The Skillful Podcast

Today, Marielle and Ed discuss the skill of Radical Acceptance. Radical Acceptance is a Distress Tolerance skill that helps you stop fighting reality, however painful that reality is. When you can fully open up and radically accept what is happening in the present moment, suffering decreases.

Show Highlights:

• Getting too focused on change can sometimes backfire
• Radical acceptance is not against change
• Radical acceptance is different than plain old acceptance
• Our instinct is often to fight painful things that are happening
• Radical acceptance is not negating a sense of justice or fairness
• Denial of reality can keep us from taking steps towards change
• Acceptance does not equal approval
• Accepting painful things can be a process
• The first step in moving forward from painful things is accepting that they did happen
• Sadness often comes up when we radically accept
• Pain is a part of life for everyone - it can't be avoided
• It's a fallacy to think that if you accept things you don't like about yourself you won't change
• Radical acceptance doesn't mean we don't have preferences
• We need to radically accept the past
• If you are practicing Radical Acceptance of something in the future make sure you are only accepting known limitations
• Willing Hands is a skill that can help you Radically Accept
• To practice Willing Hands, turn your palms towards the sky and relax your arms
• When we fight reality, we are often holding a lot of tension in our bodies

Links & Resources

www.bayareadbtcc.com

DBT Skills Training Handouts and Worksheets, Second Edition

We'd love to hear from you! Where are you getting stuck with your skills application? Ask us a question for the chance to have it answered on the podcast. Submit your question here.

Please note that questions, and this podcast in general, are not a substitute for individual mental health treatment.

Marielle and Ed continue their conversation about Distress Tolerance focusing on the TIPP skill. That extra P in TIPP isn't a typo! TIPP is an acronym that actually stands for 4 different skills. The skills in TIPP intervene on a biological level to bring down overwhelming emotions to help you think more clearly.

Learn how to assess your distress level using the Subjective Units of Distress scale, or SUDS, in order to figure out which skills you need in an emotional crisis. If you are someone who leans toward impulsive behaviors when under emotional distress then tune in to learn more effective ways of responding to strong negative affect.

Show Highlights:

• Measuring your distress level with the SUDs scale (Subjective Units of Distress)
• SUD scale 0-10, from peaceful to an unbearably overwhelmed state of mind
• TIPP skills and reasonable expectations
• T - Tip the temperature of your face with cold water
• I - Intense Exercise
• P - Paced Breathing
• P - Paired Muscle Relaxation
• Ed describes the body's response to cold temperature
• Exercise can bring down the fight or flight response (2 minutes of jumping jacks, running up and down stairs, etc.)
• Differentiating between regular exercise vs. intense exercise in the moment
• Parasympathetic nervous system vs. sympathetic nervous system
• Sit or lie down as Marielle leads you in practicing a Paced Breathing exercise
• Paced Breathing is the most accessible TIPP skill because you can do it anywhere
• Ed leads you to practice a Paired Muscle Relaxation exercise

Links & Resources:

www.bayareadbtcc.com

Subjective Units of Distress : https://en.wikipedia.org/wiki/Subjective_units_of_distress_scale

We'd love to hear from you! Where are you getting stuck with your skills application? Ask us a question for the chance to have it answered on the podcast. Submit your question here.

Please note that questions, and this podcast in general, are not a substitute for individual mental health treatment.

Marielle and Ed delve into a discussion today on how you can learn to tolerate emotional distress and overwhelm without making things worse. There's a whole range of behaviors that we can learn, from mindfulness to using creative ways to distract. Learn more about how to ride out emotional storms with getting carried away by the winds.

Show Highlights:

• Resistance of emotional pain creates an additional level of suffering
• Dialectical approach of accepting what is AND looking for ways to change
• Cultural push to fix things
• When we respond to emotional pain in unskillful ways
• Learning to ride out emotional pain more skillfully
• Feeling shame over the coping habits we have established
• Distress tolerance skills are a natural outgrowth of mindfulness skills
• Concepts of emotion mind, reasonable mind and wise mind
• Subjective units of distress or SUDS
• Learning to ride out the storm
• How we define a crisis in DBT
• When NOT to use these skills
• Skilled distraction
• STOP skill is where we start: Stop, Take a Step Back, Observe, Proceed Mindfully

Links & Resources:

www.bayareadbtcc.com

Book:

"DBT Skills Training Handouts and Worksheets" - by Marsha Linehan

We'd love to hear from you! Where are you getting stuck with your skills application? Ask us a question for the chance to have it answered on the podcast. Submit your question here.

