of the clients that *I* deal with are in the partial hospital because they have had some type of problem with their emotions
speaking of......
lets figure out what emotions are. what emotions or feelings we have.
what are some examples of feelings?

Dubie:

sad, happy

Nicci:

hurt

Mike:

good

Nicci:

and angry

Gourou:

emptiness

Mike:

keep em coming

Coloredbrush:

FEAR

Nicci:

frustration

Gourou:

anxiety?

Mike:

yes

Emmespalace:

Loneliness.

Coloredbrush:

hate

Mike:

a good way to tell if it is a feeling is that feelings can usually be stated with 1 word

Dubie:

confusion

Caltex:

confusion

Mike:

I feel ________

Nicci:

a "why bother" feeling

Mike:

that's called apathy or apatheticthere is another good feeling word called ambivalent - I don't KNOW what I want
I just know I need SOMETHING
all good examples
a great thing to do is practice your "I messages" several times a day, even if it is only with/to yourself
identify what is inside
how am I feeling right now?
"I feel _____"
one word
when someone says "I feel like you are not..."
I say, that's a thought
t may be a GOOD thought, but try to figure out what the feeling behind that thought is
"I feel calm"
"I feel ANGRY"
"I feel scared and alone"
"I feel love for you and also fear that you will abandon me"
these are "I messages"
they will help us to identify our own feelings, own our feelings and express them to others without attacking them
an important thing to remember is that, as human beings, we ALL have both of these sides of our minds. Rational and emotional
but I often have clients that tell me that they "live" in one side or the other - that they are more often rational or emotional.
lets do a roll call - sound off with where YOU "live" 

Emmespalace:

I tend to be more in touch with my rational mind now a days
thanks. Good
who else?
rational or emotional. Where do you tend to be most often?

Mega:

rational

Dubie:

rational

Coloredbrush:

that's hard for me mike, cause I live in both, but never at the same time, sometimes I am totally rational, mostly that is when I am really angry and some days I am totally emotional, I cant ever seem to be in the middle

Mike:

excellent explanation
because that's right where I'm leading us

Gourou:

I'm pretty much rational... but I feel the emotional part hitting the door trying to "get in" by little burst and mood swings

Mike:

