The Lighter Side of Transformation

with Lisa Wessan, LICSW

Jan 11

From Borderline to Balance: Dialectical Behavior Therapy for Post-Traumatic Stress Disorder (DBT-PTSD)

by Lisa Wessan, LICSW

Abstract: This article offers a perspective on the impact of Dialectical Behavior Therapy (DBT) in treating Borderline Personality Disorder (BPD) and trauma. The author shares valuable insights on renaming BPD to “Intense Trauma Syndrome” for reduced stigma and increased therapeutic support. The post effectively conveys the author’s experience with DBT and the positive outcomes observed with clients. The inclusion of Solution Focused Therapy and reframing cognitive beliefs adds depth to the content, enhancing its value. Overall, it provides a comprehensive view of the transformative nature of DBT in addressing trauma-related challenges.

When I first became interested in the Dialectical Behavior Therapy methods and curriculum (DBT), one of my mentors said, “Lisa, I strongly advise you NOT to get involved with this work. If you offer DBT Skills, you will attract the WORST clients!  They will all be severely agitating with Borderline, Bipolar or severe mood disorders, it will be a nightmare for you!”

I heard what she said, and I did respect her opinion, but there was something so powerfully intriguing about the evidence-based science behind DBT, and the fact that so many people were getting well from it – people who had been considered “treatment resistant” prior to their DBT exposure.

I do like a challenge, however, and I was not afraid of this high risk population. Something inside me told me to continue…against the advice of this mentor, and other practitioners I knew.

It is now twelve years since my first DBT training, and I’m still excited to be sharing the DBT curriculum with adults (21+) in my virtual Zoom classroom.  I have had the privilege of witnessing hundreds of my DBT clients, in both individual and group sessions, go through this cognitive re-structuring process, shed their false beliefs, deconstruct their traumas, grieve and move on to have healthy, happy, contented lives.

In the process, I have learned that approximately 70% of my clients with Borderline Personality Disorder (BPD) suffer from severe co-occurring post-traumatic stress disorder (PTSD),  related to traumas that occurred during childhood. These traumas were not processed or expressed at the time,  and they caused a corruption of the client’s personality, mental and social skills.

These unresolved traumas, when treated, often bring upon a rebirth process, and the client is no longer exhibiting the Borderline symptoms.  Therefore, I humbly submit that it would serve everyone if BPD could be renamed Intense Trauma Syndrome (ITS).

Here is why:

  1. The term Borderline is heavily stigmatized in my guild.  “Borderline” sounds as if someone is on the edge of a cliff about to jump, perhaps on the verge of…suicide? Murder? Something worse?  Witness my mentor’s advice above, plus, each week I receive calls from clients who tell me “No one will work with me because I am Borderline.”  This is frustrating and heartbreaking to me.  Why is this heavily traumatized group eschewed because of their condition? Where should they go?  How will they get well? If BPD were to be re-labeled as Intense Trauma Syndrome, I think they would be helped by more therapists!  But this requires more than a branding campaign…
  2. Borderline clients often exhibit highly dissociative symptomatology, chronic suicidality, and ongoing non-suicidal self-injury.  This is also a big turn-off to my guild.  Many of my colleagues will NOT work with suicidal clients.  Why?  Too much liability, too many collateral calls, too much danger. Moreover,  my clients feel as if they are tacitly shamed by the mental health profession for being Borderline.   Yet I have found that this population, when they are truly sick and tired of being sick and tired, pick up these DBT Skills and other therapeutic interventions, and start their healing process.  They will always agree to a Safety Plan and stick with it. They learn, grow, and become healthier and successful members of society.   They do recover!
  3. When I tell my Borderline clients they have Intense Trauma Syndrome, and request that they stop describing themselves as Borderline, they start to feel so much better about their emotional challenges.  Many Borderline clients have described severe shame and self-hate due to their diagnosis. They feel hopeless and bereft of a cure. Receiving the Borderline diagnosis can make them feel worse!
    ⭐Here’s the H.O.P.E.  for Borderline clients,  Hold On, Pain Ends.⭐

Solution Focused Therapy

My DBT Skills groups cover the entire curriculum in one year, divided into three 14-week trimesters. This training includes the strengthening of the commitment to overall wellness and psychoeducation, DBT skills training, skills-assisted exposure, with radical acceptance of the past trauma and its effects on their lives.

Four leaf DBT

Finally, you explore the practice of self-compassion – as you learn to Fail Forward – and make efforts to build a life worth living. When a client has graduated from their Intense Trauma Syndrome to the more normative anxiety, career, dating, relationship challenges they are on their way to be fulfilled and satisfied with their lives.

The Intense Trauma Syndrome causes people to become quite polarized in their thinking. They often see the world in black and white, all or nothing, right or wrong, good or evil terms.  There is not much wiggle room for the vast spectrum of imperfection that exists in all of us!  One of the earliest cognitive shifts we work on is the ability to hold OPPOSITE VIEWS in their minds without having a meltdown.

Common Dialectical Beliefs

I teach that it is perfectly all right to love someone, but also to hate them at times. It is fine to be in a room of friends or family, and yet feel very lonely.  It is not a serious problem to want to go out, and want to stay home in the same breath. It is possible to feel strong and vulnerable. 

Prior to learning DBT skills, these opposing thoughts would cause a lot of stress for them, and cause them to feel as if they were having a meltdown.  To help them decompress from their polarized inner self-hating dialogue, I have learned to reduce their stress by saying, “You can feel dual emotions, you are ok and safe with these conflicting thoughts…In fact, you are not having a breakdown, you are having a breakthrough!”  This often helps them to reframe the intensity of their emotions into a more helpful and practical view.