Please note that questions, and this podcast in general, are not a substitute for individual mental health treatment.

Are you someone who's good at getting things done, following the rules and planning ahead? These can be wonderful traits to have but you may notice that focusing on doing everything right interferes with relaxing, enjoying life and connecting with others. This is known as "emotional over-control" or "OC" and today Marielle sits down with Neill Howell, MFT, to talk about it.

Neil is a psychotherapist who specializes in treating those who are emotionally over-controlled. Neil and Marielle talk about RO-DBT, or Radically-Open Dialectical Behavior Therapy, and how it can help you learn to loosen the reigns of self-control and connect authentically to others. RO-DBT has been around for over 20 years and there's clinical research behind this approach that's really gaining a lot of momentum right now. It gets into the heart of things that other treatments haven't been reaching. If you or a loved one are emotionally over-controlled, you don't want to miss this fascinating discussion on how RO-DBT can be not only therapeutic, but a FUN treatment, as well. Listen in!

Show Highlights:

• Folks who are over-controlled or "OC" are very responsible but sometimes responsibility can be too much of a good thing
• OC folks often compulsively strive to do more and get the next thing done but have a hard time slowing down, resting and being playful
• On the outside, OC folks look like they are doing everything "right"
• Hiding emotions and not letting people in is a big part of being over-controlled. Some people hide their emotions with a neutral facial expression and others mask their true feelings with inauthentic facial expressions, such as a fake smile.
• Being over-controlled has a biological component: it usually shows up at a young age with shyness and a heightened threat awareness, which leads to anxiety
• Over-control also has an environmental component: children learn that making mistakes is intolerable and that they should always strive to do better
• When you're over-controlled, you don't need more control, you need strategies to help address the underlying problem
• Emotional loneliness is a big part of being OC and many OC folks secretly worry that they are just not that likable
• Many OC folks live life in a rigid way which makes it hard to form genuine friendships, which require openness and flexibility
• Self-inquiry is the primary mindfulness practice in RO-DBT that starts with the premise that nobody knows everything and neither does anyone else, therefore, we all have something to learn
• The 2 rigid mindsets: fixed mind and fatalistic mind
• Approach coping and staying open to a better solution
• Emotional leakage and how to express emotion at an intensity that a person is comfortable with

Links & Resources:

www.bayareadbtcc.com

www.neilhowellpsychotherapy.com

http://www.radicallyopen.net/about-ro-dbt/

We'd love to hear from you! Where are you getting stuck with your skills application? Ask us a question for the chance to have it answered on the podcast. Submit your question here.

Please note that questions, and this podcast in general, are not a substitute for individual mental health treatment.

Do you know how important it is to feel validated? Validation lets us know that we have been heard and understood. We all have the need to be understood by others, especially those closest to us. Today Marielle and Ed discuss the importance of validation in all interpersonal relationships. They describe the different levels of validation and they take a look at the detrimental effects of being invalidated by someone. Tune in now to find out more.

Validation is a necessary part of all relationships, from the most intimate relationships to friendships and work relationships. Marielle and Ed start today's episode with a definition of what invalidation is to give a sense of what it looks like and talk about how painful it feels to be on the receiving end of it. Listen in today, to find out what validation is and why it matters so much in relationships.

Show Highlights:

• Marielle explains what invalidation is and what it looks like.
• Being invalidated feels painful and it can cause people to become defensive and angry.
• It is possible to validate someone's experience without having to agree with them.
• What validation is and why it matters so much in relationships.
• Validation is the best way to connect and understand someone else's personal experiences.
• Why and how validation acts as a social lubricant.
• Differentiating intent versus impact.
• How validation can prevent defensiveness.
• How validation differs from simply agreeing.
• The benefits of starting hard conversations with validation.
• The different levels of validation.
• Paying attention is the first and most basic level of validation.
• The next level of validation is reflecting back what you have heard without judgment.
• The third level of validation is called "reading minds". This is a more advanced level of validation. It involves noticing and sensing what is going on with the other person without them having to tell us. It is powerful but it can also be tricky.

Links:

www.bayareadbtcc.com

We'd love to hear from you! Where are you getting stuck with your skills application? Ask us a question for the chance to have it answered on the podcast. Submit your question here.