People who tell me that they live in the emotional mind tend to tell me things like "I'm tired of crying all the time" or "People tell me things and I just BLOW UP at them."
People who are reasonable tend to tell me things like "I don't even HAVE any emotions, until someone pushes me too far, then WATCH OUT."
This is where I am going to introduce the idea of balance to you
(Remember all the way back to where we started? :-))
If you are reasonable, the idea is not to 'become' totally emotional and throw that rationality to the wind
Likewise, if you are emotion, the idea is not to give up on those dam feelings and just dwell in reason-land.
What we all want to strive for is a balance between the two - to 'give voice' to both your reasonable as well as your emotional minds.
When I can acknowledge the facts of the situation, as well as the 'facts' about how I FEEL because it (my own emotional reaction), I am half to getting to the wise mind.
The wise mind is about finding that place where reason and emotion come TOGETHER.
Some of you have heard the term 'dialectical behavior therapy' or dbt.
Dialectics is about bringing things that seem to be opposites together.
This is the first of those things. I failed my test (fact) and I feel awful. I want to hurt myself now (may be a fact) but I realize that this pain will go away in time (wise mind statement)
another wise mind statement to that fact may be seen as a cheerleading statement
I failed my test (fact). But I realize that everyone fails at some things. I can study more for the next test
or perhaps you DID study and that's where some of this lousy feeling is coming from
in that case:
I failed my test, but maybe mathematics is just not a subject im going to excel in. 
s it true that no one is great at everything?
of course it is
and the wise mind is about being able to allow yourself to see that. even about you
because sometimes we can allow OTHERS to be imperfect beings all day long, but cannot, for one SECOND, allow ourselves to be anything less than perfect
the last thing that I want to focus on tonight is 7 actual skills that you can use for mindfulness
once again, these are not (in the form im going to give them) in your book, so I apologize for that
the 7 skills are as follows:
1. Observation
this is a mindfulness skill that has to do with awareness
awareness of yourself, your own actions and reaction, what is inside and how you are being on the outside
also part of this awareness is what is happening in your environment. What things are you responding TO
all of this is important 
the skill to practice here is called observe with the beginners mind
the beginners mind is like that of a child seeing things for the first time. Taking in all of the sights, sounds smells, tastes recognizing all that is around us as well as all that is inside
when using the beginners mind, don't stop to evaluate yet - simply experience2. Describe and label
this skill is putting the experiences we are having into words
it is not a judgment - it is simply a description of the things that you are noticing with your beginners mind
be careful of judging things as 'good' or 'bad', 'right' or 'wrong'
there are no 'wrong' feelings, only ones we may not enjoy
3. Experience
be an active participant in your own life
here, I fall back to the Nike commercial - just does it
being spontaneous and doing things for the fun of it can increase your joy, and your spontaneity
it can also help you lead a less boring life ;-)
4. Patience
begin to understand that things happen in their own time, at there own pace
you cannot force a moment to happen faster, no matter how hard you try
learn to enjoy the moment we are in
patience can be a difficult skill to master, because no one feels right about watering dirt
but it must be done so that a beautiful flowerbed may grow in the spring
5. trust, not judge
begin to trust in your own experience, your own feelings
learning not to judge often begins with others, but always leads us home
in my experience, if someone is harshly judgmental of others, they are also hypercritical of themselves
judgment is a harsh mistress and it is what 
'justifies' a number of our destructive acts
such as hurting ourselves or others
in our program, we work hard at making people aware of when they are judging themselves or someone else
whenever we hear a judgment, we tap the side of our nose with our finger to let them know, without verbally interrupting them
Try this at home. it may help you to become more aware of how much you judge
6. Acceptance
acceptance is about acknowledging what is
what is reality?
what is my own experience?
denial of what is reality, what is my own experience can only lead to one place: suffering
pain hurts. no one LIKES to feel it. but it is only when we allow ourselves to feel the pain, to accept it, that we can stop suffering and
7. let it go
this is the last of our mindfulness skills
letting it go is realizing that I do not have to hold onto painful emotions or thoughts

Emmespalace:

Ok does anyone have any questions for Mike?

Coloredbrush: ?

Mike:

go ahead

Emmespalace:

Coloredbrush your question please.

Mike:

becomes mindful that he talks a LOT....)

Emmespalace:

lol

Caltex: ?

Mega: ?

Coloredbrush:

I have the most difficulty with acceptance, because I equate it with forgiveness I guess, I think if I accept the things that happened or are happening, that it makes it right.... so what can be done to help my thinking that to accept something does not mean that it was right to begin with

Mike:

excellent point
to accept something is NOT the same as to judge it as right or wrong
acceptance is about NON-denial
it does NOT mean that I believe something was good, or right
in a harsh example, I use a rape
that may be a horrible, traumatic experience
denying it happened doesn't make it NOT have happened
it just prolongs pain and increases suffering
acceptance that this is a part of my experience means not denying it any longer, but it does NOT mean saying that I in any way WANTED it to happen, liked it, or that I forgive that person
I think caltex is next

Caltex:

what is the difference between impulsiveness and spontaneity and also if you are saying that one is to trust in your own feelings - how does that work if you are mainly operating from your emotional mind,?

Mike:

first, impulsiveness has to do with thoughtlessness - anti-mindfulness, if you will
impulsiveness MAY not be a bad thing - it doesn't HAVE to be. But a number of my clients tell me that their 'impulses' can get them into a LOT of trouble
spontaneity has to do with doing things because they will be fun, even when we may not want to. If a friend asks me to go to the park, and I don't really WANT to, it may be spontaneous to just say, yeah, what the hell. Why not. You have still thought about it, though
did that clarify?
the second has to do with trusting yourself

Coloredbrush:

good clarification, mike, I appreciated the question too

Mike:

we are all (the ones of us that are human, anyway) born with what I call internal radar

