Dialectical Behavior Therapy -- The Journey from Pain to Purpose

Episode 61: Dialectical Behavior Therapy: The Journey from Pain to Purpose

Mental Health Hope and Recovery offers a unique approach to mental health conditions

Helen Sneed: Welcome to our award winning podcast, Mental Health Hope and Recovery. I'm Helen Sneed.

Valerie Milburn: And I'm, Valerie Milburn.

Helen Sneed: We both have fought and overcome severe chronic mental illnesses. Our podcast offers a unique approach to mental health conditions. We provide practical skills, guest experts, and inspirational true stories of recovery. Our knowledge is up close and personal.

Valerie Milburn: Helen and I are your peers. We're not doctors, therapists or social workers. We're not professionals, but we are experts. We are experts in our own lived experience with multiple mental health diagnoses and symptoms. Please join us on our journey.

Helen Sneed: We live in recovery. So can you.

Valerie Milburn: This podcast does not provide medical advice. The information presented is not intended to be a substitute for or relied upon as medical advice, diagnosis or treatment. The podcast is for informational purposes only. Always seek the advice of your physician or other qualified health providers with any health related questions you may have.

Dialectical Behavior Therapy is a universal treatment method practiced worldwide

Welcome to episode 60A. life in recovery with DBT. What's in a name? Well, this is a big one. Dialectical Behavior Therapy. What does it mean? Everyone calls it dbt and today it's a universal treatment method practiced around the world. Helen, you and I have both used DBT in our own journeys to lives in recovery. And, and I know how important it also is to maintaining my life in recovery. We're especially thrilled that we're devoting two episodes to dbt. Today. Helen, you and I will explore the dramatic story of dbt, its remarkable creation and creator, the first illness it was used to treat, and the outward expansion of DBT therapy to the treatment of other mental illnesses and and beyond. We'll delve into strategies and skills, the impact on family and loved ones. We will answer the two paramount questions asked about dialectical behavior therapy. What is it? And how do I learn to use it? In our second DBT episode, we will hear from an expert DBT therapist who will explain the teaching, practice and impact of DBT on, on those struggling with a variety of mental health symptoms and diagnoses. There will be suggestions for those learning DBT and for those supporting them.

Helen: Dialectical Behavior Therapy was invented by Marsha Linehan

Helen Sneed: well, Valerie, let's start with the invention, development and implementation of DBT by Marsha Linehan. Now, Marsha Linehan is one of the most influential, extraordinary figures in the psychiatric field of the past 60 years. She is that rare visionary who had the genius, commitment and doggedness to create a revolutionary and now, universally recognized treatment that served her vision and goal to help individuals suffering from extreme life threatening mental illnesses. Little could she have imagined that she would end up helping hundreds of thousands and when she began she she chose to work exclusively with those with severe symptoms. Her primary focus on the suicidal people deemed hopelessly sick by a large population of professionals. Now her epic journey is told in her memoir, Building a Life Worth Living. Her firsthand narrative of creating dialectical Behavior therapy will be the primary source of our episode today. We strongly recommend the book to anyone interested in or challenged by her great creation and learning and using DBT are addressed in her brilliant books and workbooks that will be listed in our show notes along with other DBT oriented books because there are many Linehan overcame with almost unimaginable mental illness in her early years in order to create, develop and measure the impact of her discoveries with scientific proof and precision and then to take on and succeed at validating the legitimacy of her methods in the face of almost universal professional scorn, hostility and disbelief. Her goal, which was a bargain she struck with God, is that if she could get out of hell, she would devote herself to going back into hell to help others escape. And she has embodied this her entire career. Now it took many years of trial and error to establish the methods that her severely ill and emotionally dysregulated