Borderline1

What they need to learn is to go within and ask, “What do I need now?”  or “How can I make this better?”  Instead of saying “What’s wrong with me? Why am I like this?   I hate this!  I feel crazy! I can’t take it, I want to die!” In individual therapy, we can also explore their different Parts (with Internal Family Systems Therapy/IFS)  and gain understanding of their Exiled parts (Anderson, F.,  Sweeney, M. Schwartz, R.  2017)

I teach my clients to stop asking WHY questions, but to ask HOW questions instead.  When we ask WHY, “Why am I like this?  Why don’t I enjoy parties?  Why am I so annoying to people? Why is this person ignoring me?  Why do people dislike me? “Why am I still single?” they are on a slippery slope into anxiety and depression and possible self-harm.

When they learn to ask HOW questions, they start to change, “How can I make this better?”  “How can I be useful?”  “How can I learn to stay calm when I am triggered?”  The HOW questions lead to discovery, growth, healing and empowerment.

In Conclusion

Dialectical Behavior Therapy for Post-Traumatic Stress Disorder is a powerful healing modality.  From my experience, those clients suffering with BPD are particularly helped by this cognitive restructuring process, since typical pharmacological and generic talk therapy interventions are not always helpful.  From my perspective, DBT serves as a newly installed behavioral software program. It is slowly downloaded into their minds through the completion of hundreds of handouts, worksheets, discussions, weekly practice and role playing.  In sum, the DBT behavioral software in their minds replaces their previously corrupted and faulty software that was hurting them.
Copyright © by Lisa Wessan 2024. All rights reserved.

#DBT, #PTSD, #EmotionRegulation #DistressTolerance, #Wellness #Recovery #Peak, #Mindfulness Anxiety BPD depression Uncategorized Westford, MA

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Dec 18

How Dialectical Behavior Therapy (DBT) Skills help you learn to manage and cope better with difficult emotions, as “Serenity is not freedom from the storm, but peace amid the storm” – S. A. Jefferson-Wright.

by Lisa Wessan, LICSW

I’m excited to announce that we are hastening slowly to transform the world from the inner to outer, one DBT student at a time…

Lisa Wessan, LICSW, DBT Skills Trainer

Up next: we will be exploring “Emotion Regulation and Mindfulness Skills” from January 23 – April 23, 2024 in the Zoom Classroom.  (All registration forms, intake sessions and tuition fees must be completed by January 19, 2024).

Four leaf DBT

The Emotion Regulation module has four sections:

  • Understanding and Naming Emotions
  • Changing Emotional Responses
  • Reducing Vulnerability to “Emotion Mind”
  • Managing Extremely Difficult Emotions
DBT Mindfulness

The Mindfulness material includes:

  • Learning to be a good observer
  • Being non-judgmental
  • Staying in the present
  • Practicing being effective
  • Accessing “Wise Mind” (aka higher self, higher consciousness)
  • Understanding Reality Acceptance and detaching from negative or critical thoughts.

As DBT founder Dr. Marsha Linehan says, “It is difficult to manage your emotions when you do not understand how emotions work. Knowledge is power.”

During this 14-week program:

  • You learn to cope better with social anxiety issues, negative thinking and stop falling into the Blame Game.
  • You learn to abstain from the Compare and Despair syndrome.
  • You practice “Face it, trace it and erase it” as you work the DBT Skills and grow stronger and wiser with effective emotional regulation and self-expression.
  • You learn to access “Wise Mind” and regain your center, remain calm.  You learn to take a stand for your inner peace, and become bulletproof to bullies, others’ judgments and negative, invalidating remarks.
  • You learn to practice Radical Acceptance, as needed, and problem solve when possible. You are no longer living with victim consciousness.

If this DBT Skills training group sounds good to you, please get in touch with me to start your enrollment process. Just complete the Contact Form on my web site to begin (not to worry, this is a No-Spam Zone! Your email will not be added to any mailing lists unless you request it).

🌀 For exact dates, fees, insurance info, FAQs, DBT Flyer, videos and more details, please visit https://www.lisawessan.com/dialectical-behavioral-therapy

Onward and Upward✨

Lisa Wessan

Copyright © by Lisa Wessan 2024. All rights reserved.

#DBT, #PTSD, #EmotionRegulation #DistressTolerance, #Wellness #Recovery #Peak, #Mindfulness Addictions Anxiety BPD depression Emotional Regulation Mindfulness stress Transformation Westford, MA

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May 4

UP NEXT: Dialectical Behavior Therapy Skills training (DBT) on Mindfulness & Distress Tolerance, May – August 2023 on Zoom

by Lisa Wessan, LICSW

Serenity is not freedom from the storm, but peace amidst the storm…

Hi, 

Thank you for your continued interest in my work. I know I haven’t posted frequently enough here – but that will change soon!

For today, I’m excited to be teaching the next 14-week semester of Dialectical Behavior Therapy Skills (DBT).  This semester we will cover Mindfulness & Distress Tolerance Skills.

🌀 Click here for the current  DBT FLYER. 

With the Distress Tolerance curriculum, your will learn valuable skills and interventions to help yourself reduce your intense stress and harsh feelings in the moment – to lower the volume on your anticipatory anxiety and catastrophic thinking. These DBT skills significantly help to reduce the escalation of your inflammatory emotions, and reduce the painful, polarized and perfectionist thinking that often cause your meltdowns. You will learn to find your peaceful “Middle Path” here. 

There are many powerful skills included in this semester’s work. It is the hope of this process that you will put together your own personal Distress Tolerance tool kit with the techniques that work the best for you.

Unfortunately, there is no “one size fits all” with these various techniques, so you do need to be a good scientist in the laboratory of your life and try them all out.  You will eventually find the ones that you love, and that will work quickly and effectively for you. 

Yes, I am looking forward to continuing this exciting journey towards wholeness with this next group.  I am also deeply honored to be sharing this transformative and useful educational process with you.

If this is not for you, but you have someone in mind for this next DBT Group, please have them contact me soon at my web site – currently www.MirthMaven.com – and fill out the Contact Form which helps them briefly tell me the best times to reach them (by phone) and guides them to check out their insurance (for the Out of Network benefit).  Otherwise this course is private pay, $980 for continuing students, $1215 for new students (includes one Intake session.)  