Please note that questions, and this podcast in general, are not a substitute for individual mental health treatment.

Would you like to learn how to ask for what you want, how to resolve a conflict, and how to have your opinion taken seriously in your relationships? Today, Marielle and Ed will be expanding on the interpersonal effectiveness skills in DBT. They are working out of the DBT Skills Training Handouts and Worksheets, by Marsha Linehan, which is where you can find all the skills, and see all the acronyms that are discussed in the podcast.

Today's episode starts out with a review of the core interpersonal effectiveness skill in DBT, which is the acronym DEARMAN. Then Marielle and Ed go into some refinements of how to deliver DEARMAN. This includes how to ask for something, how to say 'no', and how to resolve a conflict when different things are important. Tune in now, to find out more.

Show Highlights:

• A quick review of DEARMAN, the foundational skill of all the interpersonal effectiveness skills: D=Describe; E=Express (your feelings or opinions); A=Assert; R=Reinforce (what's in it for the person you're asking for something); M=Mindful; A=Appearing confident; N=Negotiate.
• What's most important to you in an interaction? Your objective, your relationship, or your self-respect?
• The interpersonal effectiveness skills in DBT encourage us to plan ahead when we need to ask for something, say 'no', or interact with someone to get what we want in a relationship.
• There's a whole different set of skills that we would use to make sure that when we ask for what we want in a relationship, we're also being attentive to the relationship.
• Sometimes, maintaining our self-respect is the most important thing when we're interacting with another person.
• Our objective, the relationship, and our self-respect all things to think about in any interaction with another person.
• Some of the pitfalls that people can experience if they are always prioritizing the relationship, always prioritizing self-respect, or always getting what they want.
• We sometimes assume that the way to maintain a relationship is not to ask for too much or not to say 'no'.
• The Interpersonal Effectiveness skills help us to take each interaction for what it is and notice what will be most effective.
• The GIVE skill is the skill that we use to deliver the DEARMAN when the relationship is our top priority. G=Gentle; I=Interest; V=Validate; E=Easy manner.
• Marielle explains why Interpersonal Effectiveness skills are best accessed in Wise Mind.
• Paying attention to body language and eye contact can help us be more effective when communicating with others.
• Sometimes it's actually more effective to do the opposite of what our emotions are telling us.
• Trying to understand where the other person is coming from helps them feel understood and can improve our relationships.
• Having an easy manner is helpful when preserving or improving the relationship is the most important thing.
• Some questions that you can ask yourself to get clear about your priorities in each interpersonal situation.
• The FAST skill is used when your self-respect is most important. F=Fair; A= no Apologies; S=Stick to values; T=Truthful.
• These interpersonal effectiveness skills take thought, planning, and practice. They are also quite nuanced.

Links:

www.bayareadbtcc.com

We'd love to hear from you! Where are you getting stuck with your skills application? Ask us a question for the chance to have it answered on the podcast. Submit your question here.

Please note that questions, and this podcast in general, are not a substitute for individual mental health treatment.

Do you find it hard to say 'no', or get what you want in your relationships? Today, Marielle and Ed will be talking about interpersonal effectiveness. The interpersonal effectiveness skills in DBT are practical and they are really helpful in giving us a structure for obtaining what we want and need in relationships. These skills also provide us with a structure for saying 'no', while maintaining our self-respect. This is something that many of us seem to struggle with, so tune in now, to find out more.

In DBT, it's important to think about balance when trying to ask for something or to say 'no' to something in relationships. In today's podcast, Marielle and Ed will be introducing the interpersonal effectiveness module, and they will be discussing one of the module's core skills. Listen in, to find out what they have to share about these really effective interpersonal skills.

Show Highlights:

• In DBT, when looking at interpersonal effectiveness skills, we're trying to balance different needs and priorities.
• Meeting our objectives, maintaining the relationship, and maintaining self-respect are all important things to consider.
• DBT helps people figure out which of the three goals has top priority, in order to help people figure out which skill to use.
• Sometimes, people are not clear about what they want from a situation.
• How to look for the middle and avoid the extremes in relationships.
• Thinking about some of the hard conversations in advance can be super helpful.
• When emotions are high, we're not able to be as effective in asking or saying 'no' because the emotion may cloud things
• When our emotions are high, the tendency is to focus only on the short-term and we forget our long-term goals.
• Some common myths that people have about interpersonal effectiveness and relationships.
• Looking at common interpersonal myths such as: I don't deserve to get what we want or need or I should always be willing to sacrifice my own needs for those of others.
• It's hard for some people to tolerate others feeling upset with them, so they find it hard to ask for something or say 'no'.
• Some of the myths people who place their self-respect first all the time tend to believe. People should just know what I need so I shouldn't have to ask is a common one.
• Learning the skill of Radical Acceptance and how that relates to relationships.
• Ed and Marielle go through the foundational skill of the interpersonal effectiveness module in DBT. It's the acronym DEARMAN. D=describe, E=express, A=assert or ask, R=reinforce, M=mindful, A=appear confident, N=negotiate.
• Ed and Marielle bring DEARMAN to life with an example.
• Marielle gives some real-life examples of DEARMAN from their own working relationship.
• In the relationships where we are most comfortable and we let our guard down, is often where we are the least thoughtful. It really helps to have a structure to hold on to and to help us be more thoughtful about these types of interactions.
• Writing out a brief script for yourself before having a hard conversation can really help you to remain focused.

We'd love to hear from you! Where are you getting stuck with your skills application? Ask us a question for the chance to have it answered on the podcast. Submit your question here.

Please note that questions, and this podcast in general, are not a substitute for individual mental health treatment.

Would you like to introduce a mindfulness practice into your daily routine? Today, Ed joins Marielle once again and they continue talking about the mindfulness skills in DBT. In today's episode, they discuss what you actually do to practice mindfulness in the DBT framework. Listen in to find out more.

In the last episode, Marielle and Ed discussed the 'what' skills, or the things that you do, in order to practice mindfulness. These are observing, describing, and participating. Today, they will be talking about the 'how' skills, which are essentially how you observe, describe, and participate, and also the qualities that you want to bring to the way that you observe, describe, and participate. Tune in now for more!

Show Highlights:

• There are three 'how' skills. They are non-judgmentally, one-mindfully, and effectively.
• Talking about doing things non-judgmentally.
• How the 'how' skills deepen the practice of mindfulness when we're observing, describing, or participating.
• How our judgments can get in the way of our being in the moment.
• Learning to accept each moment like a blanket spread on the lawn can help us to observe without judgment.
• Why our judgments tend to create a lot of emotional suffering for us.
• Ed discusses the judgments and the resultant emotions that come up for him around rain.
• What happens when Ed is able to recognize his judgments, put them to one side, and focus on what's actually happening.
• Ed has found that practicing non-judgmental mindfulness around rain has decreased his reactivity towards rain.
• Noticing when you're judging and not judging yourself for the judging.
• Looking at toxic self-judgment that really causes so much emotional pain.
• Many judgments are based on inaccuracies.
• Judgments don't help to change behavior.
• Discernment is being able to acknowledge things that are helpful or harmful, and things that might be safe or dangerous, without judgment.
• In trying to be non-judgmental, we are trying to be factual.
• Practicing one-mindfulness is about just focusing on the thing in front of us.
• How focusing on one task at a time can lead to increased productivity.
• Being fully in the moment and practicing being one-mindful is really worth the effort.
• What it takes to become effective.
• Effectiveness is really about doing what works and playing by the rules.
• You need to have goals in order to be really effective.
• When we get stuck in a place of anger or hostility, we lose sight of the longer-term goals. Mindfulness gives us a moment to cool down some of the intensity of the emotion.

Links and resources:

You can find us online at https://bayareadbtcc.com/

We'd love to hear from you! Where are you getting stuck with your skills application? Ask us a question for the chance to have it answered on the podcast. Submit your question here.

Please note that questions, and this podcast in general, are not a substitute for individual mental health treatment.

Would you like to learn to practice mindfulness in the DBT framework? Today, Marielle and Ed will be discussing the three 'what' skills of mindfulness. These are called 'what' skills because they are what you actually do to practice mindfulness in the DBT framework. These skills are done one at a time. Listen in today, to find out about the three things that we do to practice being in the present moment.

In DBT, there are three things we can do to practice being mindful in the moment. The first is to observe, the second is to describe what we are observing, and the third one is to participate. Each of these is a different approach to being in the present moment. In a later episode, we will explain the 'how' skills, as these are the companion to the 'what' skills because the 'how' skills are how you do the 'what' skills. Tune in today, to find out about the three different and equally beneficial ways to practice mindfulness, one moment at a time, whenever you can, in your everyday life.