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Helen Sneed: clients needed when traditional therapy was obviously insufficient and because of their lack of response, they were deemed and damned as untreatable and hopeless. And slowly, over many years, Linehan discovered what did work for them. Dialectical Behavior Therapy, the founding belief of her technique is based on a contradiction. That's one of the most challenging aspects of using DBT to deal successfully with acute chronic suffering that is difficult to comprehend. It requires individuals to merge two direct opposites, to accept oneself, one's station in life, one's pain in the moment, and through that acceptance to become capable of embracing change and building a better life. Now to get better, the individual has to find a path of living with both concepts. It's called a dialectic, and this is the core of dbt. Synthesis is achieved by seeking out and recognizing that there is validity on both sides. And dialectics allows opposites to coexist. So acceptance and then you have change. But when they come together, it's synthesis. Radical acceptance is a tall order. It requires repeated practice called a turning of the mind, persistently riding heard on one's teeming thoughts and repeatedly returning them to the positive again and again and again. Then there's willingness, the choice to participate in the life in front of a person. And as for self acceptance, Linehan said, if you're a tulip, don't try to be a rose, go find a tulip garden. Now, in 2011, Time magazine named DBT one of the top 100 scientific discoveries. Now, that same year, Linehan and I spoke on stage together to 200 doctors and scientists at the National Institute of Mental Health. Several months later, before a large audience including her family, colleagues and former patients, Marsha Linehan told for the first time her own history with extreme mental illness with uncontrollable self destructive behaviors and inhumane abusive treatment during a two year hospitalization. Even later, maybe a month or so later, one morning I saw on the COVID of the New York Times a photograph of a forearm badly scarred by cutting and burns. It was Marsha Linehan's. The front page story was of Linehan's long battle with Borderline Personality Disorder, the very disorder that she treated with dbt. When asked why she'd kept it a secret for her entire career, she replied that she wanted DBT to be about its scientifically proven methods and impact, not about her. DBT is not an individual psychotherapy approach. Linehan emphasizes that it's a behavioral treatment program focused on thoughts and actions rather than the past. A combination of individual therapy, group training for skills, telephone coaching, a therapist consultation team, and the opportunity to help change the client's social or family situation. Now this, obviously all this treatment is the ideal because many, if not most people learn DBT with fewer treatment components.

Valerie Milburn: Thanks for sharing all that, Helen. It's just fascinating what Marsha Linehan went through to achieve the incredible treatment method of dialectical behavior therapy. And I loved learning all of that from you.

Cognitive behavioral therapy and dialectical behavioral therapy are evidence based treatments

Now I want to take a look at the comparison differences between cognitive behavioral therapy and dialectical behavioral therapy. I think it's important to compare these two because most people, from what I've read and anecdotal, understand cognitive behavioral therapy better than dialectical behavioral therapy. So let's compare CBT to dbt. CBT and DBT are both evidence based treatments that help individuals change unhelpful patterns of thinking and behavior. So that's what they have in common. They both help individuals change unhelpful patterns of thinking and behavior. Now here are excellent concise definitions of the two and a ah, comparison. Here's the definitions. CBT helps people change how they think to feel better. DBT helps people accept themselves and manage emotions to live more effectively. Let me repeat that. Here are those concise definitions.

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CBT helps people change how they think to feel better. DBT helps people accept themselves and manage emotions to live more effectively. Here are the core goals of the two different types of Treatment methods. CBT has the goal of helping people identify and change distorted or unhelpful thoughts. Negative thoughts also has the goal to modify behaviors that reinforce negative thinking. The last one is to help people develop healthier coping and problem solving skills. So that's cbt. Dbt. The goal is to balance acceptance of the present with motivation for change. Also to manage intense emotions and impulsive behaviors. And the third one is to build mindfulness, distress tolerance, emotion regulation, communication skills and boundary settings.

DBT teaches four main skills areas: mindfulness, distress tolerance, interpersonal effectiveness

Helen Sneed: Let's look at the basics of DBT because it can seem a little daunting because there's so many aspects to it. But here's one of the real basics. Learning skills is central to the effectiveness of dbt. Now there are two kinds of skills. Acceptance skills to give the client practical ways to accept the problems they have and change skills to solve the problems they have. Now, skills are action oriented. Linehan said, you can't think yourself into new ways of acting. You can only act yourself into new ways of thinking. To which I would say amen. DBT skills are life skills to be used throughout one's years to reach and sustain a life worth living.