Onward and Upward✨

Lisa Wessan

“If you can recognize and accept your pain
without running away from it,
you will discover that although pain is there,
joy can also be there at the same time.”
~ Thich Nhat Hanh, No Mud, No Lotus


Lisa Wessan, LICSW, CLYL, RM
Psychotherapist, Dialectical Behavior Therapy Skills Trainer (DBT)
Life Coach, Author, Speaker, Consultant

www.MirthMaven.com
🌀✨🌀✨🌀✨🌀

#DBT, #PTSD, #EmotionRegulation #DistressTolerance, #Wellness #Recovery #Peak, #Mindfulness Anxiety BPD Distress Tolerance Mindfulness Transformation

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Jan 5

On the “Myth of Closure,” Ambiguous Loss and Complicated Grief

by Lisa Wessan, LICSW

“Everyone experiences ambiguous loss if only from breaking up with someone, or having aging parents or kids leaving home. As we learn from the people who must cope with the more catastrophic situations of ambiguous loss, we learn how to tolerate the ambiguity in our more common losses in everyday life.” 

– Pauline Boss, Ph.D.

In my immediate family, several of my nearest and dearest have battled with cancer over the years…both of my paternal grandparents, may they rest in peace,  my dear first cousin Stephanie (may she live to be a super centenarian) and my delightful and fierce Aunt Yvette (known as “Auntie”), who is currently receiving hospice care.  It has been a long and grueling journey with cancer for all my loved ones.

Sometimes I struggle with feeling powerless, and living so far away from my family in Sarasota, FL. When they lived in New York, it was so much easier to visit. Sadly,  I can’t make frequent visits to Sarasota. The only “power” I do have is to send intentional healing and loving energy to my Auntie and family…and to practice radical acceptance so that I will function with some measure of inner peace here in my world.

For a while, my Auntie was in and out of the nursing home while she battled her cancer and other complications from treatment. Her life was severely compromised by her illness.  As harsh as this has been is for her, since April 2015,  I have also been witnessing how Auntie’s dying process is affecting everyone around her.

My cousins are fraught with anxiety and grief. Others in my family are a hot mess, watching Auntie dying so slowly, not being able to process their feelings and find some relief.  Some people get trapped in the “Blame Game,” and are always looking to find ways to defocus their pain by pointing at others.

We are all coping with the ambiguity of Auntie being here, yet not here.  She is no longer resembling her true self as we knew her.  Sometimes she is delirious, sometimes she is too weak to talk. As her body deteriorates, she is no longer living the full and robust life she once enjoyed.

ambiguous loss1

This pain we are all experiencing has a name…it is called Ambiguous Loss.  “Ambiguous loss is a loss that occurs without closure or understanding. This kind of loss leaves a person searching for answers, and thus complicates and delays the process of grieving, and often results in unresolved grief.” (Wikipedia)

There are a variety of types of ambiguous loss.  One type is when people go missing and the body is never found.  For example, a person does not return from a sailing trip, or from a hiking excursion, or war, or they are kidnapped.  Their loved ones still feel a lack of closure because the body was not found.   “Maybe they will return…” lingers in the mind.

After 9/11,  all of us in NYC were processing personal and professional ambiguous loss for all of our New Yorkers who were lost in the pile of bodies that were never recovered.

Another kind of ambiguous loss is when people experience a new emotional boundary that hurts.  This happens when people get divorced, or when someone ignores you, stops talking to you, shuts you out of their life.  Any kind of break-up creates ambiguous loss, because the person is still here, yet not here. They are alive, but dead to you.   This is considered more painful loss than when someone actually dies.

ambiguous loss3

Medical illness and addictions cause ambiguous loss.

Ambiguous loss also occurs when a loved one has Altzheimers or dementia, and they no longer recognize social connections. Similarly, when someone is very ill, such as my Auntie. We have ambiguous loss because the illness is transforming our loved one into someone other than the person we always knew. We are mourning the living remnants of our loved one while she is here…so excruciating and bitter.

When someone is living with an addiction, this too causes their personal relations to deteriorate and they are not fully present for their loved ones. Again, they are here but not here.

I have a friend who had a beautiful daughter in Cambridge, MA,  who chose to be homeless.  Her daughter was an alcoholic.  My friend tried all methods of intervention and help. Nothing worked. My friend suffered with ambiguous loss for so many years. Her daughter was a pianist, absolutely lovely.   She died a few years ago,  at 35, and it was one of the most heart wrenching tragedies I experienced.  My friend is still recovering from this painful loss.

Learning to live a good life with ambiguous loss

I recently listened to a wonderful and insightful podcast interview with ambiguous loss pioneer Pauline Boss, Ph.D., who originally coined the term “ambiguous loss.”   Krista Tippett hosts Dr. Boss on her podcast, On Being.  You can listen here:

The Myth of Closure [UNEDITED VERSION, 1.5 hours]

The Myth of Closure [EDITED VERSION, 1 hour]

I prefer the unedited versions of Tippett’s interviews, because there are sometimes fascinating nuances that are deleted to make the long form interview fit into an hour. But I’m sure whichever one you listen to will be rewarding💙

One of the ideas I took away from Dr. Boss’ talk was that we will never have complete closure from our ambiguous losses, or from our complicated grief.  What we can do is become  more adept at processing our negative feelings and difficult thoughts. Dr. Boss has some wonderful suggestions on the process.

Cognitive restructuring, which can be learned, is a big part of the solution.  Dr. Boss’ stories and explanations are very helpful in deconstructing the different kinds of ambiguous loss that we all have in our lives.

Even though I learned about ambiguous loss and complicated grief in graduate school, it seems I keep deepening my understanding of it every year.  I learn more about ambiguous loss from clients who are struggling with painful divorce, adult children with addictions, my Auntie’s battle with cancer, harsh racial and homophobic incidents and for all the ongoing loss of freedoms in the world that never seems to subside.