Caltex:

sort of - I'm just thinking at that precise moment of deciding to do something - can you tell if it is a spontaneous action or an impulsive action

Mike:

if you think about it, and think about the outcome or consequences, then it isn't, by definition, impulsive

Caltex:

ok, that does clarify it
thank you

Emmespalace:

Mega your question please

Mega:

same q as Caltex. Thanks

Mike:

hold on
second part here
some of us, mainly through invalidation in childhood, have learned to turn our radar off - to not trust our gut because we were reputedly told that we were wrong or did not know how we felt
well, we are not wrong. 
you cannot have 'wrong' feelings
so turn your radar back on.
that doesn't mean that you have to ACT on whatever emotion you are feeling, but suppressing them will not help you
hopefully, that answered part 2. Sorry. back to mega

Caltex:

thank you, it did

Mike:

back to Mega's question?

Mega:

who defines reality? the therapist?

Mike:

good one
no
reality is just reality
it defines itself
what is real? what is the situation?

Mega:

but obviously we decode it wrongly

Mike:

sometimes, we allow our own emotions to cloud our perception of what reality is
as an example, I will use another client I have had in the past
they would tell me that when their significant other left for work, they felt abandoned
the reality was, that person was leaving for work
but the bpd's reality was - if you are not physically with me, I cannot feel you with me. If I cannot feel you with me, then we are not together at all - you have left me forever
that answer sounds somewhat elusive, but I'm not sure how to better answer it

Mega:

given that situation, what would the path to take be

Mike:

a therapist does not have any better way of 'detecting reality' :-) 
are there any other questions?
I want you to know ya'll have come up with some great stuff tonight
ah
didn't realize that was a question
given that situation, I would ask the bpd person to first of all, define reality. What are the facts in the situation?
then look at the emotional side. What emotions are brought out?
and lastly, I would ask him/her to give me some wise mind statements they could tell themselves
all of these skills, from mindfulness on, have everything to do with practice. The ONLY way to get good at them is to practice
they have to become habits if you want them to work
I know this is true because I have practiced them until they have become habits for me
and they do work

Emmespalace:

Does anyone else have a last question for Mike this evening?

Gourou: ?

Emmespalace:

Yes Gourou.

Mike:

this was fun, everyone. I hope you enjoyed it

Gourou:

When will be the second class ;)

Patty:

I greatly enjoyed it and learned a lot.

Coloredbrush:

mike, a lot of times in the support room, I have ppl come in saying they feel great today, that is when I usually ask them to practice a mindfulness skill or other skill, because it helps to practice when you feel great so you know how it feels and you can draw on it when you are feeling not so great

Caltex:

yes, thank you very much from down under (p.s. what's your address so I can send the air ticket?)

Mike:

 :-)
good point, brush
practice when you are feeling good so that it becomes more automatic when you aren't
habits take time to build

Emmespalace:

can I have the floor for a couple of minutes to conclude everything?

Mike:

and bad ones take a LONG time to break :-)
all yours

Emmespalace:

I'm glad everyone enjoyed tonight's chat, and we will be having more chats.
If you didn't get the newsletter telling you of this chat please subscribe to it by going to www.borderlinepersonalitytoday.com and joining the newsletter it's free.
Also we will be posting this chat so that everyone can read it

Mike:

you are all very welcome

Coloredbrush:  

I have been in DBT for 4 years and I totally learn more every time I meet someone who is GREAT

Mike:

thank you all for having me and listening to me drone on :-)

Emmespalace:

Mike I would like to thank you very much for your wonderful discussion tonight and at this time would love to invite you back.

Patty:

Thanks so much Mike for taking your time to do this
t was wonderful.

Gouru:

Thank you very much Mike

Dubie:

thank you

Patty:

all the conferences and lots more are discussed in the newsletter

Mike:

sounds good. Again, thanks for all of your participation and patience

Patty:

Thanks Mike

Mike:

you are all very welcome
*bows*

Patty:

Good night everyone!!!!!!