Valerie Milburn: DBT teaches four main skills areas. One is mindfulness, being aware of the present moment. Two is distress tolerance, getting through crises without making things worse. Emotion regulation, understanding and managing strong emotions. And the fourth one is interpersonal effectiveness, building and maintaining healthy relationships. We're going to take a look at all four of these. The first one, mindfulness. Mindfulness is the core foundation of dbt. Remember that first core goal I just talked about of DBT was acceptance of the present. All other DBT skills are built on mindfulness. And, and we know from the definition I give of mindfulness at the beginning of the mindfulness exercise. At the beginning, at the end of every episode. That mindfulness teaches us how to observe, describe and participate in our experiences non judgmentally. One mindful knee mindfully and effectively. That's mindfulness. Mindfulness means paying full attention to what's happening right now, when without judging it. It involves noticing our thoughts, emotions and body sensations. Noticing them rather than reacting automatically or getting lost in them. Mindfulness helps people in three ways. Stay calm and focused. Recognize emotional patterns. Make thoughtful rather than impulsive choices. Our, previous episode, episode 59 is entirely devoted to the topic of mindfulness, by the way. And if you've missed, check it out.

Mindfulness in DBT helps individuals balance acceptance and change

Now the last thing about mindfulness is the key DBT mindfulness skills that I want to mention because they're so helpful. The key DBT Mindfulness skills are observe, notice what's happening inside thoughts and feelings and outside in the environment. The second one is describe. Put words to what you notice. I feel anxious, my heart is racing. Participate is the next one. Fully engage in the present activity. The next one is non judgmentally. Avoid labeling experiences as good or bad. One mindfully is the next one. Focus on one thing at a time. The last one is effectively do what works in the situation rather than what emotions, emerge. Mindfulness in DBT helps individuals balance acceptance and change. As Helen mentioned, the dialectic at the heart of dbt.

Second area is interpersonal effectiveness. This is skills that help you be effective in relationships

Helen Sneed: Now the second area is interpersonal effectiveness. This is skills that help you to be effective in relationships with others, relationships with people close to you and with people you interact

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Helen Sneed: with. Data, you know, at work, for instance. Now I had very specific problems in the, many friendships and relationships that blessed my life. And it was based on my pathological desire to please other people. I mean, the very thought of anger made me go blank. It was triggering. I couldn't think of one word in my defense. Now I could be diplomatic to a fault, but I had everything to learn about how to defend myself. Simple skills allowed me to move forward. First I bought time. I would say to the person, I would acknowledge and thank them for, you know, telling me what they were thinking about and saying that I wanted to have, you know, some time to give it my full attention. Then I would get back to them. So, see, perfectly civilized, right? Then, action. I learned to write down my issues, point of view, strategic approach to the other person. Having it in writing tangible made it possible to practice productive confrontation. And I would take that piece of paper, with my strategy on it to the meeting generally because I just have to have it or I can't think of a thing. Now DBT also taught me the basics of goal setting. And it's very simple. If you want to buy a Snickers, there are three distinct outcomes. The first is to get the candy bar. Second is to preserve the relationship with the salesperson. And third is to keep your self respect regardless of anything else. Now this deceptively simple skill helps me all the time, often in relationships with others. Now the third one is emotional regulation. Skills that teach you how to control your emotions so that you don't react to what's happening around you without reflection and don't say or do things that make the situation worse. Those with intense emotional dysregulation have a limited ability to control their emotions, which can be volcanic in the extreme. Feelings of self loathing and Shame, fear of abandonment, anger, a host of other terrible emotions lead to out of control behavior. And people with these feelings are the very definition of severely behaviorally dysfunctional individuals. I'm one of those people. My emotions and thoughts were so dysregulated that it was like a manic high. I mean, I couldn't come down, except I was trapped in these feelings that were cruel, excruciating and unstoppable, just cascading for months at a time with no relief. My most destructive behaviors, excessive self injury and suicidal ideation in attempts, were firmly entrenched in my mind as the only sources of relief left to me. The skill that gradually helped me control this hyperarousal of emotions was a kind of brutal mindfulness. Sounds like a contradiction, but it was very crude. But it was effective. I used words to stop the thoughts and emotions, and at first I'd say, shut up, shut up, shut up, shut up. Repeatedly crying from the pain and hopelessness. But the crude command had a kind of strength needed to tamp down my mind and it would stop me from cutting. And I began to find a word or phrase to repeat, or even a series of numbers. And if I said them quickly enough, again and again and again, the intrusive thoughts couldn't get through and torment me. These were the very first glimpses of a skill that brought some relief without my having to hurt myself. This was perhaps the first private action I learned from DBT that worked, and I still use it today, although it's not as primitive. I'm, more likely to say, oh, darling, please do shut up. Dan Millman said, you don't have to control your thoughts, you just have to stop letting them control you. Very wise words. And this leads to another skill that stopped my thoughts from controlling me, called opposite and action. Valerie and I are both very keen on this skill. regardless of how terrible I felt or how brutal my thoughts of self loathing, I began to be able to force myself to go out with people. I learned that isolation was lethal. And if I connected with another person, if I could just get myself out the door, I usually felt better. And for me, to this very moment, the key to emotional regulation is action.