Fun fact: Ambiguous loss is clearly part of our psychospiritual journey — for it forces us to grow and move to new levels of compassion and acceptance of things we cannot control.  “Lack of power, that is our dilemma,” says Alcoholics Anonymous  (Bill W., 1976).  Yes, in our culture, we seek to control, cure, fix and manage everyone and everything as much as possible. We don’t like messy endings.

Yet what I have come to know, is that true mastery of life is being able to live in ambiguity with peace, even joy.  My life is far from perfect…yet I am more often feeling positive, grateful,  uplifted, inspired and anticipating good interventions that will transform it.

If we can learn to live in that “not knowing” place and be peaceful — that is a vast improvement on “hating ambiguity” and perhaps yelling at G-d or the Universe, or twisting into knots over why bad things do happen to good people…again, very messy, so annoying.

The truth is, when it comes to matters of love, there is no closure. As they say at the Grief Toolbox,  “Closure is not part of the grieving process, nor is it necessary for healing. A connection formed in love can’t be closed.”  Dr. Boss confirmed this with her years of research on ambiguous loss, leading to her forthcoming book on “The Myth of Closure.”

ambigousloss5

As Dr. Boss discussed in the interview, our Western culture wants neatly packaged endings and for everyone to move on as quickly as possible.   There is plenty of ignorant shaming that goes on, as in “Aren’t you over that yet?”

Sadly, our culture does not tolerate ambiguous loss very well at all.  It requires more Eastern, dialectical thinking.  To be able to say non-binary statements such as “She is alive, but also dead,”  “He is not here, but he is possibly still alive,”  or “She looks like Auntie, but this is not Auntie anymore,” requires a leap from dualistic thinking to a more dialectical thinking which allows us to embrace opposite beliefs without sinking into a deep depression or disruptive anxiety vortex.

Solution Focused Suggestions

For today, I invite you to learn more about ambiguous loss, and start to apply these non-dualistic, non-binary, dialectical thinking ideas to your situation.

  • Listen to the podcast above, and learn some skills to help process your ambiguous grief.
  • Perhaps find a good therapist who can help you learn to cope better with your struggles.  Good news: coping skills can be learned!
  • Learn to laugh at the absurdities, paradoxes and incongruities of life (Gavin, 2010; Wessan, 2013).
  • Practice your Distress Tolerance skills …join a Dialectical Behavior Therapy group.  You may then find it easier to work through the painful moments, and allow yourself to live in ambiguity with, dare I say it, some joy!

 

Onward and Upward🌟

Lisa Wessan

 

References

Gavin, J. (03 Sept 2010). Laughing with the Joys and Troubles of Life Leads to Growth. The Chelmsford Patch. Found at https://mirthmaven.blog/2010/09/16/lisa-wessan-interviewed-in-the-chelmsfor/

Pauline Ross, Ph.D. https://www.ambiguousloss.com/

W., Bill. (1976). Alcoholics Anonymous : the story of how many thousands of men and women have recovered from alcoholism. New York:Alcoholics Anonymous World Services. Fourth edition, Chapter 4, We Agnostics. P. 45. 

Wessan, L. (2013).  Using Humor and Laughter in Therapy. Focus Journal. National Association of Social Workers.  Vol. 40, No. 4. 3,11.

Copyright © by Lisa Wessan 2019. All rights reserved.
www.LisaWessan.com

 

 

 

 

#DBT, #PTSD, #EmotionRegulation #DistressTolerance, #Wellness #Recovery #Peak, #Mindfulness Addictions Ambiguous Loss Anxiety BPD depression Detachment Distress Tolerance Emotional Regulation grief Interpersonal Effectiveness Living in Ambiguity Peace preventing caregiver burnout stress Uncategorized

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Jan 3

Moving beyond binary thinking: what are dialectical and non-dualistical truths?

by Lisa Wessan, LICSW

“If you can recognize and accept your pain without running away from it, you will discover that although pain is there, joy can also be there at the same time.” Thich Nhat Hanh, No Mud, No Lotus

“Grief is the price we pay for love.”
Queen Elizabeth II
(21 April 1926 – 8 September 2022)

“Even when all the experts agree, they may well be mistaken.”  ~ Bertrand Russell

“In preparing for battle, I have always found that plans are useless,
but planning is indispensable.” ~ Dwight Eisenhower

“The reverse of truth has a thousand shapes
and a boundless field.” ~ Michel de Montaigne

“Do I contradict myself?
Very well then, I contradict myself,
(I am large, I contain multitudes.)”
~ Walt Whitman, Leaves of Grass

“Whoever is winning at the moment
will always seem to be invincible.” ~ George Orwell

“Family values don’t stop at the Rio Grande.”  ~ George W. Bush

“Sometimes you need to get knocked down before you can
really figure out what your fight is.” ~ Chadwick Boseman

What do all these quotes have in common?  They are blending opposing beliefs into a non-dualistic framework, which is, for most people, is not easy to hold in the mind without some cognitive dissonance.

One of the reasons I love to teach Dialectical Behavior Therapy Skills (DBT) is to help people move from binary to non-binary thinking.  In this way, DBT serves to help people live with massive emotional and cognitive dissonance and yet not have an emotional meltdown (or use self-harm to distract or medicate from the pain of holding the contrasting beliefs).

For example, when you get into the DBT flow of consciousness, you realize that you can both love and hate someone.  You realize that on some level, you are amazing, perfect and rocking “as is,” yet you can improve.  Yes, you are good enough, yet you can improve!  You realize that you are sometimes brilliant, and sometimes really foolish, but still lovable, no matter what. You embrace the FACT that you inevitably will make mistakes, but you are NOT a mistake.  You are still awesome, lovable and worthy, no matter what cocka-locka-cuckoo stunt you got into, either consciously or unconsciously. You come to accept that “There is no shame in my game!”