Show Highlights:

• Marielle explains what observing is all about.
• Observing is the direct notice of sensory experience.
• Observing is noticing what you are sensing without labeling it, reacting to it, or judging it.
• One of the 'how' skills is the ability to be non-judgmental.
• Ed explains how observing mindfully helps him to pay attention.
• Why observing can be tricky for most people.
• Judgments can cause people to want to change an experience or to want to push it away.
• The many benefits of observing.
• Being mindful allows us to be present without feeling the pressure to do more.
• DBT encourages you to practice being mindful for just a second if that's what you're able to do.
• Regular practice makes mindfulness easier.
• All the mindfulness skills in DBT are about bringing mindfulness and awareness to your everyday life, to help reduce reactivity, increase feelings of aliveness, and be connected to others, and decrease emotional suffering.
• Marielle leads us in a brief observe skill practice exercise.
• If your mind wanders just bring it back.
• The main goals of observing.
• The describe skill is putting words to what you observe.
• When you describe, you stick to the facts- just the who, what, when, and where. You leave out your interpretations or your assumptions.
• Interpretations can lead to assumptions. The describe skill can help you because sticking to the facts can prevent you from becoming anxious or worried.
• Our interpretations are usually based on our own opinions rather than facts, so our interpretation of a situation can lead us to react to the situation rather than responding to it.
• Building and honing the describe muscle.
• Marielle leads us in a brief describe skill practice exercise.
• Describe can really help when you're in the throes of intense emotion.
• Ed describes the participate skills. Some may be easy and work for you and others might not.
• Ed explains how the participate skill for mindfulness is the opposite of observing and describing.
• You can use participation to anchor yourself to the present moment.
• Participation allows us to become fully absorbed in whatever we are doing.
• Participation can allow you to dance like nobody is watching you.
• Participation allows you to feel a part of something, rather than feeling apart from something.
• Participating includes acting intuitively from your wise mind. This means that your actions are in service of your long-term goals.

Links and resources:

You can find us online at https://bayareadbtcc.com/

We'd love to hear from you! Where are you getting stuck with your skills application? Ask us a question for the chance to have it answered on the podcast. Submit your question here.

Please note that questions, and this podcast in general, are not a substitute for individual mental health treatment.

Would you like to know more about DBT and where it all started? In today's episode, Marielle and Ed will be looking into the background and development of DBT. They will discuss dialectics and the concept of Wise Mind and give an introduction to mindfulness. Tune in to find out more.

Dialectics is about balancing two things that could be seen as opposite, yet also as true. Dialectical Behavior Therapy (DBT) was created towards the end of the 1980s, by Marsha Linehan, who started out doing Cognitive Behavior Therapy (CBT) with suicidal and self-harming clients. She later added the dialectical component to more effectively treat people experiencing intense emotional suffering.

Show Highlights:

• Why Ed finds dialectics to be helpful for intense suffering.
• Ed defines the term 'dialectics'.
• Always balancing acceptance and change with dialectics.
• With dialectics, two opposing things can be true at the same time.
• Moving away from 'black-and-white' thinking.
• DBT has been effective in treating people with different kinds of emotional dysregulation.
• Wise mind is an ideal state, a work in progress, and an internal sense of doing the right thing, even if it's hard.
• Wise mind is the combination of our Emotion Mind and our Reasonable mind.
• What Emotion Mind looks like.
• What Reasonable Mind looks like.
• Wise Mind can lead us to that place of intuition or inspiration.
• There are many ways to practice mindfulness.
• Mindfulness helps us to access Wise Mind.
• Ed gives a mindfulness breathing exercise to help you to access Wise Mind.
• Mindfulness is the foundational skill of DBT.
• The mindfulness that is practiced in DBT isn't meditation.
• What is mindfulness?
• Depression lives in the past.
• Much of our distress comes from focusing on the past or the future and not on the present moment.
• Mindfulness allows for choice.
• Mindfulness is both external and internal.
• Dealing with some of the problems with practicing mindfulness.

Resource:

Book by Marsha Linehan - DBT Skills Training Handouts and Worksheets

Links:

You can find us online at https://bayareadbtcc.com/

We'd love to hear from you! Where are you getting stuck with your skills application? Ask us a question for the chance to have it answered on the podcast. Submit your question here.

Please note that questions, and this podcast in general, are not a substitute for individual mental health treatment.