Valerie Milburn: Yes. I love one of your favorite phrases, action begets action. And I know that is so true. once I get going, I'm usually, you know, able to keep going.

The distress Tolerance skills help people cope with painful or stressful situations

So the last skill is distress tolerance. And we've reviewed the other three, mindfulness, emotion regulation, and interpersonal effectiveness. Let's take a look at distress tolerance. The distress Tolerance skills help people cope with painful or stressful situations when they cannot

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change what's happening right away. The goal is to survive the crisis without making things worse. These skills are most useful when emotions feel overwhelming. We want to act impulsively, self harm, lash out, quit, or the situation can't be fixed immediately. Now there are two main goals of distress tolerance. The first main goal of distress tolerance is getting through short term emotional pain safely. And the skills for this goal are crisis survival skills. These are short term coping skills. These skills help us tolerate distress until the intensity decreases. Here's an example of a crisis survival tool. It's the STOP skill. The S stands for stop, don't act impulsively. The T stands for take a step back, pause, breathe, O stands for observe, notice what's happening and P stands for proceed mindfully, choose what works best. The second goal of distress tolerance is learning to accept what can't be changed right away. The skills for this goal are called reality acceptance skills. These are long term coping skills. These skills help us accept life as it is, even when it's painful. One of the core reality acceptance skills is radical acceptance. And radical acceptance is acknowledging reality fully, even when we dislike it. And Helen, I loved your comments earlier about radical acceptance, that it's a tall order and it's a skill that has to be practiced. I also want to look at DBT and its effectiveness in treating particular mental health disorders. Evidence shows that DBT treatment is most effective for borderline personality disorder, eating disorders, suicidality, self harm and complex PTSD when it's adapted specifically for ptsd and this is actually known as dbt. PTSD research shows that DBT is a promising treatment for bipolar disorder. But this is preliminary research. DBT is not widely used or as effective for primary anxiety disorders and OCD, except as an adjunct therapy when certain presence or when certain symptoms are present.

Use of DBT by individuals with no symptoms or diagnoses is growing

Helen Sneed: Now here's an excellent irony which is sort of the other side of this, which is the use of DBT by individuals who have neither symptoms nor diagnoses of mental illness. I have said for years that DBT should be taught in every high school in America. And it came as no surprise to learn that it's being used far beyond clinical practice in schools, law enforcement, business, and even the arts. And family members are learning DBT to support their loved ones more fully. I recently heard a psychiatrist who had neither symptoms nor diagnoses discuss why he studied dbt. And with all the trappings of professional and personal success, he still had an issue with anger and he used DBT skills to overcome this big problem, and it enriched his life. So it's ironic that the method Linehan developed to treat the most severely mentally ill can also be used to help those with functioning lives to make them better. The life skills are skills for all lives, for each and every one who wants to lead a more fulfilling life connected to themselves and to others.