So dialectical thinking helps you get out of the black and white mental trap, the “All or Nothing,” Right or Wrong, Worthy or Unworthy, Perfect or Imperfect name game.  Practicing dialectical skills helps relieve so much of your negative inner dialogue, which can potentially lead you down a slippery slope, perhaps causing a spiral into a depression and even self-harming thoughts.

Over time, DBT gently muzzles the harsh inner Critic and lets you move forward with plans to grow, learn, change and improve yourself, your relationships and your life.

Borderline1

DBT makes it so much easier to “Disable the Label” of your diagnosis, gender challenge, financial issue, body image or weight issue and more.  For years, I have said that I believe DBT skills will someday soon be taught to everyone by the 3rd grade level…Now Lady Gaga, superstar and mental health advocate, has started a foundation, MENTAL HEALTH FIRST AID to bring DBT Skills Training into all the public schools in the USA. Why? Because after years of suffering, once she learned DBT Skills, she had a dramatic recovery from her mental health issues, and now she is making this possible for everyone.

It is essential that we all move out of this painful and extremely unproductive dualistic perfectionist damnation of ourselves and others!  Enough is enough, right? The exquisite radical acceptance that comes from dialectical thinking starts within, and then permeates into our relationships, politics and the world at large.

Yes, it is possible to temporarily hate ourselves for a few minutes for being a bit unconscious or even whacko in the moment, and then with the help of improved self-talk, gently shift back to a more bearable level of acceptance, possibly reach a more comfortable forgiveness level and then back to a more loving baseline. With training, this could be reduced from days/weeks of self-hate to a few minutes…that’s a big win in my practice!

This DBT process uses evidence-based skills culled from the vast Mindfulness research, Interpersonal Effectiveness, Distress Tolerance and Emotion Regulation fields.  These skills help people move from being in the extreme of “Emotion Mind” or “Rational Mind” into their “Wise Mind” and function better on every level.

Ven diagram 1 Wise Mind

Here are some of the common myths that we deconstruct in our DBT groups:

“Dialectics reminds us of the many paradoxes that are built into our Universe:

  1. The universe is filled with opposing sides/opposing forces. There is always more than one way to see a situation, and more than one way to solve a problem. Yet two things that seem like opposites can both be true.
  1. Everything and every person is connected in some way, in the way that the waves and the ocean are one. It is also believed that the slightest move of the butterfly affects the furthest star.
  2. Change is the only constant. Meaning and truth evolve over time. Each moment is new; reality itself changes with each moment.
  3. Change is transactional. What we do influences our environment and other people in it. The environment and other people influence us.” (Linehan, 2015)

For today, I challenge you to start letting go of your dualistic mind traps, end all “Compare and Despair” drama and gently start to shift into a more compassionate, empathetic and dialectical mindset that will allow yourself and others to be good enough around you, as is, while you are all improving.  Here’s the emotional math: less judging, more inner peace.  Simple, but not easy!

Onward and Upward🌀

Lisa Wessan

Reference:
Linehan, M. (2015). DBT Skills Training Handouts and Worksheets. Second edition. New York: Guildford Press. Page 150.

Copyright © by Lisa Wessan 2022. All rights reserved.
www.LisaWessan.com

#DBT, #PTSD, #EmotionRegulation #DistressTolerance, #Wellness #Recovery #Peak, #Mindfulness Anxiety BPD depression Distress Tolerance Emotional Regulation Interpersonal Effectiveness Living in Ambiguity Mindfulness Peace Political Transformation Westford, MA

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Nov 20

Holiday Blues? Pause and Take a Mental Laxative (Forgiveness 101)

by Lisa Wessan, LICSW

For some people, the holidays are a very joyful and exciting time of year.  More parties, celebrations, shopping and gift exchanges coupled with lots of social stimulation.  It’s all good…for them.

But for others, who feel painful pressure to have “forced fun” and may not have strong intimate connections, lack financial resources, struggle with illness or addiction, these times are fraught with deep loneliness and uncomfortable feelings of “Compare and Despair” (Wessan, 2011).  For this group,  we are entering “The Red Zone.”  

The Red Zone  runs through  Thanksgiving, Christmas and New Year’s Eve…and perhaps for many Valentine’s Day is also included in this over stimulating, emotionally charged, addiction riddled time of year.

When I was younger, single and living alone in New York City,  I experienced the holidays as my Red Zone.   I loved my circle of friends, but many of them were married or had moved far away. They were not available for the holidays. I found my loneliness was most acute during this time of year.

As part of my coping with loneliness,  for many years I went away for New Year’s weekend to Pumpkin Hollow Retreat Center, in Craryville, NY.  Pumpkin Hollow is a beautiful place, with magical trails on lush Berkshire hills and a thoughtful and sensitive staff.  They used to facilitate a wonderful Silent Retreat over New Year’s weekend (I noticed now they have one in late January and May).

There were moonlit walks in the woods, we ate delicious gourmet organic vegetarian meals , danced  around a huge campfire, hugged trees and meditated together in the silence.   The facilitators artfully helped us work through all the activities in silence, and I remember every year being amazed at how little language I really needed to get by and still feel peaceful and content.

For me, it was a relaxing and restorative weekend in the Berkshires, but I also I had to process some difficult feelings. 

 

Forgiveness 101

Being in the Silence can be a powerful cleanse,  as so many distractions are removed.  The Silence gives us time to deeply work through some acceptance and forgiveness issues, serving as a “Mental Laxative,” as  Iyanla Vanzant is known to say  (Vanzant, 2013). This is a perfect time to take a moral inventory of ourselves, and notice where we need to improve. 

Moral inventories vary, but at their core,  we make a list of the people we have harmed, consciously or unconsciously.  Then we make a list of the ways we hurt ourselves, consciously or unconsciously.  Finally, we make a list of our fears and regrets.  (The only way to do a moral inventory wrong is to not do it at all.)

All of this then requires a deep and thorough forgiveness practice, ultimately letting go of all of it.  Then it is done.  We have a fresh start.  

You can use this Forgiveness Prayer to help you get started.  Practice Suggestion:  Read it into your Smart Phone’s Voice Memo app (or tape recorder) very slowly. Pause 5-10 seconds between each line.  Save it, and then play it back to yourself with your eyes closed, allowing yourself to feel it deeply.  As faces and names to forgive bubble up in your consciousness, you can make a note of them to add to your lists.

For all those we have harmed, knowingly or unknowingly,
we are truly sorry. Forgive us and set us free.
For all those who have harmed us, knowingly or unknowingly,
we forgive them and we set them free.
And for the harm we have done to ourselves,
knowingly or unknowingly, we are truly sorry.
We forgive ourselves and we set ourselves free.
~ Author Unknown ~

Afterwards, we may also need to talk to a few people and apologize for our behavior (or in some cases neglect).  Hard Fact: In order to really feel healthy, whole, clean and strong  inside, it is essential to give our inner emotional pipes a good Roto-Rooter cleaning by resolving any awkward or tender hurts. Apologies and amends need to be in the process.  Fun Fact: Asking for forgiveness is the final piece in our quest for inner calm, or should I say, the Final Peace?!!  

But you don’t have to go away for a whole weekend to give yourself an effective Mental Laxative…you can carve out some time each day, or each week,  to sit quietly and review your life to forgive the imperfect moments. What worked well? What did not go so well?  Whom did you judge too harshly?  Even taking a brief inventory of your emotional interior will have huge pay offs in the long run.  

One more Mental Laxative Practice Suggestion:  set a timer for 10 minutes.  Do as much of your list making as you can in that time, and then stop.  It will be enough.  Do this on a weekly basis, or more frequently if you are ready. Ten minutes of taking a Mental Laxative twice a  week is a great beginning, perhaps once over the weekend and once during the week?  Do what feels right for you.

As you progress, this could ideally become a daily activity…and who would you be if you had no resentments, anger, unresolved grief and rage?  You would bloom on in a whole new way.

In addition, I believe that holding onto negative thoughts and unresolved anger, resentment, fear and grief will fester within, and eventually manifest into some kind of physical illness and/or mood disorder.  We need to keep all of our pipes clean!  Digestive pipes and emotional pipes, which actually work together in the big picture.

As the hallowed halls of the Mindfulness research and Functional Medicine have taught us, every thought becomes a chemical reaction in our bodies.  Please note, the Mind-Body connection is not philosophical, theoretical or conjectured.  It is grounded in science (Turner, 2014).

We need to be aware of this and carve out the time to release and let go of our negative and stinking thinking.  If we don’t, it will just putrefy within, and poison our relationships as well.

 

What is Reflective Listening?

Being heard is so close to being loved, that for the average person they are almost indistinguishable.  – David Augsburger

Another worthwhile activity to do if you find yourself being in the Red Zone now is to volunteer your time, talent and special treasure in places that will appreciate you.

Before I became a therapist, I used to volunteer at a Suicide Hotline called HELPLINE, at the Marble Collegiate Church in New York,  which for me, was an exhilarating service.  It was founded by the late, great Reverend Norman Vincent Peale, may he rest in peace.  (There is also an excellent Blanton-Peale counseling center located at Marble, with wonderful psychospiritual therapists on staff, see reference below).

Most Hotlines have a fascinating and useful training program which enhances all human relationships.  I first learned the power of Reflective Listening in my 10-week HELPLINE training, and it transformed my life. 

Reflective Listening is being able to let someone else talk and just be present for them,  listening quietly.  When they pause, then you reflect back the essence of what they have just said.  This feels very soothing and loving to the agitated talker. The person feels so validated by your Reflective Listening, it is often enough to help them  get “off the ledge.” Listening is a form of loving each other that soothes, heals and restores us.

Learning Reflective Listening  was the bulk of my HELPLINE training, plus there was also a lot to learn about making referrals and gaining trust. 

Coming from a culture of chronic interrupters and non-listeners, I had learned some ineffective communication habits over the years, which I continue to strive to improve.   The impulse to speak out and interrupt is fierce, but knowing that it compromises relationships and hurts people helps me to zip my lip, as best as I can.  For today, I remain a humble work in progress, that’s for sure.

My hope for the future is that the Hotline’s training program is something that will be  taught to all humans by the sixth grade. Similar to the skills learned in Dialectical Behavior Therapy (DBT, which should also be part of elementary school education) during training we learned about interpersonal effectiveness, mindfulness, distress tolerance and emotion regulation.  These skills give us the foundation for better emotional balance, and allow us to be more present for others’ pain and suffering, as well as our own. 

 

Ask yourself the magical question, “How can I be useful today?”

I understand that a Hotline gig may not be your cup of tea.  Volunteering at a soup kitchen, animal shelter, nursing home, botanical garden, museum, Indivisible, MoveOn or anywhere can also be very uplifting during the Red Zone. 

Nursing homes always need a river of volunteers to help with feeding, reading, translation services and transporting  non-ambulatory residents .  I learned this when I was in graduate school, as one of my internships was at the Jewish Home and Hospital for the Aged in the Bronx.  I was facilitating several  therapy groups each week, but there was a huge volunteer staff that coordinated all these helpful tasks for the residents.  I was so impressed with the volunteers’ compassion and zeal to help these nursing home residents.  

Yes, there is a time for self care, and then sometimes it is better to focus on others’ needs more than your own, to take a break from the painful  ME-ME-ME inner dialogue you might be having.

 

Transparency is Healing

Finally, being in the Red Zone totally in secret is just exhausting and no fun.  Be honest and authentic about your feelings — transparency is healing —  and see who matches your energy.  You might find a few people who also feel put upon and even hate the holidays — great — these will be your Red Zone buddies and comrades in getting through the muck of the season. 

Make it a point, however, to be victorious together, e.g.”let’s stay sober and clean through this nightmare,” or “This too shall pass. How can we be useful today?”  or “Let’s go for a hike and get away from the shopping madness.” Complaining is draining, so it’s important to find ways to support each other to rise above the chaos of the season.