Valerie Milburn: I love that you mentioned DBT skills are life skills for all lives, because I have used DBT skills for all stages of my life. Now my life in recovery, I mean, DBT was essential when I was severely symptomatic and definitely helped me move into a life of recovery. There is no doubt about that now. It enriches my recovery daily. The two DBT skills I use most often are opposite, action, as you mentioned, Helen, and what I call reality check. Opposite action is the DBT skill where we intentionally do the opposite of what our emotions are telling us to do, especially when the emotion is not justified by the facts or it's unhelpful for me, in the morning after prayer and meditation,

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Valerie Milburn: I move into the day ahead. Now, if I have an appointment, I always get going on time. But if it's a day where, yes, I have a lot to do, but I've just given everything blocks of time on my calendar I haven't put an actual start or end time on. These days, I often just don't want to get up from my comfortable little nest. Well, except to get another cup of coffee. But I, want to delay the start of the day. I want to read or call a friend I haven't talked to in a while, and I'll tell myself, well, I can just move everything to a little later in the day, you know, give everything a little less time to get it done, and I'll still get it done, I'll get everything finished. This is my tendency to procrastinate when I have a day full of tasks, projects, chores that I'm really not particularly thrilled about doing. But these are important days where I have to be productive and take care of business. This is when opposite action comes into play. On these mornings, I literally say out loud, opposite action. And I make myself get up and go get ready for the day. And I do it. But I also do allow myself that next cup of coffee. I just take it down the hall with me and head back and get going. My other opposite action skill for me, has become what I call does it need to be said? Because when my emotions, either anger, irritation.

Valerie Milburn: Fear.

Valerie Milburn: Have formed words that are about to come out of my mouth. Most often, the right thing to do is not let them come out of my mouth. I mean, not saying what I'm thinking is most often the right action. And I have learned, I don't know, maybe 80% of the time anyway, I've learned to ask myself, does it need to be said? And the answer is almost always no, doesn't need to be said. So that's opposite action in a couple of different formats. And my other really helpful DBT skill is what I call reality check. It's a simple tool and it's most helpful to me in relation to the anxiety disorder I live with. And here's an example. Recently, I was writing a 30 minute speech that I was to give at an upcoming luncheon. I had finished the opening and had outlined the rest. Now, as is normal in my writing routine, I took a break so that I could come back and review it with a clear head. But my head didn't clear. It clouded with doubt. These are the thoughts that attacked me. The opening isn't going to grab the audience. The outline doesn't capture the essence of the organization. I don't know enough about this or I don't know enough about that. I need to start over. So I went and sat back down at my computer, but I just stared at the screen and I realized I needed a reality check. So I asked myself, is anyone telling me that I have what I've written isn't a good first draft? Is anyone telling me I don't know enough to write or give this speech? When was the last time I wrote or gave a bad presentation? And you know, the reality of the situation was so far from how my doubt clouded mine was perceiving it first, it was a good first draft because there are no bad first drafts. It's the starting that matters. And I had started. Right, Helen, you just got to get going. Yes, so I reminded myself, one of my favorite sayings is there are no good writers, only good rewriters. And I checked off that. Yes, it was a good first draft. So second, not only was no one telling me that I didn't know enough to write or give the speech, the executive director and board president of the organization had asked me to give the speech, so obviously they thought I was qualified. Check off the second question. Third, I acknowledged that I am a good public speaker with tons of successful experience and that I had given myself more than ample time to write, edit, learn, and practice the speech. I said to myself, I know how to do this and I do it. Well, reality check complete. So those are the two DBT skills that allow me to live my best life in recovery, a richer, fuller life with a great deal more serenity because of those skills. And these are the skills that are now a part of me. And I do them almost automatically. I mean, it's not like I have to write down those questions. You know, it's all just thoughts that happen, really, on, you know, on automatic pilot. But it took years of practice to have these skills ingrained, and I am reaping

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Valerie Milburn: the benefits.