Being able to laugh about it, the complete absurdity and paradox of Christmas especially, is so refreshing.  Whenever I see huge displays of gifts and glittery objects everywhere tempting us to buy-buy-buy, I chuckle to myself and think “What would Jesus say about all this?  Would He be happy with this display?”  Yikes.

I’m not judging, nay, nay,  I actually love the glittery Hand of G-d in all of this (Wessan, 2012).  But you know  the commercialization of Christmas becomes excessive and downright irritating at times — so I like to take a step back and think about the real reason for the season…our awesome connectivity, celebrating our Oneness, and the mystery of the Numinous in our lives.  

Another reason is the magnitude of  working through the bittersweet feelings of existence together and being brave enough to peacefully co-exist in this tumultuous world.   We can acknowledge the dialectical paradox, that sometimes we want to live and sometimes we don’t, but we choose life anyway.  We need to be courageous during this time, knowing that we are struggling in the Red Zone while “everyone else” seems to be having the best time ever. 

 

In Conclusion

For this holiday season, The Red Zone,  I encourage you to try something different:

  • Experiment with a daily or weekly Mental Laxative experience, or go away on a retreat for more in depth forgiveness work.
  • Volunteer somewhere that will give you  a chance to focus on someone else, take a break from “Poor me, Poor Me, Pour me a drink” thinking.
  • Give honesty a chance, come clean and tell a few people how you really feel. Defrost some of that hidden grief, rage, loss, loneliness, “Compare and Despair” and all the inner stressful thinking that puts a damper on your days.

I promise if you follow some of these suggestions you will feel lighter, brighter and perhaps, dare I say it, even more peaceful during this relentless Red Zone. 

Good health is wealth, go for it!

 

 

References

Dialectical Behavior Therapy Skills (DBT).   This is a four part psychoeducation program that covers Mindfulness, Emotion Regulation, Distress Tolerance and Interpersonal Effectiveness. It takes one year to complete the curriculum.

Turner, K. (2014).  Radical Remission: Surviving Cancer Against All Odds.   New York: Harper Collins. 

Vanzant, I. (2013). Forgiveness: 21 Days to Forgive Everyone for  Everything. Carlsbad, CA: Smiley Books.

Wessan, L. (2011, September 27). Compare and Despair: How Free Do You Want to Be?  Retrieved from https://mirthmaven.blog/2011/09/27/compair-and-despair-how-free-do-you-want-to-be/

Wessan, L. (2005, October 14) Forgiving is not condoning. (8 minute video)  Retrieved from https://www.youtube.com/watch?v=avBEdDJJGrk

Wessan, L. (2012, July 13). The Glittery Hand of God. (3 minute video).  Retrieved from https://www.youtube.com/watch?v=PT2lSvLft4o&t=4s

Blanton-Peale Institute and CounselingCenter, New York, NY,  for individual, family and couples counseling.  Accepts most insurance.  Highly recommended for quality psychospiritual therapy.  Founder: the late great Reverend Norman Vincent Peale. 

Pumpkin Hollow Retreat Center, Craryville, NY. Owned and operated by the Theosophical Society.  Organic vegetarian food served from their own farm, non-dogmatic, beautiful retreat center. Highly recommend, especially the retreats on Therapeutic Touch, and the Silent Retreat.

 

Copyright © 2018 by Lisa Wessan. All rights reserved.

 

#DBT, #PTSD, #EmotionRegulation #DistressTolerance, #Wellness #Recovery #Peak, #Mindfulness Addictions Anxiety BPD depression Distress Tolerance Emotional Regulation Interpersonal Effectiveness Mindfulness resilience stress Westford, MA

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Nov 10

When you are addicted to Drama…

by Lisa Wessan, LICSW

Dear Drama

Even if you don’t have a chemical addiction (Alcohol, Pills, Sugar, Flour, Dairy,  Cigarettes etc), you might be addicted to crises, drama, or intense emotions that put you center stage.

You could even be addicted to isolation, anger, hatred, “Compare and Despair”  and other emotional states…it’s universal.  Ideally, no one would feel shame about their impulse issue, and more than half the battle is naming and releasing the shame around these issues. “If you can name it, you can tame it!” is one of the most hopeful slogans of my guild.  We are all striving to grow, learn and heal from whatever ails us.

In my Westford, MA, DBT Skills Group (Dialectical Behavior Therapy), we recently explored addiction models, including Total Abstinence, Harm Reduction and Dialectical Abstinence.

Total Abstinence is useful  when you have tried 1000x or more to practice Moderation Management but it failed. Moderation Management has you set a boundary or limit to what you can do before you are at risk.   For example, if you have a challenge with alcohol, saying “Two drinks per evening, and no more than twice a week.”  If you consistently zoom past that limit then Moderation Management has failed, and you cannot get well with that system.

Complete abstinence is usually for those who know that “One cookie is not enough, and a thousand are too many. ”   For those people who cannot enjoy one or two cookies, for whom the desire to keep going will override all rational thought, complete abstinence from cookies is the easier, softer way.   You make the decision once and for all, and then keep surrendering to it because you know it is less painful than the alternative inner haggling dialog on whether to indulge “this time” or not.

So when moderation is impossible…then you know.  Usually you cannot skip straight  into to total abstinence…most of us do the hokey pokey for a while with Moderation Management before we surrender. Fun  fact: The whole journey is necessary  for your inner process to be complete. 

Dialectical Abstinence is a middle path for those who cannot,  or will not, practice total abstinence from their substance abuse, or addictive behavior, yet ultimately desire total abstinence.  Yes, it’s the perfect paradox, “I want to abstain, but I won’t right now.”  Moderation Management and Harm Reduction are applied here to manage your addiction and prevent a complete relapse.