DBT helped me stay alive despite severe emotional dysregulation

Helen Sneed: Well, I, so appreciate your talking about, the. Where you are with DBT today, because I think people are always very curious about that and want and go, oh, my gosh. I mean, you use it your whole life. And, for both you and me, the answer is, well, yes, but I'm going to go back a little bit into, the past. And I mentioned earlier that in 2011, I spoke on stage with Marsha Linehan at the National Institute of Mental Health. And it was before an audience of scientists and doctors. Now, I had been encouraged to tell them what borderline personality disorder was like. And in my speech, I said that language failed. Words were inadequate. But there is a photograph from the Vietnam War of a little girl running down a dirt road straight into the camera. She is naked, her clothes burned away by napalm. Her little face is contorted with agony and terror, and she is screaming. Now, there are other people, adults around her on the road, but they are not paying her any attention. She is utterly alone. I call her the Burning Girl. And this is what the emotional dysregulation feels like to me. Burning. Burning all alone. Just like that little girl. When I began, ah, my first DBT course, it was at Payne Whitney Clinic in New York City. And the class was designed for people with borderline personality disorder. And most of us were women. It turns out that this treatment course was designed by Marsha Linehan herself. She came to New York and did it, and it was the first in the US Outside the original in Seattle. Well, at that time, I'd never heard of her. I mean, there was a lot to it. There was a workbook, homework assignments for class, a new vocabulary, and this emphasis on, skills, which just all seemed to me a little kind of, you know, Mickey Mouse or simplistic or something. And I was pretty scornful of the process until a classmate of mine, a blind woman named Linda, pulled me aside. She said, you'll hate DBT the first time. Stick it out. And the Second time around, it will change your life. Well, we became good friends and I never forgot what she told me. But of course, I didn't follow her advice and take it a second time. So for the next five years of treatment and the wrong treatment team, I went straight downhill until I was incapacitated with life threatening symptoms. And finally I ceased to function. I lived in this tortured isolation, seldom leaving my bedroom. By this time, DBT was beginning to be seen everywhere in the treatment world. So it was a part of much of my treatment around the city. And I was lucky. At that time, there was little access to DBT outside New York City and Linehan's base in Seattle. Now, in earlier episodes, I've related the ghastly trajectory of my condition that ended with my revered doctor telling me I was hopelessly sick, would never recover, I would never work again. I was so shocked by what she said that I looked at her and I said, I will devote the rest of my life to proving you wrong. But I had no money, I had no professional to rely on, and I was utterly isolated from my friends and family. The only thing I had was dbt. And despite the fact that I had no one to rely on, I never again slid back all the way. Not once, even when I could barely hold my head above the water, came within an inch of killing myself. Those skills somehow got me through. I didn't practice them perfectly, couldn't even remember the names of most of the skills. And it didn't matter. I didn't quit. Despite the worst state of emotional dysregulation of my life, my primitive use of DBT skills eventually helped me stay alive and continue to fight. Now, the most damaging and dangerous relationship in my world, was with myself. And DBT was the first weapon I had that eventually made me safe when I was alone with myself. And better, still, I began to shut off and control the hideous thoughts and feelings that had never left my mind since childhood. For DBT skills were the first things I could do when on my own. To reduce the chronic pain of my existence and then to build better ways. It was all about action. The strongest survival skill was to act even in the face of my self hatred. To force myself to take opposite action and reenter the world of people, regardless of how I felt. So DBT served me in two contradictory ways. To regulate my emotions in order to re enter the world, and to re enter the world in order to regulate my emotions. Now let me be clear. DBT

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Helen Sneed: saved my life. Better still, it taught me how to Save my own life. And since then, over the course of my years, I use DBT daily, often without thinking. It's the bedrock of my recovery and of the wonderful life that I have built now. Back in 2011, after we had spoken together on stage, Marsha Linehan came up to me and said that I had a deep mind, rich with words. You're a poet, aren't you? She said. It was a major turning point for, the first time in many years of sickness. I felt like my old self again. I had thought that person was dead. So you see, I firmly believe that DBT is a deep, really almost bottomless reservoir of hope for all of us battling to find our truest selves and to build a rich life worth living.

Valerie Milburn: Wow. Your story is just a true testament to the power of dialectical behavior therapy. And I'm so grateful that you found it and that it helped you fight your way back to this incredible life you do have in recovery, where you are so important to so many people, including me.

Helen Sneed: Well, thank you. And we both, DBT has certainly, done a lot for both of us.

Valerie Milburn: Yes.

Helen Sneed: And to say the least.

Valerie Milburn: To say the least. And although we could continue to talk about DBT for much longer and am so grateful that we have a second episode on dbt, because we could talk about it for much longer.