Harm Reduction is allowing for a thought system to be flexible enough so that if someone has one drink, or one cookie, they don’t say, “Oh what’s the use, why bother, I might as well go all the way and finish the bottle (or box of cookies)!”   Harm reduction takes you out of the dualistic, all or nothing, black and white thinking so that you might have three cookies and then say, “Ok, that exceeded my limit, but I’m going to stop right here. It’s good enough for today.”

As my old beloved professor Christopher Lasch at the University of Rochester once said “We live in a culture of addiction.”  Lasch was fairly well known for his book on The Culture of Narcissism: American Life in an Age of Diminishing Expectations (1979), but he had a deep belief that the rise in our addictive culture was correlated to our self-absorbed lifestyles.

Self Centered

So much of our need to medicate ourselves or have a Pity Party for ourselves is tied into our “Me-Me-Me” anxiety and fear.  Clearly there is no simple altruistic solution for our  multidimensional addictions.  The research and science on this vast topic has repeatedly shown that  when we do aim to give service and get out of our heads for a while we can find some relief and peace when focusing on fulfilling others’ needs.

And yet, if you are obsessed with others’ well being and are codependent, then you have another kind of addiction…which requires detaching and letting go of others’ business!  Oh my, it’s a slippery slope in the land of addiction!

I find with my DBT students that many of them are recovering Drama Queens and Kings.  Before they started this healing process, they were often embroiled in wildly high risk and/or  debilitating situations.  Once they realize that they do have an addiction to Drama, they start letting go of the the need to be center stage, stirring the pot and getting everyone around them wound up.  But it requires a process of compounded skill building, education, homework and practice,  and re-wiring their brains in order to shift from the “Poor Me” narrative to the “Serene Me” experience.

When someone says, “Poor me, poor me, pour me a drink!”   they are stuck in Victim Consciousness and do not see how many choices and options they have.   Slowly, slowly, with DBT training, rehab treatment, or 12 Step processes they start to see how many other options they have besides using their addiction to cope.

We live in a time where treatment for addiction and mood disorder is available, and the only way to do recovery wrong is to not do it at all.  So if you or a loved one are struggling with something along the addiction spectrum, trust that there is a solution for you.  As the Dalai Lama says, “Never Give Up!”

Copyright © by Lisa Wessan 2018. All rights reserved.

#DBT, #PTSD, #EmotionRegulation #DistressTolerance, #Wellness #Recovery #Peak, #Mindfulness Addictions BPD Westford, MA

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Dec 4

How to Improve your Interpersonal Effectiveness

by Lisa Wessan, LICSW

The full scope of Interpersonal Effectiveness focuses on improving communication, learning to set healthy boundaries, learning to validate self and others, gaining confidence in asking for what you want,  enrolling others to help you in your dreams and goals, and letting go of toxic relationships.

Below is a sample of one of my lesson plans for Interpersonal Effectiveness.  (This is one segment from 14 classes on this topic.)

Preventing Compassion Fatigue

It can very often be difficult to say no to people who make demands of us, and if we say no, we can get caught up in self-critical thoughts leading us to feel guilty. To avoid feeling guilty, we just keep on saying “yes” to every request.

Someone asks us to do something: 

Say No diagram

We can learn ways of saying “No” that don’t lead us to think self-critically or feel guilty. For example:

  • I’m sorry but I really can’t take on anything else at the moment.
  • I’m quite busy right now. Perhaps another time.
  • I’d like to help you out, but I just don’t feel up to it at the moment.
  • Thank you for asking me. You’re a nice person, but I don’t want to go out with you.
  • I don’t need a new roof (double glazing, vacuum cleaner etc). I’m happy with what I have thank you.

IMG_0393

  • If the person seems to have trouble accepting your “No,” then just keep repeating yourself, over and over if necessary. Be a BROKEN RECORD! Practice what one of my students calls Polite Perseverance…You might have to add the word “No” to the beginning of those statements, perhaps with some emphasis on that word. For example:
  • No. I’m sorry but I really can’t at the moment.

IMG_0394

Be wary of those self-critical thoughts afterwards. Practice challenging and/or dismissing them, by telling yourself:

  • I explained to them why I couldn’t do it.
  • It’s not my responsibility.
  • It would only end up upsetting me if I agreed to it – this is best for me. If I feel less tired and not resentful, then I might be a better position to help them out next time.

They’re just thoughts – I don’t need to pay them any attention (then put your focus of attention on something else).

The following dialectic affirmations about control and esteem can be helpful for finding that balance.

  • I cannot control some things but I am not helpless.
  • I cannot control other people but I am not helpless.
  • I am not responsible for those things I cannot control.
  • I accept those things in myself that I cannot change.
  • I can make positive choices for myself.
  • My strengths and abilities deserve my appreciation. Appreciate those abilities you have.

Create your own affirmations by completing the following sentences:

I am not powerless, I can ___________________________________________________

I have the right to refuse ___________________________________________________

I am not helpless, I can _____________________________________________________

I deserve to _________________________________________________________________

Remember, a wise person once said “Repetition is the mother of skill…” so aim to  repeat these phrases at least twice a day, with focused energy, enthusiasm and passion!

Onward and Upward,

Lisa Wessan

___________________________________________________________________________________________
NOTES:

It takes one year to complete the DBT Program.  During the year, we cover these modules:

  1. DBT Core Mindfulness [focusing skills]
  2. Distress Tolerance [crisis survival skills]
  3. Emotion Regulation [de‐escalation skills]
  4. Interpersonal Effectiveness [‘people skills’]

During class, we explore the act of saying “No” and turn these into powerful “Moves” to help you build new neural networks in your brain. We combine neurology, physiology and cognitive restructuring to do this, and sometimes add music and dancing to ramp up our energy. This  helps you develop a fresh new response more easily and will become your “new normal”  response to people’s inappropriate or untimely requests.

** For more information, please visit www.lisawessan.com.

Copyright © by Lisa Wessan 2020. All rights reserved.

Anxiety boundaries BPD depression Detachment Interpersonal Effectiveness Intimacy preventing caregiver burnout Private Practice stress Westford, MA

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