Woman who used DBT says it was very different from previous therapy

we need to close the topic for today. we're going to wrap it up with words of two very different individuals. The first words will be from a woman who used DBT treatment. And here's what she had to say. Doing DBT was very different from my previous experience. A very different feeling. I had had a lot of cognitive therapy, talk therapy. With cognitive therapy, you were talking and discovering things about yourself, which is great. It can be very powerful. But I had done that for so long, I needed something more practical. With dbt, I learned the skills to redirect myself, especially being effective in what I do. Those are powerful words about changing our lives. The other words come from Nelson Mandela. He said, do not judge me by my success. Judge me by how many times I fell down and got back up again. These words evoke Marsha Linehan her exceptional strength to fail over and over for years until she discovered her healing methods. These words also honor all of us who have labored time and again to make DBT effective in our own recovery. We do not quit. And now, as we always do, we will close the episode with a mindfulness exercise.

Today's mindfulness exercise combines the DBT skill Reality Check and mindfulness practice

What is mindfulness? I always give a definition. Even though we have had many Definitions today of mindfulness. It is a mental state achieved by focusing one's awareness on the present moment while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations without judgment. Today's mindfulness exercise combines the DBT skill I call Reality Check that I talked about and the mindfulness practice of Right here, right now. And you can find one of my previous mindfulness exercises that focuses on the skill of Right here, right now on our website, mental healthhopeandrecovery.com so today, let's combine these two things. Reality check and Right here, right now. Let's try it. Let's get mindful. If you can find a comfortable seated.

Valerie Milburn: Position, try closing your eyes. If it's safe to do so, let's settle in. As always, we'll begin with a few diaphragmatic breaths. Whether your eyes are open or closed, let's steady our breathing with two diaphragmatic breaths. When you do this on your own, take as many breaths as you need to become calm and centered. I usually take 10 diaphragmatic breaths to begin my mindfulness and meditation practice. Let's breathe. Inhale through your nose, expanding an imaginary balloon in your stomach. As you inhale forcefully exhale through your mouth,

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Valerie Milburn: pulling in your stomach as you do so. Again, inhale through your nose. Drop your shoulders. Expand that balloon in your stomach. Exhale through your mouth. Forcefully exhale, pulling your stomach all the way in. Keep this slow, steady breath going. Think of a time when you may have felt like you disappointed someone. Maybe you felt like you were underperforming at work. Maybe you felt like your presentation or project wasn't good enough. Or, maybe you thought you said something that offended someone. Maybe as a parent, you didn't do the best you wish you had. Visualize this situation. Putting yourself in this situation, say to yourself, right here, right now, to bring yourself to the moment you were thinking those negative thoughts right here, right now, to that situation. That moment. Those thoughts. Now let's do a reality check in that moment. That right here, right now, is anyone telling you that you are underperforming that your project or presentation wasn't good? Is anyone telling you that they are offended? Is anyone telling you that you are less than as a parent, Rather, in the reality of that right here, right.

Valerie Milburn: Now, is all well.

Valerie Milburn: M. Now look around where you are now. Your current surroundings. In your current surroundings, right here, right now. In your current surroundings, right here, right now, Right here, right now, all, is well. Right here, right now, all, is well. If your eyes are closed Please open them and gently bring yourself back to the room.

Valerie Milburn: Thank you for doing this mindfulness exercise with me.

Helen Sneed: I think we all need to thank you, Valerie, right here and right now, because, it's a good time to practice mindfulness, don't you think? When it's one of the basic tenets of db.

Valerie Milburn: I think so, yeah.

Helen Sneed: Anyway, thank you. And thank you to our valued listeners around the world. This podcast is for you. And with the year drawing to a close, we're deeply grateful for the chance to engage with you. We appreciate your time, feedback, and you're telling others about our work and commitment to mental health, hope, and recovery. Our next two episodes are not to be missed. For our holiday gift to you, Valerie will create an episode of the most effective mindfulness exercises of the past year, a perfect way to deal with the highs, lows, and in betweens of the holiday season. And following that is our second DBT episode, where an expert therapist will discuss the teaching practice and impact of DBT on individuals struggling with mental health challenges. We promise a riveting beginning of the new year, and until then, I leave you with our favorite word, Onward